Is long distance caregiving really possible?

It is possible. My mother will be 101 in a couple of days and is in assisted living. In her mid 90s she began to need more care. She is basically healthy though has Borderline Personality Disorder and narcissism which makes keeping help and dealing with her difficult. For years she had a cleaning lady who did extra stuff for her - laundry etc. but in time she alienated her, Mother went through a few people for grocery shopping each of whom worked for a while. Finally my daughter arranged for a live in senior nanny from the same agency from whom my daughter got a live in nanny for her kids (from the Philippines). Had mother been able to get along with her I think she could have stayed in her apartment. The cost of the apartment and the nanny was probably a bit less than her costs in the ALF. However she alienated the nanny, who quit after 9 months, and also a number of people in her apartment building, so, at her request, I moved her to an ALF. She lasted 6 months in that ALF, had an upset with staff - it was a mess - and I moved her to a second ALF and told her if she could not manage there, I would not move her to another ALF, but to nursing home which she dreads. There have been many problems, but in fact she is well cared for, though she cannot/will not eat in the dining room, so she pays someone to shop for her. She has home care 4 x a day ordered for life by her doctor - aides who come for about 15-20 mins. at a time to help her bathe and dress and who make her meals and clean up. Mother still keeps her apartment in order, The ALF does the cleaning and laundry. She manages her finances and calls on her financial advisor for help if there is something she doesn't understand. He is a Godsend and works in the same area she lives so visits her once in a while and does her taxes. I will be added to her accounts when I next go down to keep an eye on them as she is a bit paranoid and thinks people are overcharging her sometimes, and at her age it is wise. Most of her bills come out of her account, and I will try to set it up that they all do. I was more involved at one point but the stress of the narcissism and BPD affected my health and at 75 I have my own health issues. For a while she had a nurse, who runs a seniors help agency, do things for her, who I thought was very good, but mother stopped having her as she said she was to expensive. She takes cabs to her doctor's office. If she doesn't feel well the ambulance takes her to an ER and the ALF calls me. The ER has yet to find anything much wrong with her. She still makes these decisions herself as she is competent and wants/needs to be in control. She has a scooter and goes out quite a bit - to church and shopping. We are fortunate that she is so healthy and still mentally competent, though her personality is h*ll on wheels. A local cousin used to visit with and help her, but he has dropped out after receiving some of her criticism, and I do not blame him. My sister lives overseas and used to visit for free holidays, and do nothing to help, but does not visit since mother went into the ALF, as she would have to pay for a room. What sis wants is the inheritance when mother dies - all of it - her half and mine. Whatever! We see this time and again here,
I have digressed a bit but you can see that it is possible to care-give at a distance. by making use of suitable facilities, hired help and help available through the system. We are in Canada so it works a bit differently, but the basics are similar.
Find out what agencies etc. are in her area so you can find out what resources are available. If your mum has enough income she will have to pay for some help. If her income/assets are low enough you can apply for medicaid for her. You might want to contact the local Social Services as well as the Agency on Aging to discuss options.
Good luck and let us know how you manage. Having my mother close to me is out of the question as her mental illness is too destructive and, in any case, she wants to stay where she is. (((((((((Hugs)))))))) Joan

As others have pointed out, if you can afford one, Geriatric Care Managers can be a great solution. There are people who provide a less expensive alternative to GCMs. I have a friend who started a service where she essentially takes the role of her clients' 'daughter'; accompanying them to doctors' appointments, doing their shopping, coordinating their home repairs and home care, sorting their mail, paying their bills, etc. She charges about $25 /hour. To find someone like that, I'd imagine you'd need to call on some connections in your parent's town.
As a side note, at the AL and IL community I'm associated with, I see people whose kids have tried to manage a long-distance arrangement. I see them after they've moved their parent closer to them and into a supported living situation. They are some of our happiest customers. It's a tough road you're travelling. If you can find the right person near your mom, and you have the resources to pay for it, it can be manageable. If not, don't wait until everything falls apart to make the decision to move mom nearer to you.

This is always a difficult question that many of us face when our loved ones live a great distance from us and they've reached the point where they need extra assistance. At the time, was no such thing as a "Private Patient Advocate" whom I could hire to assist my family with their medical caregiving needs. And frankly, I didn't trust anyone with my family's finances. In my own situation, my father was suddenly diagnosed with terminal lung cancer and had already begun aggressive radiation and chemo therapy. The problem was exacerbated by the fact that Dad had diabetes and early onset ALZ. He lived with Mom who is legally blind, and my only sibling who is mentally disabled. And all three lived out of state. Because there were no other relatives, they were totally dependent upon neighbors to transport them to the hospital for Dad's radiation and chemo treatments, trips to the pharmacy and grocery shopping, etc.

