Elder-Mediation: Finding Family Balance
when Caregiver Roles Reverse
by Patricia Bertschler and Thomas O’Reilly
All situations are extracted from real
mediation or counseling cases. Names and a few details have been
changed to protect client anonymity.
"All my kids want is to take my car keys
away,” complains 82-year old
Meanwhile, Catherine’s eldest, Nancy, is tired
of getting calls from the police for her mother’s driving over
the lines or getting lost.
“My daughter wants to put me in a nursing
home. I’d rather die first,”
emphasizes 78-year old Rose.
Rose’s daughter, Melissa, who found her mother
several times this last month having left the stove on with
smoke singes on the kitchen wallpaper, agonizes over Rose’s
safety and dreads getting into another shouting match over the
need for help.
“My family thinks I’m going to come live
with them so they can control all my money,”
fears John. “Ever since I turned 85, they think I don’t know
what they’re up to.”
Jim worries that his father, John, will fall
again with no one around to help him. With John’s diabetes, Jim
can’t afford to let his father be alone much longer.
Caregiving Role Reversal
Almost daily in our mediation and counseling
practice, Thomas and I receive calls from caregivers with these
and similar stories.
Adult children with best intentions, lovingly
try to balance careers, family needs (pack lunches, drop kids
off at ballet lessons one night, rotate attending track meets
and baseball games on other nights), AND care for the growing
list of needs of their aging parents.
Somewhere in between, they are encouraged to
exercise, practice yoga for stress relief and maintain healthy
Caregiving, meant to be an act of love and
family dedication, can become at the least stressful; at the
worst, a path to burnout and even elder abuse. Sadly, caregivers
often remain unaware of conflict solutions that would reduce
stress, provide extra services, and assist middle-agers as they
juggle family, professional, and personal demands.
Elder-Mediation: Proactive Solution
One such solution is mediation: a process in
which a neutral third party (mediator) helps two or more parties
participate in a respectful decision-making session (can last a
few hours to several sessions depending on the complexity,
stubbornness, or concerns of parties involved).
Mediation can be utilized for step-families,
business conflicts, divorce dissolution, and neighborhood
disputes to name some. The process is often chosen because
people are helped to communicate respectfully, save time, and
avoid costly court battles.
For decisions involving Elders, a specialized
type of mediation has emerged within the last decade known as
Elder- Mediation (EM). Some mediators simply use the term Family
Mediation; EM distinguishes it as a specialty and
elder-mediation is becoming quite helpful. The process is the
same, though it is helpful if the mediator has experience in
senior care and good knowledge of accessing community resources.
Since 1994, EM Projects have emerged as well
as research studies both in the U.S. and in Canada, Australia,
England and elsewhere (see Yvonne Craig’s 1994 Elder Mediation
Project, Peer Counsellor (* Canadian spelling) Journal in Canada
and the Elder Mediation- Power Project (2000) studying rural
central Pennsylvania’s Union and Snyder counties.).
One mediator, Margaret Dale (79) at Sonoma
State University in Santa Rosa, CA teaches a course in Elder
Mediation. The goal of E.M. is to allow seniors a voice in the
decision-making process and to help families communicate with
compassionate candor about situations which need to be
Estate matters, end-of-life decisions, living
arrangements, medical preferences and--oh yes-- driving are
typical issues. Because all parties have a say-so in the
outcome, we see an 80%to 85% compliance success rate in most
kinds of mediations including E.M.
“This is the first time our family has had
an honest and civil conversation in years”
commented a recent client whose aging mother refused to give up
her partnership in the 75-year old family business.
Another mediation involving an aging mother
and her daughter found them in heated debate at the outset… and
making decisions compatibly at the end.
A frazzled Chris called Thomas near-tears
several months ago. Her mother, Barbara, just celebrated her
75th birthday, tries to stay fairly active in her Fairlawn home
of 50 years that she and her now-deceased husband built. Barbara
knows all the neighbors, everything is just where she can find
and reach it, and she enjoys her garden of lavender and lovely
Chris (age 47) worries because her mother fell
just before Christmas and was unable to get up until a neighbor
friend came over and found her.
“Mom repeats stories over and over and the
house is not kept up like Mom used to. She was meticulously
clean. I can’t believe she lives like this!”
“I live a half hour away, and it’s getting
harder and harder to support my husband’s new business, work
full time, and still take care of our three kids,”
she added. “I’ve even been to counseling for this as my
stress increases, but mom refuses to come.”
