Eldercare issues are often complex, inviting confusion, comment and conflict from family members who may not see eye-to-eye. Professionals who work with older adults provide, recommend and/or support the best quality of care for older adults. Some overlap between various professional groups exists; however, one specialty area is typically more appropriate as a starting place for each eldercare situation. Typically, referrals back and forth between various professionals are common to meet the needs of older adults and their families as they venture through the journey of eldercare.
Geriatric care managers provide comprehensive assessments of older adult situations, develop care plans, assist in implementing the plans and often stay involved to monitor ongoing care needs.
Elder law attorneys (as defined on www.naela.org, the website for the National Association of Elder Law Attorneys) “focus on the legal needs of the elderly, and work with a variety of legal tools and techniques to meet the goals and objectives of the older client.”
Psychotherapists diagnose and treat mental and emotional disorders, and provide consultation to individuals, couples, families and groups, using an interpersonal approach to aid clients in problems of day-to-day living.
Elder Mediators assist parties engaged in conflict around an elder (or estate) to reach agreement by facilitating the parties to work together towards resolution, seeking common ground.
An important matter to delineate between these eldercare specialties is the identification of “who is the client.” Each of these professional groups, with the exception of elder mediators, presumes the older adult(s) as the client. Attorneys can only advocate for an identified client. Geriatric care managers typically evaluate the entire family system, while advocating for the older adult(s), specifically. Psychotherapists develop therapeutic relationships with specific individuals.
Mediators advocate for the process of conflict resolution, without asserting an allegiance to any of the parties. Elder mediators bring substantive knowledge of eldercare issues and the aging process along with awareness of available resources to enlighten all the parties, as appropriate.
Eldercare professionals are trained to focus on certain outcomes. Elder law attorneys apply legal principles to produce sound legal documents and to construct legal arguments. Geriatric care managers help elders/families to make good decisions about care needs. And, psychotherapists apply their talents to help clients understand their motives and to make good decisions.
The focal point for elder mediators is to help parties resolve elder-related conflict, guiding them towards effective communication skills to aid the process of current and future decision-making.
The process of elder mediation is generally short-term. While some mediations may be completed in a day-long or weekend-long marathon session, other mediations occur over several sessions – within a few weeks, a month or longer. Mediation sessions last until the parties reach agreement or no longer feel the process is helpful. The length of the mediation is influenced by the agenda developed by the parties as well as the availability of the participants. Other factors also influence the duration of mediation — the number of parties, the complexity of the issues, the number of outside resources (lawyers, care managers) needed and the quality of the relationships between the parties. Although some parties may choose to re-visit mediation at a later date, it is more common that the parties have resolved their issues and gained tools to effectively work together in the future.
Elder law attorneys typically produce requisite legal documents within several weeks or months; it is recommended that individuals maintain a relationship with their attorney, updating documents on a regular basis. Attorneys who provide litigation services may be retained for a long period of time.
Geriatric care managers produce a care plan soon after meeting with a family; many families maintain an ongoing relationship with the care manager through months and even years of caregiving support.
Psychotherapists work with their clients as long as they benefit from the service and as long as they desire therapy.
Unfortunately, many older adults and their families wait until a crisis occurs before seeking any type of professional assistance. It is vital that all eldercare professionals be familiar with various specialists who may be appropriate, in the moment, for the elder/family. Elder law attorneys should be attentive to families seeking resources and direction by referring to geriatric care managers, who, in return, refer to elder law attorneys for legal-related concerns. Individual distress may be appropriately routed to psychotherapists.
Families presenting to elder law attorneys or geriatric care managers with overt conflicts may best be referred to elder mediators to provide for an impartial setting to work through “squabbles” before effective legal or care planning can be accomplished. In turn, elder mediators frequently refer older adults to attorneys for legal work or to geriatric care managers for ongoing monitoring. By understanding each other’s roles and partnering with each other, eldercare professionals can assist families by aptly directing them as they traverse the uncharted territory of caring for their aging relatives.
Len Riskin describes how mediation has integrated within legal practice: it has sparked collaborative law, a promising enterprise, but it also led to court-based mediations, which he believes are legalistic...By Leonard Riskin