{"id":7523,"date":"2024-01-10T08:11:09","date_gmt":"2024-01-10T13:11:09","guid":{"rendered":"https:\/\/www.silvercentury.org\/?p=7523"},"modified":"2024-01-10T08:11:09","modified_gmt":"2024-01-10T13:11:09","slug":"tips-for-long-distance-caregivers","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2024\/01\/tips-for-long-distance-caregivers\/","title":{"rendered":"Tips for Long-Distance Caregivers"},"content":{"rendered":"<p><i><span style=\"font-weight: 400;\">This is part 2 of a series about caregiving from a distance. Read <a href=\"https:\/\/www.silvercentury.org\/2023\/12\/caring-from-afar\/\">part 1 here<\/a>.<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400;\">Fern, 92, called her daughter in a panic. She couldn\u2019t turn off her television because she couldn\u2019t find the remote. Due to Fern\u2019s hearing loss, the volume was very high. Fern was afraid the blaring TV would keep her and her neighbors up all night.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Her daughter, Monica, couldn\u2019t help. She was in Michigan; Fern lives alone in Sarasota, FL.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Fern\u2019s situation wasn\u2019t life threatening. But it\u2019s an example of how even a minor issue can become a crisis when an older loved one lives far away. For the millions of Americans in that situation, it\u2019s a major source of stress. In fact, research suggests that long-distance caregiving is even more stressful than face-to-face caregiving.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Unlike those caring for an older adult nearby, long-distance caregivers often face situations that can\u2019t just be handled as they arise, whether it\u2019s a missing TV remote or a serious medical crisis like a stroke or an injury due to a fall. There are no easy fixes. But experts advise that thinking ahead, and assembling a support team, can help families navigate long-distance caregiving more effectively. Here are some tips.&nbsp;<\/span><\/p>\n<p><b>Divide and Conquer&nbsp;<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Start by gathering family members for a conference, virtually or in-person, advises Maria Hood, a social worker and director of admissions at United Hebrew, a senior care community in the New York metropolitan area.&nbsp;&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cDevelop a strategy to divide and conquer,\u201d Hood says. Make a plan to rotate visits and regular phone calls. Clarify roles so no one person feels overburdened. Those who can\u2019t visit in person might tackle other tasks: a family member who is an accountant can help manage financial issues; another who\u2019s a medical professional can establish lines of communication with the older adult\u2019s physician.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As much as possible, involve the older adult in the conversation, and initiate<\/span> <span style=\"font-weight: 400;\">it before a medical crisis or other \u201cpoint of vulnerability\u201d occurs, adds Barry Wu, MD, professor of medicine (geriatrics) at Yale School of Medicine.&nbsp;&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cUnderstand what your [older adult] family member\u2019s wishes are,\u201d Wu says. \u201cIf they don\u2019t want aggressive treatment in the event of a medical emergency, the family should know that. If their heart stops, or they stop breathing, do they want to be hospitalized? Do they want a feeding tube? You need to know what their wishes are.\u201d&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other questions to ask might include:&nbsp;&nbsp;<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">What kind of support would be helpful now? That might include transportation to doctor visits or outings, help with meals, errands or housekeeping.&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Could alterations in the home make life easier and safer? For example, switching from an upstairs bedroom to a downstairs bedroom or installing a ramp leading down from the front porch could prevent future accidents or make daily life easier.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">What about anticipated future needs? If an illness or loss in mobility makes it difficult or impossible to live alone, what would the older adult want to do? Move into assisted living? Move in with a family member? Stay at home, with in-home support, as long as possible?&nbsp;<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Remember to keep the older adult\u2019s wishes paramount, says Teri Dreher, an RN and patient advocate who assists older adults and their families.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cA sense of dignity, autonomy and agency over one\u2019s own life is even more important as we age,\u201d she says. \u201cNobody likes their children to talk to them like they\u2019re children.\u201d&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dreher says older adults can become stubborn or unwilling to share honestly about their struggles. Some may resist discussing the issue or insist, \u201cDon\u2019t ever put me in a home.\u201d In that case, a visit to an assisted living community might help reassure them.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cI worked with a couple in their late 70s that stayed in their house, even though they couldn\u2019t take care of it, until the house was finally condemned,\u201d Dreher says. \u201cOnce they moved into a senior living community, they saw how great the food was and changed their minds immediately.