By Carolyn L. Rosenblatt, RN, BSN, Attorney

Mom has dementia and her daughter, Jennie, is worried.  Mom clearly should not be driving anymore. 
Jennie finally just took the keys away.  Have they talked about it? No. Argued some, maybe. But talking starts out with anger and ends up worse than ever.

Jennie saw the dents in Mom’s car and asked about what happened.  Mom refused to discuss it. First of all, she doesn’t exactly remember.  But she’s embarrassed. She had a perfect driving record.  Not even a parking ticket. Now this. Something is happening to her memory and keeping track of things.  She doesn’t want anyone to find out.  It feels horrible to Mom.  What if they put her away?

Jennie threatens to stop Mom from doing something stupid.  Mom wants Jennie to butt out.  How dare she tell her own Mother what to do?  Can this be solved?

This scenario is real.  It’s also not uncommon.  The problem of how to approach a person who may have a vague idea of something wrong with their memory but won’t admit it is affecting thousands of families every day.  Driving is one area where memory problems can affect lives and can put the public, as well as an aging parent in danger.

Consider the concept of mediation of a family dispute about an aging parent’s driving.

Mediation is a way of resolving disputes of all kinds. We’re quick to say “use mediation” for a labor dispute, or between warring countries to bring about peace. But, we usually don’t think of it for situations like Jennie and her Mom.  However, it can bring hope when conversations and arguing end up in a standoff and anger is destroying family relationships.  There is a way to resolve even the stickiest family issues.

Think of mediation as a way to get an outside, skilled person trained in resolving conflicts to come to your aid.  Think of it as a way to end the fighting, and to work out solutions with help and guidance.  Sometimes a few simple suggestions you’ve never thought about can turn the tide of a family conflict.  People who do this are called “elder mediators” or even “family mediators”.  The process is elder mediation.  People come to their own resolution with the help of a mediator.

You can find one by doing a search in your area for mediators who work with elders and their families.  There is normally a fee, though some community mediation services provide mediation at low cost or free.  If your family is suffering over a driving issue, or any other elder-related issue, think of mediation.  It may be the way out you’re looking for.

To learn more about adult children and dangerous older drivers, see my article in Forbes.com.
To download a short book with step-by-step guidance on how to deal with your aging parent’s driving, try How to Handle a Dangerous Older Driver .

Money seems to lead the way when we look at the various things that are the source of conflict for elders and their families. While the elder is in declining health, the family may be fighting about who is in charge of the financial decisions. After the elder passes away, the courts see a never-ending stream of heirs fighting over the estate.

Mediation at any stage can help keep things from boiling over. Because relatively few people understand how mediation of a conflict can help people involved in everyday disputes, the American Bar Association sponsored a contest to encourage members to make brief videos illustrating this. At AgingParents.com, we entered the contest by producing a video on a typical dispute about an aging parent, and won honorable mention. Here’s the link to our video on elder mediation. http://www.youtube.com/watch?v=yFwLjUFaUQs

What the video illustrates is how a brother and sister are arguing about Dad’s care and what should be done for him. Threats are made, and they’re stuck in their opposite views. Of course, in our video they do work things out.

What we often see in dealing with elder related disputed is friction over who has the power to make financial decisions when the aging parent loses the ability to do so. We can’t emphasize enough how the basic document, a durable power of attorney, along with other basic planning, can avert some of these hassles altogether.

If you are over the age of 50 and your aging parent is over the age of 70, it’s time to do your durable power of attorney. While the language of the form document varies from state to state, the basic function is the same: an aging parent has named someone else, often a spouse or adult child, to take over the financial decision-making if the aging parent loses the capacity to make these decisions.

You can likely get the form for free in your state. We offer it free to anyone who visits AgingParents.com in California and asks for it. One thing to know is that it has to be specific about the powers it gives the the person appointed (agent) to take over when needed. And, it has to be notarized. If you don’t have one, please get moving!

© 2010, AgingParents.com

What Feeds Family Conflict?

