Long Distance Caregiving

I would check with the local pharmacies in his area and see what they could recommend for a pill reminder system. They may have some ideas that you haven't thought of. You may also check with the local senior citizen center to see if there is a volunteer program up and running where someone would call him twice a day to remind him to take his medications. Sometimes even with the phone call or other reminder system, the person still does not actually take the pills. If those options don't work out, you may have to hire someone from an agency to come in twice a day. Most agencies have a 2 or 3 hour minimum, so if it gets to that point, you would want that person to do more than just the med reminder. Services such as errands, transportation, cleaning, laundry all the way up to assistance with personal cares can be added. I am not familiar with responselink.com so can't comment on how that works. I am a nurse with Home Instead Senior Care and so am biased towards that agency, but there are many wonderful agencies to choose from for these services.

We struggled with a similar situation. My wife's dad, 87, is reasonably independent, but due to a stroke almost 20 years ago, cannot speak. This means he can neither make nor receive a phone call.

You are all really far from your dad's home, and we were, too. We decided that he simply had to live close to one of us, and that meant he had to move, not us.

It was not easy, but we convinced him to give up his home and move to an independent living facility less than ten minutes from us. His apartment has a full kitchen, but the facility of 70 apartments has all three meals daily for all residents, in a wonderful dining room.

Furthermore, and this was important to us, they do head counts at lunch and dinner. If a resident is a no-show, someone goes to check that they are OK. You can miss a meal if you want, and you can miss them all if you want, but you will need to respond to knocks at your door at mid-day and at dinnertime.

Dad does not need help with his meds or any other kind of help yet, but if help of that kind is needed, it is available, by us making a private deal with someone in the community. The facility has no help available, and is not set up to do business that way.

Some of the residents in this wonderful facility have large apartments with a second bedroom and some even a third, and have full-time live-in help.

Best of luck with your situation.

I think you and your siblings will have to get Dad out of the house. It will take a concerted effort - but if I were you, I'd look someplace southwest, so at least two of the three can be a short distance away.

I tried managing my dad's care a mere 35 miles away, and it was so stressful and unpredictable (midday calls at work saying he's not well, or someone stole something which proved false). He's high functioning in some respects, but totally clueless about day/time, financial and legal issues and taking meds. Putting his issues first put me on the top of the layoff list, and I'm still out of work 18 months later. Don't jeopardize your personal work or financial situation...take an LOA if necessary to resolve it in 30 days rather than drag it out trying to manage long weekends flying back and forth. BUT, and this is important, have a plan of action agreed to by the family before anyone takes time off, and line up as much as possible via phone.

You don't say if he has a house, which makes it more complicated. You may try to get him out to one of you in AZ or CA for a vacation, and just keep him there while two of you handle shuttng down his MI home. Just make sure the power of attorney forms are in place to handle sale, rental or repair of property or to terminate leases if he's in an apartment. You'll have to do this even if you put him in a Michigan assisted living home. Having a task list will focus you.

And be prepared for an exhausting experience, physically and emotionally. If your dad has lived there any length of time, he may have gotten into hoarding or just not doing chores because he's frail. My brother and I ended up cleaning out at least 9 20 cuyd dumpters from my dad's 3 flat and 2 two car garages, stuff was there from the 20's when my grandfather bought it. Took us 5 years on weekends, and an occasional handyman to get it in shape to sell.

Good luck. I know this is slightly off topic from managing meds, but that is really just a symptom of the bigger problem you are facing. Take care of this now, before your family is faced with shutting down his Michigan home in the midst of a medical emergency.

