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The first layer requires one to "clarify who in your older generation depends on you in some way. List your parents, stepparents, in-laws, grandparents, aunts or uncles, etc. In conversation with them, formalize your caregiving role. This is particularly important in [a] stepfamily situation." With this layer, not only must you identify who needs or might need assistance, you must identify the legal documents, and financial assets necessary to facilitate and provide help and assistance, and you must articulate the limitations that arise from long-distance caregiving. The authors briefly explore the potential for caregiving to help in such situations, and the practicalities of such planning:
"Then, acknowledge that by living at a distance, you cannot be available 24/7 to everyone, in person. Determine your trigger points for travel. For scheduled procedures, is there an acuity level that must be met before you fly or drive to be present? A major surgery? Yes. A physical therapy appointment? No. For emergencies, what is a reasonable expectation for arriving? Next, plan for how you will manage planned or emergency travel. We know this sounds a little advice column-y, but it’s good to be prepared for that 2 A.M. phone call that requires you to drive several hundred miles.
The second layer, "your job, " focuses on caregivers who are employed and how to juggle a job and caregiving responsibilities. The third layer, "spouse and child" recognizes the sandwich issue- caregivers also have responsibilities to their own immediate family as well as the elders for whom they are caregiving. "Communicating with your spouse and your children about your goals for this season of life is critical. Acknowledging how you will be dividing your time, and why, will help them feel engaged and involved. You will need their moral support in your role as caregiver."
Many of these circumstances will demand a "team approach," i.e., several different persons, sometimes including non-family lay persons, as well as third party professionals. Consideration and utilization of a Private Care Agreement to define roles, responsibilities, expectations, and remuneration can aid in implementing a plan, managing expectations and concerns, and resolving foreseeable and unexpected disputes and disagreements.
Technology can make such planning for care from a distance less risky and burdensome:
When you cannot be physically present, consider how you will stay connected and whether technology may help. Entire industries are developing applications that connect to smart homes, surveillance cameras, and interactive devices, such as Google’s Alexa, to meet the needs of elders and their family caregivers. Personal health monitors, as well as smart home technology, can monitor for falls and track weight gains and losses, play a favorite television show, or adjust thermostats, and thus contribute to the safety, entertainment, and comfort of older or ill adults. Already, senior-living residences have considered adopting “Addison,” a robot caregiver, who rewards residents when they meet goals, monitors changes in movement, and talks to the residents with screens strategically placed around the apartment or room. Technology can help connect when a loved one lives at a distance.
Of course, like with many solutions, senior appreciation, acceptance, and utilization may be vital to success. In the past few years, we have watched and often guided seniors and their families in a suite of solutions for distance care. These tools should be considered, and, if necessary, utilized in any Aging in Place Plan.
Caregiving is complex, potentially overwhelming, and, draining, financially, mentally, emotionally, and physically. It is, nonetheless, rewarding and routinely ranked as “highly meaningful.” Staying connected at a distance is possible when expectations are clearly defined.
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