Family members at odds? Call the mediator.

The four adult children agreed.

Their father, William Curry, a retired electrical engineer and business executive, was sinking deeper into dementia. They had found a memory care facility about a mile from their parents' home in Chelmsford, Massachusetts, where they thought Mr. Curry would do better.

But their mother, Melissa, who was 83 when her family began urging her to make this change in 2016, remained determined to continue caring for her 81-year-old husband at home, despite the growing impact on his health. When her children raised the issue of moving, “she didn't want to discuss it,” said her daughter, Shannon Curry, 56. She cried sometimes.”

Yet even Melissa Curry's memory was slipping. She forgot to give her husband's medications or she got her doses wrong. The family was worried about falls and fires. Even after persuading her to accept a hired help several days a week, the couple was still alone for much of the day and even during the night.

As the weeks passed, “we were really at an impasse,” Ms. Curry said. “Are you ignoring your mother?”

Enter the mediator. Through a friend, Ms. Curry learned about Elder Decisions, a company that offers “family mediation for seniors.” His parents and her siblings all agreed to try it. Crystal Thorpe, the company's founding director, and a co-broker, Rikk Larsen, interviewed family members by phone, then scheduled a session around the parents' dining room table.

Often associated with business disputes or divorce and custody cases, trained mediators can also help families struggling with a variety of vexing elder care issues: appropriate living arrangements, caregiving responsibilities, communication and information sharing, and healthcare decisions and financial.

When families seek mediation, “they want to do what's best, but they have different perspectives on what 'best' might mean,” Thorpe explained.

Sometimes a court orders elder mediation, typically involving guardianships or estates and inheritances. How often this happens depends on state laws and the individual judge's enthusiasm for the trial.

“It would be great if more judges said, 'You need a mediator; choose one from the approved list,” said JulieAnn Calareso, president of the New York chapter of the National Academy of Elder Law Attorneys.

But increasingly, families are seeking elder mediation privately, before disputes end up in court and endanger or destroy family relationships.

“If families can avoid litigation — its cost, its stress — they will get a better outcome,” said Beth Polner Abrahams, a trained mediator and veteran attorney on Long Island. “There won't be a winner or a loser: there will be a compromise.”

Mediation differs from arbitration, in which an arbitrator evaluates arguments and makes a decision that the antagonists accept. The mediator maintains neutrality and helps the parties reach a consensus centered on the needs and wishes of the elderly person.

Even people without legal capacity can often make their wishes known, Thorpe said. When this is not possible, mediators can draw on the person's previous statements or documents.

Mediation also differs from family therapy, although sessions can become equally emotional as participants become angry or cry, healing old wounds and voicing grievances.

“These are complicated situations,” said DeLila Bergan, a senior mediator in Denton, Texas, and co-president of the senior mediation section of the Association for Conflict Resolution.

“We don't try to make everyone happy, cheerful and love each other – that's the job of a therapist. But we can ensure that they continue to talk and focus on the problems, keeping calm, without insults.”

He recalled a dispute over a family home that a widow was preparing to sell to finance her transition to independent living. One of the children felt “she was owed the house,” Ms. Bergan said, because she had lived there for a few years and contributed to the renovation costs.

“But there was no consensus on this” among his other children and grandchildren, Ms. Bergan said. “The fighting got really bad.”

After three months of negotiations the family reached a compromise: the daughter would purchase the house at a price accepted by her mother. Even if resentments persisted, “it was an agreement everyone could live with,” Bergan said.

Sometimes, the parties document decisions in a memorandum of understanding, or in a follow-up task list, or in a care plan; families can agree to exchange information with a private family website or text chain.

The process and whatever resolution is reached remains confidential, which is valuable, since some families are embarrassed to even acknowledge that they have sought mediation. Subsequently, mediators can remain in contact at the request of the family, to facilitate communications.

Because elder mediation is a fairly new field, with no nationwide certification or licensing requirements, approaches and costs vary. A mediation can last 90 minutes, three hours, or a couple of days. Some mediators are also lawyers or social workers. Some involve senior lawyers or financial advisors in the process.

In Texas, Ms. Bergan, who works alone, charges $1,500 to $2,500 for most senior mediation cases. In more expensive Massachusetts, Elder Decisions, which typically uses two mediators, charges $400 to $500 an hour.

But the alternative can be devastating. Litigation takes months or even years and costs run into tens of thousands of dollars.

To find qualified mediators, families can consult the Association for Conflict Resolution, the Academy of Professional Family Mediators or and search for professionals who provide mediation to older adults. (Their ranks are still small, but mediation increasingly happens online, making it more widely available regardless of where family members live or where the mediator practices.)

He doesn't always succeed. If key family members refuse to come to the table, “mediation without their presence would not be appropriate,” Thorpe said. “If there is a sense of coercion or suspicion of abuse or neglect, it is not appropriate.” She expects participants to demonstrate good faith and a willingness to address a solution.

When mediation works, it can preserve or even strengthen bonds, allowing families to celebrate birthdays, graduations, and weddings together despite previous conflicts. “They should be able to be together next to their parents' grave,” Ms. Abrahams said.

William and Melissa Curry and their children, with the youngest participating by speakerphone from South Carolina, spent about an hour and a half talking with Ms. Thorpe and Mr. Larsen.

Shannon Curry described their late April session as “a problem-solving meeting where everyone feels heard, everyone has a say,” including her father. “We talked about compromise. What can you live with and what can't you live with? “It was above all a very loving attempt to find solutions.”

With his mother's consent, the family moved Mr. Curry into his new apartment a couple of months later. Less isolated than he was at home, he became friendly with staff and other residents and seemed to enjoy activities. His wife came to visit him once or twice a day, joining him for meals and fitness classes, and she also seemed to benefit from the social interaction.

He died at 82, eight months after moving. Four years later, his wife died in the same memory care unit, aged 88.

Not all families can resolve conflicts with a single mediation session, but in this case “it was a great help,” Shannon Curry said. “I wish we had done this two years earlier.”

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