You care so much.
And you’re so far away.
Trying to manage your parent’s care (or even stay updated and involved) from another country can be exceptionally taxing – practically, emotionally and financially.
The lack of ability to interact personally with mom or dad on a regular basis, to see with your own eyes how they seem and what their home situation looks like, leaves you feeling disconnected. It’s difficult to really know what’s going on; you might have someone local to keep you updated, but often, you don’t. Which leaves you feeling kind of… stranded.
Expenses quickly pile up, whether it’s hiring in-home help or travel expenses for the times you visit so you can manage the things that just can’t be done long-distance. (Ever try to downsize someone’s possessions from another country? Not happening.)
Travel also usually means loss of work time and income… and loss of experiences.
Your daughter’s soccer game?
Your son’s school play?
Your best friend’s daughter’s wedding?
You feel distraught and guilty that you missed these events because you were traveling to care for your parent.
But then again, it’s your mom. Or your dad. Don’t they deserve you, too?
In fact, it’s hard to manage or distance yourself from the guilt. First you feel guilty because you’re so far away. And then you travel to spend time with them, and you feel guilty for missing the important life events of your family and friends at home.
You just can’t win!
All that guilt takes a serious emotional toll.
We’d love to wave a magic wand and clone you; then, everyone would have the piece that they need. But modern science says: not yet.
What we can do, though, is offer you a collection of helpful, practical long-distance caregiving tips for relieving stress and overwhelm, while minimizing the negative emotions. Here goes:
Some of us are great delegators. Most of us, notsomuch.
But if you’re a long-distance caregiver, delegation is the number one skill to develop. Effectively assigning tasks will foster reassurance that your parent is well-cared for, without going out of your mind trying to do it all by yourself. Here are some tips to get you started:
1. Compile a list of everyone available to help and ask each one what they feel able to handle, and when they’re available
First, get the names down. Family, friends, your parents’ friends and neighbors, clergy members… write down anyone and everyone you think might be willing to take a role – however small – in caring for your loved one.
No pressure, so it’s not uncomfortable for you or for them. Reach out and communicate that you’re trying to coordinate people to be there for your mom, and you were wondering if they might be able to play a part.
2. Make a list or schedule of everyone’s responsibilities and contact info
Once you have a record of the parts people are willing to play, create a draft schedule with who is doing what and when. Clear it with all participants and add everyone’s contact info.
There it is: your master schedule. Hopefully, just looking at it will give you some measure of relief: you’re not alone. All these people are in it with you to give your parent the care they need.
3. Designate one contact person
As soon as you have more than one other person helping you, choose the one who will be responsible for coordination, so you don’t wind up with a case of broken telephone. The contact person can be you, a family member on the ground or a geriatric care manager in the area. The person should be accessible, responsible, and diplomatic, especially if there are many people involved.
4. Use an email group or online scheduler
A central online repository to keep everyone coordinated can help tremendously. You can use WhatsApp, or try a popular tool for this particular purpose, Lotsa Helping Hands.
5. Give financial power of attorney
Even if your parent can currently make their own financial decisions and manage their assets, the time may come when they will be physically or mentally unable to do so. To ensure that your parents’ assets will be managed properly and available to provide for their needs, make sure (ahead of time) that you or another trusted resource has financial power of attorney, as well as awareness of all financial assets and resources. Discuss with parents what their priorities are for their resources, so they will feel comfortable in trusting you with their assets.
6. Consider long-term care insurance
Costs of long-term care can be prohibitively expensive. In order to prevent depleting your parents’ resources – or your own – consider taking out a long-term care insurance policy. Israeli policies are available both through the Kupot Cholim and through private providers. This post gives a good initial overview of long-term care insurance (bituach siudi) in Israel.
7. Beware of exploitation and scams
Unfortunately, seniors are often targets for financial exploitation. Keep an eye on checking accounts for unexpected or unexplained withdrawals. Listen carefully if your mom tells you about any new best friend or overly solicitous neighbor – and get someone on the ground to check things out to clear any suspicions. Learn the warning signs of senior financial exploitation and how to guard against it.
8. Plan for unexpected trips
Expect the unexpected. In all likelihood you’ll need to make at least one (probably more) unplanned trip to your folks if an emergency or urgent issue comes up. Don’t be caught unaware. Set aside time and money now in preparation for that type of trip.
While you hope your mom will retain her physical and mental ability to make decisions about her life, sometimes that ability slips away, temporarily or permanently. Having measures in place to legally enable you to make decisions can avoid tremendous heartache.
