ELDER MEDIATION: An Opportunity for Professional Geriatric Care Managers

(I am happy to introduce my first guest blogger, Marcie D. Cooper. Marcie is a geriatric care manager with several advanced degrees and licenses, such as an MSW, LCSW, and C-ASWCM. She is the owner of her own care management company, aptly named Marcie Cooper Care Manager, LLC, located in Fair Lawn, NJ. I have worked with Marcie for many years on many elder law cases. She is top notch in her field and has become a trusted friend and advisor. Marcie is also a co-founder (with Tony Serra, Nina Weiss and me) of The Elder Mediation Center of New Jersey. She can be reached at Tel: 201-703-1699 or at marcie@GratefulCare.com. Her website is located at >www.gratefulcare.com. Welcome, Marcie, and thanks for participating)

Mediation is a process in which an impartial third-party, called a mediator, facilitates communication between parties in conflict. The mediator’s goal is to assist and encourage disputing parties to reach a voluntary and mutually acceptable agreement. Mediation offers an alternative to court-involvement and at its best, preserves relationships among participants that may have divergent goals.

The relatively new field of Elder Mediation provides dispute resolution services designed to resolve conflicts involving older adults, their families and others. The Elder Mediator works with the parties, helping them to identify their goals and priorities, to generate and explore options and to exchange information in hopes of arriving at a solution.

The kinds of conflicts that might be appropriate for elder mediation include matters with a legal basis (decision-making capability, guardianship, real estate issues, estate planning, and long-term planning); family disagreements (living arrangements, driving, second marriages or partnerships, and neglect); community disputes (landlord/ tenant, maintenance of property, pets, and wandering); bioethical matters ( medical treatment, end of life issues, and advance directive interpretation).

Who is the Mediator?

In some states, courts or legislators impose training or experience on mediators who practice in state or court-funded mediation programs. In most states, a person can offer private mediation services without taking a class, passing a test or having a special license or certification. Many private mediators have some training and experience and are associated with mediation organizations and programs.

Disciplines that have been attracted to this emerging field of elder mediation include attorneys, human service professionals, psychologists, life-coaches and business entrepreneurs. The NASW News (September 2006) included an article by Lyn Stoesen entitled “Mediation a Natural for Social Workers”.

The Role of the Geriatric Care Manager

The Elder Mediation Center of New Jersey (EMC-NJ) has developed a unique model that views the Professional Geriatric Care Manager (PGCM) as an integral part of the elder mediation process. Using an Ethical Model for elder mediation, EMC-NJ considers the professional geriatric care manager to be essential when working with parties who are in dispute and are seeking a solution involving frail or vulnerable older adults.

The Pledge of Ethics of the National Association of Professional Geriatric Care Managers guides our elder mediation practice. This approach differs significantly from other mediations models in that the PGCM is not the mediator. The PGCM supports the mediation by providing a care management assessment and formulating a plan of care that is used in the mediation process. The PGCM brings objective and professional guidance to a situation that is often fraught with emotion and disagreement. In recognizing the importance of the PGCM and the plan of care, the mediator uses the skills and recommendations of the PGCM to assist the participants in generating real options.

Ethical Principles

As a fundamental ethical ideal, autonomy represents the individual’s ultimate right to make choices in life. The NAPGCM Pledge of Ethics addresses this in our principle of self-determination. In the Ethical Model of elder medication, the PGCM develops a plan and goals based on this ideal of self-determination.

The geriatric care manager provides an evaluation to assess the extent to which the older adult has the capacity to participate in the mediation process. If it is determined that the older adult has limited capacity to participate, the care manager’s role is to provide the mediator and the parties with the voice of the older adult and to act as an advocate to uphold the principle of autonomy.

Should it be determined that the older adult lacks the capacity to fully participate in safe and appropriate decision-making, the care manager enters the mediation process to ensure that no harm is brought to the older adult. In this Ethical Model of elder mediation, the mediator is considered ‘neutral’ and the PGCM is an advocate for the best interests of the older adult.

In traditional mediation, such as divorce mediation, the parties may agree on a resolution without full knowledge of the facts and without an understanding of the risks associated with decisions that are made during the mediation. In elder mediation this could have dire consequences. The medical, emotional, safety, financial, residential, social and spiritual needs of the person most vulnerable must be considered. The professional geriatric care manager brings these issues to the table.

NAPGCM addresses the issue of loyalty to the client as a duty, even if it conflicts with the interests of others. The care manager in the ethical model of elder mediation realizes this ideal in its purist form. The NAPGCM Pledge of Ethics ensures that we strive for cooperation of all individuals involved in providing service and care. This basic tenet is shared by the innovators of the ethical approach to elder mediation.

For more information about elder mediation, visit www.eldermediationcenter.com.