The increases in the aging population and the growing demand for caregivers have pushed unpaid family members to manage from a distance. AARP estimates that 11 percent of family caregivers live at least an hour away from their loved one.
Many of these caregivers are themselves seniors, such as my 76-year-old mother, Charlotte, who cares for my 94-year-old Great Aunt Imogene. Charlotte lives in Jacksonville, while Imogene lives 3 1/2 hours away in Vero Beach, Fla.
Charlotte has always had a close relationship with her mother’s younger sister, who has lived for the last 13 years in a two-bedroom villa in a duplex at the Florida Baptist Retirement Village. Before that, Imogene and her late husband Thomas raised two children and often cared for grandchildren, even a great-granddaughter, in their home in Vero Beach. Thomas was already in long-term nursing care when Imogene moved to her villa in September 2006.
While her two children are both deceased, Imogene has other relatives living closer than Charlotte, but it’s difficult for working family to take time off to meet all of Imogene’s needs or handle tasks that must be completed during business hours.
Key roles at a distance and up close
That’s where Charlotte comes in. It’s a role that has grown over the last seven years as Imogene’s mobility has declined.
It started when Imogene had several property-related legal issues that had to be fixed.
“It took over two years of working with the lawyers and me traveling back and forth many times to resolve it,” Charlotte said. “After that, she named me executrix of her estate, and we had them set me up with a durable power of attorney so that I can take care of her business for her.”
Now, Charlotte travels to Vero Beach five or six times a year for stays lasting between five days to more than three weeks. Although her husband Bruce prefers to stay home, she has the flexibility to travel often since she retired about eleven years ago.
“I take care of her banking. Her local branch has a copy of the power of attorney on file there,” Charlotte said. “I’ve redeemed stock for her. Oh, that was a pain, even with a power of attorney.”
Many issues can be handled over the telephone, the National Institute on Aging and AARP agree, including managing records, participating in health care discussions with providers, helping with legal issues and conducting business transactions, as long as the right paperwork is in place.
The National Institute on Aging recommends the long-distance caregivers keep eight points in mind:
- Know what you need to know as a long-distance caregiver.
- Plan your visits.
- Have specific activities during your visits.
- Get in touch and stay in touch.
- Help the aging relative stay in contact.
- Learn additional caregiving tips.
- Gather a list of resources in the neighborhood.
- Organize paperwork.
Such paperwork may be power of attorney, a signed release for information from a health care provider, an advance directive or a living will. It’s essential to have all of the paperwork in one place, so the information is easily accessible during a crisis.
Despite being able to handle some issues from afar, Charlotte’s trips to Vero Beach enable her to do the things someone can only do in person, such as wash all of Imogene’s curtains and clean her blinds. She takes Imogene grocery shopping, to thrift stores and the bank.
Imogene also prefers the family touch, even if the retirement community has staff who can take her to the doctor. Charlotte, she said, “can help me keep track of what’s going on.”
Charlotte also enables Imogene to eat her own food at home, because “she cooks for me and puts so much away in the freezer. All I have to do is take it out and heat it.”
Charlotte coordinates Imogene’s social calendar and the rotation of visits from other family members who care for Imogene.
After Imogene complained that she had few visitors, Charlotte began planning annual birthday parties for her and inviting all of the neighbors in the retirement community. Charlotte also arranged for visits from Imogene’s 92-year-old niece Esther, who stays with her for about two months a year in the late winter and early spring. That includes getting Esther to and from the airport.
Challenges and an uncertain future
The challenges have now increased. Although Imogene remains mentally alert and engaging, she recently broke her hip and femur and had surgery in the last month. When she fell, she remained on the floor for more than two hours before a friend found her when the friend came by to take Imogene to church.
Recently, Charlotte was packing for a three-week vacation to visit my Aunt Carolyn in Michigan. She was prepared to cancel for Imogene, but they both reasoned that Imogene would have round-the-clock care in rehabilitation and would need Charlotte there more after she is discharged.
Charlotte’s activities over the phone have increased when she can’t be in Vero Beach. “It’s hard when the bank representative doesn’t know anything about the power of attorney,” she said.
“Sometimes I feel like the blind leading the blind. Imogene can get me so confused because she gets things mixed up.”
Charlotte worries that Imogene might not “take her medicine like she’s supposed to. I also worry that a salesperson will take advantage of her because she can’t say ‘no.’”
She also worries that with some of Imogene’s friends moving away or dying that Imogene get lonely as she also grows less mobile with her broken leg and hip.
That’s why Charlotte has been trying to prepare Imogene for the possibility of assisted living or long-term nursing care. “The last time I was down there, we toured the assisted living facility at her retirement community, and the long-term care area.”
Imogene said she couldn’t see “any advantage to leaving her villa,” but Charlotte said she knows assisted living might be inevitable.
Until then, Charlotte said, “I really do enjoy going down and spending time with her. Her disposition and faith make her a great person to be around.”
The last names of Charlotte and Imogene were withheld for security concerns.
Amy Cherie Copeland makes her living as a freelance journalist and editor, and as an academic writing tutor at Florida State College at Jacksonville. She also uses creative writing, visual art, and public performance to address mental health and human issues.