These days we can find ourselves living farther and farther away from family for a variety of reasons. If you live an hour or more away from the person you are providing support to then you need to know these 5 strategies for being a better long-distance caregiver.

Caregivers are compassionate, empathetic, patient and understanding people. Long-distance caregivers are all of that sandwiched between extra layers of stress and guilt.

Recently my 84-year-old mother had what she refers to as an ‘event’. This involved a trip to the local hospital emergency department, by ambulance, followed by hours of testing and no clear diagnosis as of yet. I am the closest daughter time-wise and I live four hours away – if the weather cooperates. I admit that we are not prepared.

We know that our parents are getting older – because we’re getting older. But most of us haven’t taken the right steps to prepare for a time when our parent, or another older adult in our lives, needs us to step into the role of caregiver. But if you have direct conversations with your parent and make plans early, you might alleviate some of the added stress.

A range of responsibilities

Each circumstance will require a different level of responsibility from a caregiver. In all of these scenarios, you would be considered a long-distance caregiver.

• Every morning you call your out-of-town mother for a brief hello.
• You drive ninety minutes each way to take your uncle for lunch every second weekend.
• Or you make necessary arrangements for family meetings with care home staff where your parent lives in a different city.

Caregiving responsibilities can range from minimal to all-consuming. You might be a solo caregiver or part of a family sharing the role with professional caregivers. In addition to the strategies to be a better long-distance caregiver, you also need to remember to take care of yourself.

Meals, transportation, and banking can be more easily managed. However, the support required for someone with rapidly developing dementia or other advancing healthcare issue will need you to be much more engaged.

There might be a gradual increase in your caregiving involvement but it is not uncommon to suddenly find yourself in the role of decision-maker for a parent due to an emergency. When you are a long-distance caregiver making these decisions can certainly test your ability to manage stress.

“One minute you are leading your own life and the next you are immersed in the healthcare system, learning the medical language and routines, spending significant time in the hospital and at your loved one’s side. …..this can be a marathon, lasting weeks, months and years.”

Connie Jorsvik  Patient Pathways

Strategies

Each of these strategies could easily be a separate topic of discussion. You can start with an overview and then dig deeper into the areas that you feel need the most attention in your long-distance caregiving situation.

1. Have the hard conversations
2. Know who is on your team
3. Where to look for support
4. Get it in writing
5. Be there

Begin with communication then you can assess the current situation so you know what has already been done. Look around to see who is already on the care team and who else you need to invite.

Since you’re not living near your loved one it’s important to identify the available resources. You need to trust that you have the right information to make informed choices with or for your loved one. And when others need certain information you need to know where to find it and how to make it available to them.

1. Have the hard conversations

The first step in helping anyone is to ask them “How can I help?”

The response will sound something like “Oh, don’t worry. I can manage.”

You need to ask hard questions so you are both prepared for the future. If you truly want to help your parent or any older adult, even when they aren’t very keen to discuss their personal life, you need to ask the right questions to get answers.

Being clear about what you want to get from these conversations means knowing how to talk about ageing.

Conversations about your parent’s health, relationships, and finances can be uncomfortable for them and for you. Doing some prep work for yourself beforehand can be helpful, especially if this is new territory.

Everyone who is engaged in the care and well-being of your loved one will base their recommendations on the information at hand. You want to give the right people the right information to help with decision-making.

2. Know who is on your team

Developing a plan to support your loved one will require an assessment of:

• overall health both mental and physical,
• safety of the home setting such as the risk of falling
• financial and legal documents

If you are not the person designated to have access to personal information then you need to know who that legal representative is and how to contact them. Organize the names and contact information for doctors and other health providers along with financial and legal contacts.

Once there is an agreement that your parent or older adult is willing to accept help, arrange for a family meeting. This way the assessment can be shared among all family members who are a part of the larger plan. Patient Pathways offers educational materials to help with information gathering and sharing.

3. Where to look for support

Depending on your current situation, helpful resources might include community support agencies, a social network, and support groups that either you or your parent can participate in.

There is wide variability in the kind of support and resources available in urban and rural areas. If your loved one requires outside paid services you will need to identify available homecare or personal care assistance in the city they live in.

Be careful to verify information that you find online. Following the pandemic I have found some information is no longer be accurate.

In British Columbia, further resources are available here. The Government of Canada offers a variety of resources for seniors’ care and support services. Check the provincial government website for services where your parent lives.

4. Get it in writing

Your parent is unlikely to receive the care they wished for without having prepared a written record of what those wishes are.

Specific documents should be completed early in the planning stage so health and financial matters can be addressed with as little confusion as possible. Information can always be updated as time goes on.

A word of caution that if there is confusion over unclear financial matters you may end up as the responsible party.

Documents including  Advance Care Planning, Representation Agreement, Enduring Power of Attorney, and others need to be explored and the associated paperwork completed.

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5. Be there

In the case of being a long-distance caregiver, a picture is not worth a thousand words. It will probably be difficult for you to determine exactly what type of assistance your parent needs if you are only able to visit infrequently.

Being there in person will give you a different perspective than a phone call or a video call.

You can see the state of their home.

• Is there food in the fridge?
• Is there a lingering odour that tells you their last bath was likely some time ago?
• Is there a growing pile of mail?
• Are familiar family heirlooms missing from the shelf?

Take stock during your visits to ensure the stability of your loved one’s health and living arrangement. Changes will inevitably be needed over time but with all the planning that you both did early on, you will know what the next step should be and what resources are available to support a transition.

Take care of yourself

When the flight attendant directs you to put on your oxygen mask before assisting others, it is a reminder that you are only able to help someone else if you look after yourself.

Maybe you are doing this important caring work alone, or maybe you are caring for children or other dependents at the same time. In either case, this can be so very difficult physically and emotionally. At some point, you may focus less on your well-being.

You might have others to share responsibilities with, and your degree of involvement and the amount of time you commit to your loved one will play a part in your ability to cope.

If you are a solo long-distance caregiver it can feel overwhelming. Yet, having siblings to share caregiving with can also be challenging. Your responsibilities may be less when there is family to share with, but family disagreements can add yet another level of stress for everyone involved.

Stress and guilt can weigh heavily on you when your aging parent lives several hours away. For a close friend of mine a visit to see her ailing mother involved an eight-hour day including travel. Because her mother was unable to speak following a stroke, neither a phone call nor a video call was an option. The stress of taking time away from family and work, and feeling she wasn’t visiting often enough created an enormous amount of guilt.

Time for yourself or with friends to talk about other things happening around you can help. You can do a self-evaluation to determine if you should get help managing your feelings. The CMHA is a good overall resource and has recommendations for stress management.

And So….

For some, this is a gradual process and there is an opportunity to plan for what is inevitable. For others, the situation is urgent and chaotic.

We can be in this role of long-distance caregiver with solo responsibility or shared; as a short-term endeavour or for many years. In my case I have sisters who I can share responsibilities with and we are all long-distance caregivers..

Your role as a long-distance caregiver or care partner will have less turmoil when you and your loved one have early conversations, develop a plan and prepare the necessary documents before an urgent situation arises.

The strategies I suggest for you as a long-distance caregiver are equally as important for each of us to start working on NOW. We will likely have long-distance caregivers of our own at some point so the challenge I propose to each of you is to Walk The Talk.