We live in a mobile society. Children that once settled down across the back field are now just as likely to end up across the country. Young and middle-aged adults may relocate for employment purposes several times during their careers. Even older folks are more often on the move. In fact, according to the American Association of Retired Persons (AARP), during the '70s the number of retirement-age persons who migrated from state to state increased 58 percent.
Couple that with the fact that people are living longer and the chances greatly increase that you may sometime have to provide care for an ailing relative living at a distance.Anyone in that position, however, has difficult questions and issues to address. Most people can't afford to travel back and forth to provide care, but that doesn't lessen the guilt over not being physically present to help. People are often unfamiliar with services in their relative's area and are unsure where or how to go about finding help.
You must also balance the need for care against the relative's desire for independence. As long as there is no threat to their physical or mental well-being, older persons should maintain control over their own lives. "The fear over being dependent is very real," Jim Thompson, manager of consumer affairs for AARP, told consumer leaders gathered for the Mid-America Consumer Conference in Oklahoma this spring.
The AARP has provided some suggestions and guidelines that will help in providing long-distance care:
Make the most of limited visits: Talk with your relative openly and honestly in assessing the current situation and supports that are needed. Be careful not to antagonize, but rather enlist your relative's involvement.
Be observant. Ask the following questions: Do you notice anything unusual? Is your relative eating nutritiously? Does he or she have contact with others? Are finances being handled appropriately? Are there obvious safety problems?
Identify the informal support system. You and your relative should try to reach a consensus about what supports are necessary. Then examine the informal network already in place: friends, fellow club or church members, other relatives or others who already provide some support. Make a list of these people, with names and addresses in case you need to reach them later.
With your relative, talk with these people to explain the situation. Let them know of your concern and how difficult it is for you since you live out of town. Ask these people to contact you if your relative's situation changes. (Remember to leave your phone number and let them know they can call collect.)
Be sure to show appreciation for assistance they are currently offering.
Expand the existing network. After you've identified the informal support network, you can expand it by asking those already involved to take on additional tasks or identifying others who are willing to be involved.
Keep in mind that persons included on your support list are concerned about your relative and may be happy to offer other assistance as long as it does not appear overwhelming.
In asking for additional support, don't have several people providing the same assistance. If a person feels unneeded, he or she may discontinue helping. Remember to continue showing appreciation from time to time.
Locate and use formal services. Many people are not aware of aging services until a crisis hits, but a little advance planning can decrease some of the stress. The chart of resources below provides some of the possible sources of help. Remember that communities vary in types of services they offer, and names used for a particular service may vary.
Social workers, clergy, nurses, physicians and employee counselors may be able to refer you to appropriate services. The government section of the local phone book can also help. State units on aging offer information and referral services at no cost.
The process of weaving through red tape to actually get services started can sometimes be frustrating. Service organizations may have a detailed application process, possibly requiring an interview and documentation of medical and financial data. You need to be prepared. In dealing with various agencies:
- Keep records. List the name, title, department and telephone number of each person you talk with, along with their comments and recommendations.
- Secure the information needed from each agency. Check hours of operation, fee and application process. Find out if there is someone in the agency, such as a social worker, who could assist you in the process.
- If the agency requires an interview, be prepared. Find out what documents are needed. Confirm the appointment a day in advance. Take notes during the interview. Clarify what is going to happen and what each party is responsible for. Never leave an original document. Ask the agency to make copies. Keep all important papers together in a folder so they can be easily located in the future.
Send a note to the agency expressing your satisfaction or dissatisfaction. A simple note to an organization can often make a difference.
Consider relocation carefully. Some long-distance caregivers think that the situation will be easier to handle if the relative moves closer, possibly into the caregiver's home. Consider the following questions carefully:
- Does your relative want to relocate? Talk to your relative and find out what he or she thinks.
- Does your relative have any social contacts in your area? Long-standing community ties are difficult to replace.
- What kind of relationship did the two of you have in the past? Unresolved conflicts need to be addressed before your relative moves. Be realistic about your previous relationship.
Be honest with yourself. Caregiving can be a very stressful experience, and especially from a distance. Recognize the strain you are under and give yourself credit for doing the best that you can.
Whatever arrangement you make, you need to keep in mind that you have an important role in keeping your loved one's life as normal as possible.
And wherever possible, remember that you deserve a little caregiving yourself.