Reversing Roles: A Support Café in Wommelgem on Living with Dementia

Imagine sitting across from your mother at the kitchen table in your childhood home in Austin’s Mueller neighborhood, the same table where she once helped you with algebra homework. Now, she’s asking you—her grown child—where her car keys are, even though she hasn’t driven in years. The roles have flipped, and suddenly, you’re the one making decisions about her safety, her finances, and her daily routine. This isn’t just a hypothetical scenario for thousands of Central Texas families; it’s a quiet crisis unfolding in living rooms and memory care units across the region. On June 1, 2026, a minor community center in Wommelgem, Belgium, will host a conversation about this very phenomenon—role reversal in dementia care—and while the event is half a world away, its themes resonate deeply in places like Austin, where the senior population is projected to grow by 40% over the next decade.

What happens when the person who once bandaged your scraped knees can no longer remember how to use a Band-Aid? Or when the partner who shared your life’s milestones starts mistaking you for a stranger? These aren’t just emotional challenges; they’re practical, legal, and financial minefields that families often navigate without a map. The upcoming talk in Wommelgem, led by clinical gerontologist Luc Van de Ven, isn’t just about dementia—it’s about the seismic shift in relationships that comes when cognitive decline rewrites the rules of family dynamics. And while Austin may not have a “Praatcafé Dementie,” it has its own ecosystem of caregivers, therapists, and legal experts grappling with the same questions: How do you honor the person your loved one was while adapting to who they’re becoming? And where do you turn when the weight of that responsibility feels crushing?

The Psychology of Role Reversal: When Caregivers Develop into “Parents”

Van de Ven’s work, particularly his book Opeens moet je voor je ouders zorgen (“Suddenly, You Have to Care for Your Parents”), frames role reversal not as a single moment of realization but as a slow erosion of the familiar. In his clinical practice at the University Psychiatric Center of KU Leuven, he’s observed that adult children often oscillate between three identities when caring for a parent with dementia: the “parent” (making decisions for someone who can no longer decide), the “child” (seeking approval or reassurance from a parent who can no longer provide it), and the “partner” (trying to maintain a semblance of the relationship’s original intimacy). This psychological whiplash is compounded by the fact that dementia doesn’t just steal memories—it distorts time itself. A parent might recall their wedding day in vivid detail but forget that their spouse passed away years ago, leaving their adult child to relive the grief of that loss repeatedly.

In Austin, where the tech-driven culture often prioritizes efficiency and problem-solving, this emotional dissonance can feel particularly jarring. Therapists at the Seton Mind Institute (now part of Ascension Texas) report a surge in caregiver burnout cases, with many adult children arriving in their offices convinced they’re “failing” due to the fact that they can’t “fix” their parent’s condition. “Dementia care isn’t a puzzle to solve; it’s a relationship to redefine,” says Dr. Maria Gonzalez, a geriatric psychologist at Dell Medical School, echoing themes from Van de Ven’s research. “The guilt comes from expecting the relationship to stay the same, even as the disease changes everything.”

This tension is especially acute in multigenerational households, which are increasingly common in Austin’s high-cost housing market. A 2025 report from the Texas Demographic Center found that 1 in 6 Travis County residents over 65 now lives with an adult child, up from 1 in 10 a decade ago. For these families, role reversal isn’t just a psychological challenge—it’s a logistical one. Who pays for groceries when the parent’s fixed income no longer covers rising costs? How do you explain to a parent with memory loss that their grandchild can’t sleep in their room because it’s now a makeshift care space? These are the unspoken questions that keep caregivers awake at night, long after the medical appointments and legal paperwork are done.

