Saturday, February 16, 2013

Care giving and Family-Mediators Can Make a Difference

Recently, I’ve been talking to a number of caregivers who are being worn out by the activity. Sometimes it’s a matter of caregiver fatigue, so putting appropriate respite services and supports in place makes a big difference. However, there are times when a family or marriage is on the brink of being destroyed because of the care giving responsibility. There are also very difficult decisions that need to be made, such as how much money each sibling can provide to help towards Mom’s care or when is it time to stop advanced life support, that all parties need to weigh in on.

 One of the things I hear over and over again in these situations is the disappointment and anger that primary caregivers express about other family members not being willing to help out. As the stress of care giving mounts, along with all the day to day issues families deal with, it’s not surprising that tempers flare, marriages fall apart, siblings end up not talking for years, the person who needs the care giving is caught in the middle, and legal action can even result.

What to do? Organize a family meeting, but with a third person.

Some families do an excellent job of organizing the care giving responsibilities, and other families, “well not so much,” as the expression goes. However, even in the best of situations, there can be times that the problems are so overwhelming and no one seems to know which way to turn. In such situations, it’s not surprising that communication breaks down, or as one colleague put it, “they eat their own.”

Before things spiral out of control, get a third party involved who can help guide the family meeting so that no one feels like they are getting beat up and the ultimate goals of providing care giving are met.

There are a variety of professionals that can serve as the third person in a family meeting-social worker; case manager; an advocate from a condition specific organization;  a pastor or rabbi; or a mediator. As good as the local minister or social worker might be, many times it’s better to have someone neutral that doesn’t have ties to any of the participating members.

Family caregiving mediation, like general mediation, provides a cooperative, non- adversarial setting for families to discuss their concerns in privacy and with confidentiality. The mediator serves as a neutral facilitator who has no connection to the case or situation The mediator does not decide the outcome or determine who is right or wrong; and there is no force on the disputing parties to reach agreement – it is a consensual process in which all parties must agree in order to have an agreement. The mediator listens to the concerns of all the parties and their ideas on how the matter might be resolved, facilitates the conversation, and helps the parties develop and agree upon a workable solution themselves.

Mediators can help with the following types of issues: daily care giving;  communication; health/medical/end of life decisions; safety/risk-taking; financial decisions; family relationships; and guardianships.

So where to find a mediator? Elder Locator can help to identify resources in your community including mediators.. Call 1-800-677-1116 weekdays, 9:00 am-8:00 pm.  Other places to try:
-       Ask the person’s medical provider, case manager,  social worker, nurse or hospice coordinator for a referral.
-       Every state has a 211 number, an information and referral service helpline available 24 hours a day. Dial 211 for assistance, or go to the 211 directory for more information in your state. 
-       Independent Living Centers will generally have a list of mediators. Call 713-520-0232 
-       The local chapter of a condition specific organization, such as the Diabetes Association, Cancer Society maybe able to refer you to a mediator or may have someone on their staff that can help you. 

Note: If finances are an issue, look for volunteer mediators or ones who provide service on a sliding scale fee.

Further Reading
Can Family Mediation Solve Disputes During Hospice? 

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