Elder Mediation: An Alternative to Guardianship

 

By Michelle W. Koufman, JD, Elder Law Attorney; Certified Elder Mediator

Seniors and their families face many different long term care decisions and transitions. These decisions/transitions often cause disagreement, discord and tension among different family members – in many cases – even leading to messy guardianship cases which are very difficult for everyone involved. However, the process of elder mediation can be a viable option – which tends to be less expensive and less emotionally traumatic for all of the parties involved. This blog post will define elder mediation; explore the process and when it might be appropriate for a senior and their family.

What is elder mediation?

Elder mediation is a relatively new practice area, which is gaining increased attention as a new and promising approach for resolving disputes between older adults and family members or other third parties. In this process of elder mediation – a trained facilitator uses a “mediation process model” in order to try to resolve disputes around elder issue. It is a voluntary process – where a neutral facilitator works with the disputing parties to try to help them to come to their own decisions about how to best resolve the issues at hand. Again, the mediator is “neutral” – so, they do not take any sides, make judgments or give advice. Meetings are confidential and are held in a safe setting, with extra attention made to accommodate the older person’s voice. Although there is no requirement or guarantee that an agreement will be reached, the goal of the parties involved should be to reach a mutually satisfactory resolution.

What is the process of elder mediation?

Elder mediation provides a forum for family decision making. Under this model – the trained mediator facilitates a purposeful and directed conversation – in which all family members involved are encouraged to express their feelings, interests, concerns, etc. The meetings also are informal and can be held at different locations that best meet all of the family members needs – including assisted living facilities, private homes, apartments, nursing homes, or hospitals.

What types of issues can be addressed by elder mediation?

Some typical areas that can be addressed by elder mediation are: healthcare/medical care decisions, caregiving, living arrangements, housing issues, caregiving, financial issues, driving issues, legal issues, and end-of- life planning and decision making. Elder mediators should inform all participants that mediators are not neutral in issues of abuse, neglect or safety and have a duty to report abuse.

 What type of qualifications does an elder mediator have?

While there are no hard and fast qualifications that all elder mediators must have across the board, it is advisable to find an elder mediator who has at least completed specialized elder mediation training. Although most mediators have taken at least 40 hours of basic mediation training, having a specially trained elder mediator who is not only familiar with the aging process and the family dynamics involved with these complex cases, but is also familiar with the local aging resources and programs, is invaluable.

 

Michelle W. Koufman, an experienced tax and estate planning attorney, practices in the following areas: long term care planning, estate planning, Medicaid planning, VA Aid & Attendance benefits, guardianship, probate administration and elder/family mediation. She is a member of the National Academy of Elder Law Attorneys (NAELA) and the GA Chapter of NAELA, as well as the National Aging in Place Council, Greater Atlanta Chapter. For additional information, please visit her website at http://www.GeorgiaElderCareLaw.com.

 

“I Can’t Do This!”

Caregiver Stress

Caregiver Stress

By Theresa Bayman, Program Director Coastal Region

Recently, a member of one of my support groups (with whom I have become very close),  reached her caregiver “breaking point.” Most, if not all caregivers, find themselves at this point at least once throughout their experience. This particular caregiver is a retired nurse – which you might think would give her a leg-up when it comes to care-giving for a loved one at home – but you’d be wrong about that.

When it comes to caring for someone we love, especially a parent or a spouse, the playing field is leveled.  Dementia care-giving is unlike most other care-giving experiences because of the ever-changing needs and limitations of the person receiving care.  With many illnesses, a caregiver can ask the patient “Are you in pain?; Are you hungry?; Would you like some company?”  With a dementia diagnosis, caregivers do not always have the benefit of verbal answers and cues. Instead, they learn to read body language and anticipate needs based on other clues and symptoms. Caregivers are part nurse, part detective, part cook, scheduler, transporter, husband/wife/daughter/son, etc. In short – mostly superhero!