By Carolyn L. Rosenblatt, R.N., B.S.N., Attorney at Law

There are a lot of kinds of conflict, but some of the very worst are the kind that occur in families. Why is this? A long history of interacting in ways that don’t work, family members who are totally closed to change, lack of self-awareness and self-understanding, and fear are among the things that can maintain patterns of conflict for years on end.

Psychology teaches us that all behavior is motivated. That is to say, from that perspective, everything we do comes from some reason, some conscious or unconscious place within. If people behave unreasonably, there is a cause for their behavior. Knowing that may not change a thing about family conflict, but it can help us deal with it a little better. Dealing with family conflict is essential as our elders age and family members have to step up and make decisions about aging parents.  Everyone may not get along so well in this situation.

In our practice of elder mediation, fear seems to be the single biggest motivator that drives the conflicts we see. It can be fear around money, or control, or change. It can be fear of being found out, exposed. It can be fear of being asked to do something one is not competent or willing to do. It is one of the most basic of human emotions, but an emotion that causes extreme self-protective reactions. These reactions sometimes manifest in strong words, violent behavior, or generally hostile contact with others.
Mediators work to help participants at mediation find ways to agree and to make compromises. The stronger a participant’s fear, the more difficult it is for that person to give in to anything, or to make agreements that touch upon his or her fear.

What can we do about all this? Perhaps we can start by recognizing that no one enjoys being horribly difficult at mediation or any time. Behaving badly is simply what shows on the outside. What just might be on the inside is a person frightened of losing control, security, money, the family home, an inheritance, the right to make decisions, or anything.

Compassion and understanding can do a lot to uplift the process of working with persons who are showing their worst side in a dispute. It does not change the difficult person’s behavior, but it can cause the whole tone of a mediation to soften. Understanding that emotion feeds conflict can cause one to step back and try to imagine what it is like to be the person who is acting out.

If one is able to imagine that, to “walk in someone else’s shoes” for the moment, it makes it a lot easier to compromise or try to figure out what would work for that difficult person. I guess you can call it being a little less selfish in a dispute.

It works. This, of course doesn’t apply only to mediation of disputes involving elders. It’s a general concept, and can apply to any kind of conflict. Difficult as it is to see the other’s side of the story in any clash of ideas, working at doing just that is essential to getting things resolved.

At the risk of sounding too philosophical here, I conclude that elder mediation can uplift us if we are willing to put forth the effort to stop thinking of only our own point of view. It’s not easy. The upside to the effort is that your dispute could be over with, or at least down to a workable level. Were we all able to see past the specifics of a family conflict to the underlying emotions we would surely be more peaceful.

To learn more about family conflicts and aging loved ones, sign up for our free newsletter at http://www.AgingParents.com.

© 2009, AgingParents.com

Can an Elder With Dementia Participate in Mediation?

Carolyn L. Rosenblatt, R. N., B.S.N., Attorney
© 2009, AgingParents.com

Can an elder with dementia participate in mediation? The short answer is, it depends on the progress of the dementia.

Dementia is one of several kinds, the most common being Alzheimer’s Disease. It causes progressive damage to brain cells, initially affecting short term memory, and gradually affecting all “executive” functions of the brain, including judgment, analysis, thinking, and others. The affected person eventually loses the ability to recognize familiar objects, and even loved ones.

In the early stages, this kind of dementia affects short term memory, but other parts of one’s thinking can seem to be all right. One can carry on a conversation, express one’s self, and make decisions. An elder with early Alzheimer’s Disease (AD) may be able to live alone, drive, and manage affairs. However, even at the early stages, one must be aware that this condition is progressive. It affects everyone differently, and is therefore, unpredictable.

What we know is that a person’s decline with AD is steady and that it will certainly get worse until a cure or better treatment is found. We don’t have that yet. In the meantime, what if there is a family conflict, mediation seems to be the way to deal with it, and the elder has dementia? Do we invite the elder to come?

