acr and flafcc task forces: broadening the definition of … webinar 12-12-2017 material… · afcc...

12/11/17

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ELDERCARING COORDINATION: Adding room at your table for the rest of the family!

Linda Fieldstone, M.Ed. ACR/FLAFCC Elder Justice Initiative on Eldercaring CoordinationAFCC Webinar December 2017

Sponsored by OurFamilyWizard.com

ACR and FLAFCC Task Forces:Broadening the definition of “Family”

�Families do NOT age out of conflict! ACR / FLAFCC Elder Justice Initiative on Eldercaring Coordination / AFCC Webinar December 2017

Alternative Dispute Resolution Institute of Canada National Adult Protective Services AssociationAmerican Association for Marriage and Family Therapy National Academy of Elder Law AttorneysAmerican Bar Association Commission on Law & Aging National Association of Area Agencies on AgingAmerican Bar Association Dispute Resolution Section National Association Aging Life Care ProfessionalsAmerican Psychological Association National Association of Social Workers Association of American Retired Persons National Center for State CourtsAssociation of Conflict Resolution Elder Justice CoalitionAssociation of Family and Conciliation Courts National College of Probate JudgesHamlin University School of Law National Committee on the Prevention of Elder AbuseNational Council of Juvenile and Family Court Judges National Guardianship AssociationNational Guardianship Network

•FLAFCC – Florida Statewide Organizations/Entities•Advisory Committee offers support by recognized experts in related fields

ACR / FLAFCC Elder Justice Initiative on Eldercaring Coordination / AFCC Webinar December 2017

ASSOCIATION FOR CONFLICT RESOLUTI0N INITIATIVE ON ELDERCARING COORDINATION

US/CANADIAN ORGANIZATIONS

Department of Children and Families Adult Protective ServicesElder Justice CenterFlorida Association for Marriage and Family TherapyFlorida Attorney General’s OfficeFlorida Bar Elder SectionFlorida Chapter of the Association of Family and Conciliation CourtsFlorida Chapter of the National Association of Social WorkersFlorida Coalition Against Domestic Violence

• Advisory Committees offer support by recognized experts in related fields

Florida Dispute Resolution CenterFlorida Legal AidFlorida Psychological AssociationFlorida State Guardianship AssociationFlorida State OmbudsmanNational Association of Professional Geriatric Care ManagersNational Patient Advocate, Inc.Mediation Training GroupOffice of the Public GuardianStetson University College of Law Center for Excellence in Elder LawUniversity of South Florida Conflict Resolution Collaborative


FLAFCC TASK FORCEFLORIDA STATEWIDE ORGANIZATIONS/ENTITIES

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PURPOSE of PROJECT

• Address non-legal issues • Avoid delays/make better decisions• Free judicial time• Foster self-determination • Ready elder and family to work with others• Increase safety of elder and family• Create intergenerational support system


Definition of Eldercaring Coordination

� A dispute resolution process during which an Eldercaring Coordinator (EC) assists elders, legally authorized decision-makers, and others who participate by court order or invitation to resolve disputes with high conflict levels in a manner that respects the elder’s need for autonomy and safety…


BY:

§Enabling more effective communication, negotiation and problem-solving skills;§Offering education about elder care resources; §Facilitating creation, modification, or implementation of elder care plan;§Making recommendations for resolutions; and§Making decisions within scope of court order or with parties’ prior approval.

Transforming Intractable ConflictACR / FLAFCC Elder Justice Initiative on Eldercaring Coordination / AFCC Webinar December 2017

EC QUALIFICATIONS

�Minimum of Master’s degree�Licensure or Certification�Extensive practical experience in

profession related to high conflict families

�Required training:Family mediation, Elder mediation, Eldercaring coordination


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WHEN ELDERCARING COORDINATION?

When the conflict, rather than the issues, becomes the driving force of the family and/or litigation process.


COMPARING PROCESSESELDER/FAMILY MEDIATION

Issue Driven.Focus: Care of elder

Conflict Driven.Reducing conflict over elder’s care and safety

Voluntary Process Court OrderedScreen for abuse, neglect, and exploitation

Ripe for identifying abuse, neglect, and exploitation

Facilitate negotiation and decision making

Multiple tools and strategies, person centered/trauma informed

ELDERCARING COORDINATION


COMPARING PROCESSESELDER LAW

Focus on legal issues Non-legal issues drive the conflictOne person is the client Elder plus multiple parties are the

clientsFamily dynamics are distracting

Family dynamics are central to elder’s care

Use of court motions and orders to accomplish goals

Work with family outside court to establish priorities and examine consequences



Comparing ProcessesPARENTING

COORDINATION

Primarily dyads Multiple parties/ stakeholders

Parents are decision-makers Elder/Elder’s rep is decision-maker

Parents with minor children Generational power-shifting

Addresses non-legal issues re: children

Addresses non-legal issues re: elders



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Social Determinants and Intergenerational Influence


High Conflict is a HEALTH Issue for Elders, and their children, and their children, and their children,

and their children, and…(StayWell/WellCare Medicare and Medicaid Provider)

Conflict may put elder’s health in jeopardy

�Mis-medication or missed medication�Irregular meals�Lapses in daily hygiene�Environmental hazards and obstacles �Delays in treatment �More transitions

(Semple, 1992; Scharlach, Li & Dalvi, 2006; Holst L, Lundgren M, Olsen L, Ishoy T. Dire, 2009)

