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Dstevens66 Asked June 2013

Long distance caregiving, how much can be done remotely?

I live in CA, my brother lives in MI, near my parents (age 82 and 83). They've both had a lot of medical issues, and I'm convinced they need to be in nursing home, and definitely can't stay at home. My brother has been doing a good job of shuttling them to medical appts and talking to the doctors so he knows what's going on.

But he often talks like Mom and Dad are just sick, and can live by themselves if they ' just take care of themselves'. First, the past five years they've done nothing to take care of themselves. Mom has been to the emergency room 4 times in five years because Mom and Dad let some medical problem get to that point. They have no idea of their medical situation when I ask them.

My brother has been very dutiful, but I think he's in denial about what we need to do - talk POA, estate planning, finding a nursing home, etc. He's angry and frustrated over our parents not taking care of themselves. I keep telling him they never will.

I've flown in every time there is an emergency and we've begged, reasoned, demanded they do what the doctors have asked. They don't take their meds, don't do the exercises they're supposed to... won't quit smoking although they both have COPD. Things have just gotten to that point. He sort of agrees.... then says 'if they just took better care...' I guess I need to step in and start doing this stuff myself. The MI estate planning lawyers I spoke to said 'sure, come in with your parents we can do a free consultation.' I can fly to MI a couple times a year, but I can only take so much time off from work.

I'm not even sure what I'm asking.... anyone know how much can be done remotely? Could I be a guardian if I live across the country? Can I get POA if I live far away from my parents?

Dstevens66 Jun 2013
Thanks everyone. My brother has actually been unemployed for over a year. My parents are basically paying all his bills. I've said to him basically he has a job, getting paid to take of our parents. I've assured him I realize he's in a tough position - his unemployment ran out awhile ago, if we're paying for AL or NH they can't help him. I told him I'm thinking of him as well, and I send him money periodically.

I've also brought up the idea of him moving back in with our parents. He acknowledged that was a logical idea. But he still expects to get a new job, and he feels there isn't enough work in my parents area. He also said, and I agree with him.... he isn't the best personality type to do this. He gets short-tempered and angry at the best of times.

I also admit I'm feeling guilty because I left MI over 20 years ago, and don't go back that often (until recently). He's the one in the house, seeing them at least once a week. So I've trusted his judgement, until now, but the Mom has one medical emergency after another, Dad is often confused and forgetful.

Marco40 Jun 2013
Dear Dstevens66, Chicago1954 gave you a good answer. May I expound a fit further.

My guess is that your brother is stressed and strained, and if he is not being reimbursed for this expenses...and frankly his time (albiet he loves his parents), remote family members do not have an understanding of the daily stress and strains on those that are "right there"..and engaged in the day to day situations that may occur. If your brother is becoming fustrated, he is, and probably beyond what you know...cause you are not there. I am sorry to say, but remote family members can not manage this situation, especially if things are declining...and it sounds like they probably are declining..and/or will continue to decline. If your brother is working full-time...and trying to put his arms around all of this, you guys need to make some decisions, plan a stratgey to "fill in" for your brother. His close proximity puts the "emotional" burden on him. Is he the one that says " I guess I need to step in and start doing this stuff myself?" or is this your comment?

You can have the POA, but you are remote, and as much as you have tried to participate, only the person that is close by (and it sounds like your brother is doing everything he can) is the best to monitor and watch the situation. Not an easy job to say the least..and very draining. Hats off to your brother thus far...but the stress and strain will continue.

If you and/or the family can afford to find a "good" caregiver..maybe just to stop by, observe, and provide for an overview, you will gain additional insight that will help you understand. I am sure your brother would be accepting of this, and to relieve him to some degree.

I live in Michigan and took care of my Mother for nearly ten years. I had a remote brother and sister-in-law in Washington D.C. As much as I would explain what I was going through, it mostly all fell on deaf ears...and there was no recognition for "value" in terms of financial value. I am finding that this "family thing" in addressing what the caregiver sacrifices, emotionally and financially, is not recognized by the remote family members...rather "it's your choice"...basically an ignornant statement from the far removed.

You and your brother need to sit down and talk..and to bring perhaps another professional into understanding the dynamics of your situation...and explore all alternatives that will better enhance your lives, yet still embrace your parents' desires. Not an easy one, but start talking and start exploring on all fronts.

Good luck to you..I know you care. Marco40

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ferris1 Jun 2013
My best advice to you is no, one cannot adequately care and govern the actions of parents who live so far away. They are resistant to taking care of themselves as you mentioned they still smoke with COPD. That is most certainly a death sentence which they might want. Unless a person is constantly viewing what is going on, in my opinion, one cannot trust those to take care of themselves and therefore need others to do it for them, (i.e. making sure they take their meds, bathing, eating properly, etc.). So if your brother in MI will not take responsibility as a POA and guardian, then you either have to move to MI, take a leave from your work, or keep worrying yourself sick about your parents. The choice is yours...

Chicago1954 Jun 2013
I know from experience what your brother is doing is overwhelming. Is he getting reimbursed for his expenses or is he expected to transport them because he is the son? I have made certain that relatives caring for my Mother at least get their expenses covered. So, from your brother's stand point, he can't be asked to do one more thing.

Yes, your parents need to be in assisted living or the next step down, but it is their decision. You can't just drop them off there, although some of us would like to.

Even if and when they go, it is still A LOT of work, for the person living near by.

momhouseme Jun 2013
Keep your relationship with brother going..assert yourself and say I think we should x, y or z and let's get poa, and so on in place brother! Then, you could enlist with your brother to start the process by taking the steps, with brother, to get poa. You cannot force poa but you can go to court to get guardianship although it is expensive and costs alot in time.

Supergram Jun 2013
My mom lives in Washington and I live in Georgia but I have POA for her finances and health. I don't know what the laws are but the POA's were initiated by my parents but it took a long time to convince them. They were both relatively healthy at that time. Have you and your sibling(s) tried to do a type of intervention explaining to them the ramifications of the future? As I said, I have a POA and can do quite a lot even though I am on the opposite coast. My situation is different in that my Dad has now passed away and my mom is in an assisted living facility (only because she is wheelchair bound) and she still has all of her mental capabilities. You may need to talk to a local lawyer and find out what your legal options are. I don't think you can "force" POA unless there are grounds for commitment but it sounds like it is worth a try.

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