Focus on Caregivers

Caregiving when miles intervene

Long-distance caregiving is usually difficult for everyone involved. The issue becomes more complicated when parents decide to live far away from their children. This kind of lone decisionmaking can cause stress on all family members.

An 87-year-old man insisted on traveling from New York to St. Petersburg for the winter against the wishes of his daughter, her father's main caregiver. He had a memory problem, was on medication, but otherwise healthy. The man's son and daughter had decided he should live in Orlando with his son's family, but the living arrangements did not work out.

The father demanded that he be taken to St. Petersburg, where he owns a mobile home. There were hard feelings and cross words between the man and his son. The older man remembered only the good times he used to have in the park, but in reality he could no longer live independently. The man was unable to drive and had to rely on others in the mobile home park. He wanted social interaction, stimulation and activity, but he needed those things in a safe setting.

Months went by with only phone calls from his children, during which time he assured them that everything was fine.

Having respect for a parent's independence is important, but it is also important to connect with older parents through talks, personal contact and observation. Phone calls won't always work because they cannot relay eating habits, personal hygiene, home maintenance and safety and decisionmaking skills.

Adult children of aging parents must be able to:

Work on new ways of interacting with parent(s);

Face their parent(s) and gently confront them with reality when unpopular decisions need to be made in their best interest;

Respect elders' right to self-determination while protecting their welfare;

Face a parent's frailty and the fact that a loss of life will come.

Ongoing conversation is vital for family members before a crisis. Most people, and certainly older parents, find it difficult to have candid discussions about finances, health, or other personal matters.

Here are things to consider:

Talk with your loved ones about their needs and concerns.

Keep an updated journal of household, personal, medical and business documents;

Establish a list of friends, family or neighbors who can be called in case of trouble.

Be in the know about the financial and legal matters, health care and end-of-life wishes of your loved one.

Gather information such as insurance policies, names and numbers of doctors, a list of medications.

An updated durable power of attorney, advance directives, living will and health care surrogate are important to have before a crisis.

List housing options, local services, adult care centers and meal delivery.

Organize visits in advance to doctors, lawyers, health care professionals; have questions ready.

Buy a medical alert system; leave a duplicate house key with only a known, trusted, friend or neighbor.

This information is offered as a means to help families and their loved ones develop deeper relationships that allow them to relax and discuss the reality of change, and perhaps bring them closer together in love and respect.

- Ethel M. Sharp is executive director of Aging Matters Inc., a nonprofit network for family caregivers and elder care. You can write her in care of Seniority, the St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731. When seeking more information, please enclose a stamped, self-addressed envelope and include your telephone number, with area code.

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