Caregiving Across the Miles

Q. I live in Northern Virginia, 700 miles away from my parents, who are in Florida. My father has Parkinson’s and insists on staying in our family home. His mobility has diminished, and I worry about him falling nearly every day. I cannot move closer because of my husband’s government job and my job, and the quality of education being afforded to my children here.  How can I effectively be involved with my father’s caregiving from a distance? 

A. Whether you live an hour away, in a different state, or maybe even in another country, caregiving at a distance presents very real challenges. Like yourself, many long-distance caregivers have families of their own and careers to manage while arranging care from afar. Despite the best intentions, adult children usually end up feeling guilty that they cannot spend more time with their parents and provide the care necessary. They also may feel overwhelmed by the challenges of arranging services long distance, especially if this role is new to them.

How can you be both a caring daughter or son and the coordinator of a multitude of tasks required when taking on the day-to-day responsibilities of a loved one? There is no one right way to be a caregiver; everyone’s situation is different. Here are some helpful tips to keep in mind for caring for your parent from a distance:

  • Preferences from your father: As much as possible, involve the one who needs care in any decision-making process, especially those related to care and housing. Be sure to listen to his or her expressed preferences and respect known values, even when these differ from yours. Provide any instructions to paid caregivers in writing.
  • Available Resources: Gather as much information as you can about available resources and services in the community (e.g. transportation, home health care, errand services, etc.) as well as about your loved one’s medical history. That way, in an emergency situation, you’ll have the information you need on hand. Although every area is unique in the type of services that are offered, similar kinds of services are found throughout the U.S. (e.g. adult day care, home care, case management, etc.). Eldercare Locator at (800) 677-1116 can direct you to the Area Agency on Aging appropriate for your parent(s). The Family Caregiver Alliance’s Family Care Navigator offers a state-by-state searchable database to help you locate help in your state.
  • Contacts in the community: It is helpful to have contacts in your loved one’s community who can serve as your eyes and ears and who can help you decide what issues can be dealt with by phone and what issues require a visit.
  • Care notebook: To keep things in order, long-distance caregivers often benefit from keeping a care notebook — a central place to keep the important information that you gather. Be sure your notebook contains current information on your parent’s prescriptions. If paid caregivers are employed to provide care to your loved one, you will want them to maintain a separate notebook documenting medication administration, vital signs, and other key physical and mental health status information.
  • Professional Guidance: Caregiving can be stressful. If you feel overwhelmed at any point, never hesitate to call in a friend or professional to help. Create a support network for yourself. Talk with friends and family. Allow yourself to hire help or involve other family members. Trying to do it all yourself is not healthy for you or your loved one. Please read our blog post, “Caring for Caregivers,” for more information.
  • Family Dissension: A social worker, geriatric care manager, or mediator can facilitate a family meeting to help prepare a care plan and/or deal with family dissension. If you are in Northern Virginia or Washington, D.C., please see our list of trusted referrals in the community.
  • Caregiver team: No one can master everything, not even the people who are experts in their field. The solution lies in putting together a team and using each team member’s strengths — including yours.
  • Legal documents, such as an Advance Medical Directive and Financial Power of Attorney should be prepared before a health condition makes it impossible for your parent to do so, and it is important to know where to locate these documents, if needed. At the Farr Law Firm, we offer a service called DocuBank to ensure that that the documents you’ve completed will be there when you need them most, such as when you or a loved one are hospitalized.

To help long distance caregivers, the National Institute on Aging developed the So Far Away booklet, offering tips you can use no matter who you are caring for—an older relative, family friend, or neighbor. The free booklet is organized in a question-and-answer format and can be downloaded or ordered here.

What happens when your loved one needs more help than you can provide? Nursing homes in Northern Virginia and Washington, D.C. cost $10,000 – $14,000 per month (a few thousand less in the Fredericksburg, Virginia area), which can be catastrophic even for wealthy families. By being proactive and helping your loves ones plan for long term care in advance, you can help make sure your loved ones always receive the care they need without worry or financial struggle. You’ll further avoid many costly legal headaches that often result when people are not prepared for incapacity or ongoing care needs. It’s never too early or too late to get started. Learn more at The Farr Law Firm website, or call us in Fairfax at 703-691-1888, in Fredericksburg at 540-479-1435, or in Washington, D.C. at 202-587-2797 to make an appointment for a no-cost consultation.

 

 

Dear Saki and Alley,

I am a caregiver for my mother with Alzheimer’s. I am realizing that I cannot do this alone. Can you provide suggestions on how to create a caregiver team?

Caryn Formom-Alone

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Dear Caryn,

Taking a team approach to caregiving can be essential to preserving your well-being. What many caregivers fail to realize is that if they don’t care for themselves—and lighten the burden—there may be no one around to care for their loved one.

These are some steps to help you set up a caregiving team:

  1. Identify tasks you need help with: Start by identifying the tasks you need help with. Is it paying bills or preparing meals? Or, do you need help with assisting your mother with activities of daily living, such as bathing and hygiene? After you know what needs to be done, it will be easier to identify the right people for the job.
  2. Turn to siblings: Though you may be the lead caregiver, it’s critical to let other family members, such as siblings, know that they need to play a role, too.
  3. Look to friends and neighbors: Depending on the relationships you have, friends and neighbors can be another viable source of help. You may not want a neighbor to help pay bills, but you might feel comfortable asking her to watch your kids while you run your mom to the doctor’s. Be sure you are clear about what the person will be doing and the time commitment, as people are more likely to lend a hand if the expectations are clearly defined.
  4. Know which resources are available: The ElderCare Locator, sponsored by the U.S. Administration on Aging, is one place to start. You can also get information from local churches, synagogues, senior centers, and government agencies. Once you start looking, you may find a whole network of services available to help.
  5. Hire help: If you have the resources, you may consider hiring people to be part of your caregiving team. Hired help might include a geriatric care manager, who can help you plan and orchestrate your relative’s care. You may also consider hiring a home health aide, house cleaning service, a handyman, lawn care or transportation services.
  6. Find a support group: A support group can serve as a place for you to meet others in similar situations, ask questions about specific challenges, and get information about community resources. Be sure to check www.ALZTalk.org and your local Alzheimer’s Association chapter for a list of support groups in your area.
  7. Get some respite: Most caregivers eventually need a break from the rigors of caregiving. That’s when you should find someone to provide respite care. Whether it’s a couple of hours a week at an adult day care or a weekend break provided by your sister, the goal is to give you time away from your duties to recharge.

At the Law Firm of Evan H. Farr, P.C., we recognize that caring for a loved one strains even the most resilient people. If you’re a caregiver, take steps to find a team of people that you trust to help, to preserve your own health and well-being. Part of taking care of yourself is planning for your future and for your loved ones. Please call us in Fairfax at 703-691-1888, in Fredericksburg at 540-479-1435, or in Washington, DC, at 202-587-2797 to make an appointment for a no-cost consultation.

 

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