I recently was involved in a case involving a guardianship of an elder with dementia which proved to be a wonderful case study and a great example of the benefits of an early intervention/facilitated family meeting. The names and some of the facts have been changed to protect the identity of those involved.
The case involved a gentleman we will call Robert and his family. Robert is close to seventy and suffers from vascular dementia. He lives in a home he shares with his wife Judy. Robert and Judy have three children, all of whom are grown and live in the area. A neuropsychological evaluation had been conducted in 2007 and determined that Robert had significant problems with thinking, judgment, logical analysis as well as a denial on his part of his own condition. Judy was no longer able to care for him and in fact he often became violent when she tried. The children also were helpless in helping their father.
Judy, with the help of an Elder Protective Services agency decided to obtain a guardian and conservator for her husband and felt it would be best if it was an outside party. Because of the dynamics with her husband she did not believe that it would be a good idea for her to act as his guardian or conservator and the children did not want to be in that position either. With the help of the protective services agency, they were able to find an agency that would act as guardian and conservator at no cost to the family. Other than the family home, there were few assets. Robert had a small pension and Judy worked part-time. A petition for guardianship and conservatorship were filed and much to the surprise of everyone, shortly before the deadline for objecting an objection was filed by an attorney on behalf of Robert.
It turns out that the attorney had probably been hired by Robert’s brother, a high powered executive in Philadelphia. The dynamics between Robert’s wife and the brother were not good. She resented that he never actually helped care for his brother or came to visit but felt it was his place to get involved at this stage. The result of the objection filed on behalf of the elder was that the matter was marked up for a pre-trial conference. Because of the history and bad-blood between Judy and Robert’s brother, there was no communication between them to determine what could be done to resolve the situation. Even though there was little money involved, the case was moving in the direction of contested litigation. The result would be high legal fees and a long delay in resolving the situation. In the meantime, the situation at home was getting worse. The family had decided that it would be in Robert’s best interest to move him to an assisted living facility. However, as long as the litigation was pending, taking any action concerning a permanent move would be difficult.
I arranged for a family meeting. The meeting was attended by Robert, Judy, all three children, the brother, the supervisor at the agency that was going to act as conservator/guardian and the caseworker on the case, the lawyer for Robert, the protective services caseworker. In short, there were a lot of players in the room.
The short story is that as a result of the meeting, an agreement was reached and shortly thereafter, the guardianship and conservatorship were finalized with the proposed agency being appointed as guardian and conservator. At the meeting, the children all spoke about how they were coping (or not) with their dad’s demise, what they were looking for and why. It was apparent that they all were helping in whatever way they could, they cared deeply about their dad and had all agreed that the guardianship and conservatorship was necessary. They had also done a fair amount of research into assisted living facilities. Robert’s wife also spoke about how difficult it had been for her and why she was in favor of the plan that had been proposed. She also had an opportunity to tell Robert’s brother the difficulties she had had with his involvement (or lack thereof). Robert spoke also. He may not have completely understood everything that was going on but one sensed that he certainly understood that there were a lot of people in the room who cared about him deeply and all were looking out for him. Robert’s attorney seemed to be concerned about which assisted living facility the family was considering and what the cost would be. Concern was expressed about whether the house would be sold to pay for assisted living or whether Judy would stay in the house.
Ultimately, once these issues were discussed it became apparent that everyone in the room was on the same page as to what a future plan should look like. In the end a 1 ½ hour meeting not only accomplished the goal of avoiding costly and drawn out litigation but gave the family an opportunity to discuss these difficult issues in a safe setting. I believe the meeting also brought the family together and may have led to some positive transformation in some of the relationships.
This case admittedly involved a fairly low level of conflict. However, even in high conflict cases (unless there are concerns about physical safety), it is hard to imagine a situation in which a facilitated meeting would not help. If nothing else, the meeting could help narrow or define the issues. Ideally the meeting should be facilitated by a neutral party who does not have an interest in the outcome. If that is not possible it should at least be facilitated by someone who has had some training in mediation or group facilitation.
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