The Family Meeting

The Family Meeting

Conflict Resolution 101

Regardless of how close and loving a family may be, all families go through conflict. Estate and legacy planning, end-of-life decisions, living arrangements, medical preferences, and driving ability are typical issues that seniors and their families disagree on. Conflict often occurs most intensely during times of crisis.

Family conflict is unique for several reasons. There is a high emotional attachment between family members, and these underlying feelings can quickly intensify differences; family relationships are long-term and often in close proximity, requiring daily interaction; and, families are private and insular, beholden to their own norms and rules, and often resistant to outside intervention (Melak, 2003). In cases involving adult children and their parents, these characteristics can be amplified by the seriousness of the situation and the healthiness of the family system. In most cases, with planning, a set of rules, and a neutral third party guiding the process, even unhealthy families can have a meeting that is under control, structured, and productive.

Family meetings, sometimes called family conferences, are like task forces in business that meet to solve problems. A certain group of people who bring strengths and resources to the work team focuses on establishing a plan to solve a dilemma. In essence, holding a family meeting requires creating a family task force.

In family meetings, the goal is to establish a strategy for the management of care of older parents or family members who need ongoing care. Meetings may occur once or multiple times. They can be informal, or they can utilize the services of a professional mediator. Meetings can be in-person, over the phone, on a conference call, or a combination of in-person with some members on phones. Consider the following eight steps.

Step One: Why the Task Force is Created

A family meeting is often scheduled when there has been a crisis or a marked change in the health of an older adult family member. Most times, siblings or the spouse of the care recipient will coordinate the meeting, but coordinators must not take matters into their own hands and dominate a meeting or control the agenda. Shortcuts in the process can have disastrous consequences. A bossy coordinator may instigate a mutiny, and the care recipient who is already under a great deal of stress can become overwhelmed with negativity and dissension in the family. A family meeting is a form for open, honest, and direct communication.

Step Two: Attendees – Whom to Invite

  • Who should come? The people most involved with the care and who are concerned about the outcome of the decision-making process.
  • Remember – shared decisions generally produce the best results. All participants will feel as if they own the outcome.
  • Create opportunities for multigenerational dialogue. Siblings, children, grandchildren, spouses, and loving friends can all be involved.
  • Don’t assume that family members should be left out just because they live far away and haven’t been very involved in past family affairs. Excluding a member can be potential sabotage: A faraway son who wasn’t invited to a meeting may say, “Mom, I would have never let them do this to you had I been there.”
  • Are sons- and daughters-in-laws to be included in the meeting? What about grandchildren?
  • Generally use three criteria: who is most concerned? Who is most affected? Who has resources to offer?
  • Exclude the “cousin Bobs” who only want to give advice, judge, and criticize.
  • Send letters to all concerned outlining the necessity or the meeting. In a crisis or medical emergency, make phone calls.
  • A coordinator who expects a contentious attitude out of one or more family members should find a professional facilitator who will agree to coordinate the meeting. Establish a neutral meeting site if necessary, where family members will be on their best behavior. Note: If family members have never gotten along or there are major unresolved issues (physical or sexual abuse), a facilitator will probably be necessary.

Step Three: Preparing for the Meeting

  • Attendees should prepare for the meeting by reviewing their beliefs, attitudes, and assumptions about what it means to be a loving and dutiful child, grandchild, friend, spouse, etc.
  • The coordinator can prepare a list of questions.

Step Four: At the Meeting – Giving the Floor to All

  • Set up ground rules at the beginning of the first meeting: speak for yourself, don’t interrupt, one person talks at a time. Post the ground rules for all participants to see. Review these ground rules before additional meetings.
  • Everyone should have a chance o speak his or her mind, including the care recipients whenever possible.
  • Consider suggestions and options from each participant.
  • Lay the groundwork for full participation. How will everyone be heard?
  • In contentious families, expect storms in the early sessions or in the first part of the meeting.
  • Family meetings are not the time to resolve old conflicts.
  • Clear the air and listen to what other participants share.

Step Five: Identifying the Problem – What’s Going On? What’s Our Reality?

  • Gather information about the issues. Is the older adult safe in his or her home? Contact professionals such as geriatric physicians, geriatric social workers, folks from aging services, and mental health workers who specialize in the geriatric population for reality checks.
  • Define the problem: “Mom is not safe anymore she almost burned the kitchen down.” Major resistance in this step can be denial that the older adult has “the dwindles” or is going downhill fast.
  • Don’t panic if things seem overwhelming. Direct energies to find specific options to the challenges that the care recipient faces.

Step Six: Discovering Who Will Make Commitments

  • The zero hour – who does what, when, how much? Who contributes money? What are family members and friends willing to do?
  • This is often when task force members drop out (temporarily or permanently). Self-confrontation is often painful. Family members may need to participate in introspection (i.e., a personal reflection about one’s perceived duties and obligations to one’s parent or older adult relative). Religious beliefs and family values will come to the surface.
  • Create a window in which to alter decisions: “We’ll do this for three months and then revisit the situation and see how everyone is doing. At that point we can change the plan if we need to.”
  • At each step of the commitment process, check in with the care recipient to establish his or her comfort level with the decisions

Step Seven: Participate in the Process of Introspection

  • Members separate from the task force. Members of the meeting do a reality check by looking at what’s on their life plates. They review other commitments and ask themselves if they can live with the choices and commitments they are going to make. He commitments may be determined by the relationships family members have with the care recipients.
  • Tell fellow task force members the truth, announcing in advance the limits of involvement is better than copping out later.

Step Eight: Set Personal Priorities and Reach a Family Agreement

  • Members make decisions and establish a workable agreement with a commitment written out in the form of a group contract. This may be a vastly different than what members anticipated.
  • Allow room for change in the future as the care recipient’s condition change or other life events come to the forefront.
  • Check in again with the care recipient to make certain he or she is comfortable with the plan.

Family Meeting Roadblocks

Here are five common roadblocks in the family meeting process:

  1. Family members may say things they don’t mean.
  2. Family members may keep secrets. Everyone must be encouraged to speak the truth without blame or judgment. Family members who tell the truth about their perspective will positively influence the decisions of the group. If a family member has been abused by the care recipient and can’t handle supporting him or her, it is vital that the collective hear what happened so they will understand the person’s reasons for balking t becoming involved in care.
  3. Family member may hide feelings. Some family members will hide their feelings because they focus on what “good” people should feel, instead of what they actually feel.
  4. Family members may make promises or commitments they do not intend to keep or may not be able to keep if circumstances change, such as, “you won’t ever go to a nursing home,” or “We promise to call you every day.” Avoid using the words always and never.
  5. Family members may jump the gun and make hasty decisions that don’t honor the wishes of the care recipient. The process can be staged out based around the care recipient’s needs.

When There’s an Impasse

  • Stick with the basics. Follow the rules of process established by the family members. Take a 10-minute break and come back with fresh eyes and ears.
  • Keep your heart open to the process. Don’t le fear rule your decisions.
  • Get a trusted family friend to act as a facilitator or a trained professional to facilitate subsequent meetings.
  • The family task force must be ready to adapt the original agreement based around the needs of the care recipient.
  • The task for composition may change because of divorce, relocation, illness, withdrawal, etc.
  • Setbacks won’t destroy the task force unless the members give up.
  • Working together can produce the most effective action.

    The information above is reprinted from Working with Seniors: Health, Financial and Social Issues with permission from Society of Certified Senior Advisors® . Copyright © 2009. All rights reserved. www.csa.us