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Tips for Long-distance Caregiving

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Let’s say you live in Maine, but your parents, ages eighty-eight and ninety, live in Florida. As the eldest—or perhaps only—adult child, you’re the designated caregiver. How do you manage?
 
With difficulty, if you’re like most of us. For three years I was responsible for my mother’s care in Shreveport, Louisiana, a job for which I had far too little patience, and even less aptitude. Instead of going it alone, I found many sources of help. And along the way, I learned important lessons.
 
Lessons Learned:
 
I learned to be grateful for all the things my mother had done to make my job easier: having a will, organizing her papers, and saving enough money to provide for herself. I also learned to be thankful for college friends who provided me with a home-away-from-home and their spare car when I came to visit.
 
I learned to appreciate the network of friends in Brunswick, Maine, and in Shreveport who took me out to dinner, made me laugh, and insisted on going for long walks and to the movies. And I learned to be grateful for my best friend who brought clothes, soap, shampoo, and sandwiches to me during the long days and nights of the two-and-a-half weeks that Mother was dying.
 
Before her death, however, during the time I was back home in Maine, I often received three to five phone calls a day telling me that she had fallen, that her medications were upsetting her, or that she was anxious.
 
Sometimes all I wanted to do was throw my hands up in despair. Instead, I took training in active listening so I could learn to listen with empathy to all the telephone complaints and respond appropriately. In doing so, I learned to have compassion for this strong, independent woman, my mother, who now needed my support. And I learned to ask for divine guidance so that I could provide it.
 
After many missteps, I learned that it is helpful to have a plan, to stay organized, and that no matter how hard you try, some things are always going to go wrong.
 
Survival Kit:

1. Take time to review your parents’ advance health-care directives, living wills, and health-care power of attorney documents. Or consider the use of The Five Wishes booklet, available online or at your local hospice. This guide helps your parents express how they want to be treated if seriously ill and unable to speak for themselves. It is unique among all other living will and health agent forms because it addresses all needs: medical, personal, emotional, and spiritual.
 
2. Designate an area in your home to handle paperwork. You may want to buy a special desk and small filing cabinet to use for that purpose.
 



3. Ask your parents’ lawyer to make at least twenty official legal copies of your power-of attorney forms since home copies will not hold up in court.

4. Invest in a fax-machine. In addition to your telephone and email account, it will become invaluable when corresponding with doctors, accountants, hospitals, Medicare, insurance companies, pharmacies, and banks.
 
5.  Utilize online banking. Set this up with your parents’ bank before your parents become incapacitated. It may be necessary for them to answer questions and/or give permission on your behalf. Doing this will save not only postage, but time and energy.
 
 6.  Find a way that your parents can have access to spending money. My mother’s assisted living facility set up a small banking account for her. This is something that I had to ask for. The facility didn’t do it automatically.
 
7.  Keep a rolodex of important phone numbers relating to the affairs of your parents. Include the names of physical therapists, nurses, doctors, financial advisers, lawyers, insurance agents, ministers and friends. Do the same with your email address book on your email site.
 
8. Organize copies of important papers—such as wills, power of attorney documents, living trusts, living wills, insurance papers, bank and tax statements—in a carry-all file box. Many of these original forms will probably reside in a safety-deposit box in your parents’ hometown bank. Accurate records will help avoid later disputes.
 
9.  Put the key to the safety deposit box in a place that you will easily find it. You might want to keep it in a large bright red, orange, or shocking pink envelope and place this envelope at the front of the carry-all file box mentioned above. It can be easy to misplace the key if you become distracted by your emotions if- and-when your loved ones become seriously ill.
 
10. Visit as often as time and money allow. Not only is it important to your parents’ mental and physical health, it is equally important to their financial, legal, and medical health. When a doctor, nurse, or lawyer can see that you are attentive, they are not as likely to let things slip.
 
11. Massage is beneficial for those in assisted living and nursing homes. Set up a regular appointment for a therapist to visit. My mother, who was not ordinarily a touchy, feely person, loved it! And when it comes to touch, don’t forget yourself. My massage therapist in Brunswick became a source of soothing solace during those three years!
 
12. Ask for help. Make friends with your parents’ friends and keep in touch. Consult with geriatric specialists in the state where they live. Laws vary from state to state.  If you have siblings, find ways they can help even if it is buying and selecting seasonal gifts. Join a care-givers support group, if the task seems too overwhelming, or if you are confused about how to help parents who are lonely or in despair over their deteriorating health. You will be comforted and your parents will appreciate the fact that you did!

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