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Mediation in the case of elder abuse and mistreatment is increasingly employed in North America to resolve conflicts that disproportionately affect older adults. The attendant dangers of mediation in these cases require awareness of and sensitivity to issues facing older adults and their families, including elder abuse, ageism, and consent and capacity. This article charts the introductory stages of an elder mistreatment mediation project started through a law school-based mediation clinic. Responding to expressed local need, the project developed an Intake Guide that attempts to balance the autonomy of the older adult with safety screening. The model employs an interdisciplinary approach, with specialist social workers acting as advocates throughout the process. Lessons learned from the project include: the importance of training; the need for flexible and responsive approaches to mediation; the importance of a specialized intake and screening tool; the benefits of interdisciplinary, strengths-based approaches and the centrality of collaborative community relationships to ensure program sustainability.