Once upon a time, families lived together as multi-generational units. Middle-aged adults took care of both the very young and the very old. In today’s America, that model is long gone. Many families are spread out geographically, and less able to provide daily in-person support to aging parents. The challenges of long distance caregiving are widespread, both in number and in scope.
For the purposes of this article we’ll refer to “your parents,” but it could be a spouse or sibling, grandparent, aunt or uncle, even a close friend who relies on you for care. Whoever it is, the concerns you may have about their daily care and overall health can be many. Are they taking their medications? Making and keeping doctor appointments? Managing basic activities of daily living, like bathing, dressing and eating?
When the answers tend toward no, the first thing many people consider is whether one of you should move. We’re assuming this has been discussed and rejected. Your parents moving in with you, or moving into a nursing home or assisted living facility, are not yet options to which they will agree. And your moving to their town is out as well, due to family and career obligations. So long distance caregiving it is.
The responsibility can be fraught with guilt, frustration and even anger. It’s tough. Fortunately, there are a few things you can do to head off some of the practical and emotional problems.
Who is the primary caregiver?
Long distance caregiving is a team effort, but one individual should be in charge. In many cases, it is a spouse in the same house – mom caring for dad, say, who herself needs support and respite from time to time. Often, it’s the sibling who lives closest to the parent’s home. It may also be a hired professional – more on this later.
Either way, you should get together as a team and define your roles. Ideally, one person will be agreed upon to be the primary caregiver. He or she should be the main contact with doctors and nurses, lawyers and financial advisors, and any other people involved in the parent’s life, care, and eventual end-of-life and estate decisions. Securing legal, financial and/or medical powers of attorney is almost certainly going to be a smart idea that will save everyone time, confusion and hassle down the road.
It’s not all the one person’s responsibility. If there are several siblings, talk over who is good at what. Maybe one sibling is assigned responsibility of money and insurance matters, another medical decisions including prescriptions and equipment, and a third takes care of maintenance, cleaning and physical upkeep around the house. Plan on having regular conference calls, too, or weekly email updates. Keeping each other well informed will make it easier to make tough decisions when they arise.
You may also have to go outside the family, and enlist friends and neighbors, or even hire professionals. Known as Geriatric Care Managers, Elder Care Managers, or Aging Care Managers among other titles, these professionals can oversee any or all of the functions we’ve been talking about. They may do some of the tasks themselves, or resource, hire and supervise a team of specialists to provide the care your parent needs. They can serve as a liaison between you, your parent, and the medical team. Most will charge a fee for initial consultation, and then an hourly rate once their role has been defined and approved by you. These costs may be covered by long term care insurance, but probably not by traditional health insurance or Medicare.
Visit in person
Some things are hard to determine over the phone. Someone needs to drop by from time to time, and see for themselves how your parent is faring. Look for any evidence of new problems or changes from routine. Be sure an easy-to-read list of important phone numbers is by their house phone (and keep a copy for yourself!) and/or stored in their cell phone. Sit and chat, ask questions, and listen to what they have to say about their lifestyle, needs and concerns. Be flexible – what you expected to happen might very well change over time.
Finally, plan ahead!
One way to prepare for uncertain and potentially costly circumstances is to apply for long term care insurance. If your parents are of an advanced age or have a condition that already requires long term care, they are unlikely to qualify – but if they’re only around 60 and still in relatively good health, long term care insurance may be a very smart option. It’s better to talk together about the options earlier rather than later. The challenges of long distance caregiving are tough enough – give yourself, your siblings and your parents the best chances of meeting them with communication, cooperation, and confidence.
LTC Consumer is an independent, free online service to help consumers understand what long term care insurance is, how it works, and how to evaluate coverage options. Our mission is to provide an educational, no-pressure resource for learning about long term care planning, with the opportunity to speak with specialists who can help them.