Elder Mediation and Bio-ethical Mediation

May 1, 2009 · Filed Under Mediation - General · Comment 

By Dave Finch

Few disagreements there are whose resolution cannot be aided by mediation and those involving the care – medical as well as financial – of the elderly are certainly not among them, though the field of elder mediation has been slow to gain traction.    Elder mediation or guardian/conservatorship mediation as it might sometimes be called is now recognized as an important, valuable and needed service field.

The term, Elder Mediation, is to be preferred because, while it encompasses those issues commonly dealth with the formal legal structures of guardianship and conservatorship, issues commonly arise in which troubling conflicts arise that can be resolved without court intervention and to the more tailored satisfaction of all concerned.

One of the more common situations calling for mediation is when family members differ  among themselves or with the elder on the right course of action for the elder to take in managing her resources, putting the elder in the uncomfortable, often confusing, position of having to choose one loved one’s preferred approach over another’s or of refusing the proffered advice of one.  These situations arise it seems most often when the differing opinions are arrived at without sufficient understanding of the best interests of the elder or without sufficient decision making skills.  A mediator schooled in ferreting out essential interests, often not fully understood by the elder herself, and in identifying poorly understood biases of conflicting parties, can help the parties hear each other more clearly, consider needs and interests previously overlooked, identify any outside help that would ease resolution, and find a harmonizing solution that is the truly best for the elder.

This kind of mediated approach is uniquely helpful in what has come to be referred to as bio-ethical mediation, in which the neutral aids the communication process in conflicts involving the elder’s medical care.  Here again family members may take positions on what care should be given the dangerously ill or terminally ill elder without separating their own agendas from the better solution.  Often conflicts arise between doctor and patient, where, for example, the doctor does not feel the patient has sufficient understanding to accord him autonomy in treatment decisions.  Conflicts also may arise between nurse and doctor, hospital administration staff and treatment staff, and between  doctors of differing viewpoiints.  Achieving agreement here on what best serves the interests of the patient is a paramount consideration and the mediator may be the essential instrument for the protection of those interests.