Long-distance Caregiving
"Long-distance caregiver" is a term used to describe an
increasing number of adult children who live in one part of the country
but are trying to monitor an aging parent's health and well-being in
another. Most sons and daughters who do this experience worry, frustration
and guilt. How do you know if Mom is eating right? Why didn't she tell
you she was going in for that test? Why did you take this job so far
away? How many voice-mail messages do you have to leave before her
doctor calls you back? What's going on there? The urge is to hop on a
plane and go find out. The reality in most cases is commitments to
spouse, children and a job, not to mention the expense of airfares,
make that impossible.
Here is a list of special things to consider for
"long-distance" caregivers:
Contact information. Make sure your name, address and phone
number are posted by your parent's phone with a note asking
that you be contacted if there is a problem. Be certain your parent's
doctor has the same information. The same holds true for any home-care
services people (visiting nurse, housekeeper, physical therapist and
so on) who may be working with your mother or father.
Neighbors and friends. Give your name, address and phone number
to the neighbor or the friend who is already in regular contact with
your parent and get his or her number. Ask if you can give him or her
a call if for some reason you can’t reach your parent. Maybe you
can arrange to check in with this person once in a while just to see
how Mom is doing.
Plan in advance. If your parent is going to be released from a
hospital or nursing home, ask to speak to the discharge planner, as
soon as possible. This is the staff member who figures out what
services your parent will need and how frequently he or she needs
them. Don’t wait until the day your parent is going home. Sometimes
there’s not much notice on "discharge day." So do some
planning in advance.
Contact local resources. If you're looking for health or
social services in your parents’ area, call the telephone directory for
their area code and ask for "Senior Information and
Assistance" or call the toll-free
Eldercare Locator
number:
1-800-677-1116. Most areas have case management services. Through a
state-subsidized or private program, a case manager can coordinate the
team of health and home-care professionals who will be working with
your parent.
When you talk to your parent on the
phone
Pay attention. Is there something new going on? For example, is
she talking about friends dying? Is she suddenly concerned about a
particular ache or pain? Don’t discount comments because you’ve
"heard it all before." Listen to the message between the
lines. Is she afraid of being alone? Is she worried that she may be
have a new medical problem?
Talk to both parents. If both parents are still living, spend
time talking to each alone. Ask Mom how she's doing and ask her how
Dad is doing. Ask Dad the same.
Call frequently and regularly. Agree on a time that's good for
both of you. "I’ll call you on Monday evening." "I’ll
call Thursday morning." But be careful. Mark it on your calendar
so you don't forget. A week probably passes very quickly for you. That
may not be true for your parent who really looks forward to hearing
from you and will worry about you if you fail to call.
Make a list. Suggest that your parent jot down a few notes
between calls to get ready for the next one. You do the same. That way
neither of you will forget something important that needs to be
discussed or a bit of news that will be fun to share.
When you're going to visit your parent
The telephone can be an invaluable tool for monitoring your
parent's well-being but it works best when coupled with visits to Mom
or Dad. Those visits can go a long way toward meeting the needs of
your parent and helping calm your worries, too. Here are some
suggestions for going home:
Plan ahead. Maybe you want to call Dad's doctor and others
working with him and arrange appointments to meet and discuss how he's
doing. If possible, include your father in any meetings. Waiting until
you are at Dad's house to begin setting up meetings means trying to
make arrangements on short notice and spending time on the phone that
could be better spent with him.
Be prepared for medical questions. When you do meet the doctor,
have your list of questions and concerns ready, based on the what Mom
has said—and not said—during your telephone conversations, on what
you have observed during this visit with her, and on the most current
assessment. How have your parent's health and living conditions
changed since the last time you were home? What needs have become more
prominent? Are there new ones?
Don't panic. You may encounter what seem like drastic changes,
including a great deal of deterioration. Because you haven't witnessed
those changes on a day-by-day or week-by-week basis, the difference
between now and six months ago may seem more startling to you than to
your parent or a sibling who has been around more frequently. Their
failure to mention these changes to you does not mean they have been
hiding them from you, they simply may not see them. You each have a
unique perspective; all are helpful when trying to make an accurate
evaluation.
Don’t charge into town with all the answers. This will often
meet stiff resistance, not just from Dad but from your siblings who
may live closer and also have been playing a role in taking care of
him. Ask how you can help and offer suggestions. Work with your
father and siblings.
Think small. Prioritize the needs. Begin with suggestions that
are least threatening and that allow your parent the greatest amount
of independence. Maybe this is the visit to set up some sort of
housekeeping. Next time may be the right time to arrange for
assistance with finances. But begin that process now by raising the
issue with your parent. You are not going to fix all the problems in
one visit. Give yourself time. Becoming agitated with yourself, your
parent or your siblings only gets in the way.
Remember that your role as long-distance caregiver is something new
not just to you but to our society. In days gone by, most members of
the extended family lived close to one another and those who did move
far away returned infrequently, if at all. Automobiles, interstate
highways, jets, cell phones and the Internet made our world smaller
and made the role of long-distance caregiver possible.
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