by Linda Fieldstone, M.Ed., Judge Michelle Morley, Sue Bronson, LCSW
It was an enormous honour to be at the United Nations for World Elder Abuse Awareness Day to talk about eldercaring coordination, a conflict resolution process developed specifically to protect the autonomy and safety of ageing persons. Thank you to the International Federation on Ageing, and the reminder it gives us to raise our collective consciousness about the treatment of our ageing, and to all of you for your work in that direction.
Let your mind wander off for a minute, to the warm and aromatic kitchen of an ageing person who is surrounded by loving family members, all focused on the ageing person's care, safety and well-being. It's a Sunday afternoon, and the family has come for a visit. While growing older has its challenges, this parent or grandparent's ageing process is an inspiration, a source of joy for the family, celebrating the life of their ageing loved one and the many happy occasions shared throughout the years together.
Now imagine, instead, if you were an ageing person losing independence, feeling scared, sad and alone, perhaps confused and isolated from loved ones. Instead of at your kitchen table, your grandchildren are home alone while family members are seated opposite one another in a courtroom to argue over your care. The tables between them have become battlegrounds for revenge, blame and ridicule. For some families, overseeing a loved one's transitions through ageing can be a painful reminder of the past. They remember the tumultuous ways in which they have dealt with disagreement and become consumed by disappointment, anger and loss. Instead of being supportive during the ageing person's transition, their personal positions over-ride their ageing loved one's needs and safety. Now, the family members only see each other when they go to court, urging their lawyers to degrade and belittle one another. Strategic litigation tactics heighten the hostility between them as the ageing person fades dramatically into the background, whispering, I just want my family to get along!
Eldercaring Coordination is a solution - for the ageing person's anguish and the family's aggressive actions. Eldercaring Coordination is a compassionate, court-alternative response to family conflict, one that engenders respect and protection for the ageing person. This court-ordered dispute resolution option focuses on reducing family conflict and minimizing risks and abuse to respect and preserve the dignity and quality of life of ageing persons. To do that, the ageing person's voice must be at the centre of the conversation, yet all the voices of concerned family members must be heard.
How can that happen A high conflict family dispute resolution specialist called an Eldercaring Coordinator helps families refocus on the ageing person, set their disagreements aside peacefully, and elevate the ageing person's needs and preferences. Families are referred to eldercaring coordination in a court proceeding, once the family conflict is identified by the court, or upon the request of the ageing person, family, attorney or guardian. They can be recognized by their frequent motions to the court regarding non-legal issues, cross allegations and unsubstantiated claims, safety concerns, and withholding of information, money, time and affection of the ageing person. The court orders who participates in eldercaring coordination: the elder, legally authorized decision-makers, and others by invitation. Why does it take a court order when we want to enable the family to resolve disputes out of court Because all too often family members in conflict refuse to meet together unless they are court-ordered to do so.
The eldercaring coordinator enables family members to develop more effective communication and problem-solving skills, and to develop and implement a care plan that is flexible according to the transitions of the ageing person. As the needs of the ageing person change, the family returns to the eldercaring coordinator, rather than reverting to the gavel of a judge for decision-making on non-legal issues.
Family conflict regarding ageing persons is an issue without borders, a global issue, unattached to economic, racial, religious, ethnic or national boundaries. Worldwide, our ageing population is growing exponentially as people are living longer. Where ageism exists, the mistreatment of ageing persons perpetuates the potential for adverse effects on their families. Family conflict involving ageing persons is not just a social problem, it is a medical problem, with health implications. The effects of conflict on this vulnerable population is a societal issue, involving not only the quality of life but the length of life of our oldest population. Research shows the many ways that an ageing person's health is compromised when caregivers are overburdened, treatment is delayed, decisions are obstructed, and their safety is jeopardized by family conflict. And it doesn't stop there The cumulative effects of prior and current generational conflict are harmful, resulting in a lack of social capital and accrued interpersonal skill deficits. So, even the youngest generations benefit through eldercaring coordination, as it reduces the tension of their parents, heals ruptures in family relationships, and provides a dignified model of conflict resolution for them to integrate. Recognizing that high conflict in families is a health issue for ageing persons, United States StayWell Medicare/Medicaid health plan provider has contributed to providing scholarship funds for eldercaring coordination in Florida. Eldercaring coordination is based on the idea that with open communication and effective planning, family members can come to the best resolution to resolve disputes, said Elizabeth Miller, president of Staywell Health Plan. Ongoing conflict can put undue stress on a family and delay needed medical treatment and therapies, adversely impacting the health of elders and their children. When we help our ageing loved ones, we are helping our children as well.
