Easing the burden of elderly care

Getting a family to agree on what’s best for an ageing parent is fraught with difficulties. A new approach can help

WORKING OUT what’s best for ageing parents is a tricky business, no matter how you approach it. Even suggesting that someone should plan the type of care needed for another person is in itself rife with difficulties, even if that person seems not to be fully capable of deciding what his/her care needs are.

Now there is a new group of professionals who specialise in mediating between family members about “age-related issues”. “It’s called elder mediation, mediation with age-related issues or simply peacemaking,” says Judy McCann Beranger, a Canadian mediator who is in Dublin this week to train a group of Irish mediators in elder mediation.

“From my experience, the most challenging issue is the burden of care – or the unequal burden of care when someone becomes ill or has progressive dementia or a chronic condition,” she says.

The role of the elder mediator is to bring all members of the family, friends and other significant people together, with or without the ageing person (depending on whether it would be stressful for him/her), to discuss all the issues.

“A trained elder mediator facilitates a process that helps people reach mutually acceptable agreements that, to the greatest extent possible, support everyone’s best interests,” says McCann Beranger. “The focus is on addressing concerns and issues while keeping the myriad existing relationships growing and respectful,” she adds.

The most common issues that elder mediators deal with are decisions around caregiver burden, healthcare and financial issues, neighbour disputes, living arrangements, stepfamily issues, grandparenting and intergenerational issues, family disputes, nursing home decisions, retirement issues and end-of-life decisions.

“The role of the family can’t be replaced, so the key is to bring as many people around the table as possible. This can include a partner, brothers and sisters, adult children, a choir director in the church where the person sings, the bank manager. Then, members of the family from abroad can be phoned in,” she explains.

“The mediator helps to calm the situation and create an environment to have a conversation by reframing and explaining things in a more gentle way. This can bring in formerly ostracised members of the family and bring people closer together. It’s a wonderful blessed thing if people know what they are doing,” she says.

The idea is that families can work out practical issues while also dealing with deeply emotional issues in a supportive environment. For instance, while one family member might be most responsible for supervising the care of an ageing parent, another might make arrangements to have meals delivered or pay for a caregiver at certain times. A family member living abroad could arrange their holidays so that the principal carer can take time off while he/she is back home.

“The key in all of this is the vast wellness component. We talk to people about their strengths. And then we also have a preventative role in that we can anticipate issues such as the need to move house. This allows families to do some short-term planning which prevents them from panicking at a later stage,” she says.

“Families feel valued and honoured if they are facilitated by someone who understands ageing,” she says. Trained mediators currently undergo a peer-reviewed international certification process to become elder mediators.

The most important thing of all is that the older people are accorded the same rights and responsibilities as any other person and that they are helped to remain as independent as they can for as long as possible, according to McCann Beranger. And if there are any concerns about abuse or neglect of the older person, the mediator will deal with them upfront right at the start of the process.

As societies throughout Europe continue to age at a rapid rate – and Ireland catches up with other European countries – McCann Beranger predicts the demand for elder mediators will grow. “People are living healthier and living longer and we will have more and more centenarians. Older people won’t accept how they were treated in the past. It’s already scary to think that we could be so arrogant as to treat someone who is 70 or 80 any differently than someone younger,” she says.

themii.ie and eldermediation.ca