Caring for Aging Parents When You Live in Another State
With more people moving away from the towns where they were raised and more retirees choosing to spend their golden years in locales with warmer climates or lower costs of living, today’s families tend to be farther apart than ever before. So, when distant parents begin to show signs that they are no longer able to care for themselves or adequately handle the responsibilities of day-to-day living, ensuring their continued well-being can pose significant challenges for their adult children. If you are facing this growing problem, the following information will help you better understand the situation and take appropriate action.
How Far Is Too Far?
Parents don’t need to be hundreds of miles away to be out of reach. If they live far enough away that you can’t easily get to them on at least a weekly basis, they might as well be in another country.
A lot depends on how well your loved ones are still able to care for themselves. If they are relatively independent and socially active, a weekly phone call and the occasional visit may be sufficient to relieve any concerns you may have. However, if they live alone and have medical issues, the picture changes dramatically. Suddenly you need to be prepared for anything.
By making a checklist like the one below, you’ll get a much better idea of the steps to take and kinds of assistance you may need to look for.
- Do your parents currently need skilled medical help?
- Do they need help with daily personal care?
- Do they need transportation to doctors and other appointments?
- Do they need home modifications, such as wheelchair ramps or grab bars?
- Do they need help with household chores such as cooking, shopping, and cleaning?
- Do they need legal assistance or help with money matters?
- Do they need opportunities to socialize with others?
Gather Local Support and Caregiving Resources
If your loved one has friends or other relatives who live nearby, you may want to enlist their aid in keeping an eye on things. The nephew across town or the downstairs neighbor might be able to check on them every day or two just to see that everything is okay.
Another good resource for ongoing personal support is the local place of worship. Perhaps a local clergyman or member of your loved one’s church group would be able to pay them a visit on a regular basis.
Often, seniors living alone suffer from loneliness, or simply lack things to do to occupy their time. This is especially true of seniors who have recently lost a spouse or close friend and suddenly find themselves alone. Along with the support of local clergy, friends and family, they may benefit from joining a local senior center for some needed social interaction.
However, if your loved one has ongoing medical conditions that must be monitored and require regular medication, you might need to engage the services of a part-time home health aide who can visit on a regular basis to make sure medications are being taken properly and that health problems are under control.
You may be surprised at the range of resources available to older adults in today’s communities. From senior centers to Meals on Wheels to adult day care, there’s help available to address a wide variety of issues and circumstances. The U.S. Administration on Aging offers an Eldercare Locator that can help you find these valuable services anywhere in the country, many of them free and with no income requirements.
When to Choose Long-Term Care
The time may come when a home health aide or a caring neighbor simply isn’t enough. If health problems are causing frequent trips to the emergency room, or if your loved one is showing signs of increased disorientation, depression, or the inability to care for him or herself, it may be time to seek other options outside the home. Glance over these signs that your loved one shouldn’t be living alone. If you are not in a position to care for your aging relative yourself, and there is no one else in your family who is willing or able to do so – don’t feel guilty, there are many fine senior care alternatives available to you.
In recent years, senior care has developed and evolved, creating new and better options, and adjusting to meet many different needs – the health of the older adult, his or her mental capabilities, the desire for social interaction, and the family’s ability to participate in the care. As a result, the long-term care decision, though difficult, can ensure that your loved one is safe, secure and living life to the fullest extent possible.
Here is a brief checklist that may help you to decide whether your loved one needs more assistance than can be provided at home:
- Are medications being properly taken? Missed doses or overdosing can result in health concerns and even hospitalizations.
- Are your parents eating properly? Often, seniors stop cooking, lose interest in eating and even miss meals completely.
- Are their finances in order? Are bills being paid on time and are important papers organized and easily located?
- Is the home being maintained? Is the house neat and clean, are clothes and dishes being washed, and needed repairs being done? Other signs of trouble include lawns not being mowed, mail piling up, and trash not being taken out.
- Are they taking care of their appearance? Declining personal hygiene or wearing the same clothes over and over can be a sign of the inability or unwillingness to keep up with these important tasks.
- Is driving becoming a problem? If they are no longer able to drive safely, are they in walking distance to food stores and do they have transportation to doctors’ offices and other support services?
- Is mobility decreasing? If walking is becoming a problem, your loved one will be increasingly dependent on others to help him or her with the tasks of everyday life.
- Are they becoming a danger to themselves? Are they leaving the stove on, cigarettes burning, or forgetting to lock or even close doors? These could be signs of dementia and may pose serious safety issues.
