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Caring for Our Aging Parents

An elder mediator and author helps siblings negotiate care for Mom and Dad

Q. What are other reasons for disharmony and tension?

A. Parents are living longer. Dad may not be the capable patriarch he used to be or Mom no longer the communication hub. That means the old way of communicating and doing things must change, and that creates a leadership vacuum and thus more opportunities for disagreements. Also, the oldest isn't necessarily the smartest or the best leader, and maybe their parents have given them all the power. And don't forget entrenched family relationships. If you get people together, they sit where they did 30 years ago at the table and unconsciously act like they did then, too.

Q. How do you keep the ancient history from thwarting sound, joint decision-making?

A. You get it out there. Let people vent and acknowledge those old wounds. I might ask, "What do you need to hear from your brother in order to move on?"

Q. Why is it so tough to resolve these issues?

A. Siblings tend to feel strongly that their position is the right one and then talk over one another and don't really listen. Often sibling X reacts to an issue, like Dad burning pots and pans and not paying his bills, by insisting on an extreme outcome, like he has to go to a nursing home when there are other less drastic options available. Dad and sibling Y want him to stay in his own home as long as he's safe.

Q. What do you do?

A. Together, I'll work with them on thinking about ways to meet their common interests, which are to keep him safe and support his happiness and well-being. As a group, we'll do some collaborative problem solving. Depending on the situation — rather than the nursing home route — it could be hiring a bill-paying service and a part-time caregiver, signing up for Meals on Wheels or getting Dad driving help.

Q. Is professional help necessary to resolve elder issues?

A. Certainly there are families who successfully manage major life transitions by themselves, but I have no doubt that if you bring in a professional, the process can be less painful and the outcome better. The truth is that no family goes gently into that good night. By that I mean there are always issues, whether addressed or not. The way people communicate is critical, and unfortunately during times of elder transitions, that communication is tested. The typical family communication system is rarely up to the challenge, so just the act of getting together in a formal, safe session with a third-party neutral who isn't going to be making decisions is tremendously powerful and often leads to great problem solving.

Q. But everyone needs to have the same information for that to happen, right?

A. The first task is to get the facts on the table. We often ask families to bring in outside experts like a financial planner, a geriatric care manager or the family attorney to explain complicated legal and financial matters so that everyone has the necessary information and understands it.

Q. Is there a way to reduce or eliminate the ill will?

A. It's ideal to have families discuss issues before parents die, but we all know that doesn't always happen. One scenario I've seen repeatedly is the decision to give one child less money in the will because that child has a lot more financial resources than the other siblings. But that sibling might feel mistreated and view it as a symbol of not being loved because the rationale behind that decision was never discussed. Again, it's a communications problem.

Q. Does everyone have to agree in order to have a good outcome?

A. What's wonderful about mediation is that it allows everyone to be heard, and even if they can't completely agree, at least they've been treated well in the process and have a clearer understanding about why certain decisions were made.

Q. Is it expensive?

A. On average it's around $2,000 to $7,000. It depends on the number of people in the family and the complexity of the issues. If there were three or four individuals, it would cost around $2,000, and if you bring in financial experts it would cost more, but it would still be a lot less than going through litigation. Mediators don't usually take retainers or charge by the hour, and it typically takes two sessions.

Sally Abrahms, who writes on aging and boomers, has published in Time, Newsweek, the New York Times, Parade, and USA Today. She lives in Boston.

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