9. Assign legal and health powers of attorney
Just like you need a durable power of attorney for financial issues, you also need one for legal and health issues. If Dad becomes incapacitated and you don’t have a legal power of attorney, the courts will need to get involved in appointing a guardian, which can be a long, drawn-out and uncomfortable process. If Dad becomes incapable of decision making or communicating, and he doesn’t have a health proxy, he may end up receiving treatment that you – and they – don’t want.
Get all legal and health proxies in order while your parent is still capable of making those legal appointments.
10. Write and file an advance medical directive
To decrease even further the chances of your mom being submitted to medical treatment she doesn’t want, it’s wise for her to have an advance medical directive in addition to the health proxy mentioned above.
Advance medical directives (in Hebrew, hanchayot refuiyot makdimot) enable you to specify which treatments and interventions you do/do not want to receive in the case that you are terminally ill and unable to communicate your wishes.
Details about how to write it and where to keep an advance medical directive are in our blog post on advance medical directives in Israel and other end-of-life medical documentation.
While it’s certainly not the same as being there in person, sometimes technology can enable you to help your loved one as if you were right there.
11. Use remote surveillance technologies
Electronic pill dispensers can enable you to make sure that Mom or Dad has taken their medication. Advanced door locks can prevent wandering caused by dementia. Cameras can let you keep an eye on your parent’s health and safety.
Obviously, any surveillance technologies should only be installed and used after receiving permission from parent or their legal proxy.
12. Use remote access computer software to take care of online tasks
Does Mom need help paying bills online? Making appointments? Checking financial accounts and statements? Remote access software like TeamViewer can let you use her computer through your own computer, while she watches and monitors.
No one likes planning for emergencies. (Except maybe doomsday preppers, but that’s a whole separate subculture, isn’t it?)
But when emergencies happen – and, let’s be honest – this is Israel – emergencies DO happen – nothing’s worse than the regret of not having planned.
Emergencies can range from a medical situation affecting just your parent, to a natural disaster affecting their entire area, to sirens and trips to the safe room in their building. Think ahead with these tips.
13. Assign an emergency contact on the ground
Find someone – family member, friend or professional care manager – who is local, accessible and willing to drop everything, take responsibility for your loved one and act as liasion at least until you or other people can come and relieve them.
14. Have emergency medical information on hand
Names of doctors, lists of medications… and do you know where your loved one’s teudat zehut is located? Make sure all paperwork and important info is accessible should an emergency medical need arise. We have a free downloadable aging toolkit that will walk you through every list item, as well as personal, medical, financial and insurance information.
15. Know which hospital your parents prefer
The ambulance crew has your mom on a stretcher in the back. The driver jumps into the front seat and yells back to whomever is accompanying her: “Where to?” Will you – or the person on the ground – know what to say? Will your mom be happy with your choice?
Find out if your parents have a preference when it comes to emergency medical facilities. Then make sure anyone who might end up accompanying them in case of emergency knows where to go.
16. Consider who would stay with/advocate for them in the hospital
Any senior in an Israeli hospital (to be fair, any person in any hospital in any location) should have someone able to remain with them at all times. Too many things can go wrong in a hospital for a senior with no advocate.
17. Trust a neighbor with a spare set of keys
Exchange phone numbers with this neighbor. If you suspect something is wrong (like you’ve been calling your parent’s house for hours with no answer and they should be home), you’ll want someone you can ask to run over and check on things.
Caregiving at any distance can be emotionally draining. Use these tips to avoid the energy suck as much as possible.
18. Don’t take “guilt-producing statements” personally
This is a hard one. Especially as long-distance caregivers who have enough of our own guilt, any statements by your parent can hit home – hard.
Take a deep breath. Don’t get sucked into guilt. Use your rational mind and check whether this guilt is motivational (i.e. reflective of something you’re really doing wrong and could fix) or misplaced (i.e. you’re doing the right thing in a complex situation, but you feel bad anyway).
If you come to the conclusion that your guilt is misplaced, try and let it go. Realize that any “guilt-producing statements” are an expression of your parent’s frustration with her situation, and not a true reflection of you or what you should be doing.
19. Enjoy quality time
When you finally go for an in-person visit, you might be tempted to tackle all the technical things that “need to get done.” That’s actually one of the reasons we exist – we take care of all the pragmatic matters so that when you visit, there’s nothing you HAVE to do!
Spend time doing fun things. Make positive memories to sustain both of you during the time when you’ll be away.
While not exactly a “tip,” this one is the most critical of all for giving you the peace of mind to withstand the inevitable stress, and the strength to keep going and doing. Sometimes our parent can express his or her appreciation, and sometimes they reach a point where they no longer can. It’s at those times that it’s so important for you to realize the incredible import of the work you’re putting in.
Your parent is fortunate to have you. We feel that. Make sure you feel it, too.