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Estate and Elder Law

Caregiving from Afar

A recent article in Money magazine discusses the challenges faced by adult children whose aging parents live far from them.  According to the National Alliance for Caregiving (NAC), approximately 7 million Americans care for a senior relative long-distance.  They face guilt and anxiety from not being able to be there at a moment's notice to dealing with financial stresses.  Such caregivers spend an average of $8,700 per year on support for their family members, which is nearly twice as much as those who live closer to their parents.  Some of the added expense is because of travel, but the long-distance caregivers also incur additional expenses in hiring people and services.  There are several strategies that these caregivers can use to help reduce stress and maintain a good quality of care.

First, assess your parents' needs.  You can begin by observing your parents and their environment when you visit.  Look for unopened bills and letters on the counter, and food in the refrigerator that is well past the expiration date.  Notice whether your parents are still steady on their feet.  When you are back in your own home, keep in touch by phone, or by a video chat service such as Skype.  These video visits can enable you to observe changes in condition such as weight loss or confusion.  Software such as PointerWare and InTouchLink can help simplify computer interfaces for the elderly.  Donna Wagner, a gerontology professor at Towson University, says, "You're looking for significant changes from normal patterns."  You can also enlist the support of friends and neighbors who can contact you if they notice anything unusual.   If your parents have a physician's visit while you are in town, see if your parents will permit you to accompany them to the appointment, and try to get them to sign HIPAA consent forms so the physician can share information with you. 

If you think that your parents could benefit from assistance, talk with your parents in a way that does not express your fears.  For example, "Dad, I noticed that your refrigerator is empty.  I wonder if we could do something to help you with grocery shopping." You may be able to put together a plan that consists of family and friends willing to help with taking your parents to their healthcare providers, having them over for meals, or doing laundry. 

You might be able to arrange for grocery deliveries from the store or for someone to periodically clean the house.  If your parents need assistance managing their financial affairs, then, you will need a general durable power of attorney, and you can also work with your parents on establishing online access to their accounts to help with bill paying.  Shared online calendars, such as,, or, can help coordinate efforts.

If you have gaps to fill, there may be services available in your community to assist.  Your local agency on aging may able to help you access services such as meal programs, transportation, and social activities.  The employers of the adult children may be able to assist as well; some large companies may offer elder care referrals through the employee assistance program or benefits package.

If your parents require more assistance to be able to stay in their home, then you may have to hire aides to provide additional help.  Home health aides may be needed if medical monitoring is appropriate.  Personal care aides can assist with cooking, light housekeeping, and bathing.  Coordinating these activities from afar can be a challenge.  Oast & Hook's life care planning services can assist by providing an assessment of the situation, including recommendations and referrals for services.  A care manager can help coordinate services so the parents can stay in their home as long as it continues to be safe.  Life care planning also provides information regarding available resources and benefits to help pay for care.  Your family and you can have peace of mind that your parents are being well cared for.


Sandra L. Smith joined Oast & Hook in 2003.  Oast and Hook has served Southeastern Virginia and North Carolina for more than 80 years. Visit their website at for more information. Ms. Smith practices primarily in the areas of elder law, estate planning, estate and trust administration, special needs planning, asset protection planning, long-term care planning and Veterans' benefits. She is certified as an Elder Law Attorney (CELA) by The National Elder Law Foundation (NELF). In 2008, Ms. Smith was named as a Rising Star by Virginia Super Lawyers magazine. Rising Stars names the state's top up-and-coming attorneys.