Exploring the Role of Elder Mediation in the Prevention of Elder Abuse

Appendix A: Bibliography

Appendix b: Code of professional conduct for mediators specializing in issues of aging

Code of Conduct for Mediators Specializing in Issues of Aging (150 KB, PDF Help)

Appendix C: Elder mediation canada
Certification and training standards

(Consultation and collaboration with stakeholders held over several years—with input both nationally and internationally—led to the development of the following document. It is considered a living document and is updated on an annual basis.)

Background

In the early 1990's the service of elder mediation was recognized as being very helpful to families and others addressing age related issues. Consistently, evaluations from those who used the service reported how mediation with age related issues had heightened awareness of situations, improved family communication and stimulated more involvement and support from previously uninvolved family members. Puzzled families would lament, "Why haven't we heard of this sooner?" Participants in the process were surprised to the degree that mediation helped bring focus to their needs and how it challenged everyone to assist in reducing stress while heightening quality of life.

Included in many of these mediations were people living with early stage, progressive dementias. Mediators and other stakeholders were concerned as to when it was appropriate to include a person if there was threat of due harm.

I am so appreciative that dementia in the later to severe stages is highlighted in certification standards with regard to the person diagnosed attending mediation. I believe that to involve persons when they are too impaired is very inappropriate, ineffective and often harmful. We have an ethical responsibility to do no harm. This is so important for elder mediators to understand if they choose to work in this specialized area. —Gerontologist, Jena Winterburn

I will never forget the testimony from the woman, [Pat Mutch] and her family who used mediation. What an inspiration and reminder to us how important it is to be informed mediators. —Ernest Tannis, lawyer, mediator, and radio show host

Elder mediation has a strong wellness and prevention component that can often go unnoticed. It assists families in identifying ways they could support each other while keeping levels of conflict to a minimum. The families who agreed to have a mediator assist them with focused conversations reported a marked decrease in stress levels. For those dealing with moving a family member to community or nursing care—a much feared and drastic move—the outcome of mediation was often reported to be an increased likelihood of the person being cared for at home longer. Also significant was there was a heightened ability to distinguish from when people needed "counselling" and when they needed "mediation".

During a workshop in 2007 at the Alzheimer Disease International convention in Caracas, Venezuela participants representing organizations spanning the globe expressed concern about referring to mediators when there was no standard or roster in place for mediators specializing in age related issues. Meanwhile there was considerable excitement at the prospect of elder mediation assisting families and professionals addressing age related issues. The need for professionally trained mediators with sensitivity to these issues was identified along with the need to develop a plan for a certification process. As there was no elder mediation certification process in place, organizations reported being hesitant to refer for fear that the mediators would not be adequately trained or sensitive to the issues that might arise—especially with chronic illnesses and progressive dementias. The first World Summit & Symposium on Elder Mediation (Ottawa, Canada—May 2008) supported this thinking and called for action.

In late 2008 the code was updated, elder mediation and specific training opportunities were hosted, and groundwork that gave considerable support to the development of a pilot certification process began. Family Mediation Canada was supportive through the entire process and several of its Board Members donated time to the project. Family Mediation Canada gave permission to adapt materials as needed and many of their Board members have stayed involved offering expertise along the way.

Vision

To inspire excellence in the practice of Elder Mediation in Canada.

Mission

The mission of Elder Mediation Canada is:

Goals

  1. To advocate for the profession and specialty of Elder Mediation both nationally and internationally.
  2. To raise awareness of Elder Mediation as an important option on the continuum of comprehensive care.
  3. To alert professionals working with older adults of the ethical responsibility to promote mediation as a viable option and to promote the prevention of elder abuse.
  4. To promote adherence to a code of professional conduct
  5. To facilitate the sharing of elder mediation knowledge that exists, through email, webinars, workshops, symposiums, conferences, meetings, professional contacts, papers, discussions, publications, a virtual institute and other media.
  6. To promote elder mediation research that evaluates how families using the service experienced mediation and how mediation can influence quality of care, how they found it helpful and how it can be improved.
  7. To maintain a certification plan for elder mediators interested in maintaining high standards of education, conduct, ethics and adhering to a consistent, credible, national and international standard.
  8. To provide ongoing collaborate and consultation opportunities.

Elder Mediation is a cooperative process in which a professionally trained elder mediator helps facilitate discussions that assist people in addressing the myriad of changes and stresses that often occurs throughout the family life cycle. Elder mediation typically involves larger numbers of participants including older people, family members, friends and others who are willing to give support. Depending on the situation it is not uncommon to include paid caregivers, hospital staff, nursing home and or community care representatives, physicians and other professionals. Elder mediation is a confidential process unless participants otherwise agree.

Over the past 20 years mediation with age-related issues has been emerging as a distinct specialty in the field. Elder Mediation is now being recognized internationally as an important step in the continuum of care—promoting wellness, developing prevention strategies and enhancing quality of life. The focus is on addressing concerns and issues while maintaining and strengthening the myriad of relationships critical to the well-being of the older person. Typically it involves many players who are concerned or affected by unexpected or unresolved events, or a multitude of other issues including:

Elder Mediation is based on a wellness model that promotes a person centered approach for all participants—tapping the collective creativity while exploring the many ways that will best work to enhance continued quality of life for all concerned. Often family members who come to the table with poor communication skills are surprised at how, with the help of a mediator, they actually learn new ways of talking with each other. Participants in the mediation identify topics they wish to discuss or issues they wish to resolve and work towards reaching agreements that attempt to promote well-being and quality of life. Ideas for ways of helping are generated as people come together and talk about how they can move forward together supporting each other, often through some very difficult times. Elder Mediation promotes communication and the involvement of more family members and others who wish to help. It is becoming more common for hospitals, nursing homes, or community care homes to participate in and often to promote and initiate the process.

