The Alzheimer's Digest: Caring at a Distance

If your mother has Alzheimer's disease and lives in Phoenix and you're in New York, how do you help take care of her? Angela Heath, director of the Eldercare Locator Hotline of the National Association of Area Agencies on Aging, has compiled 10 strategies to help you cope. This article is adapted from Heath's book, Long-Distance Caregiving: A Survival Guide for Far Away Caregivers.

Tip No. 1: Get organizedKeep track of important information in a care log.

I didn't know anything about Alzheimer's before my mother and my stepfather developed it at roughly the same time in the spring of 2005. I was living outside of Portland, Oregon; they were living in Mission, Texas. They were 86 and 84, respectively. I had tried to talk them into moving to an assisted-living community in Portland previously, but they always said they were doing fine. So I was surprised when my mother called one morning out of the blue and said, "We need help." My husband and...

Tip No. 2: Identify your informal networkAsk for help from people in your loved one's community, such as relatives, neighbors, longtime family friends, and members of religious, civic, and social organizations. Ask them to call you collect if they spot a problem with your loved one.

Also, consider installing a webcam in your loved one's home as a way to check up on them and see how they are doing. Also equip your loved one with an emergency necklace or bracelet that allows them to alert the police or paramedics with the push of a button should they need help.

Tip No. 3: Investigate travel alternativesBe prepared to "care commute." Investigate travel options in advance. Keep your car in good repair, and check on the route and weather before traveling.

If you rent a car, look for the best rates. Don't pay for insurance if you already carry full coverage or your credit card company offers coverage. You may get a discount when buying bus or train tickets if you disclose that it's an emergency. Learn how to buy airline tickets in a way that ensures you get the best deal.

Tip No. 4: Discuss legal and financial issues
These topics may be difficult to talk about, but they help ensure that your loved one maintains decision-making authority even when incapacitated. Preplanning will also lessen family disagreements and protect family resources.

Will: Your loved one decides how to dispose of assets after death.
Power of attorney: Gives a caregiver the authority to act on behalf of your loved one.
Trust: Estate-planning document allows your loved one to transfer assets and avoid probate and other legal problems.
Joint ownership: Makes it easier to gain access to your loved one's finances.
Representative payee: A caregiver receives government checks for the loved one unable to manage money.
Medigap insurance: Pays portion of medical bills not covered by Medicare.

Tip No. 5: Take care of necessary paperworkFind all legal, financial, and insurance documents, including birth certificates, social security cards, marriage or divorce decrees, wills, and power of attorney documents. Identify bank accounts, titles, sources of income and obligations, and auto, life, homeowner's, and medical insurance papers. Review these documents for accuracy and update them if necessary. Store documents in a secure place such as a safe-deposit box or a fireproof box. Be cautious -- make duplicate copies.

Tip No. 6: Tap into the aging networkContact the local department on aging in your relative's community. This agency can help you identify helpful services. Use the National Eldercare Locator Service at (800) 677-1116 to find local aging agencies.

Tip No. 7: Develop a plan of careIf possible, bring the family together for a meeting. Decide with your loved one what his or her primary needs are, who can provide assistance, and what community resources would help. Summarize your agreement in writing. Keep in mind that family difficulties are typical. You may need to bring in a family therapist or social worker to help.

Tip No. 8: Adjust your plan of care when necessaryBe aware that your care plan may need to be altered. Your loved one's needs may change, and helpers will come and go. Use your care log to deal with changes.

Tip No. 9: Explore relocation issuesPrimary questions are when, who, and where.

When: Relocation is appropriate when a health professional recommends a change, your loved one needs 24-hour care, his or her safety is at risk, or the home does not meet fire or safety standards. Other reasons may be less obvious. Remember, your loved one may be willing to bear a little inconvenience to remain in his or her home.
Who: Should you or your loved one relocate? Examine the financial and emotional costs.
Where: There are many options for senior housing. Contact your local department of aging for assistance.

Tip No. 10: Take care of yourselfCare giving can be taxing. Maintain good health, make time for yourself, set limits, and allow others to help.