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What is a long-distance caregiver to do?

by Isabel Fawcett, SPHR

Some long-distance caregivers are under-estimated or under-appreciated. In fairness to long-distance carers, geographic distance only serves to complicate roles, responsibilities, communication and family relationships. How might a long-distance caregiver take an active role in eldercare? Sometimes it may feel like damned if you do, damned if you don't. However, there's hope.

Family Expectations: As Far Apart as Geographic Distances

Whether or not primary caregivers share expectations with family members who live far away, there are likely to be unstated expectations on both sides of the family's fence.

A family member who lives far away may assume that relatives who live locally need to do whatever it takes to care for their chronically ill parents - without being asked. Why wouldn't they, is the prevailing thought. After all, they live locally or nearby. Similarly, some local primary caregivers may assume that they should be relieved of their eldercare responsibilities without having to ask a far-away family member for help. Never the twain shall meet, it seems?

In such situations, something, or someone, has to give in a manner that will allow family members near and far to openly share the effects and expectations of caring for an elder who is chronically ill and whose health may be declining. The sooner families can reach across the miles to support each other, the better.

Family Care Ice-Breakers

Instead of beating around the bush and waiting for some family crisis to occur, there are many things you can do to help your family move past its eldercare gridlock.

  • Assume a position of leadership in communicating. Regardless of whether you are the primary caregiver, or not, nothing precludes your asking the family's tough questions.
  • Discuss your parents' contingency long-term care plan. The contingency plan discussion should include individual family members' roles and responsibilities in the event of chronic disease onset or emergency medical care or incapacity.
  • Don't talk around your parents. Invite them to lead in developing or proposing their long-term care family contingency plan. Are there family members who are more inclined to assist your parents with in-home care or local errands, for example? Some family members pitch in financially to obtain agency help for their elders.
  • If either or both of your parents are no longer in good health, you may benefit from using a resource such as EldercareLink.com's Needs Assessment to get a better handle on eldercare resources and agencies by geographic location.
  • Consider all options by first doing your homework.Your parents and other family members may not have planned for their long-term care housing and assistive needs. They may resent or resist reasonable attempts to help guide them in elder life transitions. Know what all of their options are before you engage your parents in communication. Putting together a concise packet of information for discussion with your parents and siblings may be a sound communication strategy.
  • Call a family stakeholders meeting. Before calling the family stakeholders meeting, first consider who should be invited to participate in the meeting. Your parents should be asked for input, first, regarding who should attend.
  • Identify family members who are in close geographic proximity and long-distance relatives -any family member who has truly cared about the well-being of your parents for any extended period of time. Consider whether any on-again, off-again temporary caregivers to your parents might be interested in meeting with family stakeholders at a future date - after the family has a tentative eldercare contingency plan ironed out.
  • Ask your parents to enlighten you regarding their current medical and in-home needs. Is it increasingly difficult for your parents to make it up and down the stairs of their home? Do they feel safe in their present neighborhood, including coming, going and while at home? How has the neighborhood changed over the years? It is possible to feel like a stranger in a changing neighborhood where nothing seems familiar. What household chores might they need help with? What would it cost to modify their home to better accommodate their disabilities? Their answers will define the best in-home, agency and geographic housing options for them.
  • Document and organize your parents' health and medical information. Subject to your parents' authorization, their administrative file should include names and contact information for all treating physicians, current prescriptions, surgeries, medical diagnoses, durable power of attorney, living will, and/or all advance directives as authorized by your parents.
  • Treat all of your parents' information as sensitive and confidential. Be selective in distributing the information within the family and be sure your parents retain control over who is granted access to their information.
  • Is there a trustworthy accountant in the family? Before income tax time rolls around each year, would that person do the honors of preparing your parents' income tax return, whether for a nominal fee or free of charge?

Lead or Follow - Just Remain Involved

There are plenty behind-the-scenes, communication and leadership responsibilities for any long-distance family caregiver who is so inclined. Ask, share and most importantly, don't be afraid to be the chief family cornerstone in your parents' eldercare. If you do not wish to be in the lead, just ask the primary caregiver what you can do to help. Remember that reassurance goes a long way, too. Save the Monday morning quarterbacking for the day after Super Bowl.