When family members “jump out of the woodwork” in Elder Mediation
- nick6301
- 1 day ago
- 6 min read
What Elder Mediation has taught me about conflict, grief, and the human need for certainty
In aged care and health care settings, there is a phenomenon that many practitioners quietly recognise.
An older person experiences a sudden decline. A hospital admission occurs. A dementia diagnosis is made. An aged care placement is discussed.
Then, seemingly overnight, previously absent or distant family members suddenly become deeply involved in decisions about care, accommodation, finances, or medical treatment.
The local caregiver, who may have spent years providing unpaid support, often experiences this as shocking, frustrating, and deeply unfair.
In elder mediation, we sometimes describe this as family members “jumping out of the woodwork.”
While the phrase is informal, the phenomenon itself is increasingly recognised in research.
Studies by Kramer, Boelk, and Hamano have explored how conflict often intensifies during periods of decline and end-of-life decision-making, particularly when family members who were previously less involved suddenly become active participants (Hamano, et al., 2025; Hamano, et al., 2018; Kramer & Boelk, 2015; Kramer, et al., 2010).
Working in dispute resolution and elder mediation, I have repeatedly observed this same pattern.
What fascinates me is that these conflicts are rarely just about aged care.
Underneath the arguments about safety, accommodation, finances, or substitute decision-making are often deeper emotional currents:
grief
guilt
fear
uncertainty
attachment injuries
unresolved family dynamics
fear of exclusion
fear of regret.
What the research in practice revealed
To explore whether these observations aligned with the literature, I evaluated 150 recent dispute resolution matters involving older people and their families:
Several patterns emerged:
Emotional distance between family members was present in 72% of cases.
Communication difficulties appeared in 61% of matters.
Elder abuse allegations emerged in 43% of cases.
The “jumping out of the woodwork” phenomenon appeared in 42% of cases.
Trigger events such as hospitalisation or aged care admission were present in almost half the matters.
One finding stood out.
Physical distance had a strong relationship with sudden involvement (Pearson correlation of 0.6)
This raises an important question:
Are families really fighting about care arrangements? Or, are they struggling to manage anxiety, disenfranchised grief, ambiguous loss, identity, and uncertainty during a period of profound transition (Boss, 1999; Doka, 2013). Are these stressors exacerbated by physical or emotional distance?
Decision-making as a scarce resource
One pattern I frequently observe is that decision-making itself becomes framed as a scarce resource.
When a distant family member suddenly learns that a parent has dementia, experienced a fall, or may no longer be safe living independently, the situation can feel catastrophic.
Even if the decline has unfolded gradually over many years, the distant relative experiences it all at once.
The response is often a heightened need for certainty and control.
This can look like:
demanding immediate residential aged care placement
questioning existing caregiving arrangements
making allegations about neglect or abuse
insisting on urgent decision-making
attempting to take over communication with health professionals.
Meanwhile, the local caregiver may have already spent years adapting to the older person’s decline.
Both parties are reacting to the same event.
But emotionally, they are experiencing the older person's decline from different timelines.
The danger of intuitive thinking during crisis
What I find particularly interesting is how quickly stress can narrow our thinking.
Under emotional overload, people often shift into reactive and intuitive thinking.
We can jump to conclusions, because we search for simple narratives that reduce uncertainty. Our search for meaning in events can create narratives that are often melodramatic (Hardy, 2021).
Daniel Kahneman described this tendency as our heuristic bias for "associative coherence" (Kahneman, 2011). This happens when the intuitive, fast-thinking part of our brain creates a coherent, logical story out of the limited patterns it immediately sees, without pausing to ask what data might be missing (Gilovich, et al., 2002).
The distant family member may assume the worst about the care being provided. The local caregiver may assume the distant relative is motivated by money, guilt, or control. Health professionals can become triangulated into family dynamics. The older person may become emotionally overwhelmed and caught in the middle.
The role of Elder Mediation
This is where Elder Mediation can be extraordinarily valuable.
The role of the Elder Mediator is to create enough psychological safety, structure, and communication for people to move away from rigid positions and toward collaborative problem-solving.
Often, the conflict softens when participants begin to feel heard. Especially when the voice of the older person is central to the decision-making process.
Naming emotions and needs underneath the conflict can be transformative (Rosenberg, 2015).
Families frequently experience relief when the Elder Mediator helps them to sit with the discomfort of emotional risk and realise:
these reactions are common
grief can present as anger or control
uncertainty can intensify blame
caregiving transitions affect every family member differently.
