Long Distance Caregiver - Challenges and Solutions
By: Helen Hunter, ACSW, CMSW

Families who struggle to care for a parent across the miles have a unique disadvantage. They cannot be there to know what is really happening. It is often difficult and frustrating to reach doctors or social service agencies and to be able to coordinate the needed care. The older parent may forget what the doctor has told them, or choose not to “burden” their child with problematic information. Indeed, many adult children are not aware that there is a problem until a visit is made, and they see the changes in the parent’s physical, mental or emotional functioning.

Situations that might occur would involve the following scenarios:

• The older parent is a danger to himself

• There are safety issues in the home environment

• The older parent is wandering and is confused

• Short-term memory is getting worse

• Other people in the community may be taking advantage of the older person, either financially or emotionally

There are a number of challenges that the adult child faces when dealing with long-distance care of an older parent.  These include the following:

• When phone conversations are held, everything sounds fine. “No need to worry dear. I’m doing fine on my own,” when you know in your gut that everything is not fine.

• Trusting someone else with the day-to-day care when you think you should be the one to provide the care.

Dealing with the various emotions often associated with caregiving, such as:

1. Guilt - over the fact that you are not able to be physically present all the time

2. Grief - over your relative’s decline in health

3. Resentment - over the fact that you don’t live closer and that others are doing more

4. Sadness -since your relative is showing signs of decline

5. Anxiety - at having to rush back and forth to visit and manage care from a geographical distance, and not  knowing what tomorrow will bring

6. Frustration - since you can’t be there all the time

7. Anger - at the whole situation

8. Fear - of the unknown

Often, adult children are also faced with a demanding relative who wants to know why you just can’t drop “everything” and spend time caring for them.

What can adult children do to be better aware of and be able to manage care for their older relative when there is a physical distance between them?  The following strategies might be utilized:

1. If there is a neighbor or close friend who lives near to the older relative, entrust them to check up and visit on a regular basis. Make sure that you are contacted if there are any serious changes that occur.

2. Make contacts with formal services that are appropriate with the older person’s care. These services might include visiting nurses, senior centers, adult day care or a meals program. Keep in regular contact with these agencies and make sure that the older relative is receiving the care that is needed.

3. Keep in regular contact with the older relative’s physician. Call and speak to the physician directly. If you feel comfortable, have the physician send you regular, updated notes on the visits and tests that are administered.

4. Hire a private care manager. There are professionals throughout the country who are trained and experienced in the assessment, coordination, monitoring and direct service delivery of services to the elderly and their families. Many people hire private care managers to serve as their “eyes and ears” in relation to the status of their older relative’s condition. Private care managers can also assist families with implementing and monitoring a long-term care plan. Family members are relieved to know that someone is watching over their loved one, and is keeping them informed if a problem arises.

A private care manager helps to reassure the family regarding the care that the older person is receiving. Another role is to assist in helping family members deal with emotional concerns, such as not being able to be physically present to provide care or dealing with guilt over the past relationship and emotional distance that might still be felt toward the older parent.

When you are not able to be around to oversee the day-to-day care of your older relative due to geographical distance, it is comforting to know that there are strategies that can be used to plan and to monitor your relative’s situation. Customizing a caregiving network will make your life much easier, which will lead to decreased stress and both you and your older relative will reap the benefit of the care that is provided.

Helen Hunter, ACSW, CMSW, is an independent geriatric social worker, consultant and trainer. She is also a writer, and has had numerous articles published in national magazines

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