Our experience at AgingParents.com with elders who have dementia is that they are invited to come to mediation if they are willing and want to be there. They may not stay for the entire discussion. We may want to provide for a caregiver to accompany them elsewhere after a part of the talking is done. We do want an elder to be able to express his or her wishes. We do want him or her to feel respected and a part of the process. However, we don’t want to expect too much from someone with limited capacity to remember and participate.

As mediators, we offer the opportunity for the elder to participate when we have a pre-mediation conference with the family or others who will be present at mediation. At that time, we try to assess the level of function of which the elder is capable. We ask the elder about coming if the elder is available to us by phone.

Sometimes, things will be talked about at mediation which could upset the elder, or cause unnecessary stress. We make every effort to be sensitive to this, and to arrange with the family members to spare the elder from extra stress.

In our experience so far, some elders stay for the entire session, and some leave early. In some cases, the elder is too disabled to be there at all. So, the question of whether to ask or permit an elder with AD to come to mediation must be decided on a case-by-case basis. Even if their participation is only symbolic, and they are likely to forget what happened by the next hour or day, it can be a respectful gesture to ask the elder to be at mediation, at least for awhile. The family’s wishes about this are also considered.

The final point is that settling an issue at mediation requires the ability to make a reasoned decision and to keep commitments made at mediation. Where there is conflict, those participants who have decision-making authority should have the final word about any outcome of mediation.
©AgingParents.com
Learn more about dealing with elders with dementia at http://www.agingparents.com

The thing about this kind of mediation practice is that, invariably, emotions are high. The dispute may not be about money, but sometimes it is. Money is emotional for lots of people. We find that families in dispute about their parents or other loved ones often fall back into patterns of behavior they have been in with each other since childhood. As immature as it seems, the players can’t seem to break the patterns. Some have observed that siblings even assume the same places around a table at mediation that they had at the family dinner table growing up. Talk about being stuck!

We find that for mediation to be successful for anyone, whether an elder is in the mix or not, one must be willing to give up one’s position, or to be able to view a problem from someone else’s point of view. Why this is so difficult seems to be rooted in the emotional attachment siblings, or others have to their Positions. (I’m right, I know I’m right, and I don’t care what you say!)

So, if one wants to mediate a dispute and has any hope of success, one has to come into the mediation willing to have some flexibility about the problem at hand. If one expects all the changing to be done by the person(s) on the other side of the dispute, it is a sure-fire way to fail at mediation.

Mediators work with participants to try to help them see things from each other’s point of view, but no one can force a person to compromise. A mediation is helped by participants who work at making “a deal”, whether it’s about money or about control, or a place to live, or whatever. Siblings fighting about their elders have a choice about whether to make their best effort to work it out, or to spend their time trying to make each other wrong. Likewise with the elders themselves. Some are just plain difficult, and compromise is not something they want to explore.

People have many reasons for holding onto their positions in family conflicts. Sometimes there are old resentments dating back to childhood. One mother who said she didn’t trust her son to manage her money wouldn’t give a reason until pressed. Her son was a responsible businessman, and likely could have done the job. He managed his own money responsibly, as reported by all and agreed to by the mom. As it turned out, he had gotten black oil on a favorite embroidered towel she had when he was a little boy, and that was her basis for not trusting him.

She was not about to give up her position. She had a very difficult time in her life, and though she made agreements at mediation, she spent a lot of time afterwards, we were told, undermining that to which she had agreed.

She’s a good example of a person who wasn’t likely to succeed at growing old gracefully. She also wasted thousands of dollars on attorneys, courts and got minimal value out of mediation. However, most of the time, mediation does work. People make agreements, they figure the way out of the mess. And sometimes it doesn’t, about 20% of the time. These are some of the reasons why it sometimes doesn’t work.

To learn more about how to handle family disputes, see How to Handle Family Conflicts About Elders, Vol. 7, The Boomer’s Guide to Aging Parents, available at http://www.AgingParents.com/familyconflict.