It’s a fact that daughters are usually the ones who take responsibility for caring for elderly parents.  And midlife is when the burden commonly becomes the heaviest.  And, if you live in another city, an already stressful situation becomes an even bigger source of concern.

This very practical article covers a multitude of suggestions for reducing the long distance anxiety factor as much as possible.  Heck, it’s just plain useful whether you’re close by or not.

How do you care for your elderly parents when they live far away? That's a problem that many families face, including my own. Two or three times a year, my wife flies to Europe, but it's not to look at the Eiffel Tower or the Roman Coliseum or Buckingham Palace. It's not to shop at Harrods or to enjoy the beaches in Provence or to snack on tapas in Madrid. It's to take care of her elderly parents who live in Finland. The journey is roughly 8,500 miles or 13,600 kilometers from our house to theirs. In other words, she can't just drop by whenever she feels like it.

Recently, her mother had a minor heart attack. (I say minor because she survived.) A week later, her father slipped on the ice and broke his arm. He couldn't get undressed or dressed without help. My wife flew over to take care of them while they recuperated. Near the end of her stay, she phoned me. "The day I leave to come home, my mother's supposed to go in the hospital for tests. My father can't drive her because his arm is in a sling. The next day, my father needs to have his arm looked at but his doctor is twenty miles away. I won't be here to take either of them. Who will do it?" She was frustrated and worried.

We began looking at how you care for elderly parents by long distance. Here are some of the things we found out.

Start with the Department of Aging Services

We found that a good place to get started is the local Department of Aging Services. Sometimes it goes by the name of the Area Agency on Aging or Department of Aging. You can find it from the Internet or the local government pages of the phone book in the area where your parents live. The people there understand the problems of the aged. They know what social service agencies, non-governmental organizations (NGO's) and other services are available. They have reference materials on everything from safety to legal information. Many departments have funding to care for those who are particularly needy. If there's a problem that doesn't require an ambulance, they may be able to send out a staff member.

List your Parent's Needs

Sometimes the elderly don't get necessary services because they lack the money, energy or memory to provide them. It helps to have a list of things to watch out for. If you go over the list with them occasionally, you may discover things they're doing without. Here are some of the things that you may need to take care of from afar:

Food. Some local grocery stores will deliver for a small fee. There may be a "Meals on Wheels" program in the neighborhood.

Living quarters. It's usually most comfortable and least expensive for your parents to continue living in the home they know and are used to. But if they can't take care of themselves and need more than a little help, you may want to suggest an assisted living community or nursing home.

Laundry. Some laundry services will pick up and deliver clothing, bed clothes, etc.

Help with bathing and dressing. As with my wife's father, an accident may make it impossible for a person to bathe or dress himself. Most communities have in-home nursing services that will help for a fee.

Medical care. With Medicare and Medicaid in the United States and other medical programs in other countries, the elderly should be able to get basic medical care without having to worry too much about the cost. But they may still be reluctant to seek it, so you may need to arrange a doctor visit for them.

Medications. Some elderly have trouble getting to the pharmacy to purchase medications. Quite a few pharmacies will deliver if necessary. A bigger problem can be remembering to take the medications. Pill boxes with compartments in which to store doses for each day of the week and by morning, noon and evening are available at pharmacies and online. Pharmacies and in-home nursing services will sometimes help sort medicines into the right compartments.

Company. Loneliness is one of the biggest scourges of the elderly. Local senior centers, churches and volunteer organizations can help fill lonely hours. So can TV and radio. A daily phone call from children or brothers and sisters is something many elderly look forward to. You may also want to help set up a phone circle in which several elderly in a neighborhood or friendship group check on each other by telephone each day.

Paying the bills. If your parents don't have money to pay electric, water, gas and phone bills, or if they forget to pay them, you may have to arrange for payment. Most utility companies have special programs for those in need. In any event, someone has to pay the bills and it's a good idea to check periodically that your parent is able to pay his or hers.

Transportation. When a parent gets to the point where she can't drive anymore, how does she get to doctor appointments, buy food, or go to a movie? It's important to know bus schedules, have the phone numbers for taxis and be able to call on a friend or neighbor for a ride. My wife found out from the local Department of Aging Services that her parents are entitled to "Taxi Cards" that let them take a taxi for the cost of bus fare. That solved the problem of how they were going to get to their doctor appointments after she returned home.

Entertainment. No one wants to be bored. Fortunately, television works for many people. Some libraries will drop off and pick up books and videos. But it's also important to think about your parent's specific tastes. Does he or she have certain hobbies that can fill empty hours? If so, be sure to hook up with organizations that support it in your parents' community.

Get Lots of Phone Numbers

If you can't be there all the time, it's important to have other people you can call on. Make sure you have phone numbers and email addresses for as many helpers as you can get. Leave a copy for your parent or parents, keep one for yourself and give copies to your siblings and other caregivers. Here are some people for whom you may want to collect contact information:

•    Department of Aging Services
•    Neighbors
•    Friends
•    Pastor, priest or bishop
•    Primary-care physician
•    Taxi
•    Your siblings and step-siblings
•    Concierge services •    
•    Local utility companies•    
•    Local police and fire departments
•    The manager or front desk of the assisted care facility or nursing home where they live, if they live in one

Here is a form (in PDF format, requires Adobe or other PDF reader) that you can print and use to collect contact information.