Long-Distance Caregivers, Part 3

For long-distance caregivers, a visit to an elderly or ill loved one often feels more like a cross between a business trip and emotional roller coaster than a homecoming or reunion.  There is only so much that can be accomplished each visit, so it is important to set realistic goals.  Balance is key.  In weighing the importance of multiple priorities, tilt the scale in favor of “visit” time with your loved ones.  Those opportunities are irreplaceable.


The timing of your visit can be important.  It’s beneficial if your visit coincides with your loved one’s appointment with his/her primary physician.   If that’s impossible, another option is making an appointment to meet independently with the doctor, with written permission from your loved one.   Many long-distance caregivers plan their visits to give the primary family caregiver a much-needed break.  Frequently, these visits become focused on getting things settled for a loved one; remember to make time to enjoy each other’s company.


As you plan your itinerary, take the time to:

    * Have a discussion with the primary family caregiver, if there is one.  Face-to-face conversation provides an ideal chance to raise and resolve issues, identify specific ways you can help from a distance, and develop contingency plans for long-term or crisis care for your loved one.  Discuss options for sudden illness, rapid change in condition, or the need for more assistance.


    *  Meet others who play roles in your loved one’s life:  the pharmacist, the homecare nurse, neighbors, church members and friends.  You are building relationships that provide a safety net for your family member; obtain their contact information and share with them the easiest way to reach you.  Be sure to obtain their contact information and share your own.


    * Closely observe your loved one’s condition.  Be prepared for the subtle and not-so-subtle changes that cannot be detected over the phone.  Those changes also include behavioral changes, unusual forgetfulness, or mood swings.

   
    * Carefully observe your loved one’s surroundings.  Identify:

          o Possible falling hazards – loose throw rugs, poor lighting, and unsafe clutter.

          o Safety concerns – lack of grab bars in the bathroom, hard-to-manage locks, and steps           that should be replaced with a ramp.

          o Personal care needs – dirty or disheveled clothing, stale urine or stool odors in furniture or carpeting.

          o Household management needs – lack of food in the refrigerator or cupboards, excessive clutter or filth, evidence of hoarding, stacks of bills and mail, piles of laundry.

          o Healthcare risks – medications in disarray, missed physician appointments.
         

It’s important to remember not to handle your observations as an investigation or interrogation; when you view your loved one’s surroundings with the fresh eyes of a visitor, it can be easy to offend your loved one or the primary caregiver.  It’s especially important to remember and recognize the difference between an individual choosing not to care for his/her own needs (self-neglect), the inability to care for oneself, and circumstances of elder abuse.


When issues are identified, our ill or elderly loved ones may choose not to acknowledge them or may become angry when approached.  It is important to respect their privacy and independence while also obtaining current and correct information from them.  These are delicate conversations for all family caregivers; it is better to begin them by asking respectful questions or offering gentle suggestions rather than making judgments and criticisms.  Don’t impose your standards, preferences, or opinions.  You may feel strongly that you loved one needs a new doctor, changes in diet, or living assistance; you will make more gains by loving persuasion, rational discussion, and patience than by force, assertion, and pressure.


Some of our loved ones are willing to discuss their healthcare wishes and legal and financial standing with us.  But sometimes they prefer to share this information with an attorney or physician.   Both options are legitimate choices that should be respected.  The important thing is that your loved one expresses his/her preferences to someone.


Can the issues you’ve identified be corrected during your visit or is personal care, housekeeping, home improvement or lawn care necessary?  Does a health care professional need to be involved?  Some long-distance caregivers hire a geriatric care manager/healthcare advocate to identify the needs and oversee the care your loved one may need.  If these arrangements are necessary, aim to make them before the end of your visit to assure they will be implemented in a timely fashion, and recognize that continuous follow-up may be required.


Above all, take care to not make promises that you may not be able to be keep.  For example, in an attempt to reassure a distressed love one, it is easy to make a commitment that he or she will never have to leave their home; despite all our effort, there may come a time when remaining in an independent living arrangement is no longer be an option for your loved one.