Independence is a hard habit to break, and for many older Americans in declining health, changes and adjustments are often made harder by well-meaning children, advisers and health care workers pushing their own opinions of what's best.
Deciding where to live, what kind of medical care is appropriate and what role other family members should play are tough questions. And in some cases, a professional mediator can make the difference between family harmony and all-out war.
A mediator, whose job it is to help all the parties see their own positions clearly, can help transform conflicts into opportunities to deepen relationships, especially among family members, and maybe spur some solutions, said Elisabeth Seaman, founder of Conflict Prevention & Resolution Services in Palo Alto, a for-profit mediation firm.
"My aim is to help people get a better understanding of each other," said Seaman, who has worked with numerous elders in her general practice. By talking with each other in the company of a neutral professional, aging adults and their loved ones often realize that they have biased views of the situation based on their own interests.
"The point is to get people listening to each other and in such a way that they understand another's point of view," she said. They don't necessarily have to agree with each other, Seaman added. But solutions are only possible when each party respects the integrity of the other.
Issues surrounding aging parents are as varied as the people involved, Seaman said. She has helped a stepmother and stepdaughter air out their differing ideas of care for a debilitated husband and father. She agreed to mediate among three sisters and a brother to build trust in anticipation of the holiday season with aging parents.
Cultural issues can complicate relationships with elders. Seaman once
mediated a conflict between a young Asian family that had fully acculturated
in America and their elderly aunt, whose expectations of how she should be
treated after she moved in with them were at odds with the rest of the group.
While there was no resolution of the issue, each side came to better understand the other's point of view and culture-based expectations, Seaman said.
Unlike a court case, where there's a winner and a loser, people who choose mediation to address conflict are in charge of making the decisions themselves. According to Margaret Dale, 79, a mediator in Santa Rosa, Calif., who teaches a class on elder mediation at Sonoma State University, relying on the legal system for resolving family disputes can be devastating for everyone involved.
"It's rough being pulled into court and being told you're incompetent," she explained. "Things move too fast. They never get a chance to say what they want."
Dale recalled one case in which the children of an aging father disputed his decision to leave his estate to his new wife, who had been his caregiver. The children assumed the woman had married him for his money, even though she agreed he should give most of his assets to them when he died.
"Mediation didn't solve the whole problem, but it made one of the daughters see the father as a person who had a right to make these decisions," said Dale. When money enters into a family dispute, as it will for so many in the baby boom generation, conflicts become especially messy.
Dale has also worked with elders who are reticent to give up their role in the family business. In one case, a son was so distraught over his father's reluctance to give him final decision-making responsibility -- despite mistakes that were leading to lower profits -- that he threatened to leave. By hashing it out with his father, and with Dale guiding the process, the were able to work it out and the father stepped aside.
Mediation can yield a resolution much faster than the judicial system. As the courts become clogged, time between hearings has grown lengthy. Mediators often can help people resolve their problems in two or three two-hour sessions. So, while their fee is often as high as an attorney's, the process is ultimately far less costly, practitioners say.
Finally, "People feel good about themselves afterwards and find they don't have to be in an adversarial mode," Seaman said. "It's a way of creating peace, one on one."