The Legal and Financial Labyrinth: When “I Love You” Isn’t Enough

In his book Gevecht in de echt (“Battle in the Marriage”), co-authored with Lies Van Assche, Van de Ven explores how dementia strains even the strongest partnerships. But the ripple effects extend far beyond the marital relationship. In Texas, where estate planning laws are notoriously complex, families often find themselves tangled in legal battles over guardianship, power of attorney, and Medicaid eligibility—all while trying to provide compassionate care. The Travis County Probate Court has seen a 35% increase in guardianship cases since 2020, with many petitions filed by adult children who never expected to be making life-or-death decisions for their parents.

One of the most fraught issues is financial exploitation. The Texas Department of Family and Protective Services reports that seniors with dementia are four times more likely to be targeted by scammers, and adult children often find themselves in the impossible position of monitoring their parent’s bank accounts without overstepping. “It’s a Catch-22,” says Austin-based elder law attorney Sarah Chen. “If you don’t step in, your parent might drain their savings on a timeshare in Florida they’ll never use. But if you do step in, you risk being accused of overreach—or worse, financial abuse yourself.” Chen’s practice has seen cases where siblings end up in court over disagreements about whether to sell the family home, with one child arguing for the parent’s comfort and another for preserving the inheritance. “Dementia doesn’t just change the person; it changes the whole family system,” she notes.

Then there’s the question of long-term care. Texas ranks 42nd in the nation for Medicaid funding for home- and community-based services, forcing many families to choose between depleting their savings or moving a parent into a nursing home. In Austin, where the median cost of a private room in a memory care facility now exceeds $7,000 per month, this decision can feel like a Sophie’s choice. “People assume Medicare will cover everything, but it doesn’t,” says Mark Rivera, a financial planner specializing in elder care at Edward Jones’s Domain office. “A lot of families end up spending down their assets to qualify for Medicaid, only to realize too late that the facilities accepting Medicaid have long waitlists.”

The Invisible Workforce: Austin’s Caregiver Economy

Behind every statistic about dementia care is a human story—often an untold one. In Austin, where the gig economy thrives, a parallel “caregiver economy” has emerged, with home health aides, respite workers, and even “dementia doulas” filling the gaps left by overstretched families. The Workforce Solutions Capital Area estimates that there are now over 12,000 professional caregivers employed in Travis County, a number that’s grown by 20% since 2022. Yet, despite the demand, the average wage for a home health aide in Austin is just $14.50 an hour, barely above the city’s living wage for a single adult.

This workforce shortage has led to a rise in “caregiver collectives,” where families pool resources to hire private aides or share respite care. One such group, Central Texas Dementia Caregivers, meets monthly at the Twin Oaks Library to trade tips on everything from managing sundowning (the increased confusion and agitation that often occurs in the late afternoon) to navigating insurance denials. “We’re not just sharing advice; we’re sharing the emotional load,” says group founder Linda Nguyen, whose mother has early-onset Alzheimer’s. “No one prepares you for how lonely this can be.”

The emotional toll is perhaps the most underdiscussed aspect of dementia care. A 2024 study by the University of Texas at Austin’s School of Social Work found that 60% of family caregivers report symptoms of depression, yet only 1 in 5 seek professional help. “There’s this unspoken expectation that you should just ‘power through,’” says Nguyen. “But dementia care isn’t a sprint; it’s a marathon with no finish line.”

When the System Fails: The Gaps in Austin’s Care Infrastructure

For all its progressive reputation, Austin’s infrastructure for dementia care has struggled to keep pace with the city’s rapid growth. The Alzheimer’s Association’s Central Texas Chapter reports that waitlists for adult day programs can stretch up to six months, leaving families to cobble together care plans on their own. Meanwhile, the city’s public transportation system, which many seniors rely on, has seen service cuts that make it harder for caregivers to get their loved ones to appointments. “Austin is a city that prides itself on innovation, but when it comes to aging, we’re still playing catch-up,” says Dr. Raj Patel, a geriatrician at CommUnityCare.

One bright spot is the rise of “dementia-friendly” initiatives, like the Austin Public Library’s memory cafés, where people with dementia and their caregivers can socialize in a low-pressure environment. But these programs are often underfunded and underpublicized. “We have the tools to make life better for these families,” says Patel. “We just need the political will to scale them.”

