I'm a family nurse practitioner as well as the mother of a 23-year-old son with autism and the wife of a 57-year-old man with early-onset dementia. Communications in our family have never been normal.
Social workers are not trained to recognize the signs of early dementia. Looking back, I now realize that my husband's disease went undiagnosed for years. We went to family counseling because of tension between my husband and son. I knew that the problems were largely due to my husband's distorted interpretation of things, but I couldn't make any counselor recognize it for what it was.
My husband can speak and hear, but he misinterprets things. My son, on the other hand, understands everything and forgets nothing, yet he cannot always make himself understood or give information back. Our family dynamics are completely atypical, and I am the constant go-between (and often the bad guy).
Now I know why I have always leaned toward surgery: I can almost always promise a patient that the pain will get better eventually. Kudos to those practitioners who deal with chronic illness—and in particular neurologic conditions—on a daily basis.