 Making sense of Alzheimer’s disease in an intergenerational context The case of a Japanese Canadian nisei ( second- generation) - headed fam ily ANDRÉ P. SMITH University of British Columbia, Canada KAREN M. KOBAYASHI University of British Columbia, Canada Abstract An appraisal of cultural values and life history events is necessary to fully understand the ways in which family members interpret the significance of cognitive symptoms and make decisions about accessing clinical services for a relative in the early to moderate stages of dementia.This article presents a case study of a nisei (second- generation)-headed Japanese Canadian family in which the father was referred for clinical evaluation at a dementia clinic and diagnosed with Alzheimer’s disease.This case study identifies the traditional issei (first-generation) Japanese Canadian values of filial obligation and shame and awareness of the father’s life history as salient mediators in family members’ interpretations of dementia symptoms. Furthermore, a discussion of the role of the clinical evaluation in arbitrating between divergent interpretations of the nature of the father’s disruptive behavior among family members is included. Keywords Alzheimer’s disease; dementia; family; intergenerational relationships; Japanese Canadian Introduction This article introduces a case study of a nisei (second-generation)-headed Japanese Canadian family in which the father was referred for a clinical evalu- ation at a dementia clinic where he was diagnosed with Alzheimer’s disease (AD). It explores the ways in which family members interpret disruptive behavior in the father and make the decision to seek medical help relative to their adherence to traditional first-generation Japanese Canadian values, roles de men tia dementia ©    London, Thousand Oaks,  and New Delhi  ( ) – [ - ( ) :; –;]