Taking Care of Your Parents when You Live Far Away

There comes a time in everyone's life when they need more help getting around than when they were 25. If a parent's health is generally good, they may still be driving, doing their own shopping, and cooking for friends at age 80. Even so, unless they are one of the luckier people on this planet, they aren't as likely to want to rake the yard or go holiday shopping for 3 hours.

Parents and their adult children need to come to an understanding of how the older half of the equation wants to handle things as they get closer to the cohort of frail elderly or just plain really old. (True, this is better than the alternative any day of the week.)

The bottom line is that as long as the parent (or aunt or older sibling) can make cogent decisions it's not your beeswax unless they ask for assistance. I addressed this in another article on this site, "How to Help Your Aging Parents: Deciding When to Step In."

Once it is clear that your parents need help you have an added challenge if you live more than a few minutes away. And let's face it - you're likely to be many hours away by car or plane. You have to assess the situation in terms of several factors. For example, how strong is your parents' support network and can your parents seek medical care or other services on their own?

A Strong Support Network May not be Enough

It's the lucky person who has lived in the same neighborhood for years and has many friends - especially if some of them are a couple decades younger. If this is the case, you likely know your parents' friends and perhaps their fellow churchgoers and doctors. But, you don' know all you think you know, and it's hard to gather information from a distance. Here are some steps to take before there is an emergency.

1) Get phone numbers for your parents' closest friends, neighbors, doctors, and church. These are people you can call if you cannot reach your parent, or if you need advice on local resources. You also want them to know how to find you.

2) Ask your parent to keep you updated on their medications -- prescription and nonprescription. You may be the person a new doctor or an ER calls when there is a crisis. Even if your parents normally track meds and dosages on their own, there may be a time when they cannot relay this information.

3) Ask your parents to designate you as someone physicians and hospitals can talk to about their condition. Well-intentioned as the privacy laws are, they can prevent a doctor from discussing your parents' condition with you, and you may not be able to see your parents to judge for yourself.

4) When you do visit, go to senior apartments or assisted living homes when mom and dad do not need to be there. Assure your folks that you are not trying to force them to move, simply learning more about their preferences. (Sometimes an assisted living residence will let you eat a meal to learn more about what they serve, so there could be free food involved.)

5) If your folks do not have a mobile phone, encourage them to get one, even if it is a prepaid cell service. (You can always add minutes for them if needed.) It can be difficult to reach a phone from a hospital bed, and if your folks make an ER visit it could be hard to make a long-distance call.

6) Don't assume you know what you need to know about local resources. Do some research from your home, and follow up the next time you visit. For example, a home care agency may have the best ad on the Internet, but when you visit you may find staff less friendly than at a smaller home-care agency.

7) Familiarize yourself with local transit capabilities. Few things are more frustrating than losing the independence of a car, whether temporarily or permanently. You need to know whether the local bus company has a door-to-door service for those who need it and how much it costs to take a cab if cabs are available.

8) Learn where the local Area Agency on Aging Office is. These partially government funded entities, usually nonprofits with a board comprised of local citizens, know just about every senior resource in the area -- even if your parents live in a rural area. They would be your first call if a parent needs home delivered meals. An Internet search will lead you to the local agency. Unless you live in a large metro area, they generally cover multiple counties.

9) Ask if local utility companies will let you kow if bills go unpaid. Your parents may need to approve this.

10) If at all possible interview any health provider who will enter your parents' home. A recognized home health agency will have conducted their own interview and is bonded. However, you know your parents better. One person won't mind a health aide who calls them "hon" 50 times each day and makes your parents follow a rigid routine. Others would mind this very much. Your parents are entitled to be comfortable with their direct care providers.

Gauging Their Needs from a Distance

If things are working well, your parents can tell you how they feel and they can get where they want to go unassisted. It can be hard to tell if a parent is losing some capabilties when you do not see them often. Conversely, when you do get there, you might see more change than someone who sees them often, because a change will seem more dramatic to you.

You don't want to get into 20 questions every time you talk to your parents on the phone, but it is fine to ask if they need more help or see changes in what they are able to do. If you are not overbearing, you may learn that cooking is getting harder and together you can figure out which frozen meals they might like, or whether they should start to get Meals on Wheels.

Mental agility is harder to determine from a distance. If they start to respond to questions using similar phrases, that could be a clue. Not everything is "fine, fine, fine," which became my mother's standard response -- and she had most of her faculties until the day she died.

Assessing their coping capabilities might entail somewhat regular contact with your parents' friends. Seniors guard their independence and will not "tattle" to a friend's adult children if another senior has a first-time fender bender. However, if you keep friendly communications open, a neighbor will tell you if they notice your parents' house has grown unusually cluttered or mom and dad appear to be losing a lot of weight.

Supporting Local Caregivers

Here is your choice if you have siblings who live near your parents. If you want to help, really help. Visit so that your brother or sister can get away, send funds if you can and it would be helpful, or tacfully supply information. Under no circumstances should you consider yourself an advisor to someone who is doing a lot for your parents. If your sister wants you as a sounding board that's great. She doesn't need someone second guessing how she helps your parents.

If it looks as if there will be one sibling on site and others far away, you need to draw up some ground rules for interacting with each other. Forget about whether "mom liked her best" and settle into a routine for keeping in touch on the important stuff.

Keep in mind that it's challenge for the person in the same town to keep everyone up to date all the time. It's tedious to make a lot of phone calls and it can simply take too much time. Email is fine, but don't post notes on your social networking site -- your parents deserve their privacy.

Finally, cultivate a sense of humor if your is not finely honed already. It makes everything easier.