CLC has a reality check worth considering in the note. Deterioration usually manifests itself with measurable things first. By that point, many other issues have probably come and gone, some tended to some not. Issues like property taxes, overdue accounts, and the most distressing of all, abuse by those close to them that they have come to trust. As executive function goes with no memory for back up, your role will need to transfer from supportive to administrative. Seriously, this is the time to get the details and formulate a plan. My response comes from a personal and professional background. Things got way ahead of us because we were overseas during 3 of the 5 years her ability to manage her affairs broke down. Check points I thought I had in place with neighbors and medical personnel did not work. Her neighbor extorted 2k from her. I moved her in with my husband and me. It has not been easy for anyone. She is now getting her medication on schedule, eating regularly, and getting ready to move with us to Hawaii on our next set of orders. She would rather go home..........Talk about long distance..I am an only child and know that I can not manage her affairs from Hawaii to NC. Hang in there and work for a clear understanding of what issues and options are in play. God Bless.

My Mother lived in PA & I in Ky. when she because unable to manage her affairs. After about a half-year of tolerating daily caregiver visits for which she wrote the checks for herself, she was ammendable to moving. I gave her two options; either assisted care/nursing home in her area, or moving in with me. I was brutally honest in explaining that I would not be able to visit any more than I've been doing; once every nine or ten months. She suprised me by choosing to move to my place in Kentucky (she never liked country living or living on the farm). She will have been here for 2 years this summer. I don't want to make this sound easy, it has been & continues to be an adjustment, for both of us. But now at least I am able to either take care of her myself, or arrange for her care when necessary. And I am so thankful I don't have to face that long, long drive by myself every year, or those phone calls from her neighbors & social service personel asking me "... if I know what...?"!

As a follow up: he had over 60 banker's boxes full of his and my mother's personal papers. He raised holy hell when we tried to sort thru it all. After my mother died, we/I just plowed through it all over several months. I also took his PO box key from his ring during one of his hospital stays (that and his car keys eventually - the only way to get control).

It would take these overnight stays at the hospital, or my brother distracting my father for me to quickly go through cupboards, drawers, pockets and shoe boxes, to find property tax bills (past due), his supplemental BCBS (in cancellation), and 5 years of IRS penaly notices for not filing. (He assumed H&R Block automagically took care of that once he filed back in 2000.) It took several months and a professional to square away the IRS issues (fortunately, we produced medical records that supported his dementia, so they waived about $40K in interest and penalty.) He 'lost' one of the property tax bills, so taxes on one of his two lots was being paid by a tax scavenger - that was about $2K to redeem and settle. He was having survivor benefits withheld for my mom, but since she preceded him, I found out totally by accident that he was due a return (which really screwed up taxes with a lump sum.) And those boxes? I found almost $15K in uncashed IRA distributions, refunds of overpayments on car insurance (he likely paid twice, forgetting the first payment). I have only been able to recover about 2/3rds of it, directly from banks or thru state unclaimed assets. Plus had to cancel a dozen credit accounts (cards still unsigned and in his wallet.)

And that doesn't count the entire basement flat full of file cabinets and boxes (125+) from his old consulting business and 10 years as a congressional chief of staff.

My point is, unless you really know your father's financial, personal and business affairs, be prepared for a lot of work. I'd work 50+ hours, sort through a few boxes that I carted to my house, toss and shred most, and sort through papers covering almost a decade. At one point, I had 45 packed boxes, double wrapped in trash bags, taped shut, stacked at my curb for pickup by the garbage crew. Had I left it at his house, he would have hauled it all back in (really). I had a three day garage sale alone from all the tools and construction materials left in just one of the garages.

Your situation may not be as crazy, and I'm sure that I could have called junkers to haul it away (at $500 a truck load). But I managed to make about $7k to help defray house remodeling and clean up (did I mention he hoarded cats?).

Just saying: it's hard enough for the kids of aging parents (esp. w dementia) to handle the direct responsibilities of the illness. Layer the shutting down of one or more parents households and financials, and it is beyond overwhelming. I have no idea how I ran my own house, worked full time, and handled his life. No wonder I lost my job from being burned out. Don't be afraid to acknowledge your limits, and if you can afford pulling in professionals to manage some of the tasks, do it rather than kill yourself to save a buck.

Check out the website: Caring From a Distance, http://cfad.org