Visory Health Caregiver Series:  Caregiving from a Distance

We all have loved ones who live on the other side of town, in a different city, or perhaps in a different state. You may be wondering how you can help your elderly parents or relatives from a distance. Although you live far away, you can still provide support in a long-distance, caregiver role.

In this blog we will discuss caregiving from a distance, some steps to provide caregiver support from a distance, and how to assess if your loved one can no longer independently care for themselves.

What is Long-Distance Caregiving

If you live more than one hour away from your loved one who needs care, you are a long-distance caregiver. As a long-distance caregiver, you may provide help in varied ways.

Practical Tips for Long-Distance Caregivers

I’m stepping into a new role as a long-distance caregiver, what do I do?

1. Learn as much as you can regarding your loved one’s health, treatment, and available local caregiving resources.
2. Organize important paperwork- keep all vital information updated and in one place.
3. Ensure that at least one caregiver has permission to receive medical and financial information about your loved one.
4. Plan local visits when possible. During your visit, assess any additional needs of your loved one.
5. Until you can visit, ask family or neighbors to check-in on your loved one.
6. Stay connected and with permission, schedule calls with providers and other caregivers to keep up to date on your loved ones’ well-being and changes in medical needs.
7. Consider caregiving training. Some caregiver training is covered by Medicare. Contact your local Medicare office for more information.

Tasks Long-Distance Caregivers May Provide

From a distance, a caregiver may help loved ones individually or with family, friends or other caregivers who live nearby. When life gets overwhelming for your loved one, some tasks to help may include:

• Money and finance assistance. Help with bill paying and sorting out finances/obligations.
• Arrange and coordinate care management or in-home care. This may be obtaining non-licensed, custodial care to help with personal, everyday needs, or licensed nursing care, if required.
• Obtain necessary medical supplies including medical equipment and medicine.
• Update and help organize important paperwork and records.
• Help with advance care planning, or making decisions about future medical care if your loved one becomes seriously ill or unable to tell you their healthcare wishes.
• Help to understand insurance benefits.
• Research medical information, future care options, and address the changing needs of your loved one.

How Do I Know if Caregiver Support is Needed?

You’re not a long-distance caregiver yet but are concerned about a loved one.

As we age, sometimes it’s clear when caregiver help is needed. But sometimes changes and the need for assistance may not be as obvious.

According to the National Institute on Aging and AARP, signs that may indicate additional caregiver help is needed include:

• Falls or changes in mobility.
• Changes at home: an inability to keep up with household chores: a once clean and tidy home is now dirty and unkept; an inability to prepare meals on the stove safely.
• Neglected hygiene, change in appearance or change in behaviors
• Confusion regarding appointments, overall confusion, or changes in memory
• Poor nutrition
• Obvious weight loss; is there a loss of appetite or no food available in the home?
• Difficulty with financial responsibilities – unopened bills still in envelopes or collection alerts
• Changes in mood
• Inability to manage medications
• Driving challenges: multiple tickets or accidents

These may be signs that your loved one can no longer safely care for themselves and need assistance to meet their daily living needs.

What Can You Do Initially if You Think Your Loved One May Need Caregiver Help?

Mobility and Home Safety

• Evaluate the living space: ensure it is clear from clutter or slippery rugs
• Observe how well your loved-one is moving/walking, how steady they are while walking/moving, shuffling or dragging feet, getting up from a chair, getting out of bed, general gait
• Does your loved one need additional assist devices to help with mobility? Cane, walker
• Shower safety: handrails, grab bars, shower chairs, walk-in tubs?

An occupational therapist or physical therapist can provide an evaluation and suggestions for home and mobility safety.

Memory Changes, Confusion, Behavioral Changes

• Changes in behaviors, memory, appetite, weight, energy levels, irritability and difficulty sleeping may have underlying medical cause
• Assess food sources in the home; refrigerator and cabinet contents. Ask how groceries are obtained? Discuss appetite and if your loved one expresses changes.
• Does your loved one need a grocery delivery service or family member/friend grocery shopping help?
• With permission, discuss medication and possible interactions with a primary care provider or pharmacist

A healthcare provider can provide a medical assessment to determine if there are possible underlying medical reasons for changes you’ve observed.

Changes in Appearance

• Changes in appearance may have many causes. Ask questions to help determine the reason for the changes: Is your loved one wearing the same clothes? Appearance is unkept, lack of hygiene; do you notice bodily smells? Are clothes soiled and left dirty? Check the towels in the bathroom and shower for overuse or no use.
• Ask your loved one about their daily routine regarding hygiene, showering, change of clothes, bed linens, towels etc. Are mobility challenges, safety concerns impeding daily care for your loved one? Does your loved one have unexplained bruises?
• Talk to your loved one and observe if they seem confused or can’t recall?
• Discuss who your loved one sees daily and on occasion? Who is their immediate support system/friends/other family members? How and when does your loved one interact with persons outside of the home? Is your loved one isolated or lonely?
• Consider additional safety measures for the home: bathroom (grab bars), higher toilet seats, shower seats, handrails, walk in shower or others you identify.

Cognitive and behavioral changes as well as safety concerns may contribute to changes in appearance. Isolation and loneliness can contribute to cognitive decline.

A home safety assessment (occupational therapist, physical therapist or certified aging-in-place specialist: CAPS) and medical assessment (medical provider) are necessary to ensure you fully understand environmental home safety concerns and why your loved one is displaying the changes you observed.

Financial Matters

• Help your loved one sort through mail and prioritize bills
• With permission, review financial accounts, banking with your loved one
• With permission, help to set-up automatic bill pay
• Help organize and centralize all pertinent legal documents, insurance documents
• Discuss the need to assist with management of affairs in emergency situations

Medications

• Review medications with your loved one. Look at the medication bottles/amounts. Have your loved one explain their medication regiment and routine. How do they take their medications? How do they get refills? Do they have an emergency contact if questions arise regarding medications? Are there any new medications that could contribute to the changes you’ve observed?
• Review your loved one’s medications with the primary care provider or pharmacist for possible interactions or side effects.
• Consider pill sorters or similar devices that help organize medication management and administration.
• Can your loved one afford their prescription medications? Are they still taking their medication as prescribed? Visory Health can help. You can download the Visory Health Discount Prescription Card to get up to 80% savings on over 10,000 medications. It’s a free service, with no registration, or coupons required.

You can provide long-distance caregiving by using some of the suggestions provided.

However, when you need additional information that helps you understand your loved one’s total needs and care, a professionally trained assessment is likely necessary.

How Do I Start?

A good place to start is with your loved one’s primary care provider for an assessment and to recommend additional professionals to help with the evaluation.

• Other professionals who may assist include other specialty providers, visiting home nurses, social workers, occupational therapists, physical therapists, and certified aging-in-place specialists.

Long-distance caregiving can be a rewarding challenge that improves the life of your loved one in need. Visory Health supports our Visory Caregiver Community.

We see you and we hear you!  Stay Healthy, Stay Visory!

To Your Health,

Dr. Creamer

DNP, MSN, MSS, MA

 

Source:

AARP: Caregiving  https://www.aarp.org/caregiving/home-care/info-2021/assessing-need-for-caregiver.

National Institute on Aging (www.nia.nih.gov), part of the National Institutes of Health

National Institute on Aging- Caregiver’s Handbook: https://order.nia.nih.gov/publication/caregivers-handbook

This article is not medical advice. It is intended for general informational or educational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition, diagnosis or treatment. If you think you have a medical emergency, immediately call your physician or dial 911.