Long-Distance Caregiving for Elders

Tips for taking care of your elderly parent or relative from afar.

Taking care of an aging parent or loved one when you live far away can be challenging. Yet nowadays, over seven million adults in the United States are acting as long-distance caregivers for elderly parents or relatives in no small part because people are living longer and moving more frequently. But dealing with emergencies and day-to-day issues when your elderly loved one lives an hour or more away pose both logistical and emotional difficulties. When you get the emergency call in the middle of the night, how do you determine the severity of the problem? Do you hop on a plane or stay home and try to handle the problem via the phone and the Internet? How do you know what daily help your parent or relative needs? And how do you get that help when you don't live nearby and aren't familiar with local resources?

The key to successful long-distance caregiving is preparation. By planning ahead, you can better deal with emergencies and make sure your parent or loved one gets the daily services he or she needs. This article explains how to assess an older relative's situation and needs, collect and store important information, access local services, and get help from others all to ensure that you stay in touch and on top of things.

Assess Your Elderly Relative's Living Situation and Needs

The first step in providing care from afar is to assess how your loved one is doing and what additional help might be needed. Plan a visit of sufficient duration so that you can spend time with your elderly parent and observe the situation. Talk to other family members, your parents' friends, doctors, and other people who have contact with your loved one. Most important, involve your elderly parent in this process as much as possible. You may also want to get help from a professional, like a geriatric care manager. (To learn more about geriatric care managers, see the "Get Help From Others" section below).

Here are some things to look for and think about:

Is the Home Safe and Accessible?

Now that your parent or relative is older, some aspects of their home may pose a safety hazard or prevent them from caring for themselves properly. For example, throw rugs may pose a slipping danger to an older person who is unsure on their feet or using a walker; cabinet hardware and stove dials that are difficult to use with arthritic fingers may prevent a senior from preparing meals; and bathrooms without safety bars may make toileting or bathing dangerous.

Go through each room of the home, the yard, and the garage thinking about the following:

• Safety. Does anything pose a safety problem in the room? Can the senior move around the room and perform tasks safely?
• Accessibility. Is everything accessible to the senior? Can they reach things and work switches, doors, cabinets, and plugs? Can they perform necessary or desired tasks in this room?
• Adaptability. Are there things in the room that could be adapted so they are easier for the senior to reach or use or so that the senior can get around more easily and safely?

Then, make a list of modifications that would help your aging loved one continue to perform the tasks necessary to care for themselves and navigate around the home safely.

To learn more about the home modification process, including planning and paying for renovations, see Nolo's article Home Modifications for the Elderly.

Are Older Relatives Caring for Themselves Properly?

While you are visiting, take careful note of how your loved one is caring for him or herself, focusing on things like:

• Food. Are they able to prepare nutritious meals? Are the refrigerator and pantry stocked with food?
• Medical care. Is the senior taking all medications in the right dosages and at the correct time? Are they able to fill their own prescriptions at the drug store? Can they get to doctor appointments or to the lab? Do they remember and attend doctor appointments? You may have to talk to your relative's doctors' offices to get information.
• Home care. Is the home relatively clean? Is the kitchen clean and food stored safely? Is clutter posing a safety hazard?
• Finances. Are there piles of mail around the house? Are bills lying around? To learn about other warning signs that could mean your loved one needs help with finances, see Nolo's article Helping Seniors Manage Money and Finances.
• Driving ability. Is your aging relative able to drive safely? For tips on determining if your loved one is safe on the road, see Nolo's article When Should Elders Stop Driving?

Does Your Relative Have Adequate Social Interaction?

Ask questions about your loved one's daily life to find out if they have regular contact with friends or family. For example, do they go to activities at senior centers or in the community? Do they have any hobbies or attend classes?

What is Your Relative's Mental State?

Look for clues as to how your aging relative is feeling. Do they seem depressed? Anxious? Scared? Overwhelmed?

Once you have assessed what tasks your older relative can handle independently and any areas where they might need help begin collecting information that you will need to deal with emergencies and to contact local folks. You should also collect any information you can use to assist your relative with finances, or to keep abreast of their medical care.

• Contacts. Get contact information for neighbors, clergy, friends, or others who will have regular contact with your loved one, or who can help out in an emergency.
• Medical information. Even if your aging relative is capable of handling his own medical care, get detailed medical information in case of an emergency. This includes doctors' names and telephone numbers, medical insurance information, medications (you'll have to keep current on these as prescriptions can change often with elderly patients), and other important medical information.
• Financial information. At a bare minimum, know where your relative keeps their financial documents. If they need help managing money, you'll have to dig deeper getting information about all sources of income, checking and savings accounts, investment accounts, monthly bills, expenses, and the like. Get contact information for accountants, tax preparers, and other people who have information about your relative's finances. To learn more about helping your aging loved one with financial matters, see Nolo's article Helping Elders Manage Money & Finances.
• Legal documents. Get copies and know where your relative stores the originals of important legal documents such as a will, deed to the house, or advance healthcare directive. Get contact information for your relative's lawyer, if they have one. (To learn more about what legal documents your parent or elderly relative should have, see Nolo's article Caring for an Elderly Relative: Where to Begin.)

Scope Out Local Agencies & Services

Once you've determined what additional help your elderly relative may need, find out what agencies and services are available. You can do much of this research using the Internet and telephone. The local Area Agency on Aging (AAA) will have a wealth of information about elder services in your relative's area. You can find the AAA nearest to your loved one by visiting the federal government's Eldercare Locator at www.eldercare.gov.

Some ideas to think about when looking for local services:

Meals-on-Wheels. If your relative has trouble preparing meals, or just needs a break from daily cooking, contact the local Meals-on-Wheels program. Almost every area has this service, through which volunteers deliver hot, nutritious meals during the weekdays.

Senior centers. Senior centers often provide meals, along with social interaction and planned activities.

Elder transportation. If needed, look into bus schedules and special senior transport services to help your loved one get out of the house if they can no longer drive.

Get Help From Others

The most important part of caregiving from afar is establishing a network of local friends, family, and other people who can check in on your loved one, act as a trusted "observer," or be of assistance in an emergency.

• Find out if there are any neighbors or younger friends who would be willing to check in with your relative on a regular basis.
• Consider employing a high school student or other person to run errands for your relative, check up on them, or perform chores like mowing the lawn or watering plants.
• Schedule occasional calls with doctors so you can keep abreast of your relative's medical care and needs. (Have your relative sign a release that will allow doctors to talk with you about all aspects of your relative's health and treatment.)
• Consider hiring a geriatric care manager. These professionals (usually licensed nurses or social workers who specialize in elder care) can evaluate your loved one's situation and recommend and coordinate necessary care. Before hiring one, check credentials, get references, and take other precautions to ensure that the person you hire is competent. Contact the National Association of Professional Geriatric Care Managers at www.caremanager.org for referrals and information about screening candidates.

Check In Regularly

It goes without saying that regular telephone contact is important when you are a long-distance caregiver. But it's also important to schedule occasional visits. These are opportunities to observe how things are going, attend a doctor's appointment, or visit the senior center or classes that your older relative frequents. Of course, your visits should not be all business. Take time to enjoy your relative's company, treat them to a nice meal, or engage in some activity that they enjoy or cannot do alone.

For more tips on managing the care of your elder relative, you may find it helpful to consult the following Nolo resources: Long-Term Care, by Joseph L. Matthews (Nolo), and Social Security, Medicare, and Government Pensions, by Joseph L. Matthews and Dorothy Matthews Berman (Nolo).