When I was growing up as an only child, I envied my friends with siblings. “You have built-in playmates,” I would say. Quite a few of them looked at me as if I were crazy. Later, as a caregiver for both my parents, I again envied that sibling relationship. How nice it would be to share my burden with a sister or brother. Again, for many, not so much.

What happens when one adult child feels their sibs aren’t carrying their share of responsibility for mom or dad? Or they disagree on the appropriate living situation, or degree of care needed? How well do they communicate? Sometimes families need a little help to problem solve effectively for their loved one.

Meet Mary M. Berk, LCSW

Certified Mediator

In my work as a nurse in the community, I found many families who struggled  among themselves about what to do about mom or dad. Many families need support as they confront long term care issues. Mary M Berk, LCSW, has worked with older adults and their families for over 25 years in both healthcare and community settings. As a mediator since 2016 her objective is to empower older adults and their family members as they confront the challenges of caregiving and later life.  In May 2021, with the support of Lifespan, she began Elder Transition Planning Through Family Mediation. https://static1.squarespace.com/static/531f242de4b0467fe7ea5084/t/60d49317e0d25046e8639657/1624544027260/Family+Mediation.pdf

How does it help?

Mary explained, “Unresolved family issues often resurface when adult children face the challenges of a parent struggling with aging and health issues. This may be the first time they have had to work together to make family decisions as adults and it can be difficult to let go of past hurts in the interest of a parents’ well-being. Mediation provides the support and structure that can help family members communicate more effectively and move to problem solving.”

Mediation, unlike therapy, is problem focused. Family members are encouraged to share their perspectives in a safe environment and work together to create plans that will work best for their family’s unique situation.

It is not unusual for some family members to resist the idea of mediation when it is presented. In those situations, Mary suggests to the family members who do want help to consider coaching. These are one on one meetings where the client is encouraged to explore personal options he/she has based on what that individual can control. Often, when a family seems ‘stuck’ one individual choosing different behaviors will impact the entire family system.


Don’t parent your parent

Every time I hear a caregiver say, “Mom was there for me, now it’s my turn,” I want to scream, “watch out!” There is a world of difference between raising a child and caring for an elderly parent. The main difference is you lack the control your parent had over you. If three-year old you screamed you did not want to go to the doctor’s, you went anyway. You do not have that kind of power over your parent. Nor should you unless there is significant dementia on board. (I know how I would react if my son argued with my decisions, tried to solve my problems, or worse yet, told me what to do. It would not end well for him.)

It was good to hear Mary agree. “It can be frustrating for caregivers when they realize that they have little or no control over their loved ones’ decisions. It is difficult to watch parents make what we consider bad decisions. The tension between recognizing their need for independence and our need to keep them safe can be agonizing.  If a parent or loved one has advanced dementia, that is a different story.”

Next Steps

Any family faced with the challenges of caring for a loved one should know that both mediation and coaching are available to them. The landscape of long- term care is unfamiliar to most of us, and it can be helpful to have a guide whose role is to support the family in finding the best answers for them.  “It’s all about empowering people,” Mary said.

In her role as a mediator, Mary does not recommend specific agencies or individual practitioners. She may suggest areas that families need to consider and refers them to the resource lists available on the Lifespan website.  She stresses being as pro-active as possible. Proactive decision making is always preferable to making decisions in a crisis where your choices may be limited.

(If you live elsewhere and need to find local elder resources, begin with the Office of Aging in your parents county. I did that for my in-laws in Florida’s Pinellas County and found a wonderful case manager for them.)

“Adult caregivers need to know they are doing everything possible for their loved one, and at the same time, must realize there are limits to what they can do. In the end, unless there is dementia, it is the elder who decides what is acceptable to them and that is what caregivers should support.”

In addition to her mediation work, Mary welcomes the opportunity to talk to groups about family caregiving issues and solutions. You can reach her at Lifespan at mberk@lifespanrochester.org. or call her at (585) 244-8400 x 170.

A special thank you to Mary for her written contributions to this blog. I appreciate your time and generosity.