Because many seniors were raised thinking that
counseling is taboo, they are often resistant to anything that
smacks of that profession.
However, mediation which allows seniors and
all parties in the conflict a voice in decision-making is often
more conducive to attempting a fair resolution with a mediator.
Chris was desperate. The dynamics of their
once loving mother-daughter relationship were quickly
deteriorating and frequent arguments became the norm. Chris
tried to discuss assisted living options with her mother who
“I will die in my own home. End of story.”
Chris, feeling strong layers of guilt for even
having to consider moving her mother, believed safety first was
in mom’s best interest. And Barbara felt resentment and
“After all I’ve done for you!” threatening to hire an
attorney and write Chris out of her will.
When they arrived at the first mediation
session, Barbara was accompanied by her close neighbor whom she
trusted and who had befriended her; Chris and her husband, Ray,
came without the children. The atmosphere was cordial yet
Most mediators follow a six-step process which
was also used with Barbara and Chris’s family.
Following introductions, Thomas as mediator explained his
background, what to expect in the mediation process and
articulated ground rules such as no name calling, one person
speaking at a time, no dragging up past hurts in order to keep
focused on the present situation and future planning, speak only
for oneself rather than guess what the other is thinking, etc.
Step Two Both
parties related his/her side of the conflict as each saw it.
Barbara was adamant she was not going to a
nursing home; Ray and Chris spoke of their feelings of love and
guilt and growing concern for mom’s safety.
Each side was asked to repeat what the other
said to make sure each was being represented clearly.
Step Three Thomas
asked for clarification on some points, reminded parties about
needing to keep emotions in check, and proceeded to ask for some
alternatives to keep Barbara feeling independent and Chris
knowing her mother was safe.
Barbara, though resistant at first, at least agreed to hear some
suggestions from Chris, though it was obvious she was holding
her ground to stay alone at home.
Chris threw several options on the table
including a three-month trial at assisted living closer to where
Chris lives, a live-in caregiver, living with the family on
weekends, and adult day care.
Thomas also suggested options such as using
the Meals-on-Wheels program, looking into a local Senior Center
for social support, and a parish nurse to help check in on mom.
Barbara was even able to disclose to Chris how
afraid she was laying there on the floor for two hours until her
neighbor happened by.
Step Five Chris,
Ray, and their mother began the negotiation phase of the
mediation by taking a look at each option, tossing out ones
unacceptable and keeping others.
At this time, yet another option surfaced:
having Barbara go through a Geriatric Assessment (comprehensive
medical and psychosocial screening, generally covered by
Medicare Part A if inpatient, Part with co-pay if outpatient).
Step Six All
family members agreed to the Geriatric Assessment, to
Meals-on-Wheels, and to looking into services of their church’s
Parish Nurse Program.
It was critical at this stage of mediation
that all participants felt they walked away with a Win-Win
resolution to their conflict.
Thomas drew up a contract which all parties
signed and mailed it to the family within a day or two. Barbara,
Ray and Chris agreed to implement these decisions immediately
and to re-evaluate the situation in two months.
Chris called a few weeks ago. She has relaxed
a bit knowing that her mother’s Geriatric Assessment showed a
very slight sign of early dementia which is being monitored, and
that many other elements are now in place that have taken some
of the strain off their relationship.
“At least I know there’s a process to go
through to help guide us in making these weighty decisions. I
was such a wreck before, and my husband and kids were taking the
brunt of it. I never heard of Elder Mediation, but now I’m
beginning to feel like I’ve got my mother back. We don’t argue
near as much, and I know if mom deteriorates, someone can help
us sort it all out,” Chris mused.
Elder Mediation is just one of many options
caregivers have and must avail themselves of to maintain healthy
family balance, to consider decision-making options about which
they may be unaware, and most importantly, to change a
caregiver’s attitude from being grudgingly responsible for aging
loved ones to feeling a restored sense of empowerment,
self-control, and freedom to love and care for family members as
Submitted to Akron Life and Leisure Magazine,
Mediator Makes U.S. News & World Report’s List of “Best
Careers of 2009”
For the third year in
a row, the career of mediator has made U.S. News & World
Report’s list of 30 “Best Careers of 2009.” In selecting the
most promising careers of 2009, U.S. News considered job
satisfaction, training difficulty, prestige, job market
outlook and pay.
