Having listened to thousands of stories from family members about all aspects of the dementia journey for 20 years, I felt began to consider the possible benefits of offering mediation sessions combined with a knowledge of the law. I anticipated that this could really help alleviate stress and conflict between relatives/friends of the person with dementia and help them move forwards feeling heard and respected. Hence, 2 years ago, I trained as a mediator and have now worked with many families with unique dilemmas in relation to best interests decisions.
If I could offer some tips from what I have learnt since starting mediation work these would be my top 3:
1.Bear in mind that some people are very risk averse, other are risk takers. These can be innate traits which are difficult to change/modify. (Then you have everyone who is somewhere on that scale depending on the specific details of the risk.) This is important to consider because it can heavily influence approaches to care and support. For example, one adult child might feel terribly anxious about a crisis occurring with a parent with dementia who lives alone, and would much rather the person move to a suitable care home sooner rather than later, as facing a crisis can adversely affect the options that might be available when/if that crisis occurs (which preferred care homes have rooms available for example). A sibling may feel, understandably, that it is too early for their parent to go into care: they are often a person who tends to operate from an optimistic viewpoint believing that what we worry about invariably doesn’t happen (80% of the time in fact, according to research!) But one can undoubtedly see both sides of the dilemma here. Neither party is necessarily right or wrong, one prefers to mitigate risk as far as possible, the other tends to operate on the assumption that a crisis is unlikely and even if it does occur, they can deal with it at the time.
2.There is often one person who is taking on more responsibility for the person with dementia than other people in the family. This builds resentment which then feeds into decision making: returning to the first scenario of risk taking, I could be working with a family where the risk averse person is fairly sure that should a crisis occur then they are likely going to be the person that needs to sort out the problem – this has historically been the case and they are dreading it happening again. So it is not only their risk averse personality feeding into the conversation, it is the fear of having everything land on their shoulders again. Therefor there has to be a conversation about division of duties and agreement about who is going to step in if a crisis does occur. This is when my taking notes and sending them to the attendees after a session can be useful because they feel reassured that no-one is going to go back on an agreement made just because they don’t feel like it or genuinely don’t recall making that commitment.
3.Trying to keep historic family dynamics of the session entirely is virtually impossible but it is a good exercise to acknowledge this every time it happens to keep people on track. The main purpose of mediation is to look forward not backwards. So at the start of the session all parties agree that we are going to work very hard to focus on the decision that constitutes the most urgency and try very hard to keep historical grievances out of the discussions where they bear little relevance to the matter in hand.
For more information email admin@pathwaysthroughdementia.org or call 0203 405 5940 or see the page on our website regarding mediation services: Family Mediation – Pathways Through Dementia
