Table 3.

Direct quotes responding to the patient from the caregiver and family member perspectives.

Staff	Caregiver response to the client	Family member response to the patient
Corporate staff	None	“So, a lot of time, and I think that’s what makes our cognitive support program special, that we really do work and educating the family. Through that process, but that also might mean that they’re not willing to accept that their loved one needs to be in this type of receiving this type of care. So, there’s a lot of just human elements that we’re dealing with in this as well.” [Corporate staff 1]
Franchise owner and case manager	“You know, it’s been nice to have access to an engagement tool where we can engage in a different way with our clients. We’ve had a couple particular situations where the caregivers have really embraced the concept of the iPad and have had one-on-one training with [Cofacilitator] from Generation Connect, which has been really awesome. And really helped them to develop and get a better understanding of how to really use the iPad to better engage the clients and just seeing the caregiver’s just come up with more creative ideas of how to use the iPad.” [Franchise owner and case manager, location B]	“We do get, sometimes, you get [a patient] who is just so resistant and the family member gives up. That mean, you know, the care recipient only wants that family member around them, uh, attempts to throw everybody out. And the family member just decides that it’s not worth, the hassle.” [Franchise owner and case manager, location B]
Formal caregiver	“So, what I try to do is, I try to redirect, I have a patient now. Who, she’ll tell me, did my husband died? And I will tell her, yes. I heard he was such a jokester, why don’t you tell me about a joke? And even though she, it’s kind of like she’s reliving the grief every time to hear that she died it’s bringing up happy memories, uh, know how he was when he was alive.” [Formal caregiver, location C: CGa2]	“The client’s family. Daughter in-law and son she lived with were very well educated. He was a professor. She was a registered nurse. And when I would come, they would argue with her all the time, and it made me feel like I was the bad guy because I would go along with it. If she told me, ‘the moon was made of green cheese,’ but they would argue all the time with her. And I know, [my manager], she gave them lots of videos and lots of links to look at. but they just wanted nothing to do with that. If they were there the whole time that I was there with them, I was exhausted mentally and physically, and I mean there were times I left there crying, because I was so upset with them. And then, the client that I had just before this one, I couldn’t have had a better support system with a son and daughter-in-law, I mean, it’s just phenomenal. She was a teacher and I forget what he did, architect. But, you know, I just, yeah, I just feel the mind has to be open to the heart or vice versa to be able to understand the daughter of my client now.” [Formal caregiver, location A: CG2]
Informal care partner	“Building on what [Location F: Family 1] said when I first noticed changes in my dad. I wanted him understand things logically. So, I would argue with him and try to make him see my point of view, which only led to not good situations. And my case worker through [home care company] sort of suggested to redirect. If we’re talking about something, mentioning something else, can redirect the conversation’s show that his mind would go on something else, not what we were talking about, and gradually, I learned to just go with the flow.” [Informal care partner, location E: Family 1]	“I did a little bit of reading, but to me, it just started feeling that [it] was the only choice, you know, because I really wasn’t interested in having an argument with my dad, you know. I didn’t need to win him over to my point of view. So, I think that was just a little bit, for me, it just seemed like a natural thing to do. I think my sister, I think she, just, over time, also saw that there wasn’t any percentage in it...we were not able to convince him of this factual thing, or that actual thing, and so I think she’s, that, just over time, she also kind of, I don’t know, maybe she saw me do it, but it also could just have come to her. She just has a different personality. She’s a more, she’s a more logical, analytical person so that you know that was her, her go-to’s – we’ll lay out the facts. I have a different way of being in the world. And so, I’m more interested, I’m more looking like, ‘well, what’s, you know, what’s the relationship here, what’s connected?’” [Informal care partner, location F: Family 1]

^aCG: caregiver.