Meeting the ever-changing needs of a loved one with dementia requires continuous evolution of the caregiver(s) themselves. Often times family dynamics/roles must shift in addition to changing perspectives, reactions, the way we make decisions and spend our time – just to name a few. It’s a huge adjustment – even for people like my dear friend who has been a professional caregiver for many years. She came to me asking for help, saying “I can’t do this” but the truth of the matter is just that you can’t do it aloneRecognizing the need for help and support is the first step to becoming a truly successful caregiver. Help can come in many forms – church members, nurses, home health agencies, adult day care, hospice, facility settings, good friends who know how to listen, family that is willing to step up to the plate and take on new roles, friends who can bring meals or keep you in their prayers, support group meetings, Alzheimer’s Association counselors and staff and many, many other ways. These options are out there waiting for you because care-giving just isn’t a one-person job. You can do it – and you don’t have to do it alone! Counselors are standing by on our helpline 24/7 – 800-272-3900

Can a Person with Dementia Live or Stay Alone?

 

There are many things to consider when thinking about whether or not a loved one needs to move or have in-home care, etc. Most of us want our loved ones to experience the most independence possible for as long as possible – but safely. It can be difficult at times to balance independence and safety and a careful evaluation is appropriate (and perhaps frequent re-evaluations as time progresses) to help make these types of difficult decisions.

The below questions can assist with identifying some safety concerns. Some of these items may only apply to individuals who are currently living by themselves rather than those who may be left alone for a short period of time while a caregiver is out. These questions are only a guide but if there are one or more problems noted in each category, then that could be an indicator that more supervision or a change in living arrangements is needed. For more information on home safety or our Medic-Alert/Safe Return program or for any other questions, call 800-272-3900 to speak with a counselor. More information on home safety is also available online at: http://alz.org/care/alzheimers-dementia-home-safety.asp

 

Safety Concerns

Does Your loved one: 

  • Have driving accidents, even minor ones?
  • Get lost driving or walking?
  • Burn pots on the stove or forget to turn off the burners or oven?
  • Forget to extinguish cigarettes?
  • Let strangers into the house or lock him/herself out of the house?
  • Forget to secure the house at night/when going out?
  • Demonstrate mood swings and suspicious/paranoid behaviors?
  • Know there are firearms or dangerous tools in the house and how to use them safely?
  • Know how to operate the thermostat and judge temperature correctly?
  • Have a recent history of being a victim of scams or crimes or any nature?

Personal Care

Is your loved one able to: 

  • Eat well-balanced meals and drink plenty of fluids?
  • Dress appropriately for the weather?
  • Safely bathe and use the toilet independently?

Other Tasks

Is your loved on able to: 

  • Keep up with the housekeeping duties and home repairs?
  • Pay bills on time, balance checkbook and use credit cards appropriately?
  • Shop for, store and cook food safely and correctly?
  • Use the phone and remember important phone numbers or where to find them?
  • Take medication on time and in the correct doses?
  • Recite their current address and phone number?

 

20th Anniversary J. Paul Austin Golf Tournament a Success!

On Monday June 23rd, Sam Austin hosted the 20th Anniversary J. Paul Austin Golf Tournament at Peachtree Golf Club in Atlanta. The event, which is named in honor of his father who suffered from Alzheimer’s Disease, has been a wonderful success through the years in both raising funds and awareness for the Alzheimer’s Association. This year was no exception, raising $185,550 (see bottom photo) for the Alzheimer’s Association. Though it threatened to storm on several occasions, the golfers waited it out and finished up their rounds in time to enjoy a prize ceremony and the presentation of the giant check! We are so grateful to all who came out to support this effort – golfers, volunteers and sponsors alike. THANK YOU for making this event possible!

20th Anniversary Program

20th Anniversary Program

Staff & Volunteers help with registration

Staff & Volunteers help with registration

 

Shirts for the golfers and 1st, 2nd and 3rd place prizes.

Shirts for the golfers and 1st, 2nd and 3rd place prizes.

 

Sponsors

Sponsors

 

Carts lined up ready to go!

Carts lined up ready to go!

 

Golfers get warmed up

Golfers get warmed up

 

Sam Austin welcomes the golfers to the tournament

Sam Austin welcomes the golfers to the tournament

 

And they're off!!

And they’re off!!

 

Peachtree course

A beautiful day on a beautiful course for a great cause!

A beautiful day on a beautiful course for a great cause!

 

The money raised!!

The money raised!!

Getting a Grip on Anger

Grrrrr!

