Maryland Mediation Blog

Parents and adult children often live in different parts of the country. My Maryland mediation practice receives calls from families in need of assistance with elder issues.Telephone mediation is especially helpful for families facing issues that some or all need to weigh in on, or discuss. That is, when there are multiple decision makers living in different places.

Brother and his wife, who are in their late 60's live in Minnesota. They have a sister, in her late 70's who lives in Indiana. Indiana sister never married and had no children. Indiana sister had an acute medical problem and was hospitalized for more than a week. When she was ready to be discharged from the hospital, she wanted to return to her home, but she was unable to care for herself and needed assistance.Minnesota brother and Indiana sister had another sister and her husband, who were also in their 70's who also lived in Indiana, but two hours away from needy Indiana sister.

Healthy Indiana sister felt compelled to manage the care of needy Indiana sister. But, the husband of healthy Indiana sister also had medical problems that required healthy Indiana sister's supervision. Minnesota brother and his wife saw the writing on the wall before needy Indiana sister was hospitalized this time. They had been asking needy Indiana sister to move to Minnesota. They had researched assisted living communities in Minnesota and thought they found the ideal location for needy Indiana sister. However, needy Indiana sister was not interested in leaving her home or Indiana.

Healthy Indiana sister felt strongly needy Indiana sister should stay in State and near where she's used to living. Healthy Indiana sister also researched assisted living communities in Indiana. Healthy Indiana sister and Minnesota brother were stressed and had many heated discussions about what was best for needy sister. At times Minnesota's wife and healthy Indiana's husband weighed in on the situation. More often then not the conversations erupted in conflict. Efforts were misunderstood and feelings were hurt. Meanwhile needy Indiana sister was discharged from the hospital to a rehabilitation center.

At wits end, healthy Indiana sister contacted me for help. "Shuttle diplomacy" (third party intermediary) was necessary to get the siblings talking again about needy Indiana sister's care and living arrangements. Needy Indiana sister was moved into an assisted living community in Indiana. Healthy Indiana sister visits regularly. Minnesota brother visits several times a year and otherwise keeps in regular contact by phone. Earlier this month all the siblings and spouses met in Wisconsin.

Every family is unique, and many families are dealing with elder care issues. Disagreement and emotionally charged arguments are common. Until family disputes are resolved, care and treatment of a vulnerable aging parent or elder family member may not be consistent. Where the elder family member has declared a preference for care, family disputes may interfere with the observance of the preferences.

While mentally competent, aging family members may be reluctant to discuss plans for care in the event they are no longer able to live independently. Many people find the prospect of discussing advanced medical directives overwhelming. However, when a family member can no longer independently manage the activities of daily living, or live alone safely, the time has arrived to discuss care.

In some cases, despite an aging or elder family member's written medical directives, children and/or other family members still fight about treatment, discharge, and follow up care for the parent or elder family member. A daughter may resent that care of the elderly family member falls to her. A son may not be ready to "pull the plug."

Decisions may be made in the home of the children, or the elderly family member. Families that deal with the emotionally charged issues of elder care outside of the assisted living facility, nursing home, or hospital, assist the case managers and care providers with already overwhelming workloads.

Mediation is ideal for families in conflict related to elder care. In my Maryland practice, families benefit from a neutral third party who assists them with thoughtful discussion and negotiation related to the highly charged emotional issues relevant to elder care.