RENEE MONTAGNE, host:
It's MORNING EDITION from NPR News. I'm Renee Montagne. Good morning.
Today in Your Health, conflicts over caregiving for elderly parents. They are the disputes that can split families apart. Maybe Mom's left a pot on the stove again and the daughters want her to give up her house, or Dad bangs up his car and his kids want to take away the keys. Now there's a new option for families: Call in a mediator.
NPR's Joseph Shapiro explains.
JOSEPH SHAPIRO: Rikk Larsen is a mediator, and he specializes in what's called elder mediation. He talks about one case where an elderly dad was getting forgetful and wasn't paying his monthly bills. His children, who live far away, found out when the father's heat and electricity got turned off. But the elderly man got angry when the kids tried to help.
Mr. RIKK LARSEN (Mediator): Dad simply didn't want any of his kids to know how much money he had and how his finances were organized.
SHAPIRO: One son insisted on going to court to get Dad declared mentally incompetent, so the family could take control of the father's finances. Larsen came in as a neutral mediator. And in the end, the brothers and sisters — along with their father — came up with a simpler solution for their dad.
Mr. LARSEN: He got his accountant to send over a junior member, who would come every couple of weeks, and the accountant would physically write the check out. It became this kind of business meeting that the father had, and he got to maintain his dignity and his sense of control, and the bills got paid.
SHAPIRO: Larsen, who started his firm outside Boston seven years ago, says elder care raises some of the most complex issues in family mediation. There can be a dozen or more interested parties in the room, and all have to come to a consensus. There are no rules or legal procedure for doing so.
Trickiest of all are family dynamics. It's not uncommon to hear one sibling bitterly tell another: Mom liked you best. Larsen says long-established family roles can play out the moment siblings walk into a mediation.
Mr. LARSEN: When they come into a room and sit at a table, they'll very often take the position they took at the dinner table 30 or 40 years ago without even realizing it.
SHAPIRO: Larsen saw that with the mom who wanted to live at home and was being cared for by a daughter who lived nearby. But as the mother kept getting more frail, another sister got alarmed.
Mr. LARSEN: There was a sibling who lived far away and didn't see Mom too much and came in and - what we call swooping - came in and gave a whole bunch of instructions about how this, that and the other thing, let's get a person in during the day and occasionally at night, and making everybody feel guilty.
SHAPIRO: In the mediation session, the sisters talked openly about their own guilt and resentments. And the elderly woman listening to her children surprised them by agreeing it was time to move into an assisted-living apartment.
Good mediators make sure that the older person's voice is heard. Bob Rhudy, an attorney and mediator in Baltimore, says that's important even when someone has Alzheimer's or dementia and might have trouble following the conversation.
Mr. BOB RHUDY (Mediator): Even when there may be some fairly substantial limitations on capacity, people have the ability to say what family member that they are comfortable with, who they care for, respect, trust, where they like to live. They may not have the capability to make substantial legal or financial decisions, but they certainly have the ability to express opinions and wishes and desires.
SHAPIRO: The field of elder mediation is growing, but it's little regulated, and that worries Penny Hommel.
Ms. PENNY HOMMEL (Center for Social Gerontology): In reality, anybody who wants to can put a shingle out that says, I'm a mediator.
SHAPIRO: Hommel is one of the founders of the field. At the Center for Social Gerontology in Ann Arbor, Michigan, she's trained about 300 mediators, a large number of the people who do this around the country. But she worries that too many people doing elder mediation lack the training to negotiate the complex legal, health and emotional issues that surround aging.
And she says that puts a lot of pressure on the consumer to find a mediator who has lots of experience with elders.
Ms. HOMMEL: You look at the training that the mediator has, look at their experience in the numbers and kinds of cases they've mediated in the past.
SHAPIRO: Private mediators charge 100 to $300 an hour for a session that can last several hours. But community mediation centers and others work for a nominal fee, or sometimes even for free.
Joseph Shapiro, NPR News.
MONTAGNE: And we have tips for finding an elder mediator at npr.org.
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