CAREGIVING FROM A DISTANCE: MAKING IT WORK
PART II
By Barbara Payne, MSW

When you are a long distance caregiver, you have to be organized and prepared for anything. In the previous section, we discussed how to organize the information you might need at a moment’s notice. Having this information along with a local phone book for your parent’s area will save you much time and effort.

However, information is not the only help you will need. This article discusses how to make your long distance caregiving role easier on you and your support system.

“We all live so far away from our mother that we couldn’t be sure she was okay. ElderCare Strategies keeps us up to date all the time. And Mom likes the attention we aren’t there to provide…”

The Family Plan: First and foremost, it is crucial to have a plan that outlines the needs and problems that have been identified and the steps to improve or resolve them. The Plan is simply a guideline; it can and should be modified as the situation changes. But having a plan in place will greatly reduce the potential for crisis; or should one occur, you will be better prepared to manage it. Each family situation is unique and each plan should reflect the issues identified. But here are some suggestions for consideration when developing the Plan:

• Identify your support network; this can be family, friends, volunteers, etc.
• Divide up areas of work among family members (and/or friends) if possible and identify who has responsibility for each identified need
• Establish a communication system that will work for you and make sure everyone knows it
• Have a plan for dealing with emergencies
• Make sure everyone involved is willing to put aside personal issues and keep in mind the focus on assisting the parent; if this is difficult, consider using a mediator or geriatric care manager to help facilitate family meetings

Dealing with Caregiver Stress: No matter how willing you are to be a caregiver, you will experience episodes of stress and exhaustion. Do not feel guilty for putting yourself first. A worn-out caregiver cannot do a good job. You must take care of yourself before you can take care of others. Following are some tips to reduce stress:

• Make sure you have adequate information to deal with your situation.
• Organize your resources so that you can locate what you need quickly
• Use your support network when you need help
• Know your limits; no one can do it all

Make Visits Count: When you try to provide care from a distance, you will need to build visits into your plan whenever you can fit them into your schedule. It is likely that you will not be able to make lengthy visits so you must plan ahead to make the visits count.

• Prioritize what you wish to accomplish
• Make appointments with professionals in advance of your trip or at least when you first arrive; keep in mind that many will not offer weekend office hours.
• Include quality time spent with your loved one and remember that they move slower than you do—plan accordingly so you are not rushed for time.
• Don’t forget to have your looseleaf binder with you that contains all the pertinent information you will need. This will be a good time to update your contents.

How Do You Deal With Problems from Far Away? No matter how carefully you plan, problems will arise, often at a time when you can’t make a visit. Or, how will you even know there is a problem if you have parents who either don’t see it or won’t admit it? How do you handle a situation in which your parent won’t accept help? What do you do when the help you hire is unreliable or untrustworthy? What happens in a crisis? What if your family member can no longer remain at home and you need to organize a move? What if finances are diminishing?

Any number of situations can occur that leave you worried, frustrated or angry. Being far away makes it all the more difficult to deal with problems, but it is not impossible. For those problems that are related to concrete situations, such as poor services or declining funds:

• Call on someone who can visit and assess the situation for you so you are positive you are getting a complete picture
• Utilize the information in your notebook to make phone calls to appropriate parties to alleviate the problem until you can arrive or solve it.
• This is the time to go to your back-up or emergency plan that you prepared for times when things are not going according to Plan A.

Though upsetting, those situations are usually much easier to deal with than the nebulous ones that have to do with your family member not telling you what is going on, or refusing the help you wish to give. Most older people do not want to feel dependent and will do anything to preserve their independence and dignity, even if it means they are unsafe. And very often, the thought of leaving their homes is terrifying. They become resistive to your help. After all, they are the parents and they are no more used to taking orders from their children than you, the child, is used to giving orders to your parent. The right approach is everything. Try to keep the discussions calm and non-threatening. Don’t tell your folks what you want them to do, but rather, let them know your concerns about their welfare and safety. Help them understand some of their options and how adding some help might increase their ability to stay where they are, rather than move. Stress the positive aspects of any life changes. And above all, avoid making any promises you will not be able to keep. You cannot predict the future, so don’t make promises about it. If you promise your parent you would never put them in a nursing home, someday you may have to break that promise. Simply let them know you will do everything in your power to help them remain as safe and comfortable as possible.

If you find that nothing you say is working, and the situation is becoming increasingly difficult, consider hiring a professional such as a geriatric care manager. Many times, they can say things to your parent that you can not, and often, your parent will feel differently about hearing information from a professional person who does not have a family bond.

Using professional assistance has one other very important aspect. It makes them the bearers of information and news that you as a family member may not want to give, and it allows the family member the luxury of being a just that, a loving relative.