In Elder Mediation, I have also found narrative approaches particularly useful.
Rather than positioning a family member as “the problem,” we can externalise the conflict (Fisher, Ury & Patton, 2011; White, 2010).
Sometimes the real problem is not the sibling.
Sometimes the problem is dementia. Or anticipatory grief. Or fear. Or years of emotional distance colliding with a perceived crisis. Or perhaps the problem is simply our shared human need for predictability.
A more compassionate lens
Importantly, understanding these dynamics does not excuse harmful behaviour.
Some matters involve:
coercive dynamics
psychological abuse
longstanding estrangement
trauma
complex personalities
serious safeguarding concerns.
Older people can become emotionally unsafe when family conflict escalates around them.
Elder Mediators, health professionals, and substitute decision-makers all have a responsibility to remain alert to this.
But I do think there is value in approaching these conflicts with greater curiosity and compassion.
Sometimes the family member who suddenly appears is not simply controlling.
Sometimes they are frightened. Sometimes overwhelmed by guilt. Sometimes struggling to integrate a new identity of “caregiver” with the deeply held and secure identity of “child."
And sometimes the exhausted local caregiver is not simply resistant.
Sometimes they are burnt out, isolated, and desperate to protect the older person’s autonomy.
Final reflection
One of the most humbling parts of this work is recognising how vulnerable all of us are to reactive thinking during periods of stress.
As Elder Mediators, medical practitioners, and family members, we are all susceptible to filling gaps in understanding with assumptions.
We all want certainty. We all search for patterns. We all risk jumping to conclusions.
Perhaps the real work is learning how to slow down enough to stay curious.
Elder Mediators can support families to communicate more openly, tolerate uncertainty, and better understand each other’s emotional realities. Elder mediators can "change the shape of the conflict" when the family shifts from reactive arguing to objective dialogue (Lederach, 2014).
As Ken Cloak says, mediation can appear "magical" in these transformative moments when a tense conflict shifts into resolution (Cloak, 2023).
Elder Mediation may not be perfect, but it can be enough to reduce harm. Enough to restore dignity for the older person. And sometimes, enough to help families reconnect during one of the most difficult transitions of their lives.
Want to learn more?
If you are interested in learning more about Elder Mediation or wish to become an Elder Mediator, please visit the Elder Mediation Australasia Network website: www.elder-mediation.com.au or reach out to me via LinkedIn.
References
Boss, P. (1999). Ambiguous loss: Learning to live with unresolved grief. Harvard University Press
Cloak, K. (2023). The magic in mediation: A search for symmetries, metaphors and scale-free practices. Goodmedia Press.
Doka, K. J. (2013). Counseling individuals with life threatening illness. Springer Publishing Company.
Fisher, R., Ury, W. L., & Patton, B. (2011). Getting to yes: Negotiating agreement without giving in. Penguin.
Gilovich, T., Griffin , D., & Kahneman, D. (Eds.). (2002). Heuristics and biases: The psychology or intuitive judgement. New York : Cambridge University Press.
Hamano, J., et al. (2025). Clinical and communication factors associated with family conflict in palliative care units: A survey of bereaved families in Japan. Cancer Medicine, 14(17), e71192.
Hamano, J., Morita, T., Mori, M., Igarashi, N., Shima, Y., & Miyashita, M. (2018). Prevalence and predictors of conflict in the families of patients with advanced cancer: A nationwide survey of bereaved family members. Psycho-Oncology, 27(1), 302-308.
Hardy, S. (2021). Conflict coaching fundamentals: Working with conflict stories. Routledge.
Kahneman, D. (2011). Thinking, fast and slow. Macmillan
Kramer, B. J., & Boelk, A. Z. (2015). Correlates and predictors of conflict at the end of life among families enrolled in hospice. Journal of Pain and Symptom Management, 50(2), 155-162.
Kramer, B. J., Kavanaugh, M., Trentham-Dietz, A., Walsh, M., & Yonker, J. A. (2010).
Predictors of family conflict at the end of life: The experience of spouses and adult children of persons with lung cancer. The Gerontologist, 50(2), 215-225.
Lederach, JP. (2014). The little book of conflict transformation. Good Books, Skyhorse Publishing.
Rosenberg, M. B. (2015). Nonviolent communication: A language of life (3rd ed.). PuddleDancer Press.
White, M (2010). Maps of narrative practice. W. W. Norton & Company.
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