WINNEMUCCA - When you live far from your loved one with Alzheimer's, the separation complicates caregiving. Concerns about the person's safety, nutrition and health may become overwhelming as the disease manifests itself differently each day, each conversation and each visit. Messages relayed by family and friends may be misleading whether over-reaction to "normal" progression of the disease or a lackadaisical view to increasing problems. It's easy to misinterpret when you see a loved one daily; intervening time definitely compounds potential difficulties. Here are some strategies to manage long-distance caregiving provided by the Alzheimer's Association.
Begin by establishing support contacts, a list of people and resources to help you coordinate care. This may be family, friends and neighbors who check in on your loved one or those who are willing to stop by the home or care facility for regular visits and updates. Your loved one's doctor should communication with you so that you are contacted when there are concerns about the person's mental or physical well-being. Openness with trained medical personnel often offers an unbiased observation.
Most community organizations, including churches, neighborhood groups and volunteer organizations have personnel who will listen to and support you. They may provide meal delivery, transportation or companion services. Sometimes it is simply an ear to hear your worries, to listen and suggest without taking away your voice.
Your local area agency on aging (AAA) or hospice has services that can help with meals, chores and transportation. Home care services can be hired to assist the person with bathing, personal care, preparing meals and taking medications.
It is also helpful if you get to know trusted professionals, such as bank officers who can help your loved one pay bills and manage finances and who will alert you when there are unusual monetary transactions. Elder law attorneys work with older clients and their families to get legal documents in place for making healthcare, legal and financial decisions. When issues are discussed in advance, in the open, many potential disagreements and misunderstandings may be avoided.
The Alzheimer's Association (1-800-272-3900 or www.alz.org) or local support group such as the Winnemucca Alzheimer's Support Group can help you with decision-making possibilities, locating and arranging appropriate services for your loved one or just being available with non-judgmental re-enforcement.
When you are able to visit make the most of the time you are together, avoiding arguments. Although the situation may seem wrong and frightening, sit back, pay attention, listen and then offer helpful insight, not bullying advice. Key ways to use your time effectively include making appointments with your loved one's physician, lawyer and financial adviser to participate in decision-making conversations. Chat with neighbors, friends and other relatives to discuss how they think the person is doing. Ask if there have been any behavioral changes, health problems or safety issues. Take time to reconnect with your loved one by talking, listening to music, going for a walk or participating in enjoyable activities. Browsing through scrapbooks or jotting down memories can be a peaceful reuniting.
If your loved one is still living in his/her home, take the opportunity to observe the surroundings. Is there food in the refrigerator? Is it spoiled? Does it appear that the person has been eating regular meals? What is the condition of the inside and outside of the home? What cleaning and repairs need to be done? Are the bills paid? Are there piles of unopened mail? Have clothes and linens been washed and changed? Are the hallways and main walkways clear of clutter so that your loved one can navigate without slipping?
Is your loved one still driving safely? A tough decision, often one of the first decisions of intervention, is removing driving privileges. Fear of accident and injury to your loved one or others forces action. Sometimes your loved one's doctor will notify the DMV about dangerous reflex and response reactions. That means you dodge the horrendous responsibility of saying, "No" to a parent or other adult. Sometimes, however, officials are not prepared to assist you simply because they do not recognize the dangers or understand why family doesn't just intercede. A friend took her spouse in for renewal and even though he could not read the instructions handed to him, respond to the examiner's questions, sign his name or stand correctly for his photograph, a four-year renewal license was given.
Close or from a distance, caregiving is hard, but there are many sources to support you.
Gini Cunningham is the facilitator for the Alzheimer's Association Support Group, which meets the second Wednesday of each month at noon at Humboldt General Hospital. Her column appears the second Tuesday of each month in the Humboldt Sun. She can be reached via e-mail, gini.cunningham@sbcglobal.net.
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