This had been my fear all throughout adulthood. My husband and I immediately took time off work; obtaining a Family Medical Leave of Absence (FMLA), traveled to their home, started packing, secured a real estate agent and miraculously sold their home within 3 days for a huge sum! We then moved them to our city to live in a condo within 6 blocks of us. I retained the services of an Accountant and an amazing Elder Law Attorney who advised us all on my becoming Legal Caregiver of all 3 of my family members (Power of Attorney: Healthcare and Fiduciary), set up a Special Needs Trust with my mother as "for the Benefit of", and all 3 of my loved ones signed DNRs, Living Wills, and Advance Directives for Healthcare (ADHCs). I set up appointments for all three with the best physicians in the specialties that met their medical needs and had their former physicians mail (or fax) their full medical histories to their new MDs. By the time my father tragically passed away from Lung Cancer, he was comforted knowing "his girls" were under the loving care of me (and my sweet husband).

If this scenario is something that you don't think is do-able in your situation, then I highly recommend that you investigate Private Patient Advocates in the area where your mother lives. I empathize with your situation (3 times over!) and wish you the best in making a decision that put your mother's bio/psycho/social needs at the forefront of your decision-making. I hope you realize that, sadly, her condition is not likely to improve, as it's part of the natural aging process that our parents will need more and more assistance. Do you really want a stranger handling your mother's healthcare and fiduciary needs? It's a tough decision and I wish you the best.

I think it will be difficult to maintain a long distance caregiving absent family members or long time friends who are trustworthy and willing to make themselves available for your mother. For now if you can come up with a plan to make sure she has good eating habits (perhaps meals on wheels) and a paid friend to accompany her shopping and to/from medical appts. If you can switch to a doctor who makes house calls that would eliminate many problems scheduling appts and getting transportation for her. If memory is beginning to be an issue, things like driving and using the stove could be problematic.
Living far away you may need to see if she can safely use the shower, perhaps a transfer bench and a new hand held shower head is needed with protective
bars in the tub area so she doesn't fall. Does she have a high toliet or need a bedside commode at the bed or over a traditional toliet to give her handles to help her rise from the toliet. I think with a POA and health directive, you can handle the bill paying online or just have them mailed to your address. It is the safety issues which are very important to reduce injury due to memory lose or loss of mobility.

However, uprooting an elder has its drawbacks too. Now they have a loss of memory and they are in unfamilar surrounds. Not a good combination.

I think long distance caregiving is possible but like all caregiving it will not be a walk in the park but may be a walk that you must take to help her.

Good luck
Elizabeth

One other item- as long as the elder can still make their own decisions(the dr determines that) they have the right to do what they want. My Dad is very good and careful around the people that might make that type of determination-(hence the 2 yr battle to stop driving) that is also why he does not live closer to me -HE says he wants to stay in home.
TammyAnn is right on when it comes to cost- we pay our caregiver$42K a yr and she gets room,board,use of car- pretty much anything extra she needs. Dad refuses to give her a raise(she's been there 4.5 yrs so i usually pad a little extra somewhere to compensate since i pay the bills. When she is off the agency gets $25 hr or $210 per weekend day. He's used his LT Ins up and is working on a reverse MTG- he's 93.
The reason I used a GCM was because i hadn't lived in the area in 40+ yrs and really didn't know anyone anymore.
The 1st 2 yrs I commuted every 10 days back+forth for 4-5 days , I had a very understanding employer- It finally took a toll on my health and pocket so i had to stop. tried living with him but it didn't work so I do Long distance-

emjo -- your Mom sounds like my 97 year old neighbor -- is there something about narcissistic personality disorders that lets people live to 100???? Alienating family, controlling w/tantrums, etc. She IS nice to people if they could easily leave. I'm just a neighbor so I'm a golden-haired child. She has a long-suffering night caregiver whom she feels free to abuse verbally & emotionally since she figures she can't leave. Her long-suffering son has learned to cope by setting boundries. She is allowed to call him daily at 9:00am, not one minute sooner, and he will call her at 6pm exactly. If he were ever late (he never is) she may not call him until 6:15pm. Sounds draconian but before that she would call 7-8 times a day, dialing 17 times in a row if he or the kids didn't answer (not ABOUT anything, just calling), so the kids had quit answering her calls at all. This is a compromise they worked out that keeps everyone sane.

Don't get me wrong --- I really enjoy my neighbor, join her at Denny's for breakfast every chance I get, but it's definately been a real learning experience to be around her for 12 years. (BTW, she does NOT have dementia -- a lifetime of personality disorders, but not dementia, ).

It would be extremely difficult especially with the memory gaps. You really have no idea what she is forgetting to tell you, bills she is forgetting to pay, etc. I would suggest calling the local agency on aging where she lives for suggestions and a visit to you mom. In Colorado these sorts of services are provided through local or regional councils of governments.

I think it is possible when there are adequate finances. Everything can be hired out, realistically it does take quite a bit of money. The other option is assisted living. This forum is a great resource - good luck to you.

I am a caregiver and have had cases where family is out of state it can be done just need to make sure the caregiver has all the required documents and excellent references if you want your loved one to stay at home example- home care private 1,000 per week 24 hour care-- agency 1,500-2,200 per week and adl home up to 8,000 per month depends on income and if the person has long term health insur would help . also caregivers will travel to a case out of state with family paying expences hiope alll work out

uberhaupt nicht (umlaut over the first u)

Not at all! :-) Wayne