Overcoming Difficult Challenges in Long-Distance Caregiving

Overcoming Difficult Challenges in Long-Distance Caregiving
Adult children who are long-distance caregivers have similar but more complicated challenges as those who care for nearby parents. Practical tips, good resources and technology help long-distance caregivers cope and get a solid plan in place. Click here to view article. http://www.csa.us/email/spirit/ssarticles/0712Lifestyle.html

Long-distance caregiving is a growing trend with difficult challenges for adult children. The Pew Research Center estimates that 1 in every 8 American adults between the ages of 40 and 60 is raising children of their own and caring for aging parents. Plus, between 7 and 10 million adults care for their parents from afar.

If an adult child lives an hour or more away from a person who needs care, they are considered a long-distance caregiver. All aspects of caregiving are more difficult from afar, from determining the kind of care needed and finding good local care providers, to managing the quality of care.

Long-distance caregiving also costs more. A 2004 MetLife study of long-distance caregivers found those who live one to three hours away spend a monthly average of $386 for travel expenses and items needed by the care recipient. Those who live more than three hours away spend $674 per month. A 2008 AARP report states that the annual cost of long-distance caregiving is $8,728, compared with $5,885 for caregivers living under the same roof. Caregivers who spend the least – $4,570 a year – live close to, but not with, their parents.

Technology helps care for parents from across the world – a personal story

Source: www.NCFR.org

Sayali S. Amarapurkar, Ph.D., Family Social Science, University of Minnesota, describes how invaluable technology is in caring for an aging parent.

I realized the importance of these modern means when, during a regular phone conversation, my father-in-law –who lives in India – complained of a minor ailment and as usual, my husband, an oncologist, took down notes over the phone of the detailed history of what was happening to him and then asked him to get some tests done. What came of it was that he was about to have acute kidney failure. Immediately, he was admitted to the hospital and via phone and video chat, my husband was able to monitor his father’s health minute by minute. With close monitoring over the Internet; overseeing diet, medication and tests; and talking to doctors who were taking care of his dad, my husband was able to “be there” with his dad, even though he was really thousands of miles away.

Difficult challenges with long-distance caregiving

The most difficult challenges for long-distance caregivers include how to know when a senior needs help – because they sound perfectly fine over the phone or in emails or letters. Other difficulties are not knowing exactly how to help local siblings with caregiving; finding local professional caregiving help; keeping up with a parent’s medical care; and finding time to visit parents to help take care of their personal affairs, financial paperwork and home safety – and making the most of that time. (National Institute on Aging, So Far Away – 20 Questions and Answers for Long-Distance Caregiving).

Other challenges include providing respite care for a live-in caregiver such as a parent’s spouse, helping parents decide when it’s time to move out of their home and not being present for the entire length of time when a parent is dying. Many long- distance caregivers feel guilty about not doing enough and worry about being able to afford taking time off from work, being away from their family or the cost of travel.

Meeting the challenges – a plan

The best way to meet these challenges is to create a solid care plan for the senior. Kathy Kelly, executive director of Family Caregiver Alliance, explains “Often, families don’t really know where to start when a parent or other family member becomes frail or has cognitive problems from Alzheimer’s disease or stroke. It’s especially difficult when they live far away. Our mobile society has left families separated – sometimes by thousands of miles. As our parents age, they need more care, yet there may appear to be no one nearby to see that they receive it.”

The Family Caregiver Alliance’s Handbook for Long-Distance Caregivers, provides a step-by-step guide for families to:

  • Assess the care situation
  • Develop a care team
  • Hold a family meeting
  • Access community organizations and private agencies
  • Locate reliable online information about concerns such as paying for care and eligibility for public benefits

Assessing the senior’s needs: Observe and analyze what the senior needs help doing – and how much. Is assistance needed with Activities of Daily Living – dressing, bathing, eating, transferring oneself and toileting? How about cooking, shopping, household tasks, laundry, taking medications by one’s self or paying bills? Watch the senior go through the day and see which activities are the most difficult. Ask the senior where support would help most. Talking with the senior’s doctor can also help shed light quickly on where help would be beneficial. Be specific. A thorough understanding saves time and money in the end because the help that is enlisted is well-aligned with the senior’s needs.

A care assessment guide can be found by visiting, www.csa.us/longtermcareneedsassessment.

Developing a care team: Are family members and friends close by and available to help with caregiving tasks? If so, when and how much time, and which tasks? Their support will keep some costs down and is usually more comfortable for the senior. However, they may not be available or may not have knowledge and training for caregiving.

