Long-Distance Caregiving

by Richard O’Boyle, Publisher
More About Richard…

Families are increasingly separated by hundreds or even thousands of miles. Maybe children came of age and went to school out of state or followed job opportunities. Or maybe retired parents headed south or west for milder climates. As parents age and need assistance, the separation can be an added factor that complicates communication and care. While technology for instantaneous communication is readily available (think of the fax machine and e-mail), there are still hurdles for ensuring adequate care for your loved ones.

Identifying When Your Loved One Needs Help

If you live far from your aging parents, perhaps you have a regular Sunday afternoon call that you make. Or maybe you haul the kids to visit with their grandparents once a year for the holidays. These little rituals certainly help to keep a family connected across the miles, but sporadic connections can often mask underlying problems.

Medical emergencies or accidents would likely require an immediate visit and perhaps an extended stay. However, the slow progression of dementia or depression might not become apparent through telephone calls. If both of your parents are still alive, the well spouse often compensates for the other’s failings and may deny that anything is wrong. Frequently, illnesses like Alzheimer’s Disease are not apparent to the long-distance children until it is well-advanced.

When you visit or speak with your parents, look for the following warning signs that something may be wrong:

  • Emotionally distant, distracted, or unavailable.
  • Preoccupied with minor matters, death, or
  • Visiting the doctor too much, or not at all
  • Personal appearance is shabby or unkempt
  • Household chores are not kept up
  • Piles of bills or unopened mail
  • Empty refrigerator

It’s a good idea to think proactively if you have aging parents at a distance. Talk with friends or other relatives who are currently caring for their parents to get an idea of their experiences, especially the events that lead up to them taking a more active role in their parents lives. The death of one spouse is often the critical event that reveals underlying care issues, or at least requires a closer relationship going forward.

Improving Communication

Good communication is often lacking even when families are living in the same house. Some families have a history of openness while others are close-lipped or even secretive. Add in the distance factor and you can seriously reduce the effectiveness of communication, even leading to miscommunications.

It would be ideal for us to have frequent in-person contact with our parents, free from the stresses and hubbub of holiday gatherings or family events. So look for opportunities to communicate beyond those periodic meetings: send a card, e-mail, or letter. Attach some photos and ask your parent(s) to also send back photos. One caregiver set up a small fax machine at her mother’s home to send fun pictures and notes (but it also served as another direct line to/from her).

Many families find it helpful to schedule a formal family meeting, perhaps with the guidance of a professional care manager or family therapist. By gathering together your parents and other interested relatives, you can collectively begin to address the crisis/issues at hand. Include the elder if at all possible as you discuss what his or her wants are. You may wish to have a conversation with them privately before you have a larger family meeting.

Crises related to aging and death may bring up intense emotional and family issues. Mark Edinberg, Ph.D. recommends that family members think ahead of time about what their “bottom line” really is when entering delicate discussions with aging parents. “Do you need to get your parents to tell you EVERYTHING about their possessions or do you really need to get them to confer with a competent attorney? Do you need to get your family member into a nursing home or do you need them to be evaluated by a competent agency, physician or other provider who may come up with options that may work for your older relative?” he asks. Thinking and planning ahead can greatly minimize the stress of the situation for both your parent and yourself.

What to Do, Where to Get Help

Once you have decided to become proactive about helping your aging parents you can gradually build a list of contact people and resources. If you are in crisis mode, you may not have the luxury of time to gather this information. It’s important to work closely with your parents, siblings, and other relatives to be as effective as possible. Share information over the Internet and through regular telephone calls.

  • Make a list of important telephone numbers: Write down numbers for neighbors, doctors, banks, and professionals such as lawyers and doctors.
  • Gather information on local community services: Start with a copy of your parent’s local yellow pages. You should also make a note of their county office on aging (as well as YOUR county office on aging). ElderCare Online’s Neighborhood Networks contains state-by-state listings at http://www.ec-online.net/Community/Neighborhood/neighborhood.html
  • The Eldercare Locator phone service can be reached at 1-800-677-1116 or http://www.eldercare.gov
  • Learn about medical conditions that your parents have been diagnosed with, including expected progression and needs. Plan for those needs.
  • Consult with qualified professionals, such as geriatric care managers (http://www.caremanager.org), elder law attorneys (http://www.naela.org), or bank trust officers (check with your parent’s bank). Remember that laws may vary considerably from state to state, so consult with local practitioners.
  • Don’t forget about local friends, relatives, and neighbors: These people may be able to give you valuable information about your parent’s condition, or just stop by from time to time for friendly visits.

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