March 15, 2018

Long-Distance Caregiving: How to Help From Afar

It’s never easy to watch your parents’ health decline, but it can be even more difficult when you can’t be there in person to help them shovel after a snow storm or take them to the doctor. Relocating to be close to your parents isn’t always feasible, and Mom and Dad may not be interested in packing up to move to your town, either.

It’s a dilemma shared by 11 percent of caregivers, who live at least an hour away from their loved one who needs care, notes Mary Kerwin, MSSW, social worker for UW Health’s Geriatrics Clinic. But there are still many ways you can support your loved one no matter how many miles are between you.

The most important thing you can do: get informed and involved. “Don’t bury your head in the sand or assume that your mom is OK unless you hear otherwise,” Kerwin says.

Tips for Caregiving When You Live Far Away

Planning ahead can make the situation much more manageable. “The good news is there are a lot of resources within UW Health and within the communities in which seniors live,” Kerwin notes. She shares these tips:

Broach the conversation early. It’s better to have an open conversation before a crisis hits. “I can promise you they’re already thinking about it even if they’re not saying anything because their peers are probably going through those issues, too,” Kerwin points out. “If they mention a friend has Parkinson’s, ask questions. You could say, ‘That makes me wonder, Dad: Hopefully you’re going to stay healthy for awhile, but how would we handle that if something happened to you? What are your thoughts about that?’ It’s easier for people to talk when it’s about someone else and when it’s a hypothetical.”

It can be helpful to frame the conversation around goals. “A lot of people say, ‘I want to stay in my house no matter what. I don’t want to go to a nursing home.’ But there are lots of options in between,” Kerwin says. “Find out what their goals are and how you can honor those goals, and also what’s negotiable.”

Connect with your parent’s health care provider. Ask your parent if they’re comfortable authorizing you to view medical records or talk to his or her doctor directly. “Otherwise you’re totally relying on your parent, and they may not have heard all the information or really understand it,” she says. If you can get added as a proxy on your parent’s electronic medical records (such as MyChart), it’s easier to stay up on your parent’s medications, the doctor’s recommendations and future appointments. If you notice concerning symptoms, call or email your parent’s health care provider before your parent’s next appointment to give them a heads-up. You may want to go with your parent to a doctor’s appointment next time you’re in town so you can make a face-to-face connection.

Recruit a team. “Brainstorm with your parent or other family members about who can help if something is needed right away, and start making a list,” Kerwin says. “Maybe there’s a longtime neighbor who has a key or who could watch to see if the newspaper is picked up every day. Maybe it’s a friend they play cards with or someone from their bowling team. If you’re long distance, you need to have some reliable boots on the ground.”

It’s especially helpful to have someone who can go with your mom or dad to important medical appointments when you can’t be there. “It’s always great to have another set of ears in the room to hear what the provider is telling them, especially if it’s something new,” Kerwin says. After appointments, connect family and friends via an email chain so everyone is on the same page and can reinforce the doctor’s recommendations.

Play to your strengths. There are different ways to provide support. “Say you have a sibling who is not the touchy-feely one, but maybe is good with numbers and could handle the power of attorney for finances or grab the important tax documents to make sure those things are managed. Maybe there’s someone else who can provide transportation,” Kerwin suggests.

Know what you can control and what you can’t. “You have to recognize that even if you’re an adult, your parents may still see you as a child. They do have the right to make their own decisions, even if their decisions seem wrong to you. All we can do is offer choices and information,” Kerwin says. “If your parent starts to develop dementia, they can lose insight, judgment and awareness. In those cases, we’re more direct and emphatic with recommendations because they would need that. But in many other circumstances you have to let them make their own decisions.”

Bring in a third party. “Sometimes it’s really helpful to hear information from someone else, such as a doctor they trust or a golfing buddy. Sometimes those other influences resonate more than advice from a child,” Kerwin notes. A local aging office might also have a staff member who can help facilitate a difficult conversation about lifestyle changes.

Investigate local resources. Check with your county’s local aging office to learn more about what resources may be available to your mom or dad. If it’s no longer safe for your parent to drive, explore local transportation resources — many communities offer free or low-cost transportation to help seniors get to appointments and other places. “Once you start looking, it’s surprising how many resources exist,” Kerwin notes.

Get organized. “Some adults are very organized with their health care, so they keep all their medications organized and keep their lab results and after-visit summaries in a file,” Kerwin says. “But if the person you’re caring for isn’t as organized, you can help them become organized so when you or someone else comes, that information is in the same place.”

Establish power of attorney and a living will. It’s important to make sure your parent has someone designated to act on his or her behalf in case of emergency. Find the forms online or get them from a hospital chaplain or clinic social worker.

Tap into technology. Consider an emergency medical alert if you’re worried your parent might fall or get hurt while home alone. “They’re great as long as people wear them and don’t leave them laying on the night stand,” Kerwin says. “And some have newer GPS technology, so for those elders who still get out and about, that can provide an extra layer of security.” Philips Lifeline is one popular medical alert system, and other local options include Night Owl Support Systems, Stoughton Hospital Life Assist and Life Assist. Wearable devices such as the GPS SmartSole, which is installed in a shoe, can provide extra reassurance for patients with dementia who wander. There are also in-home sensors that can detect movement in the home: GrandCare Systems and ThisCaringHome are two options.

Hire help. Geriatric private care managers are social workers or nurses who help with care management for a fee. If your parent’s case is complex, a professional can help assess needs, research assisted living options, regularly check in, and accompany your parent to medical appointments. Search the database of the Aging Life Care Association to find a local resource.

Take care of yourself. “It’s super common to feel guilty and like you’re not doing enough, but we know long-distance caregivers incur more expenses because of travel time and lost work time,” Kerwin says. Be kind to yourself and ask for help when you need it. You don’t need to shoulder this burden alone.

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