Elder Care Mediation: The Future is Now

Elder Care Mediation: The Future is Now By Judy McCann Beranger **

For the past two decades, Family Mediation Canada has been promoting mediation as a valuable option for an ever-growing range of issues facing Canadian families. Mediators are being required to become more diversified in their training as the needs of families become more diversified. The advancing age of our population, combined with our desire to provide all citizens with a better quality of life, has resulted in elder care issues steadily finding their way into the field of mediation.

Mediation in the field of elder care typically involves many players -- predominantly family members who are concerned or affected by the decisions of the elder person involved, and who may be called upon to participate in present or future care. The focus is on keeping the myriad of relationships growing and respectful, and, if the situation involves care giving, encouraging choices and plans that work for both the person receiving care as well as the caregiver. A successfully mediated outcome will ensure that maximum function and independence are promoted, while opportunities are provided for healthy interaction with others. Content areas of such mediation include decisions around living arrangements, environmental interventions, decisions around therapeutic interventions, new marriages, new partners, grandparenting, primary caregivers, paid caregivers, family disputes, nursing home decisions, medical decisions, financial issues, issues around religion, plans for rehabilitation, plans for caregiver support, holidays, driving, caregiver burden, activity-focused care, estate issues, and other "end-of-life" decisions. The success of mediation in this setting is not unlike other areas in that people are more likely to invest in agreements that have been co-authored.

One example of a growing area in the field of elder care mediation is with Alzheimer Disease and other related diseases. Since 1991, the Alzheimer Society in Prince Edward Island has been very active in this area, and has witnessed a dramatic increase in the demand for this service. Research tells us that for every person with a progressive dementia, the lives of at least nine other people are significantly impacted. This number often includes many senior caregivers. The needs of people affected can be very complex and long-term. The research also tells us that 94 per cent of people with a progressive dementia living in the community are cared for by family or friends. With a rapid rise in the senior population (the baby boomers), the prevalence of Alzheimer and other related diseases is expected to double by the year 2030, with the largest increase occurring in those 85 years and older. This means a rise in the number of family caregivers, as well as an increase in the number of years they will be called upon to provide such care. Consequently, the demand for mediation in this field can only be expected to rise sharply throughout the next decade.

Collaboration and co-operation among those service providers who deliver community care, home care, counselling and mediation services, etc., will serve to provide families with an improved quality of life. Ideas for ways of helping are generated as people come together and talk about how they can move forward together, and assist each other through some very difficult times. In the context of elder care mediation, there are unique characteristics or emphases that require the mediator's attention. These include:

- Supporting the elder person's right to maintain independence and to have a voice for as long as possible -- including the decision as to what extent the elder person can actually participate in mediation sessions.
- Being intuitive and understanding of the complexity of this area.
- Focusing on the strengths while recognizing the losses.
- Recognizing the need for a follow-up component as a result of the progression of the disease itself.
- Recognizing that the dementia-specific knowledge of the mediator is a prerequisite for elder care mediation.
- Creating a safe and trusting environment in which deficits and cognitive impairment are normalized and compensated for in a specially designed structure.

If we compare the cost of people prematurely accessing health services , due to the family's inability to resolve on its own the challenging issues that inevitably arise in caring for the elderly, to the cost of resolving these same issues together in mediation, the cost of mediation is minimal.

Across the nation there are trained mediators who can be contracted directly by families or by health care systems, non-profits, governments, and the like who are truly interested and passionate about providing mediation services in the elder care arena. A recent report of the Canadian Institute for Health Information concluded that compared to 20 years ago, older Canadians can now look forward to a longer and better quality of life. The professional practice of mediation is well-positioned to play a vital role in ensuring that such a prediction comes to pass.

** Judy McCann Beranger is the Executive Director of the Alzheimer Society of Prince Edward Island and President of Family Mediation Canada (2003-2004). This article first appeared in the Fall 2004 issue of "Resolve," the Family Mediation Canada magazine. Reprinted with permission.


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Norman B. Pickell  Lawyer - Mediator - Arbitrator  58 South Street, Goderich, Ontario N7A 3L5  Telephone (519) 524-8335   Fax (519) 524-1530