Informed and Principled Resolution
The goal of aging issues mediation is informed and principled resolution. That sounds great, but what does it mean?
Family Conflicts and Mediation: The stakes are high
when the parties to a disagreement are family members. They need a solution to their disagreement
that will allow them to continue being a family – ideally to help each other,
love each other, support each other, celebrate and mourn together over the
coming years. The stakes are higher still
if one of the parties to the disagreement, or perhaps the person at the center
of the family storm, is vulnerable. For
example, does an elderly mother suffer from dementia that will prevent her from
fully understanding the issues in conflict and expressing clearly what she
wants? Does a family member have mental
or physical challenges that impair his ability to make care or financial
decisions? Is the family member at the heart
of the dispute so ill, or so cognitively impaired, that she cannot even attend
the mediation conference?
Mediation is a widely-used method of problem solving in which a neutral trained mediator helps parties in conflict talk through their issues and reach a mutually agreeable solution. Aging issues mediation (sometimes called elder mediation) is a relatively new type of mediation used to help seniors, ill or disabled adults, their families and/or health care providers resolve disputes about plans for care, driving, managing assets wisely, safe living situations, potential guardianship, questions over the quality of or charges for care, the distribution of assets after someone dies and other related concerns. Mediators help the parties hear each other, sometimes for the first time.
A Principled Resolution: In more traditional commercial mediations such as contract disputes or auto accidents, solutions often involve parties paying money to other parties at the end of the day. For many of those disagreements, a satisfactory resolution to the mediation is simply one to which both parties can agree, whether or not an outsider would think the solution wise or fair.
In aging issues mediations, however, finding a solution to family conflict involves much more than money changing hands. It involves respect for persons, understanding the needs and issues of parties who cannot always speak clearly for themselves and helping all parties create a mutually acceptable solution that protects the best interests of the family’s most vulnerable members. This is why a resolution to the conflict must be “principled.”
An Informed Resolution: For many seniors,
chronically ill or disabled adults and their families, the challenges presented
by health and aging needs
can be overwhelming.
Crises present themselves quickly and demand urgent responses. These health and aging challenges present ever
new questions for each family that experiences them. The family’s lack of knowledge regarding
government benefits (Social Security, Medicare, Medicaid or the VA), how to
adjust to changing physical abilities, the confusing and sometimes devastating
aspects of heart disease, cancer, diabetes, Parkinson’s and many other
illnesses, the intense challenges of dementia (both for the individual with the
disease and for family caregivers), uncertainty about how to help someone make
medical decisions or handle finances when that loved one needs help, the costs
of care, the difficulty of preparing for death, the emotional toll of illness –
these concerns can be overwhelming, frustrating, frightening and divisive for
families. Part of the frustration and
fear results from not knowing what to do next or where to turn.
Aging issues mediators must be qualified and prepared to help family members in conflict explore pertinent services, benefits and resources for their specific situations. While no mediator can be an expert in every aspect of aging or illness, mediators in this new field should be able to identify issues and refer participants to the experts who can help families find the answers they need. Helping a family with insufficient information craft a solution that won’t work in the real world does a disservice to the parties to the conflict. Families can’t make good decisions unless they are aware of the many options open to them; often the mediator must also be an educator. This is why a good resolution must also be “informed.”
Unique Challenges: Aging issues mediation
presents some unique challenges.
Sometimes the cognitive capacity of a party to the dispute may be in
question or may actually be the major issue in dispute. When there are questions about capacity, then
it may be necessary to have the appropriate potential surrogate decision-makers
as parties to the mediation (agents under powers of attorney, court-appointed
guardians or conservators, the appropriate “next of kin” in some states if
there has been no legal appointment of a surrogate decision-maker). If vulnerable adults are parties to the
conflict, then mediators must be concerned about possible indications of abuse
or exploitation. If a case is already in
litigation, the mediator must consider which issues can be decided in mediation
and which are reserved for the court. How
will suggested solutions affect multiple family members, particularly if more
than one party needs help? For example,
will a decision for the husband to enter a nursing home due to a health crisis
leave his wife with dementia unsafe at home alone and with reduced assets? Workable solutions may have to consider all
these issues and more.
Aging issues mediation is a useful tool to help aging, ill or disabled adults, their families, health care providers and other advocates resolve disputes in a way that preserves relationships among family members and with other parties to the conflict. These types of conflicts present complex challenges, however, that can rarely be solved in a day. Families, other parties and the mediators should be prepared to follow up for a brief period on needs identified in the initial mediation session until the parties have obtained enough information to achieve both an informed and principled resolution of their conflict.
Making the Family Stronger: There is a real value to families in working through the stresses of illness and aging in a way that strengthens the family, rather than tearing it apart. Aging issues mediation can help.
Dee Bergan, JD, MA
E-Senior Services/AIM Aging Issues Mediation