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Start the money conversation as part of these family talks. How is a loved one paying for daily expenses now? How might they pay for additional care if it\u2019s needed? These questions are important for any caregiver, but especially when family members aren\u2019t close enough to quickly access financial records. Needs can change suddenly; an older adult could become incapacitated temporarily or permanently.&nbsp;<\/span><\/p>\n<p><b>Explore Resources&nbsp;<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Many agencies and local governments offer services to assist older adults\u2014these can be lifesavers when family members can\u2019t be present. However, it\u2019s not always easy to find out about these services. For example, some local charities, city governments or agencies offer wellness checks\u2014regularly scheduled phone calls to check in with an older adult, with follow-up calls and\/or visits if they don\u2019t respond. To determine if such a service is available in the older adult\u2019s community, try searching online using the zip code or town (such as, \u201colder adult welfare check 75024\u201d). Or check the search tool of <\/span><a href=\"http:\/\/shepherdcenters.org\/\"><span style=\"font-weight: 400;\">Shepherd\u2019s Centers of America<\/span><\/a><span style=\"font-weight: 400;\">, which provides welfare checks through more than 50 affiliates around the United States.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hood suggests contacting a hospital in the older adult\u2019s area and speaking with staff in the social work department. Similarly, the marketing staff at a senior living community near the older adult\u2019s home will likely know what\u2019s available locally.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Create a directory with contact information, including the older adult\u2019s physicians, local fire, police and EMTs, and non-emergency numbers, like those of the apartment security staff or community director where the older adult lives, and names and numbers of neighbors, friends and family members. Add a list of medications and a list of locations of key documents, such as insurance policies and the person\u2019s will. Share copies with family members and post a copy on the older adult\u2019s refrigerator or another prominent spot.&nbsp;<\/span><\/p>\n<p><b>Enlist Technology<\/b><\/p>\n<p><span style=\"font-weight: 400;\">A big source of stress for many long-distance caregivers: worry over the older adult\u2019s safety. Unfortunately, it\u2019s not uncommon for older adults, especially those 90 and older, to fall and end up on the floor for hours before someone comes to help. If the older adult is amenable, consider a medical alert pendant and\/or installing an in-home monitoring system. Most require some type of subscription or monthly connection fee that is not covered by insurance or Medicare.&nbsp;&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These systems are typically either \u201cactive,\u201d where the user presses a button on a home unit, wearable device or wall to call for help, or \u201cpassive,\u201d transmitting data from the user to a trusted care partner without requiring any action on the older adult\u2019s part should they fall or become unresponsive. For example, the Apple Watch offers a passive fall detection function that can be set up to call 911 automatically if the wearer falls. (However, this technology isn\u2019t yet 100 percent reliable and automatic updates to the watch\u2019s software may disable the function without alerting the user.)&nbsp;<\/span><\/p>\n<p><b>Make the Most of Visits&nbsp;<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Many older adult living communities see an uptick in inquiries right after the holidays, when family members visit and notice signs that their loved one isn\u2019t coping well. Visits are a good time to observe. Look for piles of dirty dishes or unwashed laundry; unopened mail, overdue notices or other signs that paperwork isn\u2019t getting handled; rotten food in the fridge\u2014or no fresh food at all; scorch marks on pans or countertops, possibly signs of inattention to cooking tasks.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Visits also present opportunities to set up local lines of communication. Accompany the older adult on a doctor visit and ask to be added to the list of emergency contacts. Inquire about joining future telehealth visits, with the older-adult patient\u2019s permission, as a way of tracking health conditions.<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Keep in mind, after the visit, that an older person\u2019s health, mobility or cognitive status can change quickly. Be ready to pivot.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Finally, use a visit to enlist \u201cboots on the ground.\u201d Go to home care agencies, visiting nurse associations, transportation services and other local support services to learn what they offer. Exchange contact information with the older adult\u2019s friends and neighbors and encourage them to call if anything raises concerns, like unusual behavior or if something seems out of place (a door left open or lights on overnight).<\/span><\/p>\n<blockquote><p><b>The key to long-distance caregiving: find local people who can provide help when your loved one needs it.