Introducing the first EMIN-certified elder mediator in England!

I’m thrilled that I’ve been certified by the Elder Mediation International Network (EMIN) as an elder mediator, having completed my training (in two years, during Covid, no less!) and successfully fulfilling the robust accreditation criteria and process of this important international network.

‘Congratulations to Margaret Doyle who has just successfully completed all the requirements for the beginning level of Elder Mediation International Certification. Margaret becomes the first Elder Mediator in England to achieve the newly established Cert.EM designation!’

https://elder-mediation-international.net/meet-emins-latest-cert-em-advanced-recipient-2-3/

As a network, EMIN raises awareness of elder mediation as an important area of specialist mediation expertise and, through its certification process, ensures that certified mediators adhere to a code of ethics and conduct their practice to a consistent, credible, recognised international standard.

Age in the UK

And to be the first mediator certified by EMIN in England is the icing on the cake (not the first in the UK – the first UK-based EMIN mediator is in Northern Ireland).

The field of elder mediation isn’t well known in the UK, but it’s thriving elsewhere in the world – including Canada, the US, and Australia. Yet the issues that elder mediation focuses on – ageing and all the pleasures and pains that go with it – are as pressing here as in most countries across the world. According to the Office for National Statistics, UK life expectancy at birth in 2018 to 2020 was 79.0 years for males and 82.9 years for females. Our population is ageing, with our demographics shifting towards older ages because of declining fertility rates and people living longer. The ONS projects that by 2032, nearly 20% of the population in the UK will be of pension age or older.

These projections aren’t uniform across the UK. As the Resolution Foundation has explained, in its report Ageing Fast and Slow, Britain has experienced demographic divergence, with older places ageing faster than younger ones and younger places getting old at a slower pace (or actually getting younger). 

Such demographic divergence matters for local government, the Foundation points out. It also matters for the services for older people administered by local government, because ‘revenue streams often do not match well with the service requirements of local populations of very different – and ever more different – ages’. There are tensions built into demographic change and divergence in the UK, tensions that can lead to disagreement and dispute.

What is old?

What is ‘old’ is a fluid and contentious topic. Here in the UK, ‘old’ might be over 50, the age at which we become eligible for sheltered accommodation. Or it might be 60, when those of us who live in London become eligible for a ‘Freedom Pass’ allowing free travel on tubes and buses. Or it might be the age at which we can start taking our state pension – for some that’s still 65, but for younger groups it’s 66, 67, and going up all the time. Or ‘old’ might be 70, the proverbial three score and ten, or 80, the age at which people were required to shield in the first lockdown of the pandemic.

I’m not overly concerned to define ‘old’, nor am I keen on terms like ‘elder’, and certainly not ‘the elderly’. What I am concerned with is that as we age, we are well supported to live the lives we want to live and we aren’t dismissed, patronised, or excluded. This isn’t about autonomous independence, but about relational independence: living as independently as we want to within reciprocal relationships, whether those be relationships of care or friendship, at home or within our communities, or with the state agencies with whom we interact.

Some of my reading material on ageing and on social care

Why ‘elder’ mediators?

I’ve been a mediator for more than 30 years, and I’ve specialised in disputes involving equalities and specifically disability rights. Although I can now be considered an elder myself, not all mediators are older people, nor do they need to be. But they do need to understand issues and concepts that might not arise in other areas of mediation practice.

The requirements for EMIN certification include being an already accredited mediator and undertaking additional specialist training (70 hours minimum) on issues including elder abuse and safeguarding, family and intergenerational dynamics, legal issues including powers of attorney and guardianship, and dementia. For my area of practice, I need to understand how social care works, including funding of long-term care. And elder mediators need to be curious and engage with questions about how we perceive vulnerability and the way ageism impacts decisions made with and for older people.

How can mediation contribute?

I believe that mediation can contribute to much-needed conversations and ideas about ageing. The underlying principle of participation and supported decision-making is key to mediation. It is also key to the theory, if not always the practice, of work done in social services, health care, including mental health, and disabilities services, including another area in which I work, that of special educational needs and disability rights. The social model of disability rights is one that can be adopted in age rights as well; it moves us away from a medical model, one that focuses on impairment, and explores and addresses the barriers (both physical and attitudinal) that compromise people’s ability to flourish.

Many of the techniques used in mediation are those used in a Strength-Based Approach used by social care professionals, which explores in a collaborative way the entire individual’s abilities and their circumstances rather than making the deficit the focus of the intervention. It is about gathering a holistic picture of the individual’s life, including from their network and other professionals. 

So there is a natural affinity between mediation and the interactions between people and the institutions and government bodies involved in social care and health care.

Who uses elder mediation?

Families, friends, community groups, care homes and agencies, hospices and hospitals – all can make use of elder mediation where disagreement about care or decision-making is affecting quality of life and relationships.

It isn’t just about resolving individual disputes and disagreements. It’s a practice and approach that contributes to better listening and more shared experience. It’s also not always about, or only about, ageing; it can also be about intergenerational dynamics and frictions, about fairness between the young and old, and about the need for better, more creative conversations between generations and within communities.

I look forward to working with individuals, communities, and care and health organisations in this new area of practice!


Ageism – spotlight on the last taboo

‘Once I went to a store to buy a book about Alzheimer’s disease and forgot the name of it. I thought it was funny. And it was, at the time.’

Nora Ephron, I Remember Nothing

A study published last year found that across the world, 1 in 2 people hold moderately or highly ageist attitudes. It’s no surprise really, especially when you include in ‘ageism’ jokes along the lines of Ephron’s, jokes about memory loss and ‘senior moments’. Face it, we find these funny. Until we don’t. And often we lose our sense of humour when, as Ephron notes, the joke starts to be on us.

