Needless to say, caring for a loved one long distance has additional challenges. As with most difficult things, breaking down the pieces will help to put the puzzle together the quickest and easiest. Here is a partial breakdown of what to consider and plan for:
1. What are the real issues to deal with now and in the projected future? Define the problems and gather information.
2. Divide, designate, and share responsibilities. Ideally, this would be done in family meetings. If you can include your loved one for their input, then even better, so they can feel a part of the decision making and solutions.
3. Arrange to have someone checking on them regularly – a relative, friend, neighbor, church member. Someone to check that they are safe, in a healthy environment, taking their medications correctly, looking for any needs that might arise.
4. Resource = National Association of Professional Geriatric Care Managers will help find someone in their area who can initially assess and monitor aging needs, while offering recommendations. These people have licenses in related fields – health care, pharmacist, nursing, geriatric counseling. Ask for references. Do they provide 24 hr. emergency services? Do they provide regular monthly assessments and reports? How do they communicate with the family members? How do they charge? Also, most long term care insurance companies have professionals who will provide this same service National Assoc. of Prof. Geriatric Care Managers www.caremanager.org
5. Schedule your own visits, saving some vacation or sick time for emergencies. Know babysitters or others who can help you at home if you need to leave at the last minute – you need support, too, for you, your own family and responsibilities. Let your friends and co-workers know that this is a situation you are currently dealing with, so that they can offer help and be aware of the difficult time you may be having.
6. Nutrition – what special diet requirements are needed? How can you get healthy meals prepared or delivered? Many times you’ll be surprised at the options you might have.
7. Safety in their home – balance and eyesight become difficult, so their living area should ideally be on one level. Doorways can be altered for wheelchair minimum clearance (27” wide). Bathroom facilities should have grab bars and raised seats. Plenty of light is needed, both natural and electric lighting – this is also important for continued, positive mental health. Look at doorknobs and cabinet pulls – sometimes, handles and levers are easier to operate with limited mobility. Put scald guard on the hot water heater or especially on the bath/shower faucet. An architect or contractor familiar with handicap approved environments can assess the situation and make recommendations for you.
8. Personal safety – medications have to be monitored strictly. Not only are they being taken properly, but over-medicating the elderly is a common problem. Watch for unsteadiness, forgetfulness, sleeping too much, sluggish personality. Contact their physician if you have concerns. Remember, as with raising your children and living your own life, sometimes your intuition knows more than the professionals. Look at their clothes and shoes – back zippers, buttons, shoes that have to be tied or have leather soles – these all become difficult. You may have to do a little shopping.
9. Driving and increasing limited mobility – stopping driving is frightening because it removes one of the last areas of independence. There are several ways to approach this conversation, remembering that it’s not just their safety you are concerned about. What about the other drivers on the road and insurance problems that could arise? You do have options – find them. If other sources of transportation are introduced, it might deter having to legally remove their driving privileges. The important issue is to provide them with a regular way to get outside, to go to appointments and, especially, to stay active socially. Look for qualified drivers to regularly schedule or find the handicap vans and taxi services available – many times you can make a friend so you can schedule the same trusted driver.
Warmly, Carolyn
