By Debbie Reinberg

The phone rings. Mom has taken a fall in her home and been rushed to the emergency room. You race to the hospital. As the only local child, you are responsible. . . . You find out that she has suffered a severe stroke—she is paralyzed on her right side and has lost the ability to communicate verbally. She looks so frail!

The hospital social worker tells you it is time to think about how Mom will be cared for, because discharge from the hospital is imminent.

Scenario 1: You freak out. You have no idea where to turn and how to make decisions. Mom clearly cannot live on her own anymore. You hold power of attorney for health decisions, but you never realized you would actually have to act. Your two brothers are concerned, but they live out of town. They have made it clear that they are okay with you handling the details. They may come out to visit in the next month or two to be with Mom, but they really haven't offered to help with decision making or caregiving either.

SUGGESTION: A geriatric care manager can help you determine the right alternatives for Mom and work with you to make sure that all the "pieces" are in place, for now and the future.

Scenario 2: Everyone is informed and supportive. You diligently start to follow the social worker's suggestions to check out various nursing homes. You contact your two out-of-town brothers to keep them informed. They both offer support, letting you know that they trust your decisions. They both ask if there is anything they can do from afar and offer to come out in the next few weeks to relieve you. You sit back in your chair and exert a huge sigh of relief. Maybe this won't be so hard after all.

SUGGESTION: Be thankful!

Scenario 2 with a twist: Family members have different ideas. One of your brothers says that Mom should not go to one of those places that warehouse people. He warns you to do the right thing, but he doesn't explain exactly what that means. And you don't know how to ask him what his "warning" means. The other brother says maybe it is time for Mom to move out to the East Coast, since he is retired and has time to oversee her care. You don't know how to satisfy everyone while also being true to your own thoughts.
 
SUGGESTION: This scenario calls for a facilitated family meeting. Although it would be beneficial for all the parties to be in the same room, it is possible to have this conversation via teleconference. A trained dispute resolution professional will talk with each sibling individually and then help the three siblings talk together to resolve the situation. A professional with an eldercare background can provide an advantage by understanding the available options as well as family dynamics concerns. It is important to understand the interests behind each person's positions.

Scenario 3: You realize that Mom hasn't designated anyone to exercise power of attorney, and all siblings would like to have control. She was stubborn and didn't want to choose one child over another. Now she isn't able to communicate any of her desires. Nobody knows if she will get better. Your two out-of-town brothers are making noises about wanting to be the decision maker, and they are both coming into town in a few days. The three siblings have been somewhat estranged from each other for quite a while—cordial, but nothing more. Someone has to step in. The hospital indicates that Mom will need to be discharged soon. You would like to have the decision-making power yourself, since you've lived closest to her in recent years and believe you understand her wishes the best.

SUGGESTION: A mediation process may be appropriate for this family. Without a power of attorney, someone will need to petition for guardianship. Without agreement between the three siblings, a very heated contest for this role may ensue, and attorney fees could add up quickly. That could be expensive and emotionally difficult. Sitting down together to determine the best steps could provide an answer to the current concern and open the door for better relations among the siblings in the future. All the siblings may believe that they are the best candidate for the decision-maker role, but we don't really know what makes them believe that, and it is doubtful that they can really have that conversation effectively without an impartial party to facilitate. Mediation could provide the appropriate "issue resolving" so that attorneys can handle the legal activities without quarrels.

Scenario 3 with a twist: Both brothers are unwilling to sit down with a mediator.

SUGGESTION: You can engage a conflict coach to help you handle the situation. A conflict coach will help you understand your own needs and provide tips as to how you can approach your siblings in an effective manner. By working with a conflict coach, you may be able to uncover the true interests of the other parties and devise solutions that can work for everyone.