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 consultation.