When You are a long distance caregiver….things to ponder.
Long distance care giving is defined as a person who resides at least one hour or more away from the care recipient and provides at least some amount care.
Today, it is very common to have family members living in different cities, states and even internationally. A recent study found that “nearly 50% of long distance caregivers report that they devote one full work day a week to managing their loved one’s needed services, and almost 75% indicated they were spending 22 hours per month providing care” (Cress, 2009).
Distance impacts the caregiving roles, responsibilities and visits. Distance also impacts the stress level of the caregiver. Providing support and care from a distance can have significant impact on emotions, finances, and time. Many long distance caregivers experience feelings of guilt due to their inability to provide more care. Financial difficulty results from taking time off work, to travel, and all the costs associated with loss of income.
For long distance caregivers, it’s important to remember the quality of the visits and not the quantity is what matters. Today’s caregiver has a number of options to ease the burdens that comes with caregiving.
If you’re like me, you may find that having a checklist helps to guide your visits:
Here are some warning signs that would indicate your loved ones may need further assistance.
Appearance and personal hygiene: Has this person lost weight? if a male, is he shaving? does this person shower less frequently, wear dirty clothes, have body odor, bad breath, neglected nails and teeth, or sores on the skin?
Mobility: Are they having trouble getting around?
Odors: Do you smell urine? incontinence can be a problem among the elderly
forgetfulness: Are there signs of forgetfulness such as piles of unopened mail, stacks of newspapers, unpaid bills, losing or hiding money, unfilled prescriptions, missed appointments or getting lost?
Ordering: is there evidence of excessive ordering from catalogs, charity appeals, insurance subscription of the same magazine? Is the mail full of letters from charities?
Medication: If the person is on medication, can they take it without supervision? what prescription and nonprescription is the person taking? Do you have a current list of them?
Driving/car: Is this person still able to drive safely? How is their reaction time, confidence, judgment, and general driving skills? Are there signs of fender benders?
Interaction: How does the older adults handle extended conversation? Do they increasingly repeat questions? Do they retain what you say? Do they refuse any suggestion or conversely agree to everything without consideration?
Refrigerator:Does the refrigerator contain appropriate and adequate food? Are there several containers of spoiled food? Any fresh vegetables? fruit?
Behavior: Does this person exhibit inappropriate behavior by being unusually loud or quiet, paranoid, agitated, angry, exhibiting mood swings, or making phone calls in all hours?
Here are some tasks the long distance caregivers can accomplish to help facilitate successful aging in place.
Before you visit:
· Make appointments to meet providers
· Write out advance questions for providers
· Bring mementos of people, photos or videos to share with your loved one
During the visit:
· Talk to your loved one about what needs to be done and who can help with what
· Take your loved one out to see how they function in the community and with others
· Take time to reconnect with him/her by talking, watching a movie, going to dinner or going for a walk
· Be with the older person for support when new services are established
· Accompany the older family member to a doctor’s appointment-speak with the physician to establish a relationship with the doctor and office nurse.
· Learn about the medications the older person takes , the pharmacy and the contact information.
· Make sure to sign a HIPAA release of Information form and have it on file so you may talk openly with the doctor- keep a copy for your records.
· Make sure the doctors, insurance companies and other providers are aware of who is the medical or durable power of attorney. Provide a copy for the doctor.
· Meet with an attorney specializing in elder law to discuss estate planning, draw up a durable POA and a living will.
· Gather all insurance information and take it to a financial planner to make sure policies are current and appropriate
· Find all legal documents, take them home and put them in a binder. Put originals in safe deposit box or safe place. Important legal and financial documents may include:
o Birth certificate
o Social security card
o Divorce decree
o Power Of Attorney(POA)
· Set up a filing system at your home for the care recipient including all pertinent documents
· Take home a copy of a fairly up to date phone book from the area where the care recipient lives
· Make a list of informal local resources such as neighbors, church friends, and other relatives
· Assess home safety whenever you visit: locks, telephone access, smoke alarms, uneven flooring, loose rugs and poor lighting. Install grab bars, or ramps to make the home safer
· Look for sweepstakes mailings, large bank withdrawals, or other evidence of long-distance undue influence.
As a long distance caregiver, don’t try to aim for perfection. With the right tools, preparation, planning and coordination, you can achieve the appropriate care for your loved ones. Health care professionals like us know it isn’t easy. You do it out of love and care, and we are here to help you any way we can.
Here are additional resources you may find useful.
For more information about home health care services and for local referrals, contact our office at: 856-470-9018
Reference: Cress, C. J.(2009). Care Managers: working with the aging family