Mediation in long-term care facilities: a pilot project.

OBJECTIVE To describe the development and implementation of a mediation model appropriate for long-term care facilities. METHODS The recruitment and training of mediators; the role of the ombudsman; and approaches to educating facility staff, families, and residents are described. Disputes identified as suitable for mediation include care disputes, resident-to-resident issues, and family matters. RESULTS Pilot project results indicate cases that reach mediation generally come to a mutual agreement that is upheld over time. Only a small number of cases referred for mediation are actually mediated. A main barrier to using mediation as an option is lack of knowledge of its availability and potential benefits. Intensive outreach within facilities is essential if residents, families, and staff are to recognize and refer cases. CONCLUSION Mediation must be considered broadly as an approach, not as a single process. Mediation can help to involve residents and families in constructive decision making that improves care, and could be a part of the overall dispute resolution system in long-term care.