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

Section 2: Elder mediation in practice

C. European Examples of Elder Mediation

a. Elder Mediation Projects—Berne, Switzerland

Elder mediator and project leader, Helen Matter, recognized the importance of elder mediators to be committed to a code and standard. As a result she translated the entire "Canadian Code of Professional Conduct for Mediators Specializing in Issues of Aging" into the German language.

Helen Matter is leading an elder mediation pilot project of Pro Senectute Region, Berne, through a group called "Innovage" (www.innovage.ch). This organization offers mediation to non-profit organizations on a voluntary basis, using the competences of its members to develop and/or coach various projects. This project is in the very early stages and its goal is to introduce Elder Mediation to the social workers in the local regions. Since these social workers often get in touch with their clients and their families before conflicts have escalated, the preventive aspect of elder mediation can be studied as it gives focus and support to this group.

A joint pilot project is being developed with the Swiss Nonpartisan Complaints Office for Older People (the independent ombudsman for older people) and CURAVIVA (Swiss association for long term care homes and organizations) to explore how elder mediation can support quality of care in long term care homes. More information will be forthcoming over the next few months (Lester, 2010).

b. Elder Mediation Project—Dublin, Ireland

A new mediation service focusing on family conflicts that involve or have the potential to affect, an older person living with a progressive dementia was launched in June of 2009 by Áine Brady, Minister of State for Older People. The service is a pilot project involving collaboration between the Alzheimer Society of Ireland and Northside Community Law Foundation. Its launch coincided with an international summit and symposium on elder mediation held in Dublin and featured speakers and delegates from the US, Canada, Europe, the UK and Ireland who highlighted the elder mediation model as a good practice.

The mediation service helps people with Alzheimer's disease or other dementias and their caregivers and families to make difficult decisions regarding the care of the person served, while dealing with any other family disputes. It involves specially trained volunteer mediators working with people with dementia and their families, with community and, where necessary with service providers in the Dublin region.

"Changes in people's needs and roles as they age can impose new stresses on elders and their loved ones. Faced with these challenges, new ways of coping with evolving relationships and changing realities are vital," says Maurice O'Connell, Chief Executive of the Alzheimer Society of Ireland and President of the Alzheimer's disease International. "Elder mediation provides an opportunity for the older person and all concerned members of the family to participate in creating a workable plan for the future," he said. O'Connell added that up to one in three calls to the National Helpline during the first quarter of 2009 were from families dealing with increased stress, family conflict and complex decision-making situations. There is no doubt that concerns of preventing or reducing abuse and neglect is as serious in Ireland as it is in Canada.

c. Elder Mediation Project (Great Britain)

Yvonne Craig, a pioneer of Elder Mediation in Britain, conducted research focused on the theory that mediation could contribute to the prevention of elder abuse at the early stages of conflict. She maintained that life transitions experienced by the elderly often led to stress and conflict. If this conflict was suppressed or exacerbated, their relationships could become painfully poisoned or erupt into threats and violence. She and her team developed the Elder Mediation Project with the belief that older people do well when they develop their natural skills in managing their own conflicts (Craig, 1996, 1997).

The premise of the Elder Mediation Project was that elder mediation had the potential to provide a holistic approach to the prevention of some kinds of elder abuse, where unresolved conflicts were perceived as threatening events. While the Project recognized the valuable contribution of counseling with older people who were vulnerable to elder abuse and intergenerational conflict, it also maintained that mediation was useful, especially where vulnerable older people are involved as mediation promotes empowerment, balancing power relationships with a respected arms length third party. A case study provided by the Project described how the involvement of an objective, respected third party was able to help an elderly couple resolve disagreements over housekeeping money where their son has previously always dominated discussions. In this situation the mediator facilitated the participants' communicating fairly (Craig, 1998).

Craig examined the contribution that mediation can make to the prevention of abuse of the elderly in families, institutions, and society and examines elder care and mediation services in the United States, Great Britain, and Europe. She researched the theories of elder abuse and mediation using mediation as a minimal form of intervention to empower older people to resolve their conflicts and thereby help prevent elder abuse. Research was undertaken to test the theory that at early stages of relational conflict, mediation can contribute to the prevention of elder abuse (Craig, 1997). Craig examined elder care in the United States, particularly the long-term care ombudsmen (LTCO) who used mediation as well as advocacy and other skills in their work. She researched the results of participant observation research in large and small institutions and in community-based LTCO services and volunteer services in the United States (Craig, 1997).

Craig also provided examples from the use of mediation in medical ethics cases (Craig, 1996) where older people were confused by conflicts between health and social care professionals with relatives about questions of intensive care or further treatment. She advocated that patients' voices needed to be heard as they worked out how they want to prepare for dying, and for possible Advanced Directives. Craig maintained that elder mediation could be most influential in mediating family conflicts involving issues around moving to residential care. Craig suggests that although mediators never advise or tell people what to do, the way in which they reflect back, or reframe what they have heard from those involved, can highlight the feelings about being burdens, or of fearing institutions, out of which their own alternative solutions may emerge. Problem-solving, constructive choices can then be made. This may involve strategies of face-saving for an overworked and angry caregiver. Mediation can encourage the caregiver to explain how stress makes her unintentionally aggressive, and enables the older person to express forgiveness, after which both are emotionally free to focus on practical remedies such as increased home help (Craig, 1998).