In many ways ageism is the last taboo, the tolerated ‘ism’. The report on the study of ageism, published by the World Health Organisation and the United Nations in March 2021, explains how insidious ageism is, worldwide – insidious yet largely unrecognised and unchallenged. Ageism applies to both the young and the old, but there is far more research on how it relates to older people. The report analyses what research exists and what it tells us about how prevalent ageism is, where it happens, the impact on health, well-being and economies, and what we can do about it. Its publication is timely, given what we’ve learned from Covid about ingrained narratives on the perceived vulnerability of older people and the way ‘older people’ have been treated as a homogenous group needing protection, whatever their circumstances or wishes.

Yet the opposite is true. When you’ve seen one older person, you’ve seen one older person. One of the most interesting findings in the report is that that ‘the longer we live, the more different from each other we become, making diversity a hallmark of older age’ (p.19). I see that illustrated in the lives of the older people in my life; regardless of chronological age, they approach life, and risk, very differently, and being older in years does not necessarily mean being more risk averse or frightened.

A global issue on several dimensions

Ageism plays out in three dimensions – the institutional (settings such as health care, the media, education, work), the interpersonal (in attitudes and behaviours) and in ourselves, as self-directed ageism. Unfortunately, most of the research on ageism is carried out in what are considered high-income countries, yet most of the world population lives in low- to middle-income countries. That skews what we know about how ageism plays out. But the report concludes, from the research that does exist, that although ‘ageism’ as a word doesn’t exist in all languages, ageism as a concept exists in most, if not all, cultures.

The study challenges the prevailing belief that cultures in WHO regions of Southeast Asia and the Western Pacific (which include China, India and Japan) have higher esteem for older people than do cultures in Anglophone and European regions. Indeed, sometimes the opposite is found to be true (the report cites examples of the way widows are treated in some societies, and the prevalence of accusations of witchcraft against older women in others). The report notes that in some societies, limits were placed on older people’s access to health care and treatments for Covid, as a form of rationing limited resources, or their access to public spaces and transport, as a means of protection. Here in the UK, ageism was inherent in the classification of all people over 70 as ‘vulnerable’ in the Health Protection Regulations for coronavirus published in 2020. That classification, and the guidance to shield at home, has been identified as a potential form of age discrimination. But the issue is complex, and the research raises questions, so in the end, the report notes, it’s inappropriate to make any sweeping generalisations about ageism and cultural norms.

Covid also exposed the narrative pitting one generation against another. In terms of the effect of restriction measures and lockdowns, for example, the vulnerability of the old was set against the mental health needs of the young. The hashtag #boomerremover appeared as a reference to Covid as a leveller, taking out the generation that had sucked up all the resources and left younger people high and dry. The WHO/UN report found that nearly one-quarter of all tweets concerning older adults during Covid has been classified as ageist.

Mediation and ageism

Although it’s not mentioned specifically in the report among the strategies for combatting ageism, I think mediation has a valuable place in countering these narratives, fostering intergenerational exchanges, and challenging ageism in both institutional and interpersonal contexts. Its potential lies in the local and individual, in community relationships rather than broader sociopolitical change. Yet its grassroots influence could lead to wider sustainable change in the ageist narrative.

In elder mediation we adopt techniques of what is known as a strength-based approach, focusing on the abilities people have and not on their weaknesses, identifying sources of resilience. This doesn’t only mean strengths that people have within themselves, and it doesn’t mean ignoring capacity challenges. It’s a fact that ageing can be associated with losses that can require support – losses in mobility, cognition, memory, physical strength. But strength can also be in the resources and support that people can draw on. Autonomy is something we often need help to attain, and it isn’t a worthwhile ambition if it can only be achieved alone.

Mediators also recognise that vulnerability is universal; we are all vulnerable in different ways and at different times. In a recent session I led with mediators on the topic of working with older people, we explored this notion of vulnerability, and I was struck by what one participant said about recognising that everyone in a dispute situation is vulnerable – even the mediator. As legal academic Jonathan Herring has noted, we should be thrilled about this. It helps us to focus on the relational nature of vulnerability – the importance of relationships – which gives more scope for generating and working together on solutions.

And mediation is an ideal forum in which to explore everyday ageism. It offers a space for raising questions, for challenging, for educating and bringing about change that is dynamic, responsive, and intensely personal. Among the issues of ageism that I’ve been involved in mediating are those related to housing, to consumer services, and to work. Behind each of these are underlying assumptions about older people that have affected decision-making and behaviours, limited access, constrained older people’s voices – and they have been shown to be wrong assumptions, or misperceptions, requiring clarification.

Self-directed ageism

One possible reason we tolerate ageism is because we have a bias toward the near. This idea is explored by Helen Small, an English professor at Oxford, in her book A Long Life. She discusses this bias toward the near in the context of philosopher Derek Parfit, who argues that this bias is a choice we make, caring more about what is close to us, including what is near to us in time. If we were to take a more neutral approach to time, he suggests, our sense of the limits on our time left as we age would decrease, we would be less depressed by ageing, and we would set ourselves up for a happier old age. Small suggests this is difficult because one of the most pernicious aspects of ageism is self-directed: the fear and pessimism we feel about our own impending old age. It is, she says, in some ways more objectionable than other forms of ageism, and certainly harder to get a moral handle on, ‘because it pretends to a kind of neutrality in including itself as an object of its own negativity’ (p.151).

This self-directed ageism is part of why ageism remains the last taboo. The WHO/UN report tells us why ageism is so different from other ‘isms’. It ‘involves bias against a moving target’; the object of ageism changes as years go by, and we are all susceptible to it if we live to be older. It is, as Caroline Baum writes in The Guardian, ‘unique in targeting our future selves’.

And that’s what makes Ephron’s joke about going into the bookstore so poignant.