Mediation is the attempt to settle a conflict between two or more parties with the help of an impartial third person: the mediator. The mediator’s role is not to give advice or find a solution, but rather to facilitate what would otherwise be a very difficult conversation. People go to mediation because they feel unable to communicate with the party they are having a dispute with; or they have tried to talk things out and been unable to come to an agreement.

Old age brings up many issues that nobody is eager to talk about because they are
all problems caused by the physical and mental decline that comes with aging and moving closer to death. Among the most frequent issues that families have trouble talking about is whether an elder should still be driving; whether it is safe to live alone; what decisions to make about medical care, finances, and end-of-life issues, and if the elder has adequate decision-making capacity for these and other problems.

Eldercare often means a role reversal between parents and adult children. Elderly parents, although looking for help, often treat their adult children they way they treated them during their childhood. And children, although adults, can have a hard time accepting the role reversal that comes with becoming the caregivers of their aging parents, particularly if the elders have retained the same authority they had in their younger years.
Elders don’t want to be a ‘burden,’ and their adult children don’t want to boss them around. Both tend to avoid talking about end-of-life issues because these conversations can be painful. Yet, both know that they are necessary.

Sometimes, similar problems arise between elders and agency caregivers, or between agency caregivers, family members, and elders. Agency caregivers often do not know what the elder’s and the family’s wishes are. Family members often live far away and cannot easily be contacted. Sometimes, the younger generation is reluctant to get involved at all.

More and more people will live into their 80’s and 90, and many of them will be single or without close family support. Practical as well as communication issues are going to increase in number and magnitude.

What can a mediator do to help? The mediator contacts all parties prior to the mediation to get a sense of how the parties see the problems that are difficult to talk about. At the mediation, the parties meet with the mediator and explain their positions on the issues they can’t settle among themselves. For example, if Dad wants to continue living in his house, and one son feels he is not safe unless he goes to a nursing home, and another son feels, it could work out with some outside help, the mediator will give each party a chance to explain their positions, and make sure that all the others listen to everyone’s point of view.

Once everyone has had their turn, the mediator summarizes the parties’ different positions, and helps them work out what everyone’s interests are. For example, Dad is interested in continuing to live independently, the sons are concerned about his safety. The mediator might frame the conflict as: “So the challenge is to preserve Dad’s independence and also make sure that he is safe.” She then invites the parties to start brainstorming for options, which might offer both independence and safety to the elder. In this example, one option was already offered: Dad could stay at home with some supervision. Another option might be living in his own apartment in elder housing, with the option of moving into more supervised living if and when it might become necessary. Another possibility would be to look into programs like HomeShare where a younger person lives in the house rent-free in exchange for some supervision and companionship for the elder. There may be other services available in the community which eldercare agencies can give information about.

Not all conflicts lend themselves to quick resolution. It can take several sessions just for the parties to learn to communicate with each other. Sometimes, there is no solution that satisfies everyone, but at least, the issue has been defined and can now openly be talked about. People will understand that they are not alone with their problem; they are not anyone’s fault, and there are solutions.

Mediation in elder care is becoming popular. Compared to counseling which elders often refuse to participate in, mediation focuses on one issue at one point in time. Some eldercare agencies routinely offer these services. Mediators can also be found in the yellow pages, and through the Vermont Mediators Association.

Gerhild Bjornson is a physician and mediator in Burlington. She writes on senior issues for the Champlain Valley Agency on Aging. This article originally appeared in the Burlington Free Press.