Elder mediators who are trained in this specialty apply their highly developed people skills to the intricate life issues facing older people with sensitivity, acute listening skills and inclusive language to make sure the mediation flows respectfully. Elder Mediation is designed to create a better way to provide for co-operative conversations and conflict resolution strategies relating to issues of aging. Research is underway to explore the benefits experienced and reported by family members. It is well recognized that the level and intensity of family support is a very important factor in the older person's adjustment to changes in their way of life. Family members who may have been uninvolved for years are invited to become involved. It is heart-warming and not surprising how many family members and close friends answer the request to participate in mediation and to provide support. Relationships are strengthened, close bonds are established, and in some situations, bonds are re-established. Family and organizational resilience can be at its best.

—Judy McCann-Beranger

Elder mediators use a client centered model of mediation where all who are willing to be involved in the process are present, where all interests are considered and any safety, abuse issues, imbalances of power or vulnerabilities are screened, cultural perspectives and implications are considered and addressed before the decision to mediate is made. The elder mediator discloses any perceived or real conflicts of interest and promotes full disclosure of information between and among all the participants. With regard to safety and well being, when apprehension surfaces by any of the parties the elder mediator addresses such before agreeing to mediate. When the mediation proceeds elder mediators stay sensitive to cultural matters that may affect the process. The elder mediator refers to independent legal advice and refers to another mediator if s/he does not have the expertise required to accept the mediation.

Elder Mediators are committed to act in ways that are:

Empathic
The feeling or capacity for awareness, understanding, and sensitivity one experiences when hearing or reading of some event or activity of others.
Person-centered
Supporting and honoring the people and partnerships amongst all concerned participants (individual, family, family support systems, care providers) while ensuring the preservation of self-hood, dignity and quality of life at all times.
Respectful
Ensuring integrity and fairness and that all participants are respected and valued during the mediation process. Mediators are committed to using respectful, inclusive language.
Responsible
Maintaining accountability for the elder mediation process and for a viable outcome.
Democratic
Promoting equity of all participants in the mediation process regardless of gender, age, culture, religion or socio-economic status.
Collaborative
Working in partnership with others to support the best outcome as determined by the participants.
Quality
Ensuring the mediation process is based on evidence-based practice and is accessible and focused on an achievable outcome.
Timely
Ensuring the mediation process is conducted in an efficient and timely manner.

Certification Process

A certified Elder Mediator (Cert.EM) has at least 100 hours of basic mediation/family mediation training and an additional 100 hours of age related elder family mediation training including: Family life cycle, & intergenerational dynamics age-related, elder abuse, family and elder law, power imbalance, grief and loss, ageism, guardianship, dementia and chronic diseases, financial and state issues, ethical issues.

Certified elder mediators have current membership in their national/country mediation organization and adhere to the code of professional conduct. They hold insurance for the practice of mediation.

To enter the certification process the Candidate will submit a completed application along with curriculum vitae, proof of insurance and three letters of reference. The candidate is expected to hold a university degree in a related discipline unless the equivalent in work and life experience can be supported, validated and agreed upon. A previous mediation certification from another body would be considered an asset as well as an approved practicum or supervision term or proof of a minimum of ten elder mediation cases that each averaged not less than ten hours.

Elder mediation certification candidates will have opportunities to demonstrate their empathic qualities, values, mediation skills, ability, and knowledge. They will demonstrate their commitment to self-empowerment and self-determination and demonstrate learning in the general area of age related issues and the family life cycle.

The applicant will be required to present a role play or live demonstration that will be evaluated by at least two approved assessors. This can be done by submitting a role play video of an elder mediation for evaluation. A self evaluation of the segment will be requested.

(When the applicant does not meet minimum requirements an interview will be held and the role play may be repeated upon request and within ten months of the original demonstration.)

After the skills assessment has been successfully completed a written, three hour exam with be required.

Recertification and proof of annual training and practice is required every four years. Knowledge of evidence based research and its implications to the practice of elder mediation will be expected. At least 17 hours of training and professional development is necessary as well as an average of ten elder mediations/co-mediations/coaching opportunities a year.

Assessment records will be held in confidence by the certifying administrator for a period of two years and a cover file will be maintained indefinitely for historical records.

The Certifying administrator will ensure all documents are received in a timely fashion and will notify the co-chairs of the certification committee when all documentation are in order and completed for endorsement from the certification committee. Notification of successful completion is done by the certifying administrator or either of the co-chairs of the certification committee.

Any concerns or reports of inappropriate ethical conduct will be investigated, time lines will be considered, and the certification committee will bring a recommendation to the Executive Committee for an in camera decision.

Elder Mediators must ensure that they have the specialized education, training and skills necessary to undertake specialties within the specialty—for example guardianship.

The certifying administrator will be a resource to the certification committee. The certification committee will oversee the development of policy and updating of policy to recommend to the Board of Directors. They will review and recommend updating on an annual basis with regard to suggestions for the code of conduct, the exam and any other part of the certification and evaluation process. The committee will address any issues that are presented by the certifying administrator that arise with regard to the certification of candidates and provide a recommendation to the executive of the Board when appropriate.

The certifying administrator will be a certified family mediator and either a certified elder mediator or elder mediator candidate with demonstrated interpersonal skills and ethical responsibility. S/he will manage the certification process, maintain the certification records, update the certification roster, and be the initial point of contact with regard to the candidates. The administrator will work directly with the certification committee, keeping a current roster of certifying assessors and trouble shoot as needed. The administrator will ensure that the certifying assessors hold current certification in elder mediation, are current in their practice, committed to continuous learning and willing to take training as necessary to update their skills.

Concerns regarding certification will be addressed by the Certifying Administrator who will consult with the Co-Chairs of the Certification Committee.