Q. I am very concerned about my mother. She is having memory problems, no longer can drive and can easily forget to turn off the stove. The problem is that I live 500 miles away. Each time I visit her she seems to be getting worse. I want to provide some homecare and don’t know where to begin. Any suggestions? B.A.

Your concern is valid and know you are not alone. Of the 35 million Americans caring for older family members, about 15 percent live at least one hour away. 

I recently had a conversation with Lynn Friss Feinberg, Family Caregiving Advocate and former Policy Advisor at the AARP Public Policy Institute. She noted, “It is challenging to be a long-distance caregiver and often a time of uncertainty.  It’s important to recognize that if you live at a distance from your mother, you can’t do it alone.” She suggests trying to coordinate with family members or close friends who live near your mother.  If that isn’t an option, she suggests considering hiring a geriatric care manager to identify your mother’s needs and arrange for services.  

This geriatric professional usually is a licensed clinical social worker who can also develop, plan and coordinate services. The National Institute on Aging has referred to such an individual as a “sort of professional relative.” The care manager can check in with you from time to time serving as your point person. Here’s the catch. You likely will have to pay for the service since Medicare and most insurance companies do not. Most charge by the hour. 

If you decide to go this route, here are some questions to ask, as suggested by the National Institute on Aging.

• Are you a licensed geriatric care manager?
• How long have you been providing this service? 
• Are you available around the clock, particularly for emergencies?
• How will you communicate information to me?
• What are your fees and references? 

Note another name for geriatric care management is Aging Life Care. To find a care manager in your mother’s community, go to https://www.aginglifecare.org/. Another useful tool is the CareNav – Family Caregiver Alliance, which helps families navigate the emotional, physical, and financial complexities of family caregiving. 

If you do not hire a care manager, you likely will be looking for caregivers. Then there’s the decision of whether to hire someone from an agency or someone who is a private caregiver offering independent services. 

 The pros of using an agency: These caregivers are pre-screened and vetted so you don’t have to do it. If a caregiver gets sick, the agency will provide a replacement. Also, you won’t have to manage payroll, benefits and liability. Caregivers employed by the agency receive training and the required certifications. Finally, agencies carry liability insurance and many have worker’s compensation. 

The cons of using an agency: One disadvantage is there is no guarantee that you will have the same caregiver each time. Additionally, fees may be higher than an independent care manager. 

The pros of using a private caregiver: You select your favorite one and have the last word in assessing the individual’s medical and daily life-assistance skills. You also have the opportunity to double-check on formal training and certifications. Another advantage is that you likely will have the same person over some consistent period of time. A private caregiver typically costs less since there is no agency to take a portion of the fee. 

The cons of using a private caregiver: You have to do all of the work consisting of interviews and background checks that are time-consuming. You also need a backup plan if the caregiver is not available. Managing employee payroll, tax deductions and other Federal law requirements are additional tasks. Finally, you are liable for job-related accidents in your home.

There is another very important person in this situation. That is you. It’s important to get emotional support for yourself. Talk to friends or find an online or in-person support group to discuss caregiving challenges as well as tips. 

Although this subject may personally sound remote or untimely, it is relevant to each of us. Former first lady Rosalynn Carter said it well in 2011: “There are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.” 

Thank you, B.A., for your important question. Best wishes in finding the needed support for your mother. Stay well and be kind to yourself and others. 

Helen Dennis is a nationally recognized leader on issues of aging and the new retirement with academic, corporate and nonprofit experience. Contact Helen with your questions and comments at Helendenn@gmail.com. Visit Helen at HelenMdennis.com and follow her on facebook.com/SuccessfulAgingCommunity

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