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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 Catherine.

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 self-care! If only…

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.

Elder-Mediation

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 addressed.

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 spring perennials.

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!” said Chris.

“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 always retorted, “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 betrayal, citing, “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 clearly guarded.

Most mediators follow a six-step process which was also used with Barbara and Chris’s family.

Step One 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.

Step Four 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 they deserve.

Submitted to Akron Life and Leisure Magazine, May, 2003

 

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 niche. 

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  http://www.usnews.com/articles/business/best-careers/2008/12/11/best-careers-2009-mediator.html

Or read below:

Best Careers 2009: Mediator

Posted December 11, 2008

Overview. If we can't solve a conflict, we tend to give up or hire a lawyer. 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 plowshares.

The 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.

The 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 embrace marketing 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 alternatives to attorneys to solve their disputes.

If you 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.

A 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:

Your 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 severance package and a permanent invitation to all company social events. Not thrilled but mollified, she agrees.

In 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 again.

Like 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.

Smart Specialty

Mortgage renegotiation. 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.

Salary Data

Median (with eight years in the field): $59,700

25th to 75th percentile (with eight or more years of experience): $42,700-$116,000

(Data provided by PayScale.com)

Training

There 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 here.

Family and divorce mediators will want to take training approved by the Association for Conflict Resolution.

You 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 mediate.com/calendar.

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Last modified: 07/27/10