THE BULLETIN speaks with Dr. Marion about caring across distances

Source: 
The Bulletin
Published: 
11/27/2009

Our society has become increasingly mobile in the past few decades.

Kids move away from home and don’t come back. Parents retire to another state. Family members shift from place to place, looking for work, going to school, building their lives.

Often, adult children end up living some distance from their aging parents. While this leads to increased travel and decreased time spent together, it has another consequence as well. Distance makes it harder to help when a parent is in need. As a result, many adults are finding themselves playing the role of long-distance caregiver.

Raeann Hamon, a professor of family science and gerontology at Messiah College in Pennsylvania, says long-distance caregiving is absolutely a trend that is likely to increase.

“Certainly, as the baby boomers and their parents age, we can expect a large jump in the number of families dealing with such caring across miles.”

These adult children face challenges of trying to find the right role to play, staying involved while not becoming overly burdened.

Starting off

 

Nancy Turk co-owns Visiting Angels, a local service that connects in-home professional caregivers to older individuals. She says about half their clients have relatives in another region or state. They have been contacted by family members in Alaska, California and Australia who want to hire help for a local relative. Typically, Turk says, a family member realizes they need to step in after visiting. “They are shocked to see the condition their grandparents or parents are living in.”

These relatives, often adult children, believe their parents are doing fine, but the reality is somewhat different. They might find rotten food or dog feces. “It’s traumatic for the kids.”

Turk says oftentimes the family members feel guilty and then hire staff to come in and assist, particularly in cases in which the parents don’t want to leave their own home.

Marion Somers, a geriatric care manager and author of “Elder Care Made Easier,” suggests adult children think about what they can and cannot do. She encourages them to set limits and to delegate. “You have to be honest about your time and resources.” She thinks of it this way: It’s like being on an airplane when passengers are supposed to put on their own air masks first before helping anyone else.

“You have to be organized, you have to prioritize, you have to delegate,” Somers said.

Challenges

 

Trying to assist a relative living far away can be quite complicated. Hamon says many adult children feel guilty about not being able to help more, while also feel angry about the imposition and feel anxious about future needs. She says many individuals feel guilt because of the “norm of reciprocity.”

“There’s the notion that you should be good to those who have been good to you,” Hamon said.

Figuring out when to visit and to allot resources — both financial and time — is another big issue. Sometimes, resources are better spent hiring someone to help than flying out to visit for a week. Somers point out that a $600 plane ticket could be used to hire someone to come in once a week to help out for a couple weeks or more.

Robert Sachs knows about this challenge from both sides. He has been a caregiver working with adult children who live in another state. And he has been the son, living far from his dying father. His experiences are chronicled in his book “Perfect Endings.”

“We’ve created this kind of quandary for ourselves.”

When Sachs worked in a hospice in New Mexico, he saw many negative reactions from staff to adult children living far away. He says staff members frequently looked on these individuals negatively, thinking, “If you really cared, you would live here and be here all the time.”

Sachs felt these assumptions were unfair. That said, he recognized why it happened. Sometimes, the professional caregiver felt as if the relatives living away were serving as armchair quarterbacks, questioning decisions and making recommendations without really knowing the situation.

Sachs says relatives’ top priority should be to develop a relationship with the primary professional caregivers.

Hamon says it’s also not good to assume an older parent will naturally move to where adult children live. She believes part of it is generational because many older individuals have lived in one place for many years. They can also be entrenched in the community and have social support. “To ask them to move, it’s a challenge.”

Practical steps

 

Hamon suggests adult children start regular rituals and routines, for instance calling once a week at the same time and day.

Somers agrees, saying, “The voice tells so much. Most older people don’t have the energy to fake it.”

When the son or daughter does visit, they need to really get to know the area. Hamon suggests they learn about the neighborhood and meet the neighbors. Who does the older relative have regular contact with? She suggests the child hand out his or her phone number and ask for theirs. Then if neighbors see anything of concern, they will know who to call. She also thinks adult children should try to assess their parents’ needs, such as help with household tasks, personal care and transportation.

Somers suggests adult children take a “look at the house or apartment with fresh eyes.” What is the lighting like? How is it at night? Are any light bulbs burned out? How easy is the bathroom to navigate? Are there any throw rugs? What about the outside, including the garage and porch? She strongly encourages installing grab bars in bathrooms, putting in sensor lights outside and getting rid of all throw rugs. Somers also believes all kitchen items should be at eye level. She says to banish footstools. She will hire a neighborhood kid to mow the lawn or shovel snow. She also encourages family members to get in touch with the parents’ church, if applicable. Getting the grocery store to deliver is another good option.

Hiring help can bring relief. Turk says many adult children appreciate being able to talk with someone who serves as their eyes and ears.

Turk says sometimes the older individuals may resist outside help, saying, “We don’t need it; we’re fine.” They see help as a sign of the end. Sometimes, however, they “respond better to someone who is not a loved one,” said Turk. With family, older individuals may feel more comfortable saying no or getting angry.

Adult children need concrete information should anything go wrong. This includes a list of their parents’ doctors, medications, insurance information and more. Knowing what they are allergic to, past surgeries, medical issues and what vitamins and over-the-counter items they take are also good ideas.

Not all parents expect their children to be there to provide physical care for them, says Hamon. “Most expect their children to be emotionally supportive.” That is the most important piece. And the good news, according to Hamon, is being a good listener and offering support “is something that’s a bit easier to do at a distance.”

Alandra Johnson can be reached at 541-617-7860 or at ajohnson@bendbulletin.com.

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