Friday, May 22, 2009

Caring From Afar

Posted by Leona Bergstrom

Last week I mentioned that we were struggling with caring for parents who live far away. (Of course, it was WE who moved away....) As Terry put it, when we are there we hover, when we are away, we worry. In my career, I have seen “simple” falls escalate to major health demise. And, I’ve seen a short hospitalization become the first of many 9-1-1 follow up crises and exacerbated conditions. But at the same time, I have watched our own parents and others exhibit heroic displays of resilience and resolve.

Recently one of our parents faced some serious struggles following a critical health incident. After things improved a bit, one of our siblings remarked, “Well, I think we dodged the bullet on this one.” It reminded me of Beth Witrogen McCloud’s comment, “We may expect one-time answers for an ever-changing landscape, single solutions for progressive conditions.” And that’s the key. We are on a journey now that is ever-changing, dynamic, full of surprises and unprecedented challenges. One-time events come at variable intervals with less time in-between. We live waiting for “the other shoe to drop.”

What do we need to know as we think about long-term care? When do we intervene with care that is proactive and appropriately responsive?

In the book And Thou Shalt Honor, Rosalynn Carter and Beth Witrogen McLeod, the writers, suggest the following:

While the decision to intervene in a loved one’s care is seldom clear-cut, certain physical and behavioral changes are definitely cause for concern. Keep a watchful eye for the following red flags:

* Appreciable weight loss or gain
* Sudden paranoia, combativeness, aggression, or hallucinations
* Disturbing changes in attitude and self-esteem
* A noticeable decline in hygiene and grooming
* Excuses for skipping routine tasks like going to a doctor, the barber or the grocery store
* Lake of interest in friends, hobbies and activities
* Social isolation
* Unpaid bills, or notices about utilities being shut off
* Unsafe behavior such as leaving food burning on the stove
* Frequent falls
* Frequent memory lapses
* Getting lost on familiar, well-traveled routes.

These things are more detectable if you live nearby. But what if we are long-distance caregivers? McLeod suggests that we need to: (1) Visit as often as you can. (2) Phone frequently. (3) Encourage other family members to phone. (4) Organize local support – like a neighbor who will check in once in awhile. (5) Utilize community resources (more on this next week). (6) Install a personal emergency response system. And maybe even consider hiring a geriatric care manager to handle those aspects of a loved one’s care that you cannot do from a distance.

We need to be watchful without being intrusive. Wise without being “know-it-alls.” It’s a difficult dance.

Suggested reading:
Caregiving: The Spiritual Journey of Love, Loss and Renewal, Beth Witrogen McLeod.
And Thou Shalt Honor, Rosalynn Carter and Beth Witrogen McLeod.
(Photo by steven and sara, shared via Flickr)

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