Parent Care: Make a plan for long-distance caregiving
Feb 22,2008 00:00 by Marsha_Kay_Seff

After talking with one daughter who is trying to care for her mom on the East Coast, I decided it's worth revisiting the subject of long-distance caregiving.

Looking out for a parent is difficult. Add the constraints of distance and it can be even more frustrating. Believe me, my sister, Bobbe, and I tried caring for our ailing parents by plane and finally gave up.

Mom and Dad had sort of agreed it was time to move closer to me, and Bobbe and I made it happen. We bought three first-class plane tickets to San Diego and hired a nurse to go along for the ride.

As it turned out, it was the right move for everyone.

For long-distance caregivers still struggling, I have a few suggestions for your next visit:

- Check out the fridge and the rest of the house to see how your parents are managing.

- Make sure the house is bright and safe. If not, do what you can to get rid of clutter and obstacles, including throw rugs.

- Set up doctors' appointments and go with your parents. Make sure you have them sign a HIPAA release so the doctors feel comfortable talking with you.

- Make an appointment with an elder-law attorney to get wills, trusts and powers-of-attorney in order. You should be able to get the HIPAA form at the same time.

- Start a notebook listing your parents' medications. Also, include any personality changes. Are they clean and well-dressed? Are they still doing the things they always liked to do?

- Take a local phone book home with you.

- Copy the names and phone numbers of people in your parents' address book.

- Set up a meeting with your siblings and agree on what needs to be done and who will do it.

- Sit down and talk with your mom and dad. Use "I" statements, such as, "I'm really concerned about you. Let's see what we can do to make your life easier."

Don't make demands. Instead, talk about the future. Give them three alternatives on everything and encourage them to design a plan.

- See how they feel about living closer to you. Suggest they visit and stay at a nearby retirement home. Otherwise, visit places in their neighborhood. All of us most fear the unfamiliar.

- Suggest hiring in-home help, if they're firm about not moving. Start interviewing but get your parents' input.

- Ask them how they feel about you taking over the bill-paying. If they don't like the idea, ask them why they're uneasy about it, and see what you can do to ease their fears.

- Call friends and neighbors and tell them exactly how they can help. For example, one or two people can stop by every day; someone can do the shopping.

- Get rid of the car, if your parents shouldn't be driving. Set up a taxi fund and emphasize how much money the folks can save by not having a car.

- Check out adult day-care centers and meal-delivery programs.

- Consider hiring a geriatric care manager, who can assess your parents' changing needs and get help as needed.

- Don't try to change everything at once. You know about Rome.

- Phone frequently. Listen carefully to what your parents say, how they say it and what they don't say. Older folks get good at pretending everything is fine.

Trust me, none of this is easy. Just try to stay flexible. As you probably have discovered, after you finally come up with a workable solution, the situation is bound to change.

Marsha Kay Seff is editor of The San Diego Union-Tribune's, a Web site for older folks and their caregivers. She can be contacted at