Family Caregiving When The Adult Children Are Long Distance

Family Caregiving When The Adult Children Live Long Distance

When families live far away from one another, the holidays may be the only opportunity that long-distance caregivers and family members have to personally observe older relatives. Decline can happen quickly. Family members who haven’t seen their aging loved for a while may be shocked at what they see: a formerly healthy father looking frail, or a mom whose home was once well-kept now in disarray.

For those who have relied on regular telephone conversations and assessment by other closer-living relatives to gauge an older loved one’s well-being, the holiday visit can be revealing. Absence – even for a short period – often allows us to observe a situation through new eyes…and the following changes may indicate the need to take action to ensure your aging relative’s safety and good health.

What to Look for

Weight Fluctuations

One of the most obvious signs of ill health, either physical or mental, is weight loss. The cause could be as serious as cancer, dementia, heart failure or depression. Or, it could be related to a lack of energy to cook for a loved one or just themselves, the inability to get fresh groceries, the waning ability to read the fine print on food labels, or difficulty cleaning utensils and cookware. Certain medications and aging in general can also change the way food tastes. If weight loss is evident, talk to your loved one about your concern and schedule a doctor’s visit to address the issue.


Pay close attention to the way your loved one moves, and, in particular, how they walk. A reluctance to walk or obvious pain during movement can be a sign of joint or muscle problems or more serious afflictions. If they are unsteady on their feet, they may be at risk of falling. Schedule a doctor’s visit and consider obtaining a personal emergency response system.

Emotional Health

Beware, too, of obvious and subtle changes in your loved one’s emotional well-being. You can’t always gauge someone’s spirits over the telephone, even if you speak daily. Take note for signs of depression, including withdrawal from activities with others, sleep patterns, loss of interest in hobbies, and lack of basic home maintenance or personal hygiene. The latter can be an indicator not only of depression, but also of dementia or other physical ailments including dehydration, a serious condition sometimes overlooked in elders in the winter months. If you notice sudden “odd behavior” with your loved one, be sure to seek medical attention.

Attention must also be paid to surroundings. For instance, your loved one has always been a stickler for neatness or for paying bills promptly. If you discover excess or unsafe clutter and mail that has piled up, a problem may exist. Offer to go through mail and old papers.

Everyday Concerns

Also, keep an eye out for less obvious indications for concern. Scorched cookware, for example, could be a sign that your loved one forgets if the stove is on. An overflowing hamper could mean he or she doesn’t have the strength and/or desire to do laundry. Look out for safety hazards such as steep steps, loose rugs, missing handrails or poor lighting. Check prescriptions and medication bottles for expiration dates, and make note of all prescriptions your loved one takes. Place that information in your personal files, as well as their wallet, in case of an emergency. If your loved one is driving, look for unexplained dents or scratches on the car, and maybe take a short drive with them to see how they handle the road.

Steps to Take

Initial Conversation

First, have a heart-to-heart conversation with your loved one about their present circumstances, concerns, and the measures they’d like taken to make things better. Introduce the idea of a health assessment appointment with their primary health care provider. Would they feel more at ease if a home health aide visited a couple times a week? Maybe they have legal questions and would greatly benefit from an appointment with an elder law attorney. Or, they may need help with housecleaning or bill paying.

Identify Important Information and Resources

While you may want to keep things light during the holiday season, do take this opportunity to collect and update all necessary information now to avoid frustration and confusion in the event of a crisis down the road.


  • Information on all medical conditions.
  • A list of medications, including the name, dose, and name of the prescriber.
  • Names and phone numbers of all health care providers.
  • Name and phone number of their pharmacy.
  • Name and contact information for local contact (i.e. care manager)
  • Register in the Premise Alert Program with the local police department.


    • A list of all insurance policies, the carriers, and the account numbers.


    • Company names and phone numbers for all utilities, including electric, phone, cable, water, and Internet.


    • A list of all assets and debts (include dollar values).
    • Monthly income.
    • Monthly expenses.
    • A statement of net worth.
    • Information on bank accounts, other financial holdings, and credit cards Real Estate.
    • Safety Deposit Box (location, where is the key) Legal
    • Relevant legal documents your loved one has (i.e. wills, advance directives, trusts, powers of attorney, etc).
    • Location of important documents (i.e. birth certificates, deed to home).   Social Security numbers.

    Make All Necessary Appointments

    Your loved one may need assistance making medical appointments. Finding the right doctor, collecting all relevant information, and assessing medical insurance and other costs can be confusing and frustrating. If your relative is open to having an initial conversation about health concerns, an offer of help from you may go a long way in alleviating some of this stress.

    Your older relative may also need to make significant legal arrangements for their property, finances, and health. If they are willing, they may need your help to schedule an appointment with an elder law attorney. This may include drafting of a will or trust, a living will, and powers of attorney. These documents and others may help your elderly relative plan for the future and ensure their continuing health and protection.

    This information is not to be considered legal advice. If you have questions about it, please contact us.


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