Providing the Care
Session 2: Long-Distance Caregiving
Course Sessions
- Seminar Introduction
- Providing Care in Their Home
- Long-Distance Caregiving
- Providing Hands-on Care
- Involving Others
- Knowledge Test
You are at work when you get a phone call from your husband. Your mother-in-law has fallen at home and is on her way to surgery to repair her broken hip. You and your husband have just returned from visiting her last weekend--an eight-hour ride. You weren't planning to go back for a few months. You are trying to figure out what to do about work demands and your children's schedules. Your husband is feeling frustrated and guilty. He tried to convince his mother to move to an assisted living facility a few months ago, but she wouldn't agree. Now he is overwhelmed thinking about how to arrange for help once his mother is out of thehospital.
In today's world it's common for family members to live in different cities and states. Sometimes it is the parents who move away from the place where they raised their family, perhaps to retire to a warmer or otherwise more appealing environment. Often it is the adult children who scatter geographically. As a result, many adult children must help from a distance when their older parents and other relatives need care. This task can be difficult, stressful and time consuming. Here are some issues to consider when trying to take care of a parent long distance.
Caring across the miles
Families whose members live at a distance from one another have many difficult questions and issues to address. For example, most long-distance caregivers are not able to visit frequently and cannot provide care in the home. It can be impossible both financially and practically. Other important responsibilities, such as jobs, family and children also need to be considered. Yet, despite having good reasons, adult children often feel guilty that they cannot spend more time with their parents. They also may feel overwhelmed by the challenges of arranging services long distance. This is especially true if they have no experience in dealing with community services.
One of the most difficult aspects of long-distance caring can be knowing when your help is needed and when you should make the trip to address a problem in person. Some situations can be difficult to assess over the phone. Your mother may not admit there is a problem. Your father may be very dramatic. In addition, your parents' and your perceptions of the issues also may differ. While changes related to aging may worry you, your parent may adjust to them very well. What you see as a major safety concern, your parent may feel is a minor risk that he or she is willing to take to remain independent.
Some long-distance caregivers think that the situation will be easier to handle if a parent moves closer, possibly into the adult child's home. Yet many older people don't want to move at all, or they don't want to live with their adult children and their families. Those who do will face losing old friends and making new ones. Problems can occur when families aren't realistic about their relationships. For example, a parent and child may care about each other but have a history of conflicts that would make living together a special challenge.
Another common dilemma that adult children face is how to interact with siblings, especially those who live nearer to the parent than they do. Will the closer sibling take the lead in caregiving? How will the adult child who lives further away help out? What family issues will this new situation raise?
Finally, long-distance caregivers often express frustration about not being familiar with resources and services in another part of the country. Being miles away from older parents can also mean being miles away from local phone books and local agencies that help older adults. Feelings of frustration often come from feelings of helplessness in trying to access needed services from so far away.
What you can do
Determine with your parent (and perhaps other family members) what assistance they need. Consider
- Opportunities to socialize
- Help with chores or housekeeping
- Personal care, such as help with bathing or dressing
- Fixing meals
- Legal assistance regarding money or health care matters
- Help paying bills
- Checkups with doctors
- Help after the death of a spouse or someone else close to the parent
- Transportation
- Changes to the home
- Living somewhere else
Gather information on community services that can meet your parents' needs. Take notes on the services offered, the application process, waiting lists and fees, and keep your notes together. You can get a lot of information over the phone and the Internet; even family members who live in the same community as their parents usually start with these tools. If an organization requires an in-person interview with your parent, find out what documents you need to take to the meeting. If you cannot go with your parent, consider sending someone in your place. Be sure you clarify their responsibility for expressing your goals.
Use the Eldercare Locator (800-677-1116) to determine which local agencies provide service where your parents live. It will refer you to the area agency on aging in your parent's community.
Share the care
Identify people your parent can call on. This includes friends, neighbors, clergy and others in regular contact with your parent. You may want to introduce yourself to close friends or neighbors and keep a list of their phone numbers and addresses. If you can't reach your parent or you have a particular concern, calling these folks can ease your mind. In addition, they may be able to help out with shopping, transportation or visits. Work with parents to collect the following necessary information before crises occur:
- Medical: Your parents' medical conditions, the medications they take and the names and phone numbers of their doctors.
- Financial: A list of what your parents own and their debts, with dollar values, yearly or monthly income and expenses, a statement of net worth and information on bank accounts or other financial holdings and credit cards.
- Legal: Other relevant legal documents they have or want to create (wills, advance directives, trusts, powers of attorney); where they keep important documents (birth certificates, deed to home, insurance policies); their Social Security numbers; and information on health insurance and driver's licenses.
Make the most of your visits
- Talk to your parent so that the two of you can decide together what needs to be done and who can help.
- While you are visiting, be observant. Do you notice anything unusual? Is your parent eating nutritious meals regularly? Are finances in good order? Are there any obvious health or safety problems?
- Allow yourself enough time to accomplish necessary tasks such as visiting social service agencies or housing that your parent is considering. Include time to socialize and enjoy each other's company and activities you both enjoy doing. A visit that is "all business" won't be good for either of you.
- Work with your parents to help them accept the services you find. Be sensitive to their views of the situation. They may be concerned about having strangers in their home or have trouble facing change. Even though dealing with these issues can be frustrating, it's important to maintain a positive focus. Tips: Explain that the services are designed to help them remain independent. Explain how the services will work. If possible, offer to contribute to the cost of care without appearing to offer charity. Have someone else your parent respects recommend the service, such as their doctor.
Be careful not to make your parents angry or stir up old family disputes. Use a relaxed approach that doesn't threaten your parent's independence. Don't change your usual style of communication, however; you might appear insincere. Plan what you want to say and accomplish ahead of time. Anticipate your parent's possible reactions and how you might respond to them. Sometimes it may help to suggest that your parents will be doing you a favor by accepting some help. Asking them to do it for you, not for themselves, might allow them to accept assistance with more dignity.
Take care of your own needs
- Recognize the strain that long-distance caregiving causes,
and take steps to reduce your stress. Learn and use coping
skills, get support and/or counseling, take time for
yourself.
- Accept that it's impossible for you to provide all the
help your parent needs. Give yourself credit for your efforts to
determine needs, coordinate services and offer support by phone
and on periodic visits.
- Ask for help when you need it. If you don't feel that
other family members are doing their share, consider holding a
family meeting to discuss responsibilities.
- Take care of your health: eat right, get regular exercise and get enough sleep.
Glossary
- Advance Directives
- A variety of documents that express health care wishes, including a living will, health care power of attorney or proxy, durable power of attorney for health care decisions, medical directive or other similarly named documents.
- Durable Power of Attorney for Finances (DPA for Finances)
- A document in which you appoint another person to make financial decisions on your behalf. The DPA either continues in effect once you become unable to manage your affairs or springs into effect at that time.
- Elder Law Attorney
- An attorney who specializes in the laws pertaining to the rights and issues of older adults, such as estate planning, wills, health care decision-making and financial issues.
- Health Care Power of Attorney (Health Care Proxy)
- A special kind of durable power of attorney called a health care power of attorney (HCPA) in which you appoint another person to make health care decisions should you become unable to do so.
- Living Will (Health Care Directive)
- A legal document that communicates a person's wishes about lifesaving medical treatments should he or she be in a terminal condition and not able to communicate health care wishes.
- Will
- A legal document that communicates how a person wishes his or her belongings, assets and property to be distributed after death.
