Manage Long-Distance Care

Managing a loved one’s care from a distance is oftentimes complex and cumbersome. Because the caregiver’s ability to oversee both day-to-day needs and crises is limited, those who find themselves in this situation report more amounts of stress, anxiety and guilt than caregivers in immediate proximity.¹Yet the incidence of long-distance caregiving continues to rise. Indeed, it is estimated that 7 million Americans live an hour or more away from a loved one in their care.²One study even found that caregivers live an average of 480 miles from the person they care for.³And as life expectancies continue to lengthen and the boomer generation enters old age, the number of long-distance caregivers is only expected to rise.

Thoughtful planning is the key to making the long-distance coordination of care a success. If you find yourself in – or about to embark upon – an arrangement of this sort, it is critical that you take the time to evaluate the toll the situation is taking…and will take in the future. The following set of management strategies, questions and considerations may be of use in this regard.

Questions to Ask Yourself Before Committing to a Long-Distance Caregiving Situation

Is this too much for me to take on right now?
What alternatives exist?
Can I handle the travel fatigue?
How will my family be affected?
How will my work be affected?
Can I afford to do this?
Do I have the patience to do this?
Will my loved one heed my advice from a distance?
Am I a good long-distance communicator?

To Do List

Family

Discuss the situation with your loved one
Identify what kind of help your loved one needs
Call a family meeting to talk about the roles each of you will play in your loved one’s care; summarize the decisions in a written document

Support

Brainstorm relatives and friends living in the area who can provide that help
Establish a log of support contacts (with phone numbers and addresses)
Contact each support contact and ask if they would be willing to lend a hand or check in on your loved one and if they know of anyone else you should add to the list
Give each support contact your name and number and ask them to call you collect if anything happens
Consider setting up an online calendar to help organize tasks. Visit Lotsa Helping Hands for more information about its private group calendar function.
Join a local support group to talk about the issues surrounding your situation
Research and use coping techniques to help relieve your feelings of stress and inadequacy

Coordinating Care

Make contact with your loved one’s doctor and explain the situation
Make sure you are the doctor has your name and number in case of emergency

Accessibility

Order copies of the phone book and yellow pages from your loved one’s area
Investigate the different travel options available
Keep in regular touch with your loved one

Services

Research publicly funded services in your loved one’s community
Contact community groups, religious organizations and volunteer services to coordinate needed services
Talk with representatives at the local Area of Aging branch to discover what services they can offer.
Log on to the Eldercare Locator web site for help finding services, care and support for older persons
Research transportation resources

Organization

Find and organize all of your loved one’s important financial, legal and medical documents. Make a complete list of all bank accounts, investment accounts, titles and insurance information. Review these documents for accuracy and update or dispose of them as needed. Make copies and store in a safe place.

And remember: you must always be ready to reassess! Situations can change at a moment’s notice, and you must be willing and able to modify your initial plan of care.

Things to Look for During a Visit

Changes in eating habits and kitchen condition
Condition of the house (both inside and outside)
Mail situation (are the bills being paid?)
Frequency of visitors
Your loved one’s appearance and grooming habits
Changes in driving capabilities

Things to Accomplish During a Visit

Speak with or see your loved one’s physician, lawyer and financial adviser to ensure everything is going as planned.
Talk with the people in your support list about how your loved one is doing.
Be observant about people who come by the house frequently (such as postal or utility workers) and alert them to the situation.
Have fun and enjoy your time with your loved one.

Professional Services to Consider

Home health care workers to help the person with grooming and bathing, personal care activities, meal preparation and medication administration.
Geriatric care managers to monitor and manage the needs of the elderly. To find out more visit the Association of Professional Geriatric Care Managers at www.caremanager.org or call (520) 881-8008.
Elder law attorneys to get necessary legal documents in order. To find an elder law attorney, visit the National Academy of Elder Law Attorneys www.naela.org.
Bank officers or personal accountants to help your loved one stay on track financially.

When Your Loved One Lives in a Care Facility

Even though it is often painful to see a loved one in a managed care facility, try to evaluate the situation with an open mind.
Ask how your loved one is doing. Listen to their comments, their compliments and their complaints.
Make appointments with the managing nurse and physician to introduce yourself, discuss the situation and assure them of your interest in your loved one’s care.
Have detailed conversations with the nurses, physical therapists and other staff members who have intimate knowledge of your loved one’s condition.
Ask what is the best time and method for you to contact the facility for updates and progress reports on your loved one’s condition.
Establish contact with your loved one’s other visitors and ask for their observations about the facility and the care it provides.

Communicating With Your Family

Try to discuss disagreements about the situation as soon as they arise
Validate your family member’s feelings and opinions, even if they are different from yours
Cooperate with your family members to figure out which tasks need to be done, what they will cost in terms of time and money, and which best suit each person
Work together to find solutions you all can live with
Be as clear as possible about each family member’s individual responsibilities and tasks
Call family meetings (either in person or over the phone) to keep the lines of communication open.

Additional Resources

USA Today article (Caregivers Cope With Stress, Mixed Emotions About Aging Parents; June 2007)
Survey cosponsored by The National Council on the Aging (NCOA) and The Pew Charitable Trusts
Alzheimer's Association LA & Riverside, Los Angeles, California