How can long-distance caregivers get and give more help?
Long-distance caregivers have to rely on primary caregivers who are at the scene 24/7. If you are the long-distance caregiver of an aging parent, the primary caregiver could be your other parent or a paid, professional caregiver. In either case, you may understandably wonder how well caregiver and care receiver are holding up, whether they need more help, and how you might procure them that help.
Lightening the burden
Let’s say that your father has always been kind of a lovable mess, and in a way your mother has always taken good care of him. But know your aging father has now developed a physical and/or mental condition that requires around-the-clock supervision and management, and your mother is in over her head. You may have noticed that she sounds exhausted when you talk to her, but she may be too proud or too embarrassed to ask for help. You could start by assuring her that she plays a very important role in your father’s care. In fact, even if she does decide to get help, that doesn’t mean she could ever be replaced. Respite care, which would give her a break from caregiving duties, is very flexible. It can be arranged to span several days or only a single afternoon. It can take place at home, in an adult day care center, or at a skilled nursing facility. Most parents wish to age at home, and to achieve that for as long as possible, some sort of home-based care is required. A hired caregiver is automatically persona non grata to some people; if your mother is one those people, you can explain to her that an in-home aid can provide invaluable help and allow her to have more free time for your father and for herself. If still unconvinced, suggest trial period.
Encouraging parents to get more help
As a long-distance caregiver, changes in the health of one of your parents are more obvious than they are to your other parent – the primary caregiver. In consequence, the primary caregiver may believe that if something is not broken, it doesn’t need to be fixed. On the other hand, the primary caregiver may be in denial concerning their spouse’s deteriorating health, and consciously or unconsciously cover up their shortcomings. For example, doing things or speaking for them. You need to be tactful, though. Forgetting things now and then does not equate Alzheimer’s disease. Be careful that you formulate your question correctly. Instead of asking “How come there’s no food in the house?” ask, “Are you having trouble getting to the store?” Moreover, really listen to the answers. Make sure you have an open, honest, back-and-forth conversation with both of your parents. Suggest practical examples of the ways in which they could get more help, such as arranging to have groceries delivered regularly, or having a home health aide drop by once a week to help with the chores, or ensure your parent is taking his/her medications. You can also offer to schedule medical appointments and arrange transportation to and from the doctor’s office – whether it is to get a proper diagnosis or even a second opinion, or make sure your parent receives adequate follow-up care.
Regardless of whether your parents accept respite care, a paid caregiver, or any other form of home-based care, the time may come where they have to consider moving out. Reasons for this include not being able to maintain their household or one or both getting to the point of needing constant care in a long-term facility. In the former case, they could move to a smaller apartment which has the potential of not only saving them but also making them – with the prospective sale of their house –much welcome money. However necessary it may be, this decision can be a difficult and subjective one, and it may be affected by how healthy and independent your parents are, as well as by their financial situation and personal preferences. As a long-distance caregiver, you may feel this is a perfect opportunity to bring your aging parents closer to you. However, you must first carefully consider how this move would affect your own family and your personal, professional, and home life. Furthermore, keep in mind that any move, whether it involves a short or a long distance, will not be easy for an elderly individual, even more so if they don’t particularly want to abandon their home, community, and everything they’ve become familiar with. One method of getting the opinion of everyone involved is to organize a conference call. And if the decision to move your parents is made, remember that you can make arrangements for it even from far away.
Moving out II
Sometimes the aging parent becomes so sick that moving to a nursing home is no longer a choice. Aware of this possibility, some parents make their children promise that they won’t send them to an institution. Making such a promise may leave you with two alternatives; either keep it – which could go against what’s best for your parent – or break it when and if the situation becomes unsustainable. What you can promise your parent is that you will always provide them with the best care that you possibly can, and that you will respect their wishes as long as they are not mutually exclusive with the right healthcare option. Any promises you make need to be realistic and based on fact rather than wishful thinking. Depending on the progression of your parent’s condition, you may not be able to keep tomorrow a promise made today. If the promise has already been made, you can cite newer developments that justify your going back on it.
Being there during the end
A few months left may seem like much too short a time for your parent to live, and at the same time it may seem like too long for you to drop everything and fly or drive to be with them until the end. As a long-distance caregiver you may have learned that you don’t have to be physically present to make a difference, and the impending death of a parent is not the exception. Talk to your parent’s doctor and primary caregiver to determine how to best see your parent through to the end, and ask them what you can do to help. Spend as much quality time with your dying parent as it is humanly possible, and when not possible, stay in touch via phone calls, taped messages, notes, cards, e-mail, chat, etc.
Putting your foot down
So far you have been gentle, caring and loving with your aging parents. Hopefully not, but you may have to use some tough love on them as well, and help them even if they don’t want to be helped. You can neither leave an aging adult in a dangerous or unhealthy situation nor fail to keep them from one. For instances, and as mentioned above, you may have to break a promise and force your parents to move our accept a paid caregiver against their will – note that forceful action should only be a last resort after you have exhausted all other options, such as talking, begging, and pleading with your parents. If you’ve tried to explain the situation and they refused to listen to reason – perhaps due to a mental condition are not even fit to reason with anymore – then take matters into your own hands, even though it means legal action.
Part of this may involve not only assigning a caregiver (if the aged P. shows signs of self-neglect) but also relieve said caregiver of his/her duties (if the care receiver shows signs of elder abuse).
A situation in which an elderly individual puts him or herself at risk as a result of memory- or judgment-impairing disorder or a chronic condition. The line between independence and self-neglect is very fine. Signs of the latter include:
Intentional or unintentional physical, emotional, or financial harm caused to an elderly person. Signs include:
· Bruises, pressure marks, fractures, abrasions, burns.
· Withdrawal from normal activities without explanation, sudden changes in alertness, uncommon depression.
· Financial losses due to exploitation.
· Bedsores, poor hygiene, unusual weight loss, unattended healthcare needs.
· Frequent arguments or a tense relationship between caregiver and care receiver.