- Are they becoming reclusive? Reluctance to leave the house, sleeping during the day, a lack of interest in visiting friends and family, or participating in social activities could all be signs of depression.
- Have there been frequent trips to the hospital? Increased falls or injuries could be signs of mobility and gait problems, while dizziness or flare-ups of ongoing medical conditions may indicate problems with taking medication.
Preparing for Emergencies
Even if your parent is in good health, in the event of an emergency, you should be prepared to react fast and deal with any outcome. The following steps and legal documents can prevent a lot of headaches and confusion when an emergency occurs:
- Copies of your loved one’s medical records, including names of primary doctors
- Power of Attorney
- Living Will
- Advance Medical Directives
- Money put aside for emergency plane fare
Resources for Long-Distance Caregivers
Once you realize that your aging relative needs more help with day-to-day living than you alone can provide, hold a family meeting to try to divide up the responsibilities and discuss how you can work together to best ensure your loved one’s health security. If the burden of ongoing care falls to you, there are several resources you can turn to for support at the local level:
- Geriatric care managers
- Home care and companion services
- Eldercare attorneys
- Personal emergency response devices and telephone hot lines
- Government and private agency services to provide meals and transportation
- Adult day care and senior centers
- Assisted living and long-term skilled nursing facilities
To locate agencies and resources in your loved one’s area, you can go online or consult the local telephone directory. National organizations that work on behalf of seniors may also be able to point you to local chapters for assistance.
Many long distance caregivers also enlist the aid of geriatric case managers to oversee and help deal with the ongoing medical and financial concerns of their loved ones. These professional consultants act as medical, legal and financial advocates for your parents when you can’t be there. This is a popular option for aging parents who don’t want their children to be burdened with the difficult medical and financial details of their care in later life. To find a geriatric care manager in your loved one’s area, contact The National Association of Professional Geriatric Care Managers at 520-881-8008.
If you live in New Jersey, my team at Regency Nursing and Rehabilitation Centers are here to help. Call our toll-free Help Line at 732-264-5800 ext 3343 to speak with one of our senior care counselors personally.
If you live anywhere else in the US, SeniorAdvisor.com is a great place to start your search. They have Senior Care Advisors located across the country who can help you find care based on your loved one’s needs and budget – call (866) 592-8119 to speak with one of them.
Judah Gutwein
Judah Gutwein, LNHA, is the Director of Admissions, Administration, Marketing, Social Media for Regency Nursing and Post-acute Rehabilitation Centers, NJ. The Regency organization has become synonymous with the best in senior healthcare and has garnered a well deserved reputation for its unsurpassed commitment to its patients and residents. The Regency Nursing and Rehabilitation Centers and Facilities throughout New Jersey have achieved numerous industry ‘gold standard’ benchmarks an have received accolades from all corners of the HealthCare community.
8 Comments
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Some sound advice here, thanks for posting. Communication is crucial in these situations but it is sometimes easier said than done. We all live such hectic lives that we feel like we don’t have the time to call. If you really think about it though, you could spare 10 minutes a day to call your elderly relative. To save time, combine it with your walk home from work or walking the dog.
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Excellent piece. Having remote aging parents leaves their children feeling worried, stressed and guilty. Great ideas about how to help deal with these situations. I have the additional issue of aging parent losing English comprehension with caregivers not knowing her language.
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Very good points to remember. My own experience has even more details to consider. Mom has dementia and is very easily agitated- enough that others are afraid to be with her. She forgets that she has changed her finances so that my brother and I can help her manage them. We neither want or need her finances, however, she is very mistrustful of people and becomes very angry that others are in her business. (They aren’t). She will not move to be with us, and we are not able to move to be with her 800 miles away. We took turns staying with her until our vacations or our spouses with serious health issues also needed our help. She will not move to assisted living or a nursing home. We are at a loss. We can’t leave her alone and can’t move to be with her. She stays calm(er) when we are there, just not when others try to stay with her. Any suggestions would be so helpful. Guilt is heavy for us right now.
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My brother and I the identical issues you are describing however it’s this with both parents. We now have a person go and ensure that they are taking their medication 2x per day. So what have you done so far? I ask as I’m at a dead end. The state will not step in and our system seems fine letting them continue to go on as healthy people. They can write checks and invest and make key life decisions even though they can’t tell you who came to visit the prior day.
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We should educate yourself on the care and services available. Although every area is unique in the type of services that are offered, like adult day care, home care. thank you for this helpful article.
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My mom was having some physical issues(breaks due to Osteoporosis but managed to do well once recovering.I live far away but called her daily…just to check in.
