National Institute on Aging, National Institutes of Health  |  5 Comments  | 

Long-Distance Caregiving: Geriatric Care Managers Can Help

It is a concern many caregivers have: "Should I encourage my parents to get more help? The last time I visited, my mom seemed very confused, like she just wasn't quite there. Dad didn't seem to notice and didn't want to talk about it when I asked him."

If you do not see your parent often, changes in his or her health may seem dramatic. In contrast, the primary caregiver might not notice such changes, or realize that more help, medical treatment, or supervision is needed. Sometimes a geriatric care manager or other professional is the first to notice changes. For families dealing with Alzheimer's disease and other dementias, it can be easier to "cover" for the patient—doing things for him or her, filling in information in conversations, and so on—than to acknowledge what is happening.

A few good conversation starters are:

  • If you thought there might be a change in Mom's condition, whose opinion would you seek?
  • I didn't notice Dad repeating himself so much the last time I was here. Do you remember when it started?

Some changes may not be what you think. Occasional forgetfulness does not necessarily indicate Alzheimer's disease. Before you raise the issue of what needs to be done, talk to your parent and the primary caregiver about your concerns. Try not to sound critical when you raise the subject. Instead, mention your particular worry, for example, "Mom, it looks like you don't have much food in the house—are you having trouble getting to the store?" and explain why you are concerned. Listen to what the primary caregiver says about the situation, and whether he or she feels there are problems.

Discuss what you think needs to be done: "Do we need to get a second opinion about the diagnosis? Can you follow the medication schedule? Would you like some help with housework?" Try to follow up your suggestions with practical help, and give specific examples of what you can do. For example, you might arrange to have a home health aide come in weekly. You might schedule doctors' appointments or arrange for transportation.

In some cases you may have to be forceful, especially if you feel that the situation is unhealthy or unsafe. Do not leave a frail adult at risk. If you have to act against the wishes of your parent or the primary caregiver, be direct and explain what you are going to do. Discuss your plan and say why you are taking action.

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