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Long-distance caregiving can be emotional and frustrating

by Carol Bradley Bursack, Editor-in-Chief

The days when most extended families lived in the same town have been over for decades. People often move from the home town right after college graduation. If not, they may move later for a better job or to follow a spouse who was transferred by an employer. Whatever the reason, once their parents show signs of aging and decline, adult children can find that being a long-distance caregiver tugs at their hearts and their wallets. Where do these people turn for help in caring for their loved ones?

Living a distance away from our parents can be freeing for the young. However, as we mature our parents mature also, or as we generally say, they age. For adult children who see their aging parents regularly because they live close by, this aging process, barring urgent health issues like a parent's stroke, is gradual. It's different for those who live at a distance. People who haven't seen their aging parents for a few months are often shocked when they do visit. It's like they've been smacked in the face with reality. Mom and Dad are old.

Parents often don't share health issues with their offspring who live away from home because they don't want to "worry the kids." Even telephone conversations often don't reveal potentially serious issues. It's easy to just live one's long-distance life in denial. That denial reverses when you visit and find yourself staring reality in the face. You know that you must soon leave so you can get back to work. Your parents need help. What do you do?

Long-distance caregiving: sibling issues

If you have a sibling who lives close to your parents, with whom you have a good relationship, it's time to set up a plan. The near-by sibling is likely to become the default caregiver. Discuss with your sibling the role each of you will play in looking after your parents. Make it clear that you want to help. If you don't clearly offer, you may be resented for being distant, and you may feel--or actually be--left out of important health decisions.

You should offer to do something concrete to lighten the primary caregiver's responsibility, but how do you help from far away? One option is to offer to pay the cost of some in-home care. Help the primary caregiver find a reputable agency in your parents' town and then, together with your sibling, make a plan so that there is relief for the on-sight caregiver.

By showing love and care for the on-sight caregiver, you can come across as a partner willing to help with parent care, rather than a critic, or someone who mistrusts the caregiver. Obviously, if neglect or abuse is suspected, you are looking at something different. Generally, however, it's simply a matter of finding your place in the parent care plan by offering concrete help.

Long-distance caregiving and the only child

What if you are an only child who lives far away from your loved one? This presents other difficulties. Some families with squabbling siblings would give the world to be an only child. They get tired of family feuds over the parent's care. Many a lawyer has been consulted in the name of family feuds over parent care. So your own situation isn't all bad. But, still, you are alone and wondering how to handle the many facets of aging care from so far away.

Geriatric care managers can be a boon to people who live at a distance. Geriatric care managers often are social workers or nurses who have decided to work as an independent contractor. The service they provide is one of assessing the needs of your parents as they age and arranging, all the while communicating with you, for the local services that your parents may want or need. Their service, of course, comes with a price tag. Also, it's a relatively new field, so not every community has geriatric care managers. One place you can check is online through the National Association of Professional Geriatric Care Managers.

Even if you don't choose a manager associated with this care manager's association, it's good to browse the site to get a feel for what a care manager can do. If you do hire a care manager, be sure to get references, and check those references. There are no licensing guidelines for this profession. I'm sure that will come, but for now it's an open field. You want to make sure you are getting not only what you are paying for, but that what you are paying for is good for your parents.

Long-distance caregiving options

In-Home Care Agencies

For some people, a reputable in-home care agency can do the job without you needing to hire an onsite care manager. A good in-home agency makes it a point to keep in close contact with you. Of course, again, be sure to ask for references and check them. Word of mouth is valuable, so if you have friends who live in your parent's community, ask around. See who they would suggest. Chances are good that they've needed some help with their parents, too.

Also, whether you use a care manager, an in-home agency or other hired help for your parents, since you can't regularly check on how the care is being handled, you should make sure a trusted friend or someone from your folks' spiritual community checks on them regularly. You don't want to risk your frail parents' health and well-being by blindly hiring someone to take over, with no check points.

Adult Day Care

While you are visiting your parents, you may want to see if there are adult day services or day cares in the community. They may not need this service now, but adult day care is often a wonderful way to get your parents out for social interaction and also know they are watched over. This works especially well if you only have one parent in the home. If you hire an in-home agency, they can arrange for their staff to drive your parent to and from day care or on and off the right bus.

Assisted Living

Again, while you are in your parents' community, you may want to look into assisted living centers. Many seniors don't want to move from their community because they have roots, but they don't mind moving to a place where they can have a social life, good food and someone to help them in an emergency. If your parents aren't ready for this now, look anyway. Make a plan.

Caregiving and aging parents

Don't forget the shock when you saw your parents after a six-month or year gap. This aging process isn't likely to reverse itself. So, now is the time to make a plan. Talk with them about their needs. They may try to convince you that everything is just fine as it is, so you need to be tactful and observant. Let them know that, even if you do live far away, you want to take care of them.

If possible, make a plan with them and include them in touring adult day care centers and assisted living arrangements. Maybe they prefer a small, home environment. Maybe they prefer a grand retirement center scheme. If they are capable, let them help plan. In an emergency, you won't have the luxury of time. If that is your situation, call friends who have aging parents. Also, check with medical professionals to ask for assistance.

With luck, you won't have to act quickly. But you eventually may have to act. Don't let denial keep you from recognizing when your parents need help. Help is available. You just need to look.