Long-distance care: When parents live far away

Care at a distance is required when parents live far away and are in need of assistance. Often their adult children work in the big city. If they also live somewhere else, they commute between their place of work, their place of residence and their home town in order to provide for their parents. Managing this logistically, but also emotionally, is a challenge. What support caregivers can fall back on and how you can avoid being overwhelmed..

What does care at a distance mean?

Care at a distance means performing nursing tasks remotely. This can be organizational errands from far away. But it also includes on-site tasks, if the caregiver travels especially for this purpose. There is no exact definition of how far someone has to be from home for this to happen. A study by the Center for Quality in Nursing defines as follows: Long-distance care is given when caring adult children live at least 25 kilometers away from their parents. In addition, the way there is 20 minutes or more.

The reason for this is the dissolution of traditional family ties. At the same time, the requirements for mobility are increasing. Younger people in particular are increasingly accepting changes of residence for their careers. When parents retire, minor on-site assistance becomes necessary over time. However, if the need for care arises, this is no longer sufficient. At the same time, long-term caregiving at a distance poses major problems for working people.

Distance Caregiving

The English term "distance caregiving" (more rarely: distant caregiving) takes into account the growing mobility: care at a distance has long since gone beyond national borders. In the meantime, there is also international scientific research that deals with the issue. The binational project "DiCa – Distance Caregiving" initiated by the Protestant University of Applied Sciences Ludwigsburg and Careum Research is part of this. Key questions are what support relatives can provide for those in need of care and assistance at a distance. It is also a matter of researching the effects and framework conditions as well as technical solutions.

How can support be arranged at a distance?

In order to provide care at a distance, caregivers can resort to some assistance. To this end, the legislature has created the legal framework with various laws. You have the following options:

1. Exemption

Employees are then entitled to time off from work. For example, they can take up to 10 days off if they are unable to work for a short period of time. This is what is offered in acute cases. During this time, you can take care of the family member in need of care and organize nursing care. There is a continuation of pay only if there is an agreement in the employment contract. However, they are entitled to care support allowance to compensate for the loss of wages.

Alternatively, you can take a six-month caregiver leave if you need a longer-term break from your job. With family caregiver leave, even two years off is possible. However, care time only applies to companies with 16 or more employees, and family care time only to companies with 26 or more employees. You can apply for an interest-free loan to cover lost wages during caregiver and family leave.

2. Care advice

Every person in need of care or his or her caring relative is entitled to professional care advice. This is provided by the nursing care insurance companies, which provide a nursing care advisor upon request. To do this, contact either your health insurance company or a care support center. The care advisor looks together with the insured which support is possible for care at a distance. He knows the social benefits and support services, both at the federal level and at the state or local level.

Not only does it provide information about individual support services. But also helps you fill out the relevant applications. This may be necessary, for example, for classification in care levels, an application for care aids or care allowance. In addition, it can help you find a suitable outpatient care service.

3. Network

A functioning local network is especially important when providing care at a distance. You have already laid a foundation for this with the care advice you receive. It is now important to involve all those involved in care and, if necessary, to find new helpers. This can be neighbors of the family member, with whom you leave your phone number and a spare key. Keep in touch with the care recipient's friends and relatives. The one or other can perhaps now and then drop by.

Other social supporters, such as visiting services from the church or welfare organizations, can also relieve the burden on relatives living at a distance. Volunteers may not take on caregiving tasks, but they can make a valuable contribution by talking to people and taking them for walks. If you build up such a network in time and inform yourself about the various offers of help, you can distribute the responsibility on several shoulders and thus avoid your own excessive demands.

4. Prevention

Caregivers at a distance are usually not present on a daily basis though. Nevertheless, many also provide assistance on the ground. Here it is important to know or observe not only the psychological but also the physical boundaries. A common problem: incorrect lifting. Caring relatives sometimes carry heavy objects, lift their relative in need of care, wash or store him or her. These various activities are especially stressful on the neck and shoulders.

The result: tension, headaches or even dizziness. To prevent such ailments, nursing care insurance companies offer free nursing courses. Here, back schools teach caregivers how to avoid back pain. In addition, courses on relaxation techniques help to loosen the muscles and also to relax mentally. In addition, numerous aids make work easier, such as a height-adjustable bed or a bathtub lift.

Health care proxy for emergencies

The thought is unpleasant to many. Nevertheless, an emergency is not excluded: The person in need of care can no longer make decisions themselves, the caregiver is not on site. A health care proxy and living will should exist for such situations.

These documents not only relieve the caregiver at a distance. But they also ensure that the person concerned receives the treatment he or she desires. Important: In order for appropriate action to be taken in an emergency, caregivers should know where such documents are located.

What to do when caregiving is overwhelming?

According to the study, 38 percent of all caregivers do not feel valued in their work. You are partly torn between your own family, parents in need of care and your job. At the same time they cannot please anyone. Unsurprisingly, if caregivers feel overwhelmed at some point. To reduce and prevent overcharging, we recommend the following tips:

• Maintain social contacts
  Don't just focus on care in your everyday life, but make sure that your own friend and family life is not neglected either.
• Taking time off
  Apply for a rehabilitation measure or a cure by yourself if needed. This time off will help you find new strength again.
• Search help
  Take advantage of psychological support. Counseling from a therapist or counselor helps you break out of the thought carousel and change perspective. Self-help groups are also helpful here.
• Engage family
  Talk to other family members and ask for help. Moreover, there is no shame if you feel overwhelmed with the situation and end up choosing residential care after all.

Mobility poses challenges for caregivers

If the parents live further away and are dependent on help, this presents their children with a variety of challenges. In remote areas, access to public transportation is poorly. Without their own car, some of those in need of care cannot be reached. Also, the time factor (car usually faster) and expenses for gasoline or tickets add to the burden. But not every relative has a car. This requires additional organization with regard to travel times and train cancellations.

In perspective, the importance of Distance Caregiving will increase. Already, long-distance care is no longer a marginal phenomenon. About 4.1 million people in Germany are in need of long-term care. The majority of these – about 80 percent – are cared for at home by family caregivers. In the case of care at a distance, Distance Caregivers perform the following tasks, for example:

• Regular calls for control
• Going to the authorities and the bank
• Accompaniment to doctors
• Discussions and agreements with other helpers
• Acquisition of information
• Household and shopping assistance
• Conversations and recreation
• Personal care

Inner conflict among distance caregivers

Care at a distance leads to a constant balancing act for caregivers between work, care and their own needs. The latter eventually run the risk of being sidelined. But this does not serve anyone – neither the carer nor the person in need of care. Distance caregivers are often plagued by feelings of guilt. A guilty conscience gnaws at them for not doing enough. And they know they can't be on the ground fast enough in case of an emergency.