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Long Distance Caring During the Holidays

It is not uncommon for families to be separated by great distances during the holidays. But what happens when one or both parents reach a stage in their lives where they appear to be frail and vulnerable? What can you do to keep from living with an enormous amount of guilt and worry or feeling that to help means sacrificing your own life? 

This article will offer a few suggestions as starting points for gaining control of the situation. 

Begin by having a thorough assessment of your parent's situation. You need to make sure that what you hear long distance from your parent and about your parent matches the reality of the situation. Everyone has different perceptions about how one should live and when one's safety is at risk. A dirty or cluttered house may not mean a parent can no longer live by himself, only that he needs help in caring for his home. It may mean he is willing to live with lower standards in order to remain at home. If you are uncertain about the situation and potential risks, consider an assessment by an outside professional who can offer a more objective evaluation. 

A careful evaluation means taking a close look at the physical, emotional, and social well being of the older person to determine what her needs are. For example: is your parent able to prepare her own meals? Does she still have friends and a social life? Are her medical needs being met? Is she managing her own medication. How safe is her living situation? Is she still able to manage finances? What is her state of health? What long term plans need to be made? 

Once you understand the issues, a care plan can be put in place. Are there people or agencies available to him that can provide him with home delivered meals? Are there senior centers where he can go? Does he have an informal network of people, who can look in on him or telephone him? Does he have funds to pay for services he might need? Is there a friend or a professional who could be an emergency contact? Is relocating to a different environment the best option for him? 

Clearly, there may be a great deal of emotional turmoil, guilt, and concern in regards to an aging parent. It is important to remember that if your parent is still able to articulate what she wants, and a physician determines she still has the capacity to make her own decisions, then it is her decision as to where and how she lives. Just as a parent needs to let go of adult children to live their own lives, a child needs to give his parent space as well. Unless your parent wishes to move or receive more assistance, she has every right to refuse, even if family and friends think she is making a mistake. All you can do is insure that she is making an informed decision and share your concern with her. 

If you feel that your parent is not capable of making an informed decision, then contact his physician for an assessment of his cognitive abilities. This poses different questions about safety and the ability to care for oneself. Yet, even in cases of dementia, there still might be resources available to help keep your parent at home. To do this, engage a geriatric social worker to assist you in making up a care plan and obtaining the necessary resources. If this is not possible due to a parent's extreme incapacity or limited resources, a social worker can also help you to either relocate him to a safer environment or assist in relocation to a facility closer to you. 

Without fully assessing your parent's situation no one can offer specific options. Find a professional who can fully evaluate the situation and provide a series of options for your parent. Prior to your next visit to your parent, you may wish to locate a physician if your parent does not already have an ongoing relationship with one. You can also contact a social service agency or a private care manager to meet with you and your parent. If there are legal matters you may need an attorney. By trying to locate services prior to your next visit, you will save yourself days of searching and waiting for appointments. 

There are no simple answers or solutions. Each person's situation is different. Each child has a different relationship with her parent, and this may also determine the level of your involvement. You need to think about your parent's needs and your own needs as well. You cannot force services upon a parent who is capable of making decisions and willing to live with some level of risk in order to remain at home. However, if your parent is no longer capable, then you need to act. Even if you notice only a small decline, it is not too early to know what resources are available and who might be able to help. You don't need to do it all yourself. Elicit the help of family members and friends, and, if appropriate, find a professional who knows the resources and can help you through the maze of decision making. You do not have to face this alone.

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