Last year I noticed early signs of Dementia(forgetting quickly(within 10 minutes) not remembering what day it was…getting agitated over balancing her books…not remembering to take her meds.Mom amazingly was pretty sharp until 90. Yet she could still live in her senior apartment as long as I called her daily.She did have a shopping service tha delivered her groceries and other positives as well as friends who checked in with her.
And she loved keeping her small apartment pretty. She’s a cleaner!
At 91 we visited her for her 91st birthday(3 parties at three restaurants) and having a lovely time…but still seeing those issues getting worse. 2 weeks after our visit-Mom ended up in a physical rehab center due to a compression fracture on her lower spine.She was in Rehab for 3 months.Then I went up to care for her after she came out. I was worried.Her memory had gotten worse, she was forgetting both long and short term…yet she still cared about her physical health and looking well. Would get very agitated if we tried to help her..Would say
“I don’t need your help! I can take care of myself!”
Shortly after staying with Mom for a month -her leg went numb and she went to the hospital and now is in a nursing home permanently.
I feel sad because she refused to move closer to us..She is a true blue small town New Yorker and why can’t WE move back?.We have a home and lives where we are and the cost of living is a lot cheaper.Can’t afford New York taxes or homes! Luckily the nursing home is very nice but I feel terrible guilt …I wish Mom could have been more open to moving closer. By law you cannot force a parent to move.
I still call her daily and she is loved by the staff so that comforts me but I feel a little lost inside . Life is never easy. And this is a tough one to deal with emotionally.-
I hear you anonymous! I too have an elderly mother who moved to Florida for the nice
weather and social engagement. There are oodles
of seniors there and many excellent medical and social support services as well.
Problem is NONE of our family lives there. Half of us are in NYC (our hometown) the other half in far away Colorado (far) Idaho (far) and New Hampshire (far, but my brother can and has driven down to NYC).
While I completely understand my mother’s desire to live in warm, sunny Florida, it is
expensive and tiring to make those visits to see her. In her mind it’s “Paradise” so why wouldn’t everyone want to go there all the time?
Fact is, she lives in a small efficiency apartment which does not accommodate overnight visitors except for on a single bed cot in the living room. She has daily helpers coming and going and the place is cluttered with walker, wheelchair, etc.
Great for one person, not good for overnight guests.
I too have economic and practical reasons for not following her there. It is simply not possible. I have not made the trip there because it is expensive and I can’t afford it. (Airfare, hotel, ground transportation, meals, etc. not in my budget). I am single, not yet retired and am just keeping my head above water.
I have not taken any sort of vacation in over a decade and I am not so young as to just fly in and fly out to see her. It is heartbreaking in a way. I begged her not to leave, but she said “oh, you’ll love it here”. She even tried to convince me to relocate to Florida. I have no desire to do that at all. She made several trips up north, but now she is physically unable to do it.
I really wish she had just stayed here. I call her regularly and she still feels abandoned. However, she is the one who left. If I were a millionaire and could travel in comfort I could make those visits. However I am not in that income bracket, nor do I have the energy of a teenager to zip in and out of town.
All my other older relatives (now passed away) stayed nearby and I was able to visit frequently, which I
and they found comforting and rewarding. Because my mother has a severe neurological problem, she decided to make the move for her physical comfort. I do not think she fully realized then or now that it would/does make visits from her children and grandchildren (who also cannot afford hotels, live far away, etc.) more improbable.
It is a very difficult circumstance. She is divorced from my dad and her second husband died many years ago. She is alone there in her old age.
She has a few very nice friends and good caregivers there. I think she magically thought her whole family would follow her down there.
Many years ago she moved to
California (for adventure).
She stayed there about 15 years and always expected the family to visit and/or relocate there.
She was able bodied at the time and eventually realized that no one was going to relocate. She moved back to NYC because she said she was lonely and missed her family. She feels so neglected because people don’t follow her around. It is magical thinking on her part, but heartbreaking nevertheless. -
I could have written this myself, except that my mom is in Washington, DC instead of New York, and she refuses to move from her large house. My brother and I live both live far away, and trying to manage round the clock care for her from a distance is a nightmare. We also tried to get her to move to where we live many times; she just insisted that we should be the ones to move. But we have secure jobs and kids in school, and the cost of living in DC is quite a bit higher than where we are now. I’m getting quite frustrated with her… I’ve had to take months off from work and away from my family this year managing her issues, with no end in sight. I wish she would agree to move to assisted living.
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