If your clients ‘holiday visit from their family was miserable and you are care manager to the aging parents, a family meeting between the adult sisters and brothers and a mediatory might be needed this January. This will help you decide if you need a mediator or you can be a facilitator at the family meeting. Care Managers can do facilitation but you need very advanced training to be a mediator.
a. Compatible. Does their family generally present as a unit and lock arms together in a crisis? Do you usually work as a team?
b. Fragmented: Is their family unable to work together as a unit? Do their family members and siblings contact friends and outside professionals with their problems, while failing to confide in each other? Do family members ask other family and other
siblings, friends, and outside professionals to keep conversations secret from certain relatives? Is there a cache of family secrets that some family members do not tell others or share? Do kin pit one another against each other when trouble arises? Instead of locking arms in a crisis, does their family point fingers and blame each other?
c. Is their family productive or non-productive?
1.Productive: Are the family members able to respond to the suggestions of friends or professionals and take necessary action to create change in the family?
2.Nonproductive: Are any family members unable to mobilize when help is really needed? Do any siblings or other kin feel powerless to act? Is “victim” a term you would use for some family members and or siblings? Do family members ignore the ideas friends or professionals who are trying to transform the sibling/ family dynamics
d. Is their family stable or fragile?
1.. Stable – When family members have disagreements, do they find a way to solve their problems? Does the family have long-standing relationships and respect the 
differences in each other?
2. Fragile: Is there a history of emotional cut-offs or distancing on the part of one or more family members? Is there a pattern of generational divorce, remarriage?
Each family is different but if this family scores 2 out of three you should investigate bringing in a mediator 
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5 Vital Clinical Tools to Help Aging Dysfunctional Families-Post Horrid Holidays-
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- Get care for aging family members when the dysfunctional family members resist
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