By Kate Shuman
Americans have become such a transient culture, adult children
are now finding themselves having to deal with an ever-growing
crisis: taking on the new-found role as long-distance caregiver.
A recent study on long-distance caregiving showed that the
out-of-pocket expense of caring for an elderly or physically
challenged loved one who lives more than an hour away has
doubled since 1997. It is estimated that long-distance
caregivers spend about $392 a month on phone calls, travel
expenses, medicine, medical supplies, meals, and home
maintenance, as well as other necessities, compared with monthly
expenditures of about $196 seven years ago. Presently,
long-distance caregiver’s yearly expenses are more than $4,700,
which is roughly the same amount of money needed for a year of
community college education. Along with the financial costs,
there’s also the cost of time. About 80% of all long-distance
caregivers are employed, and of this, at least 44% of them have
had to rearrange their work schedules, with the other 36% of
them having to miss an average of 20 hours of work each month in
order to conduct caregiving duties. These costs may even be
higher among those long-distance caregivers who worry about
people in rural areas, where it is not so easy to have a
community agency check-up on them. How do you not only juggle
the caregiving duties of a long-distance nature, but how can you
be sure that relatives in rural areas are getting the care that
they need? In this case, you’re not only dealing with distance,
but you’re also dealing with isolation.
from a distance for a person who lives in a rural area, you must
first realize that certain services in these communities will not be
as abundant as those in metropolitan areas, due to a much smaller
population. However, living in a rural setting can actually have an
advantage - the closeness which exists among the people in these
communities is genuine and strong - this can be a very valuable
resource. When you visit your loved one in their rural setting, it’s
important for you to get to know their neighbors and friends. By
engaging with this community, you’ll also be able to make sure that
your loved one won’t be isolated when you are unable to be there.
Attend as many community events with your loved one as you can, such
as fairs or church functions. Check with local churches, community
centers, and local service clubs in order to learn about volunteer
and support services which may benefit your situation.
Getting a case
manager can also help decrease the pressure that’s on you, since
they can work with services available in your loved one’s area, like
personal support, nursing services that can come to their home,
delivery of meals, in-home foot care (important for those with
diabetes), as well as help with personal hygiene. When you return to
your own home, be sure and stay in touch with the friends and
neighbors you’ve met. Talking to them will make you feel less
guilty about not being there, and also less afraid for your loved
regarding other things you can do to be proactive in the care of
your loved one, even from a distance include:
options for a personal emergency response system for your loved
one’s home. This will allow 24 hour assistance for your loved one
in the event of an emergency; it may be a good idea to leave a key
to your loved one’s home with a friend or neighbor so that they have
quick and easy access to your loved one in case of an emergency;
when you’re back on a visit, plan to meet with the care providers
involved, and have them bring you up-to-date with your loved one’s
progress; create a “communication book” where care providers can
make note of concerns or questions for you, then you’ll have the
ability to follow-up on a weekly basis; prioritize the tasks that
you want to accomplish with each visit; in order to stay focused and
less confused on visits, keep a list of people you’ll need to speak
with; and make sure that care providers know where and how to reach
you, where ever you may be.
Here are some other helpful tips:
travel alternatives - be prepared to “care commute” at all times.
Investigate travel options in advance. If you’ll be utilizing your
car most of the time for these visits, keep your car in good repair,
and check on the route and weather before traveling. If you have to
rent a car, look for the best rates. Remember, you don’t have to pay
for rental insurance if you already carry full coverage, or if your
credit card company offers coverage. You may get a discount when
buying bus or train tickets if you disclose that it’s an emergency.
Know to purchase airline tickets seven days in advance and stay over
a Saturday night.
Discuss legal and
financial issues - these topics may be difficult to talk about, but
they help ensure that the older person maintains decision-making
authority even when incapacitated. Preplanning will also lessen
family disagreements and protect family resources. Such issues
include information concerning a will, a power of attorney, a trust,
if there’s going to be joint ownership, is a representative payee
needed (a caregiver who receives government checks for an older
person unable to manage money), and information concerning Medigap
Take care of
necessary paperwork - know where to find all legal, financial, and
insurance documents, including birth certificates, social security
cards, marriage or divorce decrees, wills, and power of attorney
before and emergency happens. Also, know where to find bank
accounts, titles, sources of income and obligations, and auto, life,
homeowner’s, and medical insurance papers. Review these documents
for accuracy and update them if necessary. Store documents in a
secure place such as a safe-deposit box or a fireproof box. It’s
always a good idea to make duplicate copies of everything.
Contact the aging
network - contact the local department on aging in your relative’s
community. This agency can help you identify helpful services,
including obtaining a case worker. Use the National Eldercare
Locator Service at (800) 677-1116 to find local aging agencies.
Create a plan
of care - if at all possible, try to gather the family together for
a meeting with the person who is in need of caregiving. Find out
directly from that loved one what their immediate needs and concerns
are, and work on getting them the assistance they need. Summarize
your agreement in writing among all the family members who are
involved. Keep in mind that family difficulties are typical. You may
need to bring in a family therapist or social worker to help.
had enough time to really assess what the true needs of a loved one
are, you’ll probably be able to create a really solid plan of action
and care for them, even though there may be thousands of miles
between you. Planning for the future, continually gathering
information, and taking care of what’s needed right now are the
three main areas of focus for a long-distance caregiver, and while
it may be stressful, it’s not impossible, especially if you remember
that you don’t have to take this walk alone.
LONG DISTANCE CARING
Help with chores,
laundry, yard work and household maintenance.
Help with grocery
Need for meals
delivered to the home or fixed and served there, with
Is help needed with
personal care, such as getting dressed or bathing?
Do they need
transportation to places important to your relative,
such as church or social gatherings, the pharmacy and
needed with medical appointments, and/or consultation
with doctors and other health professionals?
Do they need
assistance with paying the bills, banking, budgeting or
other money matters like looking into financial
assistance to make ends meet?
Is it time to get
a referral to an attorney experienced in elderlaw issues?
dispensing of medications and ensuring they are taken on
Have a safety
inspection of the house (test smoke alarms, look for
uneven flooring, loose rugs, lighting) in order to
decrease in-home dangers.
Install grab bars
or ramps to make the home safer and easier to navigate.
Arrange for trips
out of the house, perhaps to an adult day care or senior
Utilize the network
of friends and neighbors in the rural community who can
make sure on a weekly or even on a daily basis
that your loved one is well.
additional social visits from friends, family and other
care provider volunteers.