Not Just Around the Corner: Long-distance caring for elderly loved ones

Have you gradually - or suddenly - taken on eldercare responsibilities for a loved one living some distance from you? Are your parents, or other relatives, becoming more dependent? Many carers are at the peak of their career, and in an increasing number of cases they are part of the ‘sandwich generation,’ juggling eldercare commitments alongside managing young children.

Whether you currently care for an older adult or (think it’s a possibility in the future), this guide offers:

• A closer look at the practical and emotional aspects of caring at a distance.
• Strategies for managing the guilt and stress connected with difficult conversations and choices.
• Practical insights on keeping your career on track alongside eldercare responsibilities.

Context: Long distance caring

The report, ‘Caring at a Distance: bridging the gap’ undertaken by the Employers for Carers forum (2011), sheds light on what it means to juggle work and care commitments. It discovered:

• 1 in 3 carers are worried caring will impact their capacity to work in the future.
• 1 in 4 have changed their working pattern to care.
• 14% had reduced hours.
• 10% had taken a less senior role.

Caring alongside a demanding career is tough. Carers experience increased stress, greater anxiety and disturbed sleep patterns, which can lead to exhaustion and reduced performance. It’s essential - for both employers and individuals - that we find sustainable ways of supporting elderly family members as our demographic profile shifts.

Distinct challenges: from a distance

There are specific challenges in caring for our loved ones from a distance:

• The anxiety of not knowing/seeing what goes on day-to-day.
• Practical implications of accessing medical information and consultations.
• Increased coordination required - input from a large number of people/stakeholders.
• Emotion - the guilt of not being able to do a great job of caring while focusing on your career.

Practical aspects

When you have the opportunity to be with your loved one, make the most of your visit. On the practical side, check in on the home, paper work, general wellbeing and consider whether they might need help with cleaning or meal preparation. Try calling at meal times and asking what they are cooking or eating, to get a better idea if help is needed.

Keep in touch with neighbours and the wider caregiving community, establish a good rapport, and get consent for a regular dialogue. Contact carers on a regular basis for updates. Things will inevitably change over time so if the rapport and connectivity is established up front, it makes things much easier if, or when, there is a problem. Where possible, it can be useful to explain to the person that you are helping them because you care about them, not because you want to be 'bossy' or controlling. Schedule enough time to do what’s needed when you visit, as well as spending quality time, as rushing or doing things quickly won’t help anyone.

Tips and advice:

• Try to listen and just ‘be there’ for your loved one - not overly distracted by tasks.
• Make time to offer them support, rather than ignoring or 'jollying them along'.
• Don't brush their worries aside, however painful they may be, or insignificant they may seem.
• Take your children with you and create good memories.
• If possible, make the most of your time together by taking them out to places they love.
• Try to do some ‘detective work’ about how things are, without intruding.

Emotional aspects

When there is a specific incident, such as a fall, we have an overwhelming sense that we need to be there. Carers living some distance away often feel they cannot do anything right and this leads to guilt, frustration and reduced emotional and physiological well-being. Feelings of guilt are normal but they are usually just an emotional, irrational response to a situation, rarely teaching us anything helpful about our behaviour. Getting to grips with guilt is an important part of the carer’s journey.

Tips and advice:

• Accept the help of others when you cannot be there to do what needs to be done.
• Explore what you can do e.g., talk to medics, write emails, co-ordinate the care
• Acknowledge any guilt and let it go unless you want to or are able to change things - ask yourself, “is there anything I can do differently?”
• Avoid being motivated by duty - watch out for should and shouldn’t
• Listen with love and caring - ‘I understand you want the best for mum and so do I’
• Reconcile - let go of any unresolved resentments that holds you back and drains your energy levels
• Accept you are not going to get everything right.

Difficult conversations

There may be some reluctance to talk about any changes to health or living situations. Your loved one may not want to appear a burden or vulnerable in any way, and they may not want to give up their freedom. It can be helpful to carefully explain the value of putting together the necessary plans and documentation whilst assuring them you respect their choices and privacy. Having a family meeting - in person, if possible - will help you set up any contingency plans and reassure everyone involved. If you can work as a family team, it makes sense to agree in advance how your efforts can complement one another.

Consider personality types:

• Some of us like things to be very orderly
• Some are “people pleasers” and feel guilty about not being able to make everything right
• Some are driven by knowledge, and feel better when things are explained to us
• Some avoid routine and love spontaneity

There is no single best way to be a carer. Notice what works for you and your personality and how this may differ from other family members and others in the care circle. Make sure cover is provided if someone is away so that each family member or carer can have a good rest and not worry whilst having a break. This needs to be agreed up front so that nobody feels a sense of guilt if anything should happen.

Tips and advice:

• Inspire and foster a sense of independence for your elderly relative.
• Have a family meeting - use technology (Skype, Facetime).
• Use each other’s’ strengths, take on tasks best suited to you.
• Compile a file with all important info: contact numbers, health details, financial records, and make sure everyone knows where it is.
• Ensure good communication with the medical professionals and other care givers.

Keeping your career on track

From the work perspective, we often take a deficit approach to caring, noticing only the challenges and the negative impact on our productivity. However, acknowledging the positives in our caring responsibilities can help build our capacity for resilience and keep our careers on track.

There are significant transferable skills:

• Improved time management.
• Greater confidence in a crisis (stress management).
• Clearer sense of objectives in negotiating conversations.
• Increased empathy.

Tips and advice:

• Reflect, re-frame and share... you are not alone and you can do it. Remind yourself daily of what you have achieved not what still needs to be done.
• Acknowledge your resilient characteristics - which ones do you have and which ones might you use more effectively?
• How can you invest and maintain your health, energy and attitude? Focus on the things you can control.
• Do what you need to do for you to optimise well-being and continue with your caring commitments alongside your career in a sustainable way.
• Identify further practical or emotional support.
• Perhaps talk with your manager about short or longer term changes to work patterns that could facilitate difficult circumstances.
• Keep communicating with other family members.