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Long-Distance Caregiving

Introduction

For many caregivers, the simple act of “checking in” to see if an older relative is doing well requires more than stopping by on the way to or from work. Long distance caregivers may have to plan a little differently from those who live with or live close to their relatives. Visits to loved ones, whether living near or far, are an excellent way to assess the situation and notice any changes that may require attention. Caregivers who live long distances from their older relatives especially need to make the most of their visits.

Take Stock of the Situation

When visiting, try to evaluate how your relatives are managing. Do you notice any change in their physical health or mental well- being? Are they eating properly? Is the house being maintained? Are bills being paid on time? What, if any, concerns are they expressing?

If you are not already aware, ask about what social supports they have. Do any friends or neighbors regularly check on them? Can anyone help with chores or errands, should the need arise? Acquaint yourself with these individuals. Provide them with your name and phone number, in case of an emergency. Depending on the situation, you may want to contact them from time to time. Also, be mindful to express your appreciation for their concern and help. (If you think someone may not have the best of intentions, be sure to talk to your loved one immediately, and take the precautions necessary to avoid abuse or exploitation.)

It may also be necessary to talk to their physician about current and future needs, and the precise level of care needed.

Talk It Over

It is very important to involve your relatives in any discussions or decisions regarding their care, even though this may be a stressful time for them. They often know best what help they want or need. Unless deemed mentally incapacitated, individuals have the right to determine what they want, even if every one else disagrees. Not including your older family member in the decision-making process can

often create anger, distrust, and a host of bad feelings toward those who are arranging or providing the care. It may also make them unwilling to cooperate with the care plan.

Getting Help-Informal Supports

Help from friends and neighbors can be extremely valuable to an older person. Sometimes this kind of help is free, and other times agreements are made at nominal costs. It may be difficult to even ask friends or neighbors for assistance; however, they will most likely not be offended by your request and may even be unaware of the need for their help. Shopping, taking out the trash, and shoveling snow are examples of the type of help a friend or neighbor may be willing to provide. Once again, bear in mind to express your appreciation, and be on alert for anyone who has less than honorable intentions.

Getting Help-Formal Services

Contacting a CAS counselor is an excellent first step in getting help to assess needs and identify options. If your loved one is hospitalized, talking to hospital staff about his/her condition, and to the social worker or discharge planner about community resources, is an important first step.

Many caregivers need assistance in locating and arranging long-term care services. Care management services, also called case management, can help with this task. A care manager can help families and older adults in finding, arranging, and monitoring long-term care services.

Care managers are usually social workers that coordinate the needed services for their older clients. If hiring a care manager, also known as a private geriatric care manager, look for someone who is not only experienced in working with the elderly, but also someone with whom you and your loved one feel comfortable. Communication is essential in formulating a care plan that best fits your relative’s needs when

receiving services in the home. Once a plan is developed, the care manager should present and clearly explain the plan. Be sure to ask for a detailed explanation about anything you do not understand. You and your relative should also make comments and be sure to agree with and understand the care plan before you formally accept it. Your relative has the right to refuse any part of the care plan, and may request a change at any time. In addition, the care manager should be aware and respectful of individual rights.

The care manager will implement the care plan by locating, evaluating, and scheduling the services outlined in the care plan. The services can also be monitored to ensure the quality and satisfaction of the services received. You and/or your relative should have regular contact with the care manager to discuss the care plan or to mention any problems with the services.

Care management services are not usually covered by insurance. Public agencies like Area Agencies on Aging (AAA’s) may provide care management at no cost and hospital discharge planners often provide a similar service for their patients. As mentioned earlier, there are private geriatric care managers who charge fees for initial evaluations, locating and monitoring services, and ongoing supervision. You or your loved one should play an active role, regardless of whether your care manager is paid privately or is through your local county AAA. There are no regulations governing private geriatric care management, so it is important to check references and contact the Better Business Bureau or the Bureau of Consumer Protection.

Take Care of Yourself

Keep in mind that traveling back and forth, and worrying about how your loved one is managing when you are not there can be very stressful. If you are considering having your loved one move in with you, be sure to talk to a CAS counselor to find out what you need to consider when making this decision. You may also want to take the CAS phone number on your next trip should you be concerned about your loved one’s living conditions.

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For further information about long term care planning, housing options, and community resources, contact CARIE or click

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