How to look out for parents 3,000 miles away

By Liz Pulliam Weston

As the crow flies, Joanne Selby doesn't live all that far away from her elderly mother. But the three-hour drive from Selby's farm in Idyllwild, Calif., to her mother's home in Los Angeles meant Selby couldn't just pop in every day. Taking care of livestock and dealing with her own health issues limited Selby's visits to about once a month.

That was fine until three years ago, when Selby's mother, then 91, fell and broke her hip. Suddenly, Selby was trying to manage her mother's care from afar -- and pulling her own hair out in the process.

"I would call and couldn't even get the doctors on the phone," said Selby, 64.

Frustration, worry, guilt -- these are emotions that long-distance caregivers know well. Trying to help a parent or other elderly relative from afar is a difficult experience that at worst can empty bank accounts, strain family relations and put the elderly person's health at risk.

Millions of American families face these issues, however, either because their parents moved to far-away retirement communities or because the adult children scattered across the country. Even relatively short distances can become a problem when children try to balance care-giving with their other responsibilities.

"People can have very demanding jobs or be raising children," said Phyllis Brostoff, a social worker and geriatric-care manager at Stowell Associates in Milwaukee. "There are a lot of factors that can make it difficult (to provide care)."

If you're faced with aiding a relative from a distance, elder-care experts say the following steps can help you meet the challenges.

Assess their needs

If your parent suffered an accident or has a serious health condition, some of her needs will be obvious, while others will be more subtle. Your mother may need rides to the doctor, for example, but she also may require help fixing meals or need a chance to get out of the house and socialize.

A healthier parent may not need day-to-day assistance, but could be struggling with issues he used to handle with ease, such as yard work or paying bills.

Making a check list can help. Does your parent need:

• Skilled medical help?

• Help bathing, eating or getting dressed?

• Rides to the doctor and other appointments?

• Home modifications, such as a ramp or grab bars in the bathroom?

• Help with household chores, including shopping, cooking and yard work?

• Legal assistance, such as estate-planning documents?

• Assistance with money matters, including paying bills?

• Opportunities to socialize with other people?

Isolation can be a serious problem, particularly for elderly people who have been widowed, who are new to their communities or who have withdrawn from social activity because of illness or depression. That's why elder-law attorney Donna Bashaw of Laguna Hills, Calif., often recommends assisted-living facilities for her older clients.

"Everybody always says they want to stay in the home, but the advantage of assisted living is that people are around you and people are checking on you," Bashaw said. Many of her clients resist moving, "but most settle in just fine. In general, people wait too long (to make the change)."

Adult children also need to be on the lookout for signs of financial problems, elder-care experts say, since it doesn't take much for a relatively small problem to snowball.

Terrell Dotson, 86, found himself homeless after Los Angeles County officials seized and auctioned his condominium for failure to pay a $546 property tax bill. Dotson paid his taxes each year in person but missed a small notice on his bills that he had an unpaid balance.

After a months-long ordeal, Dotson regained his home, thanks to the intervention of a judge and thousands of dollars in donations from readers of the Los Angeles Times, which publicized his plight. An Inglewood police officer who championed his cause became Dotson's conservator to prevent future problems. But elder-care experts fear others will continue to lose homes to such minor slips.

Investigate resources

If you haven't looked into community resources for the elderly, you may be surprised at the variety of services available in many areas. From Meals on Wheels to adult day care, these programs can help long-distance caregivers arrange the help their parents need.

The U.S. Administration on Aging offers an Eldercare Locator that can help you find services near your parent. Some of the services are reserved for low-income people, while others, such as transportation help and free meals, have no income requirements.

Another possible resource: The National Association of Professional Geriatric Care Managers. This relatively new profession evaluates the needs of seniors, then sets up and monitors long-term care arrangements. The cost ranges from $50 to $200 an hour, with initial evaluations typically running $250 to $500.

Selby hired a geriatric-care manager after her mother's accident so that the elderly woman could remain in the home where she has lived 92 of her 94 years. The care manager, Jan Hynek of LivHome, is a registered nurse who checks in on Doris regularly, monitors her round-the-clock caregivers and talks with her doctors. A reverse mortgage on the house pays for all the care. (Read more about reverse mortgages at AARP's Web site.)

"I feel really good about it," said Selby, who is comforted by the idea that Hynek is also on call for any emergencies.

Rally the troops

Not everyone can afford to hire help, of course. But you need people "on the ground" who can check in on your parent, offer them assistance and respond to any emergencies. This could include siblings who live nearby, neighbors, friends or clergy. Get phone numbers so you can contact them if your parents don't answer the phone or you need someone to do a visual check on your folks to make sure everything's OK.

You might consider other arrangements as well:

• Can someone in your family move closer? One poster on the Your Money message board moved a widowed aunt into an apartment near the parents' home and paid her a small sum to look after the folks.

• Can your parent move closer to you? Most elderly people "age in place" -- that is, they grow old and die in the area where they raised their children. But some are willing to uproot themselves to be closer to their kids, which could ease some of the care-giving issues.

• Can you share duties with siblings or other family members? Typically, one adult child shoulders the bulk of the care-giving burden, either because he's physically the closest or because he's the one most trusted by the parent. But others can offer respite.

Some families rotate the chores of on-site care-giving to make sure the primary person gets a break. Federal law helps out: The Family Leave Medical Act allows most employees to take up to 12 weeks of unpaid leave to care for a family member with a serious medical condition.

Others do what they can from where they are.

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