Family Members at One Another’s Throats? Call In the Mediator.

The four adult children were in agreement.

Their father, William Curry, a retired electrical engineer and business executive, was sinking deeper into dementia. They had found a memory care facility about a mile from their parents’ house in Chelmsford, Mass., where they thought Mr. Curry would do better.

But their mother, Melissa, who was 83 when her family began urging her to make this change in 2016, remained determined to continue caring for her 81-year-old husband at home, despite the increasing toll on her own health. When her children raised the issue of a move, “she wouldn’t discuss it,” said her daughter, Shannon Curry, 56. “She’d clam up. Sometimes she’d cry.”

Yet Melissa Curry’s memory was faltering, too. She would forget to give her husband his medications, or get the doses wrong. The family worried about falls and fires. Even after they persuaded her to accept a hired aide several days a week, the couple was still alone most of the day as well as overnight.

As the weeks passed, “we were really at an impasse,” Ms. Curry said. “Do you override your mother?”

Enter the mediator. Through a friend, Ms. Curry learned about Elder Decisions, a company offering “elder adult family mediation.” Her parents and siblings all agreed to give it a try. Crystal Thorpe, the company’s principal and founder, and a co-mediator, Rikk Larsen, interviewed family members by phone, then scheduled a session around the parents’ dining room table.

Often associated with business disputes or divorce and custody cases, trained mediators can also help families struggling with an array of vexing elder-care issues: appropriate living arrangements, care responsibilities, communication and information sharing, and health and financial decisions.

When families seek mediation, they “want to do what is best, but have different perspectives on what ‘best’ might mean,” Ms. Thorpe explained.

Sometimes a court orders elder mediation, typically involving guardianship or estates and inheritances. How often that happens depends on state laws and an individual judge’s enthusiasm for the process.

“It would be great if more judges said, ‘You need a mediator; choose one from the approved list,’” said JulieAnn Calareso, president of the New York chapter of the National Academy of Elder Law Attorneys.

But increasingly, families seek elder mediation privately, before disputes land in court and imperil or destroy family relationships.

“If families can avoid litigation — its costs, its stress — they’ll get a better result,” said Beth Polner Abrahams, a trained mediator and elder law attorney on Long Island. “There won’t be a winner or a loser — there will be compromise.”

Mediation differs from arbitration, in which an arbitrator weighs the arguments and makes a determination that the antagonists agree to accept. The mediator maintains neutrality and helps the parties reach consensus themselves, centered on the older adult’s needs and wishes.

Even people who lack capacity in the legal sense can often make their wishes known, Ms. Thorpe said. When that’s not possible, mediators can draw on the person’s earlier statements or documents.

Mediation also differs from family therapy, though sessions can get similarly emotional as participants grow angry or teary, nursing old wounds and airing grievances.

“These are messy situations,” said DeLila Bergan, an elder mediator in Denton, Texas, and co-chair of the Association for Conflict Resolution’s elder mediation section.

“We don’t try to make everyone happy and cheerful and loving each other — that’s a job for a therapist. But we can keep them talking and focused on the issues, and keep it calm, without name calling.”

She recalled a dispute over a family home that a widow was preparing to sell to finance her move into independent living. One of the children felt she was “owed the house,” Ms. Bergan said, because she had lived in it for some years and contributed to renovation costs.

“But there was no consensus on that” among the other children and grandchildren, Ms. Bergan said. “The fighting got really ugly.”

Over three months of negotiations, the family reached a compromise: the daughter would buy the house at a price the mother accepted. Even if resentments persisted, “it was an agreement everyone could live with,” Ms. Bergan said.

Sometimes, the parties document decisions in a memorandum of understanding, or a list of next tasks, or a caregiving schedule; families may agree to exchange information with a private family website, or text chain.

The process and whatever resolution is reached remain confidential — which is valuable, since some families are embarrassed to even acknowledge that they’ve sought mediation. Afterward, mediators may remain in contact at the family’s request, to facilitate communications.

Because elder mediation is a fairly new field, with no nationwide certification or licensing requirements, approaches and costs vary. A mediation can last for 90 minutes, three hours or a couple of days. Some mediators are also lawyers, or social workers. Some bring elder law attorneys, or financial advisers, into the process.

In Texas, Ms. Bergan, who works alone, charges $1,500 to $2,500 for most elder mediation cases. In pricier Massachusetts, Elder Decisions, which usually uses two mediators, charges $400 to $500 an hour.

But the alternative can be devastating. Litigation takes months or even years, and costs run into the tens of thousands of dollars.

To find trained mediators, families can consult the Association for Conflict Resolution, the Academy of Professional Family Mediators or mediate.com, and search for professionals who provide elder mediation. (Their ranks are still thin, but mediation increasingly takes place online, making it more widely available regardless of where family members live or where the mediator practices.)

It doesn’t always succeed. If key family members refuse to come to the table, “mediation without their presence wouldn’t be appropriate,” Ms. Thorpe said. “If there’s a sense of coercion or suspicion of abuse or neglect, that’s not appropriate.” She expects participants to show good faith, a willingness to grapple with a resolution.

When mediation does work, it can preserve or even strengthen bonds, allowing families to celebrate birthdays, graduations and weddings together despite previous conflicts. “They should be able to stand by their parent’s gravesite together,” Ms. Abrahams said.

William and Melissa Curry and their children, with the youngest participating via speakerphone from South Carolina, spent about an hour and a half talking with Ms. Thorpe and Mr. Larsen.

Shannon Curry described their session in late April as “a problem-solving meeting where everybody feels heard, everybody gets a say,” including her father. “We talked about compromise. What can you live with, and what can’t you live with?,” she recalled. “It was mostly a very loving attempt to find solutions.”

With her mother’s agreement, the family moved Mr. Curry into his new apartment a couple months later. Less isolated than he had been at home, he grew friendly with the staff and other residents, and appeared to enjoy the activities. His wife visited once or twice a day, joining him for meals and fitness classes, and also seemed to benefit from the social interaction.

He died at 82, eight months after his move. Four years later, his wife died in the same memory care unit, at 88.

Not every family can resolve conflicts with a single mediation session, but in this case “it was a huge help,” Shannon Curry said. “I wish we’d done it two years earlier.”