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Tips for Helping With Long-Distance Caregiving

Author: Helen Dennis, Specialist on Aging

Question: I am 81 years old and a full-time caregiver to my wife of the same age.  My sister is 90 and lives in her own home about 100 miles from me. Currently my brother, age 86, provides most of her care – cooking, doctor appointments, shopping, gardening and home maintenance.  He suffers from severe arthritis and is scheduled for cataract surgery this month.   Recently my sister has shown signs of dementia and has given up paying her monthly bills, driving to the market and her Bridge club.  I manage her finances, so I know she has some resources.  How can I help given my full-time commitments?

Answer: The challenge that you face has been given a name – long-distance caregiving. Here is a little background information:

The National Alliance for Caregiving and AARP report there are 5 to 7 million long- distance-caregivers in the U.S. who are caring for an older relative – a number that is expected to double over the next 15 years. They live on average 480 miles from the people for whom they care and spend an average of four hours in travel time per visit.

Employers are affected.  According to the Alzheimer’s Association’s Long Distance Caregiver Project, employers collectively lose 15 million hours a year of work time due to long-distance caregiving.

Given the responsibility and commitment, where does one begin?  The following tips may be helpful:

  • Arrange for an evaluation of your sister’s physical and mental status.  This can be done by a geriatrician who is a physician specializing in the diseases of older age.    If possible, look for one who is board certified.  This may be difficult since there are only 7,000 board-certified geriatricians in the country.  For a referral, consider calling local hospitals or go to:
  • Provide an assessment of the home environment.  One option is to contact a geriatric care manager.  This person is a professional – usually a social worker, nurse or trained gerontologist – specializing in assessing the needs of older adults and arranging for the appropriate services.

They assess the initial needs of the older person, suggest services to meet those needs, provide referrals and then arrange for the services to be implemented.  They provide a one-time service or ongoing assistance.  According to MetLife’s publication, “Since You Care:  Long Distance Caregiving,” assessments can range from $100 to $500; on-going care may cost $60 to $90 an hour. A geriatric care manager can be located through a local senior center, Area Agency on Aging, an elder law attorney or at

Remember to check references, licenses, certifications and the billing procedure.   The assessment will serve as a guide in developing a care management plan – the keystone to effective care.

  • Schedule some personal visits.  Consider arranging some respite time for yourself and visit your sister.  Here are some things to look for:   Determine if there is adequate food available, if she is taking her prescribed medications and if she is having social time with friends or family.  Finally, how does she look?  Does she appear well-nourished and well-kept?
  • If you are not using a geriatric care manager, investigate community resources.  The Eldercare Locator at 1-800-677-1116 is federally funded by the Administration on Aging and provides information about local services by zip code.  Information also is available on the Internet at Local senior centers, hospitals, the library or your sister’s church or synagogue are additional resources.
  • Keep a file of important documents.  Make copies of your sister’s birth certificate, Medicare and Social Security cards, and health insurance information.  If your sister wants you to discuss her concerns with her doctor, ask her to complete privacy release forms and have them filed with her doctor.  Keep a list of her current medications.  Finally make copies of her will, living will, trust and financial and health care power of attorney.
  • Determine who will supervise the care.  This can be difficult yet is essential.  The care manager, your brother, a friend or neighbor – or you, long distance, may be the one who makes sure that “good and appropriate” care is being implemented.

Thank you for your question.  What is most important is to care for yourself.   Consider taking some time off.  It will be good for you, your wife and your sister.

Best wishes for a manageable and easy journey with some personal rewards.

Copyright 2010 Helen Dennis. All rights reserved.

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