Navigating Long-Distance Caregiving for Aging Loved Ones

“If you don’t do the legal work that needs to be done, it’s going to cost more,” says Eric Einhart, of suburban New York City. He’s president of the board of directors for the National Academy of Elder Law Attorneys.

“If the client does not have a durable power of attorney because they do not want to spend the money, but then they lose capacity, their loved ones have to go to court and get guardianship, and it’s 10 times the cost and takes the control out of the family and into the court’s hands,” he says.

Although legal documents aren’t required to hire a home health caregiver, Einhart says, some home health agencies “may require a durable power of attorney and a health care proxy on file so they know in the event that something happens, they’ll be able to take direction from someone with the legal authority to give that direction.”

Utilize technology and apps

Long-distance caregiving is becoming more manageable because of technology that’s rapidly altering the landscape of “being there,” suggests Dr. Mark Carlson, a geriatrician, of Cedar Park, an Austin, Texas, suburb.

“It’s still not as good as being right next door,” he says, “but with the proper application of sensing devices, listening devices, and phone and text messaging and combining that with caregivers and the human element, for many elders, it can extend useful time in their home and maintain their independence.”

Remote monitoring by caregivers jumped from 13 percent in 2020 to 25 percent in 2025, the AARP caregiving report found. This type of in-home caregiving model — which enlists wearable devices, medication reminders with customized pillbox services, electronic visual caregiving systems and even small robots that can assist with home tasks — is a less expensive alternative to assisted or independent living at senior living facilities and lets older adults remain at home.

Medical alert systems, often referred to as personal emergency response systems (PERS), provide alerts in the event of a fall, just as smartwatches and other wearables can automatically detect falls. Smart speakers, video cameras and motion sensors can detect activity in various rooms of the home, providing extra peace of mind for the remote caregiver. For most, that concern is focused on avoiding a potential fall, which can set the older adult on a path to declining health.

Data from the Centers for Disease Control and Prevention, released in 2024, found that falls are the leading cause of injury among adults age 65 and older. One in 4 adults in that age group report falling each year. And 1 out of 10 falls result in an injury that causes the older adult to restrict their activities for a day or more or to seek attention from the health care system.

Build a local support network

Caregiving from a distance comes with a cost. Not only do transportation costs to the care recipient add up, but Barlam says care management service costs can range from $75 to $300 an hour. The care manager arranges caregivers, but that manager’s role is an additional cost above what’s paid to the direct caregivers.

Creating a plan of care starts with an assessment to determine who’s involved in the individual’s care, he says.

“Examples are professionals the formal support, doctors, attorneys, accountants, physical therapists, specialty doctors and the like. Informal supports are family, neighbors and the community. The community could be the religious, social, cultural community that the person is affiliated with,” Barlam says.

The care plan includes three major components that identify needs or issues of concern, as well as the desired outcome for the individual, including goals to achieve (such as preventing further weight loss). The third part is determining interventions that can get you from the problem to the desired outcome, he says. Additionally, care managers prioritize the issues and create a contingency plan if the areas of concern aren’t resolved.

“For those out of town, some clients use us on a short-term basis for three to five hours at the front end to create a plan. Then some people use us to create a plan and want us to check in a couple of times a month and lay eyes on the situation and give us feedback, and others want us to be involved for every single medical appointment and report back,” he says. “It could be a few hundred dollars for a one-time deal to $500 a month.”

And for those who can’t afford such expenses, Barlam says the local Area Agency on Aging offers resources to provide case management services at a much lower or no cost.

“But there are waiting lists and limited services they can provide,” he says.

Among some aging adults, their past affiliations may also reduce expenses. Discounts for remote devices are available for specific individuals, including veterans who may be eligible for a device through the U.S. Department of Veterans Affairs.

Consider the help of friends

Friends and neighbors can keep tabs on aging adults for remote family members, but Barlam says what they can and should do requires careful thought.

“Can you rely on neighbors to do the marketing? Sure, it’s not that great of a strain and can work indefinitely. If it’s a person in their early 80s with a chronic illness, it could be months or years, and there’s a limit on what you can expect from friends and neighbors,” he says. “The kind of tasks is a second issue to consider. You don’t necessarily want friends and neighbors doing banking and getting involved financially. You don’t want to open yourself up for risk of financial abuse or exploitation.”

In addition to remote monitoring techniques that assist long-distance family members, online banking allows them to manage their aging adult’s finances, as well as arrange grocery or restaurant delivery and attend doctor visits via telehealth.

“I’ve worked with clients remotely who have not seen their relatives for years at a time,” Barlam says. “Others come in every two or three weeks.”

Those who work in the caregiving space say families can act at a distance as long as they have the proper permissions and signed documents giving them the authority.

“Caregiving from afar is not an impossible task as it once was,” Einhart says. “You can order DoorDash food. You can order online groceries. You can set up Zoom conferences and telehealth and assist with Life Alert and hire professionals to review their environment. It’s not perfect. It’s not like driving to the next town or walking around the block. There’s no substitute for checking the environment, but there are ways to work around it.”