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<xTITLE>Tough Elder Decisions: The Mediation Option</xTITLE>

Tough Elder Decisions: The Mediation Option

by Rikk Larsen & Blair Trippe
May 2004
There is a new field developing in the mediation world – Elder Mediation. Why this new practice area? Because the way families deal with elder transitions in America is undergoing a slow revolution. It's not just that boomers are facing parental transitions now. It's the underlying powerful force of ever higher continuing care/nursing home/Medicare costs combined with the need for families to take more and more elder care responsibility at a time when multi-generational family living is in sharp decline. This “perfect storm” of clashing factors inevitably puts tremendous pressures on families.

As a consequence, while it may be overly dramatic to call it an epidemic, numerous American families are becoming "quietly bruised" by the decision process. These families stumble through a major elder decision and end up with a less than ideal solution. Family members may have stopped communicating, may feel they have an unnecessary or uncomfortable guardianship situation, or simply continue to be unable to talk about things like money and financial planning because "Daddy never did that." This uncomfortable “bruised” state of quietly suffering families can be very stable and last for years. Some families never fully recover.

We are finding that the practice of elder meditation often provides an efficient and sensitive solution to the complicated elder care decision making process. Mediation isn’t simply an alternative to litigation, a “last resort” forum without the lawyers. Elder mediation is just as effective, and often more effective, at the beginning of the decision process – when families are fact finding, struggling with options and discovering feelings about their parents or adult children that well up and make clear thinking difficult. For instance, an important form of elder mediation is simply to convene a family meeting where a trained third party neutral is present to create the space for everyone in the family to be heard on an important developing family transition. This type of meeting, before the family is in crisis, can strengthen family ties and enable all family members to deal with the changing nature of their relationships and the realities of their situation. It allows family dynamics including sibling rivalries to be addressed at a time when everyone is calm and thoughtful decision making can occur. In this context, meetings can involve not just family members but appropriate professional resources like lawyers, geriatric care managers and financial planners. These professionals are encouraged to attend as their expertise, coupled with their insights into the family’s needs, are very helpful.

As baby boomers age and government resources diminish, we will face many difficult choices concerning how we handle transitions during our elders’ declining years. Families will have to be able to evaluate resources and options and develop ever changing strategies to support their elders. This will require communication and problem solving skills that will need to be increasingly sophisticated. Elder mediation is a rational first step for families to help them address their changing needs. It gives them a forum to exchange their bruises for shared decision making and emotional health.


Rikk Larsen is a founding partner of Elder Decisions where he is a mediator, trainer and conflict coach. He has created and presented conflict skills trainings to eldercare professionals from around New England. Rikk served on a Subcommittee for the Massachusetts Trial Courts Standing Committee on Dispute Resolution. He co-presented Using Mediation in Elder Law at the Massachusetts Chapter of the National Academy of Elder Law Attorneys and presented a workshop When Families Struggle with Dementia: Facilitating Solutions through Mediation at the Dartmouth Alzheimers Conference. He is the co-author, with Crystal Thorpe, of "Elder Mediation: Optimizing Major Family Transitions" for Marquette Elder's Advisor Law Journal. Rikk is a former case coordinator for Family and Probate Court and a case liaison for Small Claims Court for the Harvard Mediation Program. He attended Harvard Law Schools Program on Negotiation, studied elder issues with The Center for Social Gerontology and the concept of introducing meditation and spirituality into the mediation process at the Harvard Negotiation Programs Insight Initiative. He is a member of the New England Chapter of the Association for Conflict Resolution and the Massachusetts Council on Family Mediation. He received his BA from Williams College and his MBA from Harvard Business School.

Blair Trippe is a mediator, trainer, family business consultant and principal of Agreement Resources, LLC where she mediates workplace and family disputes including eldercare and estates issues. In addition to her mediation work, Blair has developed and presented numerous workshops and training programs in Negotiations, Conflict Resolution Skills, and Peer Mediation for professionals and teens. Blair recently presented at the Harvard Program on Negotiation at Harvard law School, to the National Academy of Elder Law Attorneys (NAELA), served on the faculty of the Dartmouth-Hitchcock Medical Centers conference on Alzheimers disease, and presented at the Map Through The Maze 2006 and 2008 Conferences of the Alzheimers Association. She recently was featured in a SHRM (Society for Human Resources Management) article entitled Conflict Management Contributes to Communication. Blair also was interviewed by CBS Evening News with Katie Couric and appeared on a segment on elder mediation which aired nationwide in February, 2007.She earned an MBA in marketing and finance from the Kellogg School of Management at Northwestern University and a BA in psychology from Connecticut College.