When outside caregiving professionals are needed, ask for local referrals from friends, clergy, healthcare professionals, geriatric care managers, elder-law attorneys and other professionals. Contact the local Area Agency on Aging and check the Eldercare Locator for community resources and support. A good tool is AARP’s Caregiving and Advice from Genworth, which walks consumers through the process of finding care in a given area.

Communicate: Family meetings and other communications are now easier to coordinate with web conference calls, video chatting, text messaging and personal websites. At meetings, make sure someone records decisions to share with others.

Doctors should be accessible for questions or concerns from the adult child at any given time. Regular conference calls are a good way to check in on a parent’s health. (The adult child needs to make sure they have written permission to receive their parent’s medical and financial information.) Involve the senior in these communications whenever possible. The adult child who knows how care is going from both sides can change or reinforce components depending on that feedback.

It is also crucial to set up an emergency plan of action for all involved in the caregiving. Onsite caregivers should know what the family wants when the senior becomes ill or has an accident.

In-home technology monitors health and safety

Today, faraway children can monitor a parent’s health from their computers or phones using medical devices in the senior’s home that measure and distribute vital signs, oxygen saturation, blood-sugar readings, weight, temperature, and motion detection. The Internet delivers the results to the senior’s family and doctor at the time of the reading, if the senior has missed a reading or if there is cause for concern with a reading.

Motion sensors, video cameras and other devices can help the adult child make sure the senior has gotten out of bed, eaten breakfast or bathed. Also, in some situations, personal response systems help provide emergency support and communications.

Another great tool is video chatting. Through their home computers, adult children can regularly place a video call to their parent and talk, literally keeping an eye on their parent and nurturing the relationship.

Find solid emotional and psychological support

Overseeing a loved one’s care from a distance increases emotional and psychological stress. Many community and online resources, support groups and organizations such as the ones listed below offer help and guidance, as well as referrals to professionals such as elder law attorneys, geriatric care managers and more.

RESOURCES:

www.aarp.org/families/caregiving – AARP, 888-687-2277
www.archrespite.org – The National Respite Network, 703-256-2084
www.caregiver.org – The Family Caregiver Alliance, 800-445-8106
www.cfad.org – Caring From a Distance, 202-895-9465
www.benefitscheckup.org – National Council on Aging Benefits Checkup, 202-479-1200
www.eldercare.gov – Eldercare Locator, 1-800-677-1116

Setting up a quality long-distance care plan takes time, money and energy. Each person’s situation is different, but with some good research, support from others and the senior’s involvement wherever possible, the adult child living far away can feel more comfortable that their aging parent will be well taken care of every day.

I’m a long-distance caregiver. What can I do?

Source: Condensed from So Far Away – 20 Questions and Answers for Long-Distance Caregiving by the National Institute on Aging (NIA).

  • Know what you need to know. Learn as much as you can about your parent’s illness, medicines and available resources. Information can help you understand what’s going on, plan, prevent crises and make talking to the doctor easier (remember to get written permission to receive medical and financial information). Put together a paper or online notebook of vital information, share and update it.
  • Plan your visits. Talk with your parent ahead of time and find out what they would like to do. Check with the primary caregiver, if appropriate, to learn what he or she needs. Decide on priorities and leave other tasks to another visit.
  • Remember to actually spend time visiting with your family member. Make time to do things with your parent unrelated to being a caregiver. Watch a movie together, visit with old friends or family members, attend worship services, play games, take a drive or go to the library. Save outside distractions for when you are home again; focus on your parent while you are with them.
  • Help your parent stay in contact. Have a private phone line installed in your parent’s nursing home, or give your elderly loved one a cell phone (and teach them how to use it).
  • Gather a list of resources in your parent’s neighborhood. Search the Internet to collect local resources. Have a copy of the phone book for your parent’s city or town. NIA offers an online list of more than 300 national health and aging organizations and contact information.
  • Technology helps care for parents from across the world – a personal story

    Source: www.NCFR.org

    Sayali S. Amarapurkar, Ph.D., Family Social Science, University of Minnesota, describes how invaluable technology is in caring for an aging parent.

    I realized the importance of these modern means when, during a regular phone conversation, my father-in-law –who lives in India – complained of a minor ailment and as usual, my husband, an oncologist, took down notes over the phone of the detailed history of what was happening to him and then asked him to get some tests done. What came of it was that he was about to have acute kidney failure. Immediately, he was admitted to the hospital and via phone and video chat, my husband was able to monitor his father’s health minute by minute. With close monitoring over the Internet; overseeing diet, medication and tests; and talking to doctors who were taking care of his dad, my husband was able to “be there” with his dad, even though he was really thousands of miles away.

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