Long-Distance Caregiving

<TITLE>Long-Distance Caregiving</title>
 

<H1>Long-Distance Caregiving</H1>

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When you live far from your loved one with dementia, the separation can complicate caregiving.  Concerns about the person's safety, nutrition and health can be overwhelming.

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Here are some strategies to manage long-distance caregiving:


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<h2>Identify Needs</h2>

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If your loved one lives alone, he/she may have difficulty managing daily tasks. You will need to identify what kind of help he/she may need to remain independent in the home for as long as possible.

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When you visit your loved one, observe the following:

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<LI>Is there appropriate and fresh food in the refrigerator? 
Is the person eating regular and nutritious meals?
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<LI>What is the condition of the inside and the outside of the home?
Has it changed?  Is it safe?  Can your loved one safely use appliances?
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<LI>Are the bills paid?
Have the taxes been paid?  Are there piles of unopened mail?
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<LI>Do friends and relatives visit regularly?
Is your loved one becoming isolated?
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<LI>Is he/she maintaining personal care routines (i.e. bathing, grooming)?
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<LI>Is he/she still able to drive safely?
Has he/she been lost or had injuries?  Does the car show evidence of recent minor accidents and is it being maintained (gasoline, oil, tires, inspections)? 
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<h2>Establish Support Contacts</h2>


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Building a list of contact people and resources can help you coordinate care from a distance.

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<LI>Family, friends and neighbors. Keep a list of their phone numbers and addresses at your home and workplace. Ask if you can check in with them to find out how your loved one is doing. They may also be willing to stop by your loved one's home for regular visits.
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<LI>Your loved one's doctor. Keep in contact with his/her doctor. Then ask the doctor to call you with concerns about his/her well-being.  It may be necessary to obtain a privacy (HIPPA) release.
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<LI>Alzheimer's Association. Your local chapter can help you with decision-making and locating appropriate services for your loved one. To find your local office, call 1.800.272.3900 or visit <a href="http//www.alz.org/FindChapter.asp">www.alz.org/FindChapter.asp</a>.
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<LI>Community organizations. Check with local religious, neighborhood and volunteer organizations. They may provide meal delivery, transportation or companion services.
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<LI>Aging agencies. The local Area Agency on Aging (AAA) has services to help with meals, chores, and transportation. To locate the area agency on aging,  call Eldercare Locator toll-free at 1.800.677.1116 or visit <a href="http//www.eldercare.gov">www.eldercare.gov</a>.
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<LI>Home care services. You can hire home health care workers to help the person with bathing, personal care activities, preparing meals, and taking medications.
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<LI>Geriatric care managers. These elder care experts specialize in assessing and monitoring the needs of the elderly. To find out more about their services, call the Association of Professional Geriatric Care Managers at 1.520.881.8008 or visit <a href="http://www.caremanager.org">www.caremanager.org</a>.
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<LI>Trusted professionals. Elderlaw attorneys work with older clients and their families to write legal documents regarding healthcare, legal and financial decisions.  To find an elderlaw attorney, visit <a href="http://www.naela.org">www.naela.org</a>.  If you have obtained DPOA (Durable Power of Attorney), organize and simplify the finances.
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<h2>Make the Most of Visits</h2>

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Few long-distance caregivers are able to spend as much time with their loved one as they would like. The key is to use your time effectively:

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<LI>Make appointments with your loved one's physician, lawyer and financial adviser during your visit to participate in any decision-making.
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<LI>Meet with neighbors, friends and other relatives to hear how they think the person is doing. Ask if there have been any behavioral changes, health problems or safety issues.
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<LI>Take time to reconnect with your loved one by talking, listening to music, going for a walk or participating in activities you enjoy together.
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<LI>After visiting, touch base with a friend, counselor, or the Alzheimer's Association  if you need help dealing with the emotional impact of your loved one's decline.
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<h2>Considerations Before Moving a Loved One Into Your Home</h2>

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There will come a time when your loved one will no longer be able to live alone. One of the decisions you might consider is moving the person into your home or nearer to you. Here are some things to think about:

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<LI>Does he or she want to move? What about his/her spouse?  How does your family feel?
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<LI>Is your home adapted to support the person?  Might the person need assisted living or nursing now or very soon?
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<LI>Will someone be at home to care for the person?  Will you need home health care or adult day care?
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<LI>How will this move affect your job, family and finances?
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<LI>What other services are available in your community to assist you?
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Moving a person with Alzheimer's disease from familiar surroundings may cause increased agitation and confusion. Talk with your loved one's physician or a social worker and call the Alzheimer's Association for assistance before making a decision.


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<h2>Caring for a Loved One in a Facility</h2>

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Whether your loved one lives in an assisted living or a residential care facility, maintain ongoing communication with the care staff and friends who visit regularly.

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<LI>Work with the managing nurse and physician. Call to get updates on the person's condition and progress, and participate in care conferences.
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<LI>Encourage other family and friends to visit and share their observations.
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<h2>Resolving Family Conflicts</h2>

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Caregiving issues can often ignite or magnify family conflicts, especially when people cope differently with caregiving responsibilities. Family members respond at different rates to dementia.  You may be resented because you live at a distance.  Some family members may feel overburdened and that others are not helping enough. There may be disagreement about financial and care decisions.

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To reduce conflicts, acknowledge these feelings and work through them.

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<LI>Have a family meeting. Talking about caregiving roles and responsibilities, problems and feelings can help ease tensions. You may want help from a professional counselor or clergy.  In some circumstances, professional mediation may be appropriate.
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<LI>Recognize differences. Some family members may be hands-on caregivers, responding immediately to issues and organizing resources. Others may be more comfortable with being told to complete specific tasks.  Recognize the talents, skills, and preferences of each individual.
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<LI>Share caregiving responsibilities. Make a list of tasks and include how much time, money and effort may be needed for completion. Divide tasks according to individual preferences, abilities, and resources.
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<LI>Talk. Family meetings or conference calls keep the family up-to-date and involved. Respectfully discuss what is working and what might need adjustment.  Reassess the needs of the person with Alzheimer's frequently.  Decide if any changes in responsibilities are needed.  Listen and validate the feelings and opinions of each participant.
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  Long-Distance Caregiving