Long-Distance Caregiving, Part I

Family caregivers routinely “go the distance” with an ill or elderly loved one.  But what if the family caregiver also must “bridge the distance” because geography separates them from their family member?

Family caregivers have long been typecast as middle-aged women – usually wives and daughters -- who reside near or with the individual needing care.  Reality has sharply blurred this picture, however.  Family caregivers now increasingly work outside the home; reside farther from the person needing care; and are, in growing numbers, men.  Gender, income, age, social status, employment, physical location -- none of these prevent an individual from taking on caregiving responsibilities. 

Our economy is significantly increasing the ranks of caregivers who have moved away from their family members – especially elderly parents -- for job opportunities.  These caregivers are usually not able to move back home for any length of time when a loved one falls ill.  Long-distance caregivers face the same emotional and financial concerns as family members who live near by, but their roles and demands are uniquely challenging.

Consider, for example, that long-distance caregivers must:

·         Learn to discern whether a loved one’s condition is worsening simply by listening to changes in his or her voice;

·         Develop relationships of trust with doctors, nurses, therapists, home-health aides, pharmacists, and clergy we may never have met;

·         Coordinate medical care – including painful end-of-life decisions – from 3,000 miles away;

·         Recruit a support network of neighbors, housekeepers, and delivery personnel who can check up on our loved ones when we cannot be there;

·         Rehearse crisis and catastrophe plans.  What is our first response if Dad doesn’t answer his phone within 3 hours?  If his neighbor calls at midnight to report that he has fallen?  If a cousin calls saying Dad appears to be confused and disheveled? 

·         Develop detailed back-up plans for when we must be away from home to care for our long-distance loved ones.  Who will cover for us at work?  Who will take care of our kids after school?  Who will watch the pets?

·         Set aside emergency cash reserves for when we need to book an emergency flight home; when we have to help our parents quickly put their home on the market because they can no longer manage it; or when we have to pay for housekeepers to help clean the family home?

·         Cope with unique kinds of guilt, such as the guilt of not being there each day; the guilt of relying upon others; or the guilt of not being able to make radical changes to our own lives.

Medical advances have transformed caregiving into a long-term responsibility.  The caregiving journey may begin with a vague feeling that “something isn’t right” with Mom or Dad (or both); continue through diagnosis and treatment; and extend until recovery or death.  All caregivers must learn how to navigate each phase of this journey, while juggling their own personal and family lives, professional lives, and financial obligations.   For long-distance caregivers, these navigational skills are more important than speed or proximity.