Psychological distress & family conflicts





A survey conducted by the Pew Research Center suggested that the vast majority of adults feel a strong sense of duty to care for their aging parents. And although it should be noted that daughters and sons typically feel a stronger sense of obligation to care for their biological family members, the study also revealed that they are just as likely to provide care for step relatives. Yet, a strikingly small percentage of adults have their care preferences in writing. This lack of a plan can end up being problematic, specifically if there is a care transition, emergency, or crisis, as important care decisions can be left to adult siblings and step siblings who may have different ideas about the care needs of their parents and who may not get along. The truth is that working with siblings and other relatives can be one of the more challenging aspects of caring for your elderly parent, especially during an emergency or care crisis. High levels of distress often hamper your ability to communicate effectively, thereby decreasing the likelihood that you will be able to get everyone on the same page. Simply put, some families, nuclear or blended, are not going to be able to put their differences aside to care for their loved one because past tensions run so deep. Having a mediator assist the family to hold these difficult conversations in a more productive and less contentious way can be an effective approach to improving your ability to collaborate with siblings, while also putting the needs of your parents first. A proactive, mediated approach to communication may also decrease the distress you experience and improve your psychological well-being.

What does it mean to be psychologically well?

Psychological wellness refers to the caregiver’s ability to cope with stress, depression, anger, grief, and anxiety; to problem solve; and to communicate effectively with family, friends, and the rest of the health care team.

The Caregiver Wellness: U model?

Psychological wellness is a part of the Caregiver Wellness: U model, a conceptual model that incorporates the movement toward social, psychological, physical, intellectual, spiritual, occupational, and financial wellness, while also incorporating the empowerment and resilience necessary to take charge of your health on a holistic basis. The components are not chronological; rather, they represent collective components. According to the Caregiver Wellness: U model, being psychologically well means that you have adequate coping skills to deal with the sometimes competing emotions associated with caring for a sick or disabled loved one.
Talking alternatives
In an interview, Gail Goodmanand Ruth Weinreb from Talking Alternatives, a mediation firm that specializes in elder/family mediation, defined mediation as “a process used to resolve disputes rather than submitting the dispute to litigation.” As neutral mediators, they meet with adult children and their aging parents to facilitate a much-needed conversation that addresses the caregiving, housing, medical, legal, and financial needs of aging parents.
When asked why mediation should be used among families caring for aging loved ones, Goodman and Weinreb stated that “family members have an opportunity to express their concerns and emotions regarding the issues being addressed knowing that they will be heard throughout the mediation process. Once the families are able to listen to one another, they can move toward creating a mutually agreeable plan that resolves a specific problem.”
What should your family expect as a result of mediation?

Goodman and Weinreb shared that “the ultimate goal is for families to leave the mediation session with an agreement on all or some of the issues they have addressed and that the agreement would ultimately outline the plan of action the family created, including what needs to be done, who will do it, and a timeframe for accomplishing them.”

Selecting a mediator
When selecting a mediator, please consider seeking out an elder/family mediator. Elder/family mediators have been trained specifically to help families resolve a dispute. You should also keep in mind that the mediator should not be connected to any of the parties to ensure that they are, and can remain, impartial and nondirectional. Mediators should be able to ensure prospective clients that they will maintain the confidentiality of the session and that they will not steer the parties toward any particular decision they are not prepared to make. 
What do you do when mediation goes wrong?
Even though the families may have been unable to reach a resolution to all or some of the issues being addressed. The fact that the family members agreed to come to the table to listen to one another to create a resolution is a sign that the family members care about one another. Most want to find common ground and preserve their relationships. Families who are unable to reach an agreement at the end of the mediation process are still likely to continue the conversation away from the table and eventually reach an agreement.
Two valuable resources
If you are looking for a mediator, please feel free to visit Eldercare Matters: Elder Mediators in America, where you can conduct a state-by-state search. You may also consider downloading the RightConversationssm guide. Although it is up to you and your loved one to determine the right time to begin conversing about preferences for care, you may find the RightConversationssm guide helpful.  Included in the guide are 10 tips for effective communication when having a difficult conversation about the need for assistance with activities of daily living. The guide also includes a valuable, step-by-step example of how to broach difficult topics while keeping the needs of your loved one in the forefront.
1 Pew Research Center, “Social and Demographic Trends: A Portrait of Step Families,” 2011,