amily caregiving at a “long distance” usually applies to relatives who live at least two hours apart. But now during a global pandemic, unless you live together, all loved ones have been robbed of the opportunity to visit and spend time together to some extent. As a result, the unique challenges associated with long-distance caregiving for an aging parent are impacting more and more adult children as this health crisis drags on.
When you cannot “eyeball” how your parents are doing, especially if they are unfamiliar or unwilling to use video chat apps, how can you observe, assess, and monitor them for changes in their physical or cognitive condition? Many proud members of the “Silent Generation” can be, shall we say, less than forthcoming about their frailties and ailments. I am happy to share the strategies I have learned in my professional and personal life.
Get the most out of phone calls
You may be physically distanced, but nothing prevents you from calling your senior parent on a regular, frequent basis. Here are some things you can pay attention to while on the phone:
- Listen for changes in your loved one’s voice, tone, and speed of conversing.
- Does your parent sound depressed?
- Are there sudden health changes or worsening of their chronic illness without explanation?
- Are they falling or experiencing a loss of balance—as told by a spouse or another nearby observer?
- Are your conversations always the same? Do they speak in generalities like, “Yes, I’m fine,” or, “We’re doing just fine,” but they can’t tell you in any detail what they have been doing or eating?
- The same parent is almost always the one to answer the phone, and the other one usually just “sends love” from afar. This is often a sign of one spouse “covering” for the other, to protect you from worrying.
Create a care book together
Another way to assess cognitive changes in a distant parent is to suggest that you would like to create a care book together, to make it easier for you to help them if needed. A care book consists of significant information you may need in the event a parent becomes ill or incapacitated. Ask for the names and contact information for neighbors, friends and others who live near your parent, your parent’s service providers (from the hairdresser to the HVAC maintenance company), their health care providers, and some financial information such as bank accounts.
If they are unable to get this information, or resist the idea entirely, there may be a reason beyond protecting their independence. If they are willing and forthcoming, it can serve as an incredibly valuable tool should a crisis occur.
Prepare for early intervention
When the day comes that your parent has suffered a physical or cognitive setback and needs more help, being able to intervene quickly and effectively can improve their outcomes. There are many permissions and potential roadblocks you can clear away now, so you will be ready to take immediate action in the future.
It is extremely important to get permission from each of your parent’s physicians to exchange medical information about your parent. Ask the doctor’s office for a HIPAA Authorization Form, complete it, have your parent sign it, and submit it to the physician to be kept in your parent’s medical record. (The federal Health Insurance Portability and Accountability Act, known as HIPAA, protects sensitive patient health information from being disclosed without the patient’s consent or knowledge.) You can be extremely helpful to the doctors by giving them family history and background information, and they can advise you of noteworthy changes in your parent’s condition.
Many seniors and adult children put off the topic of financial and estate planning because it makes them uncomfortable, but stress to your aging parent that it is important for them to make their own planning decisions now, so they can receive the financial, medical, and legal support they want, and live in the home they choose at a later date.
This process will need some help and guidance from trusted professionals, whether it be a certified financial planner or a geriatric or neurological specialist.
Engage professional help
The reality is that it is difficult to assess a loved one’s physical or cognitive decline under the best of circumstances. If you live apart, present times make it even more challenging. The strongest suggestion I can make is to explore the idea of hiring a geriatric care manager, also known as an Aging Life Care Professional (to find one, visit www.aginglifecare.org), or request a complimentary nursing assessment from BAYADA Home Health Care in your area to determine if your parent is safe at home and if they require environmental changes or more care and oversight.
A professional care team can give you peace of mind and communicate with you on a regular and emergency basis to help you monitor the stable or changing condition of your parent. This can alleviate a large part of the challenge of caring from so far away… until you are able to be together again.