Caring from afar

Step-by-step planning and organization make long-distance caregiving manageable


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This is the first in a three-part series about caring for aging parents or relatives long-distance.

Today: Creating a care plan.

March 17: Overcoming barriers of resistance.

March 24: Caregiver health and support.


• The Family Caregiver Alliance has publications and fact sheets on various caregiving issues, including a "Handbook for Long-Distance Caregivers." Visit or call 1-800-445-8106.

• "Long Distance Caregiving," a guide from the MetLife Mature Institute and National Alliance for Caregiving is available at www.maturemarketi...

Like many people in her generation, Nancy Schwanke, 54, is working hard to help her aging parents stay as independent as possible.

Her 88-year-old mother, who has Alzheimer's disease, and 90-year-old father still are living in Schwanke's childhood home in Lincoln, Neb. Though the home is difficult for them to keep up and navigate, Schwanke respects her father's desire to remain there, caring for her mother in a familiar setting.

Schwanke knows she's walking a fine line: Her parents' delicate health means she must be prepared for an emergency and make difficult decisions about their care. In the meantime, she arranges for as much home help as they will accept and keeps in touch with neighbors and family who check on them.

The difficulty of caring for her parents is compounded by the distance between Lincoln and her home near Steamboat Springs, where she is busy running a business with her husband.

"I worry a lot - I think about my parents every day," she said.

Schwanke is among about seven million Americans, including three million baby boomers, who are providing or managing care for a relative or friend older than 55 living at least an hour away, according to the Family Caregiver Alliance.

The responsibility of caring for someone from a distance can easily become overwhelming, but there are many resources available to guide caregivers through this unfamiliar territory.

Among the chief advice from caregiving experts is to build a plan step by step, and realize that though that the situation may change, organization and planning can help prepare caregivers for those changes.

The Family Caregiver Alliance is among organizations providing support to caregivers in many types of situations. The organization's "Handbook for Long-Distance Caregivers," points out details in a caregiving plan as well as resources to help caregivers though the process.

First, the caregiver should take time to gather information that will give them bearings on their situation and prepare them to make decisions.

Caregivers can keep all the information organized in a three-ring binder or "care notebook." The notebook should include pertinent paperwork such as legal documents, copies of the older person's social security and Medicare cards, health insurance and medication information and contact information for neighbors, doctors, social workers and other people involved in the person's care.

Assessing the older person's needs will provide the caregiver a basis for establishing a care plan. Assessment should include a thorough medical diagnosis of any physical or cognitive problems as well as consideration of what the parent or relative can do independently. Visiting the older person and talking to those in regular contact with that person can help the caregiver understand what kind of help is needed.

The next step is to establish a team of people to meet those needs. Helpful services may include home health aides or therapists, transportation to doctor's appointments or errands, adult day services, congregate senior meal sites or meal delivery, respite care, help with household chores or just a friendly visit from a volunteer.

Caregivers can contact the Administration on Aging's Eldercare Locator, or (800) 677-1116 or Area Agency on Aging in the older person's community to determine what programs are available.

Geriatric care managers are a growing field of professionals who access individuals' care needs and coordinate services and arrange for help from family and friends. Care managers are usually trained nurses or social workers and may be in private practice or employed by nonprofit organizations or government agencies. In a 2002 survey, the AARP found that care managers' fees averaged $175 for an initial assessment and $74 an hour for ongoing care.

Care managers can be found on the National Association of Professional Geriatric Care Managers Website, Caregivers should be sure to check references and credentials of potential care mangers.

Asking family members, friends and neighbors living near the older person to help with care can ease the stress on the primary caregiver living far away.

Siblings of a primary caregiver also may live far from the older parent or relative, but they can help with smaller tasks such as contacting insurance companies about claims or assisting with finances. A family meeting in person or on the phone can help clarify each person's responsibilities.

Information from "Long Distance Caregiving," a guide from the MetLife Mature Institute and National Alliance for Caregiving is included in this article.


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