Elder Justice Initiative on Eldercaring Coordination / AFCC Webinar December 2017

Caregiver Stress

�Difference between elder, family member and caregiver goals�Conflict increases tensions�Differing culture, ethnicity and values – beliefs regarding gender

roles, status of family members (front or back door relatives), general caregiving practices

(Fingerman, K.L., 1996; Reamy, A.M., Kim, K., Zarit, S.H., & Whitlatch, C.J. 2011; Heid, Zarit, & Fingerman, 2015; Heid, Zarit, Van Haitsma. 2016)


Traditional Family Court Processes Exacerbate Conflict

� Promotes win-lose mentality� Encourages manipulation and distortions � Ideal of “punishment”� Encourages alliances; increases mistrust� Lack of healing element � Focus on past information and blame keeps parties from moving forward� Lack of privacy� “Momentary snapshot judgement of family structure” does not integrate transitioning family

and optimal future family dynamics � Long lasting effects of fragmented relationships.

(M.K Pruett and T.D. Jackson, 1999; M. Mitcham-Smith, M. and W.J. Henry, 2002; N. Ver Steegh, 2008)(Gregory Firestone and Janet Weinstein, 2004, Jane C. Murphy, 2010)


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Elder Mediation impasse

High conflict families are often identified by an impasse in mediation:�Forum for high conflict parties to vent, blame and threaten�Looking for neutral to “side”�Impasse heightens frustrations

(Janet R. Johnston, 1994; Alexandra Crampton, 2013)


”Sandwich Generation”

�Not enough time�Exhaustion�Not appreciated enough�Choice between parent(s) and children�Conflict takes more resources – time and money

(Elrod, 2001)


Effects on younger generations

�Less parent time/difficult parent time�Children depended upon�Grieving �Family alliances �Denied access to relationships once supportive�Cycle of conflict as model replicated by children later

(Ledger, M., 2017)


Pilot Sites: FLORIDA, IDAHO, INDIANA, MINNESOTA, OHIO

- Toronto (Ontario Bar Association)

One judge, or a group of judges, in a specific county, circuit or province who order eldercaring coordination

Or a group of attorneys who refer at least 6 cases through agreed orders…


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Identifying Cases

• Mediation impasse• Multiple motions• Imbalance of power/alliances• Possessive or controlling behavior toward the elder• Constant disputes about unmeasurable or unsubstantiated items• Cases completed with Adult Protective Services where concerns

continue


Research Up Front to Inform Development of Eldercaring Coordination

�Pamela Teaster, Ph.D., Director, Center of Gerontology, Virginia Tech

�Megan Dolbin MacNab, Ph.D., Director, Doctoral Program for Marriage and Family Therapy, Virginia Tech


Research

�Collect pre- and post- survey data from judges/court administrators, eldercaring coordinators, elders, and participants

�Analyze the effectiveness of eldercaring coordination to improve the intervention.


ELDERS (case study of 9)

• Average age 82, female• Most want better family relationships,

resolution of family issues, including:• Where they live

• Family visits• Who makes decisions• Caregiving• Finances


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Participants

�Mostaredaughters,halfcaregivers

�Believeeldersneedhelpwithmeals,housekeeping,laundry,andfinances

�Almostallwanttoresolvefamilyconflict

�Concernedaboutpsychologicalsafetyoftheolderadult,whovisits,whoultimatelymakesdecisions,andphysicalsafety


Successful:o Familycanbetterfocusoneldero Conflictreducedo Litigationavoidedo Referralsaccepted

OUTCOMES


Unsuccessful:o Partiesrefusedtoparticipateo Continuedmotionso Courtmadenon-legaldecisionso Discordimpededelder’scareandwell-

beingo Difficultyworkingwithprofessionals

continuedo Fewcasesreferred

Safety Issues and Implications on Adult Protective Services

� Neglect� Vulnerability� Unsafe environment� Coercion � Physical challenges� Isolation� Caregiver capacity� Preventing visits with elder� Substance abuse/mismedication

SCREEN! SCREEN!! SCREEN!!!ACR / FLAFCC Elder Justice Initiative on Eldercaring Coordination / AFCC Webinar December 2017

Harm from Adversarial Processes

� Cross-examination of vulnerable witnesses� Stress from prolonged discovery� Ultimate harm of winners and losers in each case

exacerbating distrust and alienation �Reinforces post process negative family dynamics

(J. Johnston, 2000; Edwards, 2007; M.K Pruett and T.D. Jackson, 2008;)


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Benefits

� Cost savings

� Fewer motions � Fewer delays/time sensitive � Focus on safety

� Person-centered care planning/Trauma informed process� Expanded elder and family options� Developing support system

� Heightened awareness and use of mediation� Requesting the intervention of ECs� Elder’s/Family cognitive shifts


More Benefits

� Potential to reallocate non-financial resources� Avoids duplication of services, developing a more efficient service

delivery system for elder� Reduces repeated court motions (Peter Salem, 2009)

� Reduces polarization reinforced by repeated failed attempts at settlement (Johnston 2000, p. 446)


Pilot Projects on Eldercaring Coordination

ACR Task Force Guidelines:

www.ELDERCARINGCOORDINATIONFL.ORG

Contact Eldercaring Initiative Co-Chairs: �Linda Fieldstone �Sue Bronson �Judge Michelle Morley


acr and flafcc task forces: broadening the definition of … webinar 12-12-2017 material… · afcc...

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