Adapted from a recent online discussion.

Question: My father has dementia. Unfortunately, his dementia manifests itself as paranoia and aggressive language. He doesn't physically harm anybody, but he is very difficult to be around.

My kids are in middle and high school and are starting to object to visiting their grandfather. My oldest child has good memories of him, but the two younger ones mostly remember him as he is now, a belligerent man with volume-control issues.

I am torn over whether I should make them visit their grandfather out of a sense of obligation or respect their wishes. Once, when it was just the two of us, my youngest said she was scared of him and gets stomachaches when she goes to the nursing home. I understand her feelings, but I don't think she shouldn't ever visit him, even if it's hard. What do you suggest?

Answer: One of the important things parents teach kids is that you don't abandon people you love just because they fall ill. Accordingly, you could require your kids to spend at least some time with their grandfather.

However, when a child is stressed to the point of physical symptoms, it's time to find another way to teach values. Your kids are seeing you take care of your father, and I think it's OK to let that set the example. Admit to them that you're torn, but say they're excused from the visits, at least until they feel emotionally strong enough to handle them.

Remember, you find these visits difficult, and you're the grown-up whom this man raised. Imagine his effects on a child, with a child's not-yet-fully-developed coping resources. And without the loving history.

Comment: Explain in a general (i.e., not scary) way that this illness has turned him loud and angry, but that it is not his fault, that he still loves them deep down, and tell them about the man he was before the illness - who he really is but who is being hidden by his illness.

Then tell them that because of this, you won't make them visit him in person, and encourage them instead to write him letters or draw him pictures for his room so they still have a connection but aren't being overexposed to the scary side. As they get older, you can explain the disease, and they will feel better knowing that they didn't completely forget about him and that their letters/drawings were with him.

Response: Such a great idea, thank you.

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