Family Counseling

Dr. Rochmes provides guidance in living with cognitive Impairment through family & individual counseling for clients in the early stage—for example, mild cognitive impairment and early stage Alzheimer’s disease. He also helps family members develop care plans and cope with the changing challenges of care  throughout the course of illness. Additionally he facilitates support groups and family meetings. Geographically distant family members can be included via conference call.

Through his affiliation with the Alzheimer’s Association, Dr. Rochmes is active in the Alzheimer’s community. He gives public presentations, facilitates support groups, and gives trainings in the skills and interpersonal approaches that make for successful and minimally stressful caregiving. He is familiar with programs available in the Bay Area through non-profit organizations, as well as the alternatives to family care at home. He draws on this background to guide families to community resources for additional information and support.

Counseling the diagnosed person and other family members can help at certain key times as cognitive impairment progresses.

After Diagnosis

A diagnostic evaluation typically comes after months or even years of gradually worsening patient functioning and and family stress. Even so, a diagnosis of severe cognitive impairment such as Alzheimer’s disease hits both the patient and his or her close family members with the weight of a death sentence, and many are in no position immediately afterward to take in accurately what they are told about treatment or prognosis. Many families benefit from a debriefing which allows them to share their current feelings, understandings of the disease, and thoughts about the future in an accepting, supportive context. One goal of a family meeting is for family members to get on the same page in their understanding of the disease and its challenges as well as to agree of the roles of each person in care.

Facing Ongoing Challenges

As functioning becomes more impaired, once-working strategies may fail and new challenges emerge. Family relationships may need to adapt as customary responsibilities, activities, and methods of communication can no longer be relied upon. Patients often face increased frustration, confusion, and fear. Spouses, partners, and other close family members often have difficulty understanding what is happening or putting themselves in the other person’s shoes. Brief counseling can facilitate understanding and help restore energy, hope, and creative problem solving.


At times families face difficult decisions. Should the person with cognitive impairment continue driving? Handle the family finances? Be safely left alone? Continue to be cared for at home? Expertise in the available options and experience with their benefits and drawbacks can help guide decision-making that honors family members’ feelings and wants.