Families these days rarely seem to live in the same city, or even the same part of the country. And it’s not just children who have moved away to go to college or pursue a career. Parents, especially when they retire, are just as likely to move—to a warmer climate or because they have the freedom in later life to live wherever they like.
But what happens when a living situation changes, someone dies, or an illness makes it harder for Mom or Dad to continue living independently? How can you provide care if you don’t live nearby?
If someone you care for is living far away, the natural anxiety you may feel about his or her welfare will probably intensify. In addition, you may experience feelings of guilt about not being there for an emergency or to help your parent cope with the physical changes that come with old age. This potential combination of anxiety, guilt, and frustration can cause significant stress in a long-distance caregiver’s life, adding stress on top of more immediate worries such as children, work, and all the other concerns part of daily living.
Becoming overwhelmed by worries won’t be helpful to your parents and certainly won’t make it easier for you. The following suggestions will help you prepare for or deal with caring for your older loved ones, even if you live far away.
What Can the Long-Distance Caregiver Do?
The first step is to conduct your own assessment of your older loved one’s needs. Even on the phone, you can gather a lot of information about possible physical and cognitive decline that may require alterations to your parent’s living situation. Ask yourself these questions:
- Is your parent able to prepare his or her own meals?
- Does your parent still have friends and a social life?
- Are medical needs being attended to properly?
- Is your parent managing his or her own medication(s)?
- Is your parent’s living situation safe?
- Is your parent still able to manage his or her own finances?
- What is the state of your parent’s health?
- What long-term plans need to be made for the future?
Regular phone calls to your parent can be brief but very informative if you plan the conversation ahead of time and stay focused. Be gentle, but persistent. It may be extremely difficult for the older person to acknowledge certain needs or changes. After all, you are questioning your parent’s ability to live independently. Don’t be surprised if strong emotions and even resistance arises during these conversations.
Also, remember that you and your parents may view things differently. What you perceive as a serious problem may not appear that way to them. Try not to let your anxiety and need for assurance overcome your respect for your loved one’s independence. They may be older and need adjustments to their living situation, but it is still their life and their right to decide how to live it. Be patient. Listen carefully. Many older people are open to compromise.
A significant exception to this willingness to change is when a parent is no longer mentally capable of evaluating personal needs and limitations. If you suspect this is the case with your parents, bring in a doctor to conduct a cognitive assessment. However, a diagnosis of dementia doesn’t mean your parent has to move. Resources are available to help keep your parent safe at home. Identifying and organizing these resources are parts of the next basic step: setting up a care plan.
Systems of Care: Establishing and Implementing a Plan
When you’re not nearby, who helps your parent with little things like shopping or changing a light bulb? Odds are your parent already has an informal support network of family members and friends living nearby to run errands or help them in completing tasks. Find out who these helpers are and how to contact them in case of an emergency or to ask for further support. They are sometimes more than willing to provide additional help. Consider asking them to:
- Visit your parent regularly, at least once a week, and observe his or her appearance, behavior, and living conditions. Ask the friend to contact you if there are sudden changes in these areas.
- Provide transportation, on an as-needed or regular basis. Getting safely to and from medical appointments, religious services, shopping, and even social events is very difficult for many older people.
- Socialize with your older relative. Isolation is a terrible burden for many older individuals. Ask a friend to visit Mom or Dad once or twice a month to share a meal or help them prepare a meal for a small gathering of friends or neighbors.
Cultivate a group of local volunteer helpers to act as your eyes and ears with your older parents. Give your home and work phone numbers to the helpers you trust most, and encourage them to call if they have a question or concern about your parent’s living situation.
As the primary caregiver for your aging parent, you can still ask for help. Family members less directly involved in day-to-day caregiving decisions can help out in other ways. In fact, they may just be want to contribute, but don’t know how. Consider these options:
- Ask someone to be the accountant. Most businesses, utilities, and merchants will send their bills to whatever address is convenient for the customer. A separate checking account can be established to pay regular monthly bills. The volunteer accountant could keep track of documents involving taxes, and perhaps help prepare tax returns.
- Ask someone to be the secretary. This volunteer could maintain a mailing list for your parents and help them send correspondence such as holiday cards and birthday cards.
- Ask someone to research a legal issue, or gather information about a needed service or product. Just using the Internet or phone could be enough to get the right information.
- Ask other family members to take over day-to-day caregiving chores during their visits. This not only offers a break for regular caregivers, but also gives other family members an opportunity to form their own opinions about you parent’s needs and capabilities.
Paid Caregivers
Getting help from relatives might work for some families, but it may not be enough for others. In these instances, paid caregivers may be appropriate. Support services include the following:
- Geriatric care managers – Professionals who assist older adults and their families in obtaining and coordinating a variety of services. They provide assessment, education, counseling, long-term planning, crisis intervention, and assistance with financial, legal and medical issues, and can act as a liaison for long-distance family members.
- Meals-on-Wheels – Meals delivered to a person’s home.
- Emergency response systems – Connect the person to immediate medical services.
- Telephone reassurance programs – Provide phone calls to check on the older person’s safety and well-being.
- Volunteer caregivers – Provide brief visits to check on your relative. They may be from local churches, synagogues, or schools.
- Home attendants – Provide personal care services, such as bathing, feeding, or dressing, and may provide light housekeeping services.
- Visiting nurse services – Provide medical care.
Another valuable source of information is your relative’s doctor. Many doctors require their patient’s consent to disclose information, so ask your parent for permission first.
Monitoring Care from a Distance
Once a caregiving network or system has been established, it is important to monitor the situation carefully. The best way to do this is to plan regular visits that allow you quality personal time with your parent, as well as to do the following:
- Assess the current caregiving plan
- Provide for new or changing needs
- Maintain a close watch to ensure your parent’s ongoing safety and comfort
Pay attention to any physical and mental changes your parent is exhibiting. See for yourself whether their needs are being addressed by the caregiving plan you’ve set up.
Consider these questions during your in-person visit:
- Is the home clean and safe? Check for dangerous situations such as sliding throw rugs, loose stair railings, unsafe water heating settings, etc.
- Do you notice a change or lapse in your parent’s grooming habits?
- Can your older parent get around safely and easily? Is public transportation accessible and affordable? What other transportation options might be arranged?
- Do friends and other family members visit, stop by, or call? How often?
If the answers to these questions make you uncomfortable, consider holding a family meeting with your parent and other involved family members to make decisions about caregiving. Identify the problems and brainstorm solutions. A family meeting is also a good time to secure promises of support and additional help from those who attend.
Finally, what do you do if your older parent calls you with an emergency and wants you to come over right away? This is tricky. Perhaps this kind of call becomes a regular occurrence. You may suspect there is another motivation (attention, unfounded fear, etc.) for the cry for help.
Think about your parents’ personalities and ways of handling their problems. If they rarely or never complain of a difficulty and are now asking for help, immediately contact their doctor and the nearest and most trusted of their friends or caregivers. However, if the cries for help are constant and questionable, step back and analyze how you can reassure your Mom or Dad without disrupting your own life and spending the money to travel on short notice. Don’t be overwhelmed by your parents’ needs and requests. Ask for help. It is available.
