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ELDERCARE FACILITATED DIALOGUE & SHARED DECISION
MAKING FACILITATION WORKS FOR FAMILIES FACING CHANGED
LIFE CIRCUMSTANCES WITH ELDERLY PARENTS
Families today are assuming responsibility for the informal care of over
75% of elderly family members, and are often faced with difficult decisions
from a bewildering array of choices including alternative living arrangements,
financial issues, and multidisciplinary care. In the best of circumstances,
this can be a stressful process, and sometimes leads to disagreements,
confusion, and conflict at a time when the best intentions of the family
are to work together for the needs of a loved and respected aging family
member. Often families do not want to admit or acknowledge they have a
family dispute, but they all know their interactions are strained and
not as comfortable as they may once have been, to whatever degree.
What is Eldercare Facilitated Dialogue & Shared Decision
Making?
Eldercare mediation (see above) is about dialogue and decision-making;
it can also be referred to as Facilitated Shared Decision-Making. Facilitated
Dialogue and Shared Decision Making is an alternative to help families
work together meaningfully and productively. With the help of a trained
professional mediator facilitator, family members engage in meaningful
conversation, share information and perspectives, obtain outside medical
and emotional and social evaluations as requested, explore and evaluate
options, and develop workable solutions through a process that promotes
open and positive communication.
The facilitator is a trained mediator and neutral that does not offer
advice, but instead offers structure for a productive conversation. The
facilitator believes that each family is unique and knows best what solutions
will work for their family as a whole. For families in conflict or simply
wanting help through a transition, eldercare facilitated dialogue and
shared decision-making offers a process that can reduce stress for a family,
including the elderly parent, and prevent a crisis. It can also reduce
stress and conflict between the family and other care providers such as
hospitals, nursing homes, and assisted living facility staff.
The process is flexible yet durable. Not only might the outcomes include
decisions about living location, personal and medical care responsibilities,
property and asset management, appropriate compensation for care, emergency
communication plans for families, and plans for ongoing communication
of family members, but they may also include decisions and plans for quality
of living such as how to stay in contact with friends, church members,
pets, hobbies, children, and even a spouse living in a separate facility.
For example, Ms. S. found herself in a difficult situation. Her 74 year
old mother, living out of state, was recovering from a broken hip, but
was not yet able to return to her own home. Ms. S. was working split shifts
as a nurse and living in a rather small second floor apartment. She and
her sister talked occasionally but had not been close for years. Her brother,
recently divorced, was struggling himself and did not think he could offer
much help. They had decisions to make, but discussion began to escalate
into arguments. The family agreed to try mediation with a mediator of
Louise Phipps Senft & Associates/Baltimore Mediation and came together
to create a plan that would provide the needed care for their mother with
the resources and time each of them could offer. As is often the case
in mediation, they became quite creative in their approaches and developed
a solution that not only achieved their goal of providing the best care
they could for their mother, with resources provided as each was able,
but also brought them closer together as a family in the process.
Who Can Be Involved in Eldercare Facilitated Dialogue and Shared
Decision Making?
Anyone who has an important stake in the decisions being made –
the older person, a spouse, sisters, brothers, sons and daughters, care
facilities, physicians, mental health providers, or just the family. If
there is a problem because of geographical distance, teleconferencing
can be arranged so that the process is truly shared decision-making. For
families who make the commitment to work collaboratively, the road that
seems paved with stones is often found to be smoother.
Family Facilitators of Louise Phipps Senft & Associates/Baltimore
Mediation believe in Better Process…Better Outcome.
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