Therefore, it is unconscionable that our attention to the abuse of ageing persons lags twenty years behind our focus on child abuse. The World Health Organization estimates that one of every six people 60 or older will suffer some form of abuse, with only 1 in 24 incidents reported, even though spouses and adult children are the most likely perpetrators. We all have family secrets and in older families, the members have even more time to become experts at keeping them hidden. The root of some secrets can lie deep, sometimes covered protectively by fear, and sometimes covered by shame, intimidation and coercion. An accusation based on assumptions and conclusions from limited information can be difficult to discern from actually hidden abuse. Ongoing exploitation may not be admitted even when confronted. Uncovering the truth becomes even more complicated in high conflict situations as harsh feelings, misperceptions and baseless conclusions cloud and conceal the reality behind family secrets.
Eldercaring coordination becomes the key to unlocking these mysteries and safeguarding the elder from conflict, threats of harm and risky situations. Eldercaring Coordinators use a trauma-informed, person-centred approach so they are better able to guide families through a supported decision-making process that protects the health, safety and well-being of their ageing loved ones. The eldercaring coordinator is trained extensively and experienced with how abuse may be minimized, rationalized, and kept a secret. Since Eldercaring Coordinators are court ordered to work with families for up to two years, it gives them time to develop relationships and hear the concerns of each person participating. They provide ongoing screening and are sensitive to hints of abuse, neglect and exploitation through unfolding conversations. When risks are present, Eldercaring Coordinators help families distinguish drama caused by vendettas from what is credible, so family members can provide the right response to protect their ageing loved ones. Eldercaring Coordinator is there to complement, not replace, services and can help the family develop a support system, connect them with available resources as needed, and notify appropriate authorities when warranted.
How was eldercaring coordination developed In 2013, the Association for Conflict Resolution convened twenty well respected the United States and Canadian organizations, who worked with the twenty statewide organizations assembled by the Florida Chapter of the Association of Family and Conciliation Courts. The Association for Conflict Resolution Guidelines for Eldercaring Coordination were unanimously approved the next year by those organizations, who recognized that it is time to protect our elders by engaging their families in the process of their care. There are currently six states in the United States with Pilot Sites for eldercaring coordination, and others interested in the United States as well as Canada and as far away as Australia. The eldercaring coordination process is being researched by Dr Pamela Teaster, director of the Center for Gerontology, and Dr Megan Dolbin-MacNab, Director of the Doctoral Program of Marriage and Family Therapy, both at Virginia Tech University. Their studies are informing best practices in eldercare coordination as it develops. The Elder Justice Initiative on Eldercaring Coordination provides the framework needed to foster the development of eldercaring coordination across the globe, with continuous support, including standardized procedures, forms and training. The Initiative is ready to include your communities to the growing number providing access to this unique conflict resolution process and help you bring eldercaring coordination to ageing persons and their families in your communities.
The benefits for eldercaring coordination is a distinct contrast to the cost of ongoing litigation and court fees:
Even the youngest generations benefit through eldercaring coordination, as it reduces the tension of their parents, heals ruptures in family relationships, and provides a dignified model of conflict resolution for them to integrate.
Think of how you would want the story to unfold if it was your parent, grandparent OR YOU in the middle of family turmoil. Do you want to spend the last chapter amidst the downpour of flying accusations and heated arguments A situation ripe for abuse and exploitation. Or would you prefer to have a comforting time with family members collaborating to meet your needs and keep you safe Remember what parents want most. for the family to all get along! Eldercaring coordination honours that ageing persons wish by giving their family the tools and support needed to create a legacy their ageing loved one can feel proud of continuing for generations, a legacy of peace in the family.
For more information check out the Eldercaring Initiative Page or contact the Elder Justice Initiative on Eldercaring Coordination Co-Chairs:
Linda Fieldstone, M.Ed. | LindaFieldstone@outlook.com
Sue Bronson, LCSW | SBronson@wi.rr.com
Judge Michelle Morley | MMorley@circuit5.org