Keeping an Eye on Mom and Dad

Long-distance caregiving is a whole other ball of wax. Not only is caregiving challenging, but trying to be responsible when you live miles away adds layers of stress and uncertainty. Many families gather for the holidays and using the face time with elders (or others that you care for from afar) to assess what is going on can bring clarity and a revised action plan for the new year.

On December 16, 2009 the National PACE (Program of All-inclusive Care for the Elderly) Association offered a free teleconference with with Cheryl Phillips, M.D., chief Medical Officer of On Lok Lifeways and President of the Geriatrics Society on how to use the holidays as a long-distance caregiver. While much of the information tapped into what caregivers might do intuitively when face-to-face with their loved ones, the information proved timely for a number of those dialing in.

Dr. Phillips suggested, for example, that the caregiver observe possible changes in appearance of the individual and home surroundings. One of the callers, Robert, mentioned that upon arriving at his parents’ home this week to celebrate Christmas, he noticed that Dad’s study was a mess. This red flag caused Robert to ask a few questions. It turns out that his father, retired for many years, but a stickler for organization, simply “forgot” how to maintain his files. He had piles on the desk and floor in an attempt to sort, but kept getting confused about which pile was which. Robert helped him clean it up, but upon the advice of Dr. Phillips will contact the family’s physician for an assessment for what might be an early diagnosis of dementia.

Next, Dr. Phillips urged caregivers to notice any signs of physical health or deterioration. Has the elder lost weight or put on weight? Is he walking differently? Is her hearing worse than last time? What about vision? I remember that in spite of frequent visits to my own mother in the last years of her life, I would notice each time that her ability to speak diminished. She had less and less to say. Eventually, we concluded that as her aortic aneurysm grew (and eventually burst, leading to her immediate death), it actually pressed on her lungs, causing her to get winded quickly. Speaking and eating became more difficult for her. While there were no interventions possible for a 93-year old, it helped knowing why she had changed from someone who liked to chat a lot to someone who stayed very silent.

While visiting, try to assess the mental state of your loved ones. Look for signs of depression, such as sleeping too much or too little. Are they getting out or do they stay in the house? Do they have any company? Depression can be a game changer for elders, in particular, leading to a rapid decline if left untreated.

How are they eating? One of the callers, Missy, mentioned that a recent visit to her mother revealed that she had been driving to the local Taco Bell three times a day for her meals. She was rather proud of the fact that she was ‘taking care of herself” and being sure to eat. While the occasional Taco Bell is yummy, this alarmed Missy. She set up a meals on wheels service to come to her mother’s house several times a week. On the other days, Mom can still treat herself to Taco Bell if she wishes, but at least there will be some diversity of food on the other days.

What about social activity? Do your loved ones belong to a church or community center? Are they participating in events with others? When I visited my mother over the years, I noticed a big change when she stopped driving, which she completely needed to do. Unfortunately, she became more isolated. She no longer went to weekly bingo or to church. Previously, she had been a terrific dancer, attending monthly senior events, learning line dances and having the occasional ballroom dance with one of the males in the group. When this all stopped, her emotional and physical health declined noticeably. I convinced her to participate in an adult day program which met five days a week. She got involved again and looked forward to hanging out with her newfound friends, doing puzzles, playing games and even dancing again.

The teleconference offered some useful tips and good reminders that using the time together to pay attention as well as to catch up with loved ones can leave everyone with more clarity about what has to happen in the New Year. And, hearing from caregivers around the country gave comfort. Knowing you are not alone can increase a feeling of competence and determination.

As a result of your visit, it may become clear that you will need to engage local caregivers more frequently, or perhaps increase the frequency of your own visits. If there are siblings or others who share your concerns, you may want to check out a new website, www.patientsandfamilies.com, designed to offer families, other caregivers and friends the opportunity to connect easily around a loved one’s care. Another valuable resource for caregivers is www.doctormarion.com. Dr. Marion Somers, a geriatric care manager, offers tips and tools for making caregiving easier.

No matter what, enjoy the holidays with your loved ones. Having time to sit, chat and decide together (if that is possible) about what kind of changes to make in 2010 can be a salve for all of you.
 

Kathryn Arbour is co-founder and President of Capabilities and Capabilities.com with products and services for elders, people with disabilities, their families and caregivers, writes about caregiving, aging, mobility and independence in several online venues. See more at Examiner.com as the Disability Examiner, Mobility Products Examiner, and Senior Care Examiner