 

It is natural for caregivers of people with dementia to become frustrated, even angry with the person that they love and are caring for. Therapists and veteran caregivers offer the following tips for dealing with those feelings:

  • Be Honest. Admit to yourself and to others that you are angry.
  • Remember that anger is not permanent. This too will pass. 
  • Try to identify specifically what bothers you.
  • Find a time and place to be alone. Scream, exercise, cry or meditate until you feel some release. 
  • Realize that no one is perfect.
  • When you feel you are about to explode, leave the scene until you feel calmer or have found a safe and healthy way to release your anger.
  • Try not to blame yourself or your loved one for the present situation – it is not what anyone wanted to have happen.
  • Let relatives or friends help with caregiving responsibilities – EVERY caregiver needs breaks.
  • Strive to live each day to the best of your ability.
  • Continue learning about how to deal with difficult behaviors and how to improve your communication. 

There are lots of resources available to help you deal with stress and anger:  Take our Caregiver Stress Check to check your stress level. Give us a call to find out about respite options in your area and support groups in your area – OR, call us if you think it would help just to talk. Call 24/7 at 800-272-3900. 

How to Have a Successful Family Meeting

Family Meetings

It takes a family to care for someone with Alzheimer’s, which is why it is important for everyone in the family to be on the same page. Here are a few tips for effective communication through family meetings:

  • Invite everyone who is going to be expected to help make and implement decisions. This includes the person with dementia if he/she can participate. Meet at a time and place convenient for everyone.
  • Meet before a crisis arises.  Diagnosis is a good time for planning.
  • Have Clear Goals.  Some questions to help formulate your goals might include: How can we provide our loved one with the needed care? What plans do we need to make for the future? How can we support the primary caregiver(s)?
  • Prepare. Have members gather needed information ahead of time: the doctor’s recommendations for care, information on financial resources, existing legal documents or a list of needed legal documents.
  • Agree to ground rules: 
  1. Appoint a leader to keep the discussion on track and someone to record decisions.
  2. Set a clear beginning and ending time for the discussion.
  3. Build in some “fun.” Serve snacks/food after business is completed.
  4. Avoid getting bogged down – you may need to make a list of questions to be addressed at a later date.
  5. Keep personal differences off of the table. Use a professional facilitator if you think it may help to avoid conflict.
  6. Allow time for difficult emotions; if family members are angry or distressed, take a break before making decisions.
  7. Encourage everyone to express his/her thoughts and feelings and be respectful of each other.
  • Decide who will do what by when. Make sure everyone has a role – set up clear lines of communication.

Remember – we are here to help however we can! Call us 24/7 at 800-272-3900.

Have You Had THE Conversation?

Difficult Conversations

If asked, most of us would say that it’s very important for our loved ones to know our end-of-life wishes.  However, many of us have not expressed our own wishes or had that conversation with those we love about theirs.

Pulitzer Prize winning journalist Ellen Goodman found herself in that situation at the end of her mother’s life.  “We talked about everything except one thing: how she wanted to live at the end of her life . . .  Once or twice when we heard about a relative or friend who was comatose or on a feeding tube, she would say, ‘If I’m like that, pull the plug.’ But, of course, when the time came there was no plug. In my mom’s last years of life, she was no longer able to decide what she wanted for dinner, let alone what she wanted for medical treatment. So the decisions fell to me. Another bone marrow biopsy? A spinal tap? Pain treatment? Antibiotics? I was faced with cascading decisions for which I was wholly unprepared. After all the years I had written about these issues, I was still blindsided by the inevitable.”

After her experience with her mom, Goodman co-founded The Conversation Project, a national campaign with this goal: “to make it easier to initiate conversations about dying, and to encourage people to talk now and as often as necessary so that their wishes are known when the time comes.”

All adults are encouraged to have these conversations.  And, it’s important to remember that persons with dementia are often still able to express their wishes when offered the opportunity.

Beginning these conversations can make the difference between a good death and a hard death.  We can also do much to unburden those we love from having to guess about our wishes.  Have you begun the conversation with those you love?

For some help beginning your conversations, see more at The Conversation Project website: www.http://theconversationproject.org.

For more information on Late Stage Care, please visit: http://alz.org/care/alzheimers-late-end-stage-caregiving.asp