Long-distance caregiving made easier

There are 34 million elder caregivers in the United States, among whom more than 5 million are managing care from a distance. A study by MetLife and the National Caregivers Alliance has found that:

* On average, the long-distance caregiver has travel expenses ranging from $386 to $674 each month.

* The average distance between caregiver and patient is 450 miles.

* 80% of long-distance caregivers work full-time or part-time.

Get a head start before you visit

If you or others you know are new to caregiving from afar, it's important to be aware that die support services your older relative needs may well be available locally. The trick, of course, is to find out about the service and help arrange it. Here are some suggestions:

* INVOLVE YOUR OLDER RELATIVES IN THE PLANNING. Talk to them about their specific needs and how you will help meet them.

* KEEP A PHONE BOOK FROM YOUR PARENTS' AREA to facilitate local contacts and schedule appointments with agency and health care personnel.

* SURF THE WEB. A wealth of information is available on the Internet. A good place to start is with the web sites listed in the sidebar on this page. You might also search for the key words "agencies on aging."

* THINK OF LOCAL PEOPLE WHO MIGHT BE HELPFUL such as your relative's neighbors and friends. Call or e-mail them to let them know you're planning a visit.

* TRY TO ARRANGE FOR ANY NEW SERVICE TO START BEFORE YOU GET THERE, so you can see how it's working and, if necessary, hire or replace personnel while you are there.

While you are there

* BE OBSERVANT ABOUT HEALTH AND SAFETY ISSUES. Is there a change in your parent's health status? Is he or she eating properly? Are friends and neighbors coming around? Is the house clean? Are finances well handled?

* TALK TO YOUR PARENT'S FRIENDS AND HELPERS. Ask how your relative is coping when you're not there. Who will drive your mother to the doctor when her neighbor goes away this winter? Is someone needed to help out with home repairs?

Be realistic about your parents' abilities. The people in their local support network may tell you about problems your relative may have kept from you. Be sure to reimburse your parents' friends for any expenses.

* HAVEAN EMERGENCY BACKUP PLAN IN PLACE. Small (or large) problems are bound to arise in your absence. Prepare and duplicate a list of key people in your parents' lives: relatives, friends, neighbors, doctors, home health workers. Include their work, home and fax numbers and e-mail addresses. Send copies of your list to each of them as well. Leave an extra set of your parents' house keys with a trusted neighbor.

Keeping contact from back home

* ESTABLISH A ROUTINE FOR STAYING IN TOUCH. Assign different days of the week for each family member to call. Encourage grandchildren to make a special effort to stay in touch. Ask friends and relatives to send brief newsy letters and photos. Show your appreciation to those who help out with thank-you notes and gifts.

* BE ALERT TO CHANGES in your relative's mood and behaviors: phone calls at odd hours or for no apparent reason, repeating information, forgetfulness or slurred speech. These may be signs of a medical problem and reason to consult with a doctor.

[Author Affiliation]

-Adapted from The Caregiver"s Guide (Houghton Mtfflin) by Caroline Robb, UN.