Preliminary results from a specialised conflict resolution program for seniors, run between a provider and a counselling group, have shown facilitated mediation may be an effective way to resolve conflicts between older people, their families and care providers.
The decision to enter residential aged care or begin community care can be complex for an older person and their family. When conflict arises over an older relative’s care or financial arrangements, a family may prefer not to settle the manner through legal means, especially as these processes can be costly and adversarial in nature, which can damage relationships further.
The Seniors Mediation Program, a trial initiative and partnership between Benetas and FMC Mediation and Counselling Victoria, was established to resolve such conflict in a non-adversarial way. The specialised mediation program was based on a person-centred approach and wellness model, which aimed to include the older person’s voice, wants and needs at the forefront of the resolution process, even when a person may have lost capacity.
While the trial of the program was still ongoing, preliminary results suggest the program was effective in preserving family relationships, improving communication and reducing decision-making stress for all parties, and in most cases, had led to formal agreements.
Giving seniors a voice
Jenni Dickson, executive manager of quality and service development at FMC Meditation will present on these preliminary findings, as well as the opportunities and challenges of elder-based mediation at the upcoming Australian Association of Gerontology Conference in November.
“Our main aim is to make sure that the older person is central and has a voice in the conflict,” she told Australian Ageing Agenda. “They may have a power of attorney acting on their behalf, but they may very well have wishes that they want to be included and including them in the process where we can and where it’s appropriate is a real point of difference.”
Ms Dickson said senior mediation sessions were also required to be more flexible than traditional mediation sessions, catering their location and length to the older person’s capacity and mobility.
Upon beginning the mediation process, the older person was assessed by a healthcare professional. Interviews, either in-person or over the phone, were then conducted with all parties prior to commencing mediation sessions. During each session, an expert mediator would facilitate discussion and set outcomes that worked for the older person and respected their needs. An advocate or support person to assist the older person may be used if required.
The outcomes of the program were measured by whether a formal agreement was reached and whether this agreement was adhered to at six weeks and at six months. Qualitative measures – such as the impact on family communication, reported wellbeing and feelings of distress – were also used.
Most disputes in the trial so far had related to financial, family or facility conflict. Ms Dickson also saw advanced care planning as an area where specialised mediation may be helpful.
Ms Dickson said one of the main challenges to the trial so far had been recruitment, particularly getting all parties to agree to attend a meditation session.
“When we’re dealing with this type of conflict, because it’s often long-standing family conflict… it can be quite challenging to get them to agree to sit down and communicate in a respectful setting. So that’s one of the challenges we’re looking at now, how we can better engage those people to bring them to the table,” she said.
Learning how to implement programs: provider
Aaron Wyllie, a research assistant at Benetas who has worked closely on the program, said that from a provider perspective, the trial has provided opportunity to learn how to best facilitate and promote such programs on the ground.
“It’s really useful to understand barriers to involvement. We have a service which appears to be quite effective in dealing with conflict, but we need now to take that one step further and look at how we can make sure that the people who need that service are able to get that service in a way that they want it,” Mr Wyllie told AAA.
Referrals pathways to the program had been adjusted throughout the trial to deal with such issues. Referrals to the program may come from Benetas staff, who pick up on strained relationships between visiting relatives or within the home. Other red flags, such as fees not being paid on time, may also encourage staff to refer an older person to the program. Benetas had also started to promote the program through facility and community managers, and through its customer service team, who may note communication issues within a family prior to admission to a facility.
Ms Dickson said that specialised mediation for seniors was still in its infancy in Australia, however the need for it would only increase as the population aged. She said that in the long-term she would like to see mediation programs used before families go down the legal pathway to guardianship or administration.
To find out more about the Seniors Mediation Program please contact the Benetas Customer Centre on 1300 236 382 or FMC on 1800 639 523.
The AAG National Conference takes place at Alice Springs Convention Centre from 4-6 November.
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