<\/b><\/p><\/blockquote>\n<p><span style=\"font-weight: 400;\">If finances allow, consider a consultation with a geriatric care manager in the older adult\u2019s area. Also called \u201caging life care managers,\u201d these professionals are usually licensed nurses or social workers experienced in the care of older people. They can provide a neutral assessment of the older adult\u2019s situation and advise on options available locally. Generally, they serve clients and families whose incomes are too high to qualify for publicly financed services like Medicaid. Care managers can also offer references to reputable home-care agencies or professional caregivers in the area. Find a care manager in the older adult\u2019s community by using the Aging Life Care Association\u2019s <\/span><a href=\"https:\/\/www.aginglifecare.org\/Shared_Content\/ALCA_Directory\/ALCA_Find_an_Expert.aspx?hkey=6c3ced7c-b5f0-4d27-9d30-37734ab6cf49\"><span style=\"font-weight: 400;\">expert search tool<\/span><\/a><span style=\"font-weight: 400;\"> or the <\/span><span style=\"font-weight: 400;\"><a href=\"https:\/\/eldercare.acl.gov\/Public\/Index.aspx\/Resources\/LearnMoreAbout\/Support_Services.aspx\">Eldercare Locator<\/a>,<\/span><span style=\"font-weight: 400;\"> a public service of the US Administration on Aging.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If the older adult has complex medical issues, consider hiring a local patient advocate who can step in should an emergency arise. Once a relationship is established, the patient advocate can accompany the older adult to the ER and serve as a point of contact until an out-of-town family member arrives.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Unfortunately, these services are not inexpensive. Labor costs have increased considerably in recent years. In-home care now averages about $26 an hour for homemaker services (cleaning, cooking, etc.) and $27 an hour for a home health aide, according to Genworth\u2019s Cost of Care Survey. Some companies\u2019 employee assistance programs (EAP) assist employees in caring for older family members, with help finding caregiving services and even help covering the costs.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some Medicare Advantage plans also provide coverage for personal care assistance, non-medical transportation and in-home meal delivery through a private provider or services like Papa.com. Papa is a platform that connects older adults with Papa Pals, vetted local people available to provide companionship or to assist with cooking, cleaning, transportation and laundry.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A Papa Pal came to the rescue when Fern couldn\u2019t find her remote. Connor Carroll has been visiting 92-year-old Fern regularly, helping her with light housekeeping, running errands and assisting with other daily needs. After each visit, he calls Fern\u2019s daughter, Monica, to fill her in on how Fern is doing.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cWe\u2019ve built a rapport,\u201d Carroll says. \u201cIt\u2019s a comfortable relationship. Fern calls me \u2018the son she never had.\u2019 Monica tells me it\u2019s nice to have me as her eyes and ears in the area.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hood says that\u2019s a key to long-distance caregiving: connecting with professionals and others in the local area who can step in to help when needed.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cWhen it comes to caring for an older adult,\u201d she says, \u201cit really does take a village.\u201d&nbsp;<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This is part 2 of a series about caregiving from a distance. Read part 1 here. Fern, 92, called her daughter in a panic. She couldn\u2019t turn off her television because she couldn\u2019t find the remote. Due to Fern\u2019s hearing<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"http:\/\/78.142.243.82\/~silvercentury\/2024\/01\/tips-for-long-distance-caregivers\/\">Read more <span class=\"screen-reader-text\">Tips for Long-Distance Caregivers<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":13,"featured_media":7502,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"_FSMCFIC_featured_image_caption":"","_FSMCFIC_featured_image_nocaption":"","_FSMCFIC_featured_image_hide":"","footnotes":""},"categories":[49,5,7,4],"tags":[],"class_list":["post-7523","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-featured","category-getting-older","category-healthspan","category-issues-in-aging"],"cc_featured_image_caption":{"caption_text":"","source_text":"","source_url":""},"wps_subtitle":"Advice from the experts on how to manage care from afar\u00a0","_links":{"self":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/7523","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/comments?post=7523"}],"version-history":[{"count":1,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/7523\/revisions"}],"predecessor-version":[{"id":7524,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/7523\/revisions\/7524"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/media\/7502"}],"wp:attachment":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/media?parent=7523"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/categories?post=7523"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/tags?post=7523"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}