Eldercare Mediation

Hurricane Katrina totally changed my life even though I left my hometown of New Orleans over thirty years ago. My mother, like many other New Orleanians, found it difficult to live in the devastated city she had called home her entire life and came to live with me in Raleigh, NC.

We quickly resumed the medical testing she had begun before the hurricane to determine the cause of some speech problems she had been experiencing. Gradually, it became clear that she was suffering from the early stages of vascular dementia.

Not long afterwards, I began suffering from the confusion and shock that accompany the early stages of caring for a loved one with this illness.

Fortunately, I found help the minute I walked into the Alzheimer's NC office. “You are not alone,” the smiling women in the office assured me as one of them loaded me up with books and pamphlets and support group meeting times.

They were right. I quickly found a boatload of families facing similar challenges, one of the most difficult being talking openly and reaching an agreement with our family members about the life-altering decisions on our plate.

Communication is Vital

Though as a species, we may have become technological wizards of communication, twittering and blogging and chatting instantly with people all around the world, what we say and how we say it are still rife with conflict and misunderstanding.

Having worked for over 15 years in a court-ordered custody mediation program, I have witnessed on a daily basis the ramifications of misspeak and the miracles that can occur when ideas are exchanged with care.

As my family navigated its way through the choices involved in my mother’s care, I came to appreciate how useful mediated conversations can be for families dealing with eldercare issues.

I learned of a family where the mother had just been diagnosed with Alzheimer’s disease. The two adult children were naturally upset and in their grief became locked in disagreement over whether their mother should live with the daughter or go to an assisted living facility.

The son had heard horror stories of people trying to care for someone with Alzheimer’s disease in their home and felt it would be best to place their mother in a facility as soon as possible. He didn’t like the way his sister was managing their mother’s finances and argued with her over the bills.

The daughter felt her brother was uncaring and trying to stop her from spending precious time with their mother.

When the mother heard them arguing about decisions affecting her life she became more withdrawn and suspicious. The whole family was in distress, with the adult children threatening to sue for legal guardianship of their mother.

Fortunately, they decided to try mediation first. After several sessions, the family learned that the mother wanted to try and live with her daughter.

The family agreed on the importance of supportive services like an adult day care and professional guidance to help them understand the progression of the disease and the options for care at each stage.

For the first time since the diagnosis, the siblings began to unite on a plan. The daughter agreed that her brother had more experience in financial planning and consented to his managing their mother’s finances.

As a facilitative mediator, my job does not involve making decisions or discerning the truth. Instead, I liken my role to that of air traffic controller, making sure that conversations stay on the right path and are productive. I help families unearth their underlying concerns so they can design solutions that address them and, in doing so, create a safety net for the entire family.

When families turn to the courts to intervene in their disputes, they receive a legal answer to something that is usually a relationship issue and they often leave more fractured than when they first sought the court’s decision.

What is Eldercare Mediation?

Eldercare mediation involves the elder (or their advocate) to whatever extent possible, as well as all family members who want to participate and any attorneys, therapists or other professionals who can help provide information to the family during mediation.

Mediation can take place early on to prevent conflict and help a family design a plan that will work for everyone or it can help even when a conflict is already tied up in litigation.

Each mediation session is unique and designed according to the needs of the family. Conference calls can be used for out-of-town family members, “conflict coaching” is available when no other family members will participate, and Memorandums of Agreement can be written to help the parties follow the mediated plan.

Finding the Right Mediator

When searching for an eldercare mediator, it is important to find some-one with experience mediating family disputes and familiarity with the medi-cal, social and legal issues of eldercare.

Since mediation is still a young and growing profession, most mediators work in other fields as well. Typically, mediators come from social work, counseling or legal backgrounds. There are many different styles and approaches to mediation and it is important to interview your potential mediator to make sure you feel comfortable with him or her. An attorney mediator will not be serving as your attorney during mediation, since it is a completely different role, but all mediators should be comfortable working with attorneys the family may have hired.


While the fee for eldercare mediation is usually between $100 - $200 an hour, in the long run this is far less than the amount families spend going to court. Families also save an enormous amount of time if they are united on their caregiving plan. Ask your mediator for a description of fees and options, including any sliding fee scales arrangements.

Where to Find a Mediator

For help locating a professional mediator, contact the Association of Conflict Resolution ( or NC Association of Professional Family Mediators (

Stephanie C. Smith, MSW, a family mediator, teaches conflict resolution workshops. If you have further questions about mediation, Stephanie can be reached at 919-833-1803 or

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