U.S News says that
“most mediators love their work, helping people beat their
swords into plowshares.” It adds, however, that there are
more mediators than there are mediation jobs, in part,
because the barriers to entry are so low. U.S. News says the
oversupply means that most mediators do not earn a
middle-class income for one to five years. It also touches
on the importance of embracing marketing by establishing a
U.S. News adds that
“success may be more likely in a slow economy as people and
businesses seek lower-cost alternatives to attorneys to
solve their disputes.”
The full report can
be found at
Or read below:
Careers 2009: Mediator
Posted December 11, 2008
If we can't solve a conflict, we
tend to give up or hire a
There can be a better way: A mediator can
often help resolve a dispute less
expensively and with less conflict, whether
it's a divorce, a discrimination claim, or
the parent of a special-education student
seeking more services from a school.
Mediators don't decide who's right. They
guide a discussion so the disputants can
more wisely reach agreement and move on with
their lives. Most mediators love their work,
helping people beat their swords into
problem is that there are more mediators
than there are mediation jobs. In part, this
is because the barriers to entry are so
low—most mediators are required only to
complete a 30-to-40-hour training course.
oversupply means that most mediators do not
earn a middle-class income for one to five
years. And even to do that, a mediator must
by establishing a niche—disputes among
postal workers, people of different races,
parents and teens, or even participants in
the online world "Second Life." Until
mediators develop a reputation, they must
schmooze with potential referral sources,
write articles or give talks on mediation,
perhaps blog or create a YouTube video, and
certainly find well-connected champions
willing to recommend them. Ironically,
success may be more likely in a slow economy
as people and businesses seek lower-cost
to solve their disputes.
have the gift for establishing trust,
generating creative solutions, calming angry
disputants, and staying calm amid ambiguity
and dissembling, and are willing and able to
market yourself, mediation can be a win-win
career for both you and your clients.
Day in the Life.
Normally, mediators are wise to
specialize and mediate no more than one
dispute per day. But here, for illustrative
purposes, are three varied cases:
specialty is employment mediation. The week
before Thanksgiving, Susan had been
downsized after 10 years with her company,
and she is suing for wrongful termination.
In the mediation, her emotions pour out. Not
only is she angry that she was let go merely
so the company could hire someone cheaper in
India, but she has no relatives and has
always spent Thanksgiving and Christmas with
coworkers. This year, she will be alone.
Everyone is moved by Susan's story, and the
company offers her a more generous
a permanent invitation to all company social
events. Not thrilled but mollified, she
your next mediation, a Muslim employee
suffers from depression and has been fired
from the small architecture firm for which
he worked. The employee claims both that he
was a victim of religious discrimination and
that the employer failed to provide
reasonable accommodations to his depression.
The employer vehemently denies that religion
or ethnicity was a factor in the firing and
maintains that the accommodations would
devastate his business. After listening
patiently and asking lots of questions, you
ask if telecommuting might sufficiently
reduce the problem. The disputants agree to
a two-week trial, after which you'll meet
most mediators, you do pro bono work. In
this next case, the police department asks
you to mediate a dispute involving a
neighbor complaining of frequent parties
that last into the wee hours: "My bed shakes
with every bass note, and it doesn't stop
until 5 a.m." The partier agrees to tone
down the music and the neighbor agrees to be
more tolerant, but you won't bet your life
that this dispute is permanently settled.
In a weak economy, the market
for divorce mediators may decline because
fewer couples can afford to break up and
thus live on one income. In contrast, with
so many homeowners falling behind on their
mortgage payments, mortgage renegotiation
could be a strong niche for mediators. Get
clients by explaining to the branch managers
of locally owned banks that mediation can
reduce the chances of a borrower defaulting.
(with eight years in the field): $59,700
to 75th percentile (with eight or more years
of experience): $42,700-$116,000
are many styles of mediation, each of which
will be valuable in a particular situation.
You'll want significant exposure to as many
as possible. So take two or more of the
30-to-40-hour comprehensive mediation
training courses. A list can be found
and divorce mediators will want to take
training approved by the
Association for Conflict Resolution.
can get brief exposure to top mediators'
styles by attending workshops at the
Association for Conflict Resolution
Conference and the American Bar Association
Section for Dispute Resolution Conference.
There also is a wide range of state and
regional conferences, which you can check at