Petaluma Mediation

Sick Elders Need the Truth, Not Surgery by Jane Iddings, Blogger

 

What doctors hate is what sick elders need most: a conversation -- a truthful conversation -- about what their realistic options are.

On October 5, 2011, the New York Times published the results of a recent study about late-in-life surgeries. The study found that the elderly (65+) are having painful, often  useless surgeries just when they need to be saying their good-byes instead.

Click  here to read "Surgery Rate Late In Life Surprises Researchers" by Gina Kolata.

Yes, the conversation is very difficult to have. People have different ideas about what to do whether they're the sick elder, the family members, or the medical team. And yes, many people cannot have these difficult conversations without the help of an expert.

The expert to use?

An elder mediator. She or he can help the sick elder, the family, and medical team to come together; to listen to each other so that they understand each other; to discuss the options and what they mean; and to support the sick elder and others in the family discussion and decision.

So let's put the knife down and talk. Let's  listen and understand until we know what it is that the elder wants. Let's help the elder to make choices that are appropriate for the elder's age and prognosis.

If you want to read about the doctor's dilemma, here's a book about the need for doctors to improve the art and science of prognostication: "Death Foretold: Prophecy and Prognosis in Medical Care" by Nicholas A. Christakis.

About the author: Nicholas A. Christakis, MD, PhD, MPH, is an internist and social scientist who conducts research on social factors that affect health, health care, and longevity. He is Professor of Medical Sociology in the Department of Health Care Policy at Harvard Medical School; Professor of Medicine in the Department of Medicine at Harvard Medical School; and Professor of Sociology in the Department of Sociology in the Harvard Faculty of Arts and Sciences. He is the Master of Pforzheimer House in Harvard College.

 

Elder Mediation: Squabbling Adult Siblings by Jane Iddings, Blogger

 

Squabbling Adult Siblings?

It's very stressful to care for our aging parents. It's even more stressful when we adult siblings start acting like . . . well . . . difficult children or sometimes even (dare I say) immature brats (I think that's an oxymoron).

If you find you and your adult sibs are fighting instead of focusing on helping your aging parents, then here's a suggestion: find out how elder mediation can help you to sit down with a professional, caring mediator who can help you to have the conversation(s) you need to have to help your parents. The mediator helps to identify the issues, structures the conversation, and keeps you focused on the goal: making responsible decisions with and about your parents.

Helping our parents is hard enough. Squabbling with our sibs just makes a difficult situation worse.

Here's an excellent article that can help you learn about elder mediation. It's from AARP (September 20, 2010):

http://www.jkbelz.com/pdfs/AARP-SiblingsNeedElderCareMediation.pdf

Elder Issues: Life and Death by Jane Iddings, Blogger

One of the worst nightmares that we face is dealing with the life and death issues of our parents. With our parents living on, way beyond previous generations, incapacitation and unspeakable suffering can precede death by years and even decades.  The parents suffer and so do the family members who are left to make horrendously difficult decisions for them. More often than not, conflicts arise between family members, medical staff, and insurance companies making the situation even harder to face.

Memoir teacher Katy Butler explores this type of conflict in her excellent article "What Broke My Father's Heart."

What broke his heart is that he did not want to live on in an incapacitated state. But early on in his dementia, a doctor insisted on installing a heart pacemaker that had a 10-year life span. The pacemaker outlived his brain and even his life causing tremendous suffering for the father, his wife, and his adult children. The conflict was not within the family, but between the medical professionals and the family. The discussions that might have resulted in better decisions never saw the light of day.

Today we are facing so many heart-wrenching dilemmas about our parents'lives. Regardless of the suffering involved, should we do absolutely everything within our power to keep someone alive? Whose decision is it? Are our parents responsible for expressing their wishes in a health directive that they execute while they're mentally and physically competent so their families aren't burdened with seemingly impossible decisions? What if they don't execute the proper document? Or what if it's ignored? Or what if it's ambiguous where a medical procedure falls -- on the side of making a patient comfortable or on the side of prolonging suffering?

Family members can be at odds about what to do. The conflict that ensues can be between a parent and the adult children, or between the adult children, or between the family and the medical staff, or between the family and the insurance company.

What to do? When the family is in turmoil, each member must search his or her own heart and conscience (the Inner Mediator). Perhaps there is a trusted doctor, or minister, or wise friend, who can help the family talk through these heart-wrenching decisions (Informal Mediator). And then sometimes a professional, trained to facilitate the difficult conversations families must have in order to make necessary decisions, can be the right answer (Professional Elder Mediator).

What is important is to start getting a handle on the conflict. Start with yourself and from there seek the help that is appropriate for your family.

And  . . . make sure you have your affairs in order for your family's sake.

You can find Katy Butler's excellent article on The New York Times online (published June 14, 2010) or by clicking here.