Elder transition planning: Family mediation for older adults & their loved ones

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The journey of aging is rarely a smooth one. As older adults and their families face emotional, financial and health challenges they often find themselves struggling with difficult decisions they feel ill prepared to make. Most families “build the plane as they fly it,” learning as they go and developing strategies they hope will work. Too often this results in conflict among family members as they disagree on care needs, financial planning, responsibilities, housing options, and “what is best” for a loved one.

This highly emotional phase of family life is complicated by the resurfacing of unresolved earlier disagreements and long held beliefs such as “You were mom’s favorite,” or “I was the black sheep,” or “You always took his side.” These beliefs can often be used to justify current choices – both positive and negative.

As older adults, caregivers and their families look for direction and support they discover multiple fragmented systems they must utilize. The good news is that there are many helpers and advocates skilled at helping them navigate these systems when families agree on goals. A family in conflict, however, can quickly sabotage planning efforts and the quality of care their loved one receives when they obstruct or fail to support these efforts.

Family mediation

Mediation is a forum for family decision making. It is voluntary, confidential and an opportunity for each family member’s perspective to be heard. It is a supportive environment that embraces respectful disagreement, acknowledges the validity of each perspective, and invites collaborative problem solving. Family mediation recognizes the value of each family member’s input while fostering their ability to develop solutions that are in the best interest of an elder loved one.

Example: Adult children of a later life marriage were concerned about their elderly parents’ ability to maintain independence in their home. To date the couple had refused help from his children or hers. One child requested mediation; the others were hesitant but agreed. Prior to this request for mediation the adult children had never discussed their concerns with their step siblings and both sides had many negative preconceived ideas about the other.

The goal of the initial meeting of just the adult children was to identify ways they might support the couple’s wish to live independently. They hoped to present these ideas to their parents at the subsequent meeting, which included the elder couple.

The result of the first meeting was that myths and assumptions were identified and dispelled. The demonized step siblings were humanized and, as a group, they developed a menu of options they could offer the couple. The follow-up meeting with the couple resulted in both parents feeling supported by their children and very grateful that both sets of children were committed to helping them. The couple agreed to a range of measures that would enable them to stay in their home.

One-on-one coaching: another option

Sometimes it helps to have a one-on-one conversation with a neutral facilitator who understands aging and is trained in coaching and mediation. You may need some help recognizing what you can and cannot control, a chance to clarify your thinking and your options, or just an opportunity to think out loud. Coaching can help you prepare for challenging conversations with family members by supporting your ideas and creativity in a non-judgmental setting. Individual coaching can be helpful on its own or before or after a mediation.

Example: A daughter was very concerned about her elderly, chronically ill mother living independently. Daughter’s healthcare background made her aware of just how vulnerable her mother was for injury from falls and more severe health symptoms. The concerns she voiced to her mother and siblings were brushed aside as unnecessary worry.

Coaching provided a space wherein she could articulate her specific concerns and develop an alternate plan to enlist the help of her siblings. In the second coaching session she reported that her siblings had rejected her efforts to enlist their help and told her to drop the subject. Despite developing a plan that she thought they might listen to, the daughter needed to recognize the limits of her ability to change minds and make changes.

Competent adults are entitled to make poor choices. They have the right to ignore good advice. This is often one of the biggest challenges adult children face as they negotiate parent self-determination vs their concerns for parent safety.

Family is the foundation of the long-term care journey. No matter how many professionals or organizations are involved in a loved one’s care, the individual and family are the final decision makers. Both elder mediation and individual coaching are available to support elders and their family members as they wrestle with the many difficult decisions that arise in later life.

Mediation and coaching are available in-person in the Rochester/Monroe County area and virtually in all areas throughout the state. For additional information, contact Mary Berk: [email protected], (585) 244-8400 ext. 170.

Mary Berk, LCSW is a Certified Mediator, Elder Transition Planning, at Lifespan, 1900 S. Clinton Ave., Rochester, NY 14618.