If family caregiving came with an instruction manual, it would need a whole chapter devoted to “family issues.” Caregiving affects the entire family. It can fundamentally change the family dynamic in inescapable ways. With so much of your attention focused on caring for your loved one’s condition, your responsibilities as a caregiver can change your relationship with your spouse, your other children, or other family members. And if the rare disease is a genetic disease, there may be more than one family member affected by the disease.