Caring Across the Miles

Illustration by John Roberge/Tallahassee Democrat

Fifty-eight-year-old Ruth recently took early retirement from her bookkeeping job so that she and her retired husband, Harry, could see more of their children and grandchildren, who are scattered around the country. The two have also been looking forward to doing some traveling overseas.

In the past year, though, Ruth's mother, who lives alone and is a two-and-a-half-hour drive away, has become increasingly frail and is starting to show signs of forgetfulness. Ruth finds herself worrying about her mother daily and making an increasing number of phone calls and car trips to check on her. Often she ends up staying for the weekend when she visits.

She and Harry have put their travel plans on hold.

Ruth is just one of approximately 7 million Americans involved in the care of an older adult -- usually a parent -- who lives in a different area, be it an hour's drive or a plane trip away. The average travel time to reach their relative is four hours.

At the best of times, caregiving involves a certain amount of stress, but often, the anxiety is compounded when there are many miles between the caregiver and care recipient.

Long-distance caregiving can be emotionally and financially draining. Worries about a parent's physical, mental and emotional health and safety can be overwhelming at times. You may wonder if plans you've set up are being implemented properly, or if you're going to get a call that there's a crisis.

You may also feel guilty that you can't be there on a daily basis to see how your parent is doing -- which may be quite different from what he or she reports -- and provide assistance as needed. You might wonder if you should be making more sacrifices -- either moving closer or inviting mom or dad to live with you.

Then there are the financial costs: the many long-distance telephone calls, travel expenses, wear on your car and perhaps the cost of hiring a companion or personal support worker because you can't be there yourself. If you're employed, you may have to take time off work to deal with crises; some employers are less sympathetic than others.

Despite these challenges, there are many ways to maintain peace of mind while providing long-distance care:

• Make it easy for people to get in touch with you. Get an answering machine if you don't already have one and perhaps a cell phone or pager as well. E-mail may also be advantageous.

• Set up a regular time to call your parent (many people choose Sunday evenings).

• Find someone local who can check with your parent daily, either by phone or in person. This could be a reliable neighbor or relative or even a volunteer from a telephone reassurance service.

• Keep important phone numbers handy: your parent's neighbors, close friends, family physician, local pharmacy and any home health-care providers. Ensure all of these people also have your name and contact information and encourage them to call you with any concerns. Stay in touch to get their ongoing perspectives on how your parent is doing and don't forget to express appreciation for their assistance.

• Shop around for a good long-distance savings plan so you don't have to be too concerned about the frequency and duration of caregiving-related telephone calls. You might consider getting a private, toll-free number so that friends, neighbors and health-care providers have no reservations about regularly calling you.

• Maintain a file of key information, such as your parent's medical conditions and surgical history, medications, medical specialists, banking institutions and other financial contacts, lawyer, clergy and daily or weekly schedule, plus any upcoming appointments. Obtain a local phone directory if possible.

• If your parent has a chronic illness, obtain information from the appropriate organization (for example, the Parkinson Foundation) to help you understand the disease and get an idea of what to expect in the future.

• Investigate other available resources in your parent's community, which might include: personal emergency response systems; letter carrier or utility company alert services; accessible transportation; adult day programs and other leisure programming; outreach services, such as foot care and seniors' dental clinics; home health services involving nursing, homemaking, therapy and companion services and alternative housing. Such information can be obtained from the local area agency on aging. (To find the appropriate office, call the Administration on Aging's toll-free Eldercare Locator Service at (800) 677-1116 or search online at www.eldercare.gov.)

When you do have an opportunity to visit, pay close attention to your parent's physical condition, mental functioning and mood. Consult his or her family doctor if you have any concerns.

Perform a safety assessment of the home environment to identify potential hazards -- for example, throw rugs that don't stay in place -- and do what you can to remove them. Visit a medical supply store and check out the many products that might make daily activities easier and safer for your parent. Better yet, locate an occupational therapist who performs home assessments and can make recommendations in this regard.

If you have siblings in the area, arrange a family meeting to discuss your parent's needs and determine who can provide help.

Ideally, plan to stay with your parent long enough so you're not rushed. That way, you'll have ample time not only to attend meetings (try to set these up in advance of your arrival) and run errands but also to enjoy your parent's company.

Even if he or she appears to be managing well right now, it's a good idea to begin learning about resources in the community should your parent require help in the future.

Keeping one step ahead will help make your role as long-distance caregiver a little easier.

Lisa M. Petsche is a geriatric social worker and freelance writer.