July 7, 2005

Aging Connection

Tips to help with long-distance care giving

More than six million Americans are long-distance caregivers to an aging loved one. When dealing with this situation it is essential to remember that you are not alone.

Many long-distance caregivers worry about their family or friends and how to assist them from far away. They feel guilty for not living closer and for relying on strangers or neighbors to care for their loved ones. They feel anxious because they can’t see what’s going on and helpless as they await the ‘crisis’ phone call. Concerns about necessary care, proper nutrition, declining health, safety, or unpaid bills can add to the caregiver’s sense of being overwhelmed.

Some long-distance caregivers don’t know where to begin because they are not familiar with the aging network in their loved one’s community. They try to get information from their loved ones and encourage them to get help but these efforts are sometimes met with resistance.

Perhaps you think your loved one would be better off living near you. You may even feel selfish for not wanting to move closer to them. Contemplating the best course of action to take and how to step in without taking over your loved one’s lives is stressful. Conflict with your siblings and/or spouse over what to do can add to the confusion.

Where should you begin?
The following suggestions may be helpful when dealing with long-distance care giving:

1) Get organized and use a binder accumulating information regarding your loved one’s illness or tenuous situation. Include a list of names and phone numbers of their friends, neighbors, doctors and other resources. Document dates, times and important issues that may come up in conversations with them or other family members. This is especially important when detecting cognitive impairment and soliciting help from professionals. A pattern of behavior may begin to develop that relates to the type of care needed. Forgetting to pay the bills three months in a row could signal the beginning of Alzheimer’s disease.

2) Discern the situation by talking about your concerns as well as theirs. Perceptions may differ from a caregiver’s and from the care receiver’s point of view. Gather as much information as possible—what is working versus what isn’t. Do those observing the elders have differing opinions? Being a good listener and suspending judgments helps communication. Keeping the tone of voice calm and respectful may prevent escalation of tension and conflict. Your loved one may also be feeling helpless and fearful of losing control of their lives.
3) Plan the visits. Make arrangements for appointments even before the trip. For example, if you need to see a lawyer, set it up from home. Scheduling ahead of time maximizes time spent while there and may reduce stress. Manage as much as possible from home. Once there, allow quality time with your loved one such as engaging in an activity both of you enjoy.

4) Time is not on your side. Everyone wants to make changes now. Sometimes all one can do is plant the seed, document the changes and concerns and then just wait. Sometimes the crisis happens anyway and then changes have to be made. Acknowledge that you are doing your best and remember that you can only do so much.
Adult children often think moving their loved one into their home would solve the long-distance care giving issue and sometimes it is the best solution. But sometimes it’s the worst solution. Here are some questions one should ask when considering moving their loved one into their home:

- Does he or she want to move? What about his or her spouse?

- Is our home equipped for this person?

- Will someone be at home to care for the person?

- How does the rest of my family feel about the move?

- How will this move affect my job, family, and finances?

- What respite services are available in my community to help me?
(Alzheimer’s Association, 1999)

Long-distance care giving is not easy. Problems vary and solutions are not necessarily simple. Adult children may wonder if they should take action or sit and wait for clearer direction. But the most important step is to speak up, voice your concerns and seek emotional support from your family, friends or professionals. There are resources for local and long-distance caregivers. Connecting with them is an important step.

Vivian I. Silva, Gerontologist/ MSW is the director of Geriatric Advisory Program at Almaden Valley Counseling Service. The service educates and advises adult children and elders on aging issues and provides individual and family consultation. For more information call (408) 975-2988 or e-mail vivsilva@aol.com.