Dear Ms. Allison: Me, my parents and siblings are frequently arguing over care for my brother, a wounded veteran (Iraq). He is paraplegic, not able to use his legs but able to use his arms, so he can help himself somewhat. Still he needs 24-hour care. When he can no longer live with my parents who are getting older and frailer, we kids are split between keeping him at home, moving in with one of us, or going to a veteran’s facility. Arguments about the place, the finances, and who gets to choose are becoming an almost every day thing. I think because at 49 he’s still relatively young he should be around people his own age. Most of the veteran’s centers seem to be nursing homes for elderly and dementia patients. Aside from the constant and heated debate, it’s stressful to several of us because we can’t do any advance planning. My dad has withdrawn and Mom wants us to promise he’ll never go to a nursing home. I know you mediate elder care issues, but who helps non-elderly adults and their families besides VA caseworkers and home care staff? JB in Northeastern Oklahoma

Dear JB:

A mediator certified in elder care mediation processes is certainly qualified to assist veterans and their families with caregiving disputes. Often called Elder and Adult Care Mediation, the process works for all adults receiving and giving long-term care. Generally, anyone over the age of 18 years old is considered an adult, so the people served would include young adults, “thirty-somethings”, middle aged people, seniors, “super seniors” (those aged 85+), and their caregivers.

Historically, care mediation is used widely and successfully in many other countries, and is now becoming a standard in the USA. That’s because of its usefulness in arriving at solutions that are custom made to suit the parties involved. There are rarely generic, one-size-fits-all resolutions in mediation. The way care mediation plays out is quite different than mediation for business, divorce, and such, which often occur as the result of filing a lawsuit. Due to the sensitive nature of care circumstances, care mediation may also take longer that the average few hours the other types of mediations require. Still, it is far more economical than a lawsuit, stress-related illness, or a family divided against itself.

Here’s how the process works for Adult Care disputes:

1. ENGAGE MEDIATOR – The disputing parties jointly hire the mediator, preferably one certified in the care mediation specialty.

2. INDIVIDUAL INTERVIEWS – To get a sense of the situation from all perspectives, every person involved in the care is interviewed by the mediator, one by one. She interviews the professionals and lay people who provide care, pay for it, and receive it, also requesting input on desired outcomes from each person. This process also includes, if the person is able to communicate, interviewing the recipient of the care – in your case, your brother – to bring all the perspectives to their ultimate center. This process assures that everyone is heard.

3. MEDIATION SESSION(S) – With consideration for the care recipient’s ability to participate (mentally, physically, and emotionally), the mediator schedules a meeting for all the parties to get together to discuss and clarify the issues and options available for resolution. During mediation, the mediator facilitates alternative solutions to be clarified, discussed among the participants, negotiated, and amended to resolve the situation fully and accurately.

4. WRITTEN AGREEMENT – Once all parties come to an understanding on the tailored solutions, a written agreement is drawn up and presented for everyone to sign. The signed, written agreement can have legal standing, as a contract. Each party gets a copy of the settlement agreement. To assure complete confidentiality, the mediator keeps no records of the proceedings. As long as the parties involved, keep the agreement private, it remains private.

5. ACTION – It is then up to the participants in the mediation to carry out the agreement as signed.

If your family would like more information on care mediation, please see my page Elder and Adult Care Mediation, and contact me to start the process.

That’s your question, Asked and Answered,
Gale Allison, Mediator