Mediators ease decisions on elders

Sometimes, the issue is big: Move a parent into assisted living or hire home care? Other times, battles erupt over tiny tussles: Who gets mom's cracked teapot when the house is sold?

Aging is rarely simple and easy, and when family is involved, the dynamics get complicated. Caregiving by committee is difficult. Family members are separated by time zones and broken marriages, and they're busy -- nearly 60 percent of the nation's 44 million caregivers work.

Enter the elder mediator, a neutral party who is skilled in listening, defusing tensions, and explaining caregiving options. While still a rarity, elder mediation is becoming better known as an option for families who seek to resolve conflicts over the care of an older relative.

"If you can help them hear each other, that's hugely powerful," says Rikk Larsen , a codirector of Elder Decisions, a four-year-old mediation firm in Lexington. "We convene families in a safe environment with a third party who's not going to be making decisions for the family."

Alessandra Nichols , a Brooklyn artist, persuaded her six siblings to gather at their mother's house in Connecticut a year ago for a sometimes-tense three-hour session with Larsen and his partner Crystal Thorpe . Two siblings at first refused , but acquiesced after the meeting was set. One attended by telephone from her home in Norway.

Their father had died in 2004, and the meeting was called in part to discuss whether to hire full-time care for their 87-year-old mother, who lives at home but has advanced Alzheimer's. A local sibling had been shouldering most of the work.

"People got to say what they wanted to say, people got to be heard. We were face to face saying these things together, which is all good," says Nichols. As a result, the siblings decided to hire full-time help, giving the main caregiver some relief. The meeting also inspired Nichols and an estranged sibling to have a talk.

Elder care, with all its rewards, takes lots of time, and it's a stage of life that's filled with gray areas and question marks. Often, older people and their families wait until a crisis before discussing safety, care, quality of life. While 60 percent of adult children say they talk regularly about health matters with their parents, only 32 percent of parents report doing so with their grown kids, according to a recent survey by WellPoint Inc., a benefits firm. A lack of planning and communication seeds later conflicts.

How does mediation work? Most mediators won't touch cases related to abuse, from alcohol to embezzlement, but they do take on disputes within families and between family members and a facility, such as a nursing home. Fees vary widely, from $350 an hour at Elder Decisions to sliding charges of $35 to $300 for a two- to three-hour session at the Community Dispute Settlement Center in Cambridge. Two mediators participate in each session.

Massachusetts requires a minimum of 30 hours of training for certification as a mediator. States generally require 30 to 40 hours of training , although none requires additional schooling for elder mediators, according to the nonprofit Center for Social Gerontology, a pioneer in the field based in Ann Arbor, Mich.

Once a case is accepted and the long hard work of getting everyone to the table is done, a mediator's job is to remain neutral, keep emotions in check, and facilitate an agreement, often put in writing later. For John Price and his sister Marie Clark , that agreement involved overcoming their elderly mother's opposition to a cross-country move.

Mayna Price , 89, lives near Clark in an assisted living facility in coastal South Carolina, but Clark plans to move to Texas, so the siblings have wanted their mother to move near Price, an Ohio financier. After the three toured a prospective apartment in Cleveland and met with mediator John Bertschler in October, Price agreed to move in January.

"John [Bertschler] sat next to her, and was trying to see it from her side, and kept the ball moving," recalls John Price, who had been juggling four trips a year to see his mother. "I feel good about it."

Elder mediation is not a ticket to permanent peace in the family, nor is it a sign that family members have somehow failed. It's an important tool for dealing with a new challenge: long-distance caregiving in a long-life-but-bureaucratic age. Keep people talking, and you give them the chance to keep helping, and to stay "family" during the tough times along with the good.

Balancing Acts appears every other week. Maggie Jackson can be reached at maggie.jackson@att.net.

(Correction: Because of an editing error, a caption with the Balancing Acts column about mediation for families for conflicts involving an older relative in Sunday's BostonWorks section transposed the names of sisters Alessandra Nichols and Marghertia Shaw. Shaw was at left in the photo.)

(Correction: Because of incorrect information provided by the Office of Elder Affairs, the Balancing Acts column in Sunday's BostonWorks incorrectly stated the requirements for elder mediators. Elder mediators do not need state certification to work with clients. For approval to work as a mediator in Massachusetts courts and to receive legal protections of client confidentiality, elder mediators must take a minimum 30 hours of training, and fulfill other requirements.)