Given My Background in Public Health Journalism, If This Trend Impacts You in Austin, Here Are the Three Types of Local Professionals You Need

Navigating dementia care isn’t just about medical expertise—it’s about finding the right allies to help you shoulder the load. Based on my reporting and conversations with families across Central Texas, here’s what to look for when assembling your care team:

Geriatric Care Managers (The Quarterbacks)

These are the strategists of dementia care—social workers, nurses, or gerontologists who specialize in creating comprehensive care plans. In Austin, look for professionals certified by the National Academy of Certified Care Managers (NACCM) or affiliated with organizations like Age Well Live Well. What to inquire:

• Do you have experience with Medicaid waiver programs in Texas? (Many families don’t realize these programs can cover in-home care, but the application process is labyrinthine.)
• How do you handle family conflicts over care decisions? (A good manager will have mediation experience and won’t shy away from tough conversations.)
• Can you provide references from families in situations similar to mine? (Dementia care is highly individualized; a one-size-fits-all approach won’t work.)

Where to find them: Start with the Agency on Aging of the Capital Area or the Alzheimer’s Association’s Central Texas Chapter for vetted referrals.

Elder Law Attorneys (The Protectors)

Dementia care isn’t just about health—it’s about legal and financial security. An elder law attorney can help you navigate guardianship, power of attorney, and Medicaid planning. In Texas, where probate laws are particularly complex, it’s critical to find someone with deep local expertise. What to look for:

• Board certification in elder law from the Texas Board of Legal Specialization. (This isn’t just a credential—it’s a sign they’ve passed a rigorous exam on Texas-specific laws.)
• Experience with “Miller Trusts” (also called Qualified Income Trusts), which are essential for Medicaid eligibility in Texas if your loved one’s income exceeds the limit.
• A transparent fee structure. (Some attorneys charge flat fees for estate planning; others bill hourly. Ask upfront to avoid sticker shock.)

Red flags: Attorneys who pressure you to make quick decisions or who don’t explain the long-term implications of legal documents in plain language.

Where to find them: The State Bar of Texas has a directory of certified elder law attorneys, or ask for referrals from the Travis County Probate Court.

Dementia-Specialized Therapists (The Emotional First Responders)

Caregiver burnout is real, and it’s not a sign of weakness—it’s a sign you need support. But not all therapists understand the unique stressors of dementia care. Look for professionals with training in:

• Cognitive Behavioral Therapy (CBT) for caregivers, which helps reframe negative thought patterns (e.g., “I’m failing” → “I’m doing the best I can in an impossible situation”).
• Grief counseling, because dementia involves a series of losses—even if your loved one is still physically present.
• Family systems therapy, which can help siblings and spouses align on care decisions before conflicts escalate.

What to ask:

• Have you worked with families dealing with my loved one’s specific type of dementia? (Alzheimer’s, Lewy body, vascular dementia, etc., each present unique challenges.)
• Do you offer sliding-scale fees or accept insurance? (Many therapists in Austin do, but it’s not universal.)
• How do you handle sessions when the caregiver can’t leave the house? (Some therapists offer virtual sessions or in-home visits.)

Where to find them: The Seton Mind Institute and Dell Medical School often have referrals, or check the Psychology Today therapist directory for filters like “caregiver support” and “geriatric issues.”

One final note: If you’re reading this and feeling overwhelmed, you’re not alone. Dementia care is one of the hardest journeys a family can face, but it’s also one where the right support can make all the difference. The families I’ve spoken to who’ve weathered this storm best aren’t the ones with the most resources—they’re the ones who asked for help early and often. In a city like Austin, where community is both a buzzword and a lifeline, that help is out there. You just have to realize where to look.

Ready to find trusted professionals? Browse our complete directory of top-rated elder care experts in the Austin area today.