Sandy moved to France two years ago. Her mom and dad reside in Texas.
She tries to visit her aging parents twice a year but sometimes she can’t make it because of her kids’ commitments and the price of the tickets.
It started during her last visit, four months ago. Her mom let the pots burn on the stove.
Not once but twice in a row.
‘I forgot’, she said. ‘That’s no big deal. I don’t get why you make such a fuss’.
Sandy was upset. That was so unusual for her mom. She is such a perfectionist. Missing a meal used to be a national disaster. How come she brushed it off so easily?
Sandy is worried and particularly concerned because her mom has always been the glue that holds the family together.
She calls her brother who lives in Florida.
‘Hey Tom, have you noticed that mom is becoming more and more forgetful?’
‘Yeah. And dad is not doing better either. He struggles to walk these days. His knee is painful. He hardly gets off his chair.’
‘I’m afraid, they’ll need some help soon if the situation keeps deteriorating.’
‘What are we going to do, Sandy? I can’t move to live closer with my job and my family. Mom and Dad will never want to leave their house either.’
‘And I’m living an ocean apart at the moment! I feel powerless.’ exclaims Sandy.
Not knowing where to start, Sandy and Tom let weeks and even months go by…
One day, Sandy gets a phone call: mom fell down the stairs. She’s in the hospital.
No matter how hard you work and how well organized you are, it’s not always possible to prevent a crisis. But there are actions you can take that will help you monitor your stress level.
Linda Resca, MS, is an experienced caregiver. 
Not only does she take care of elderly people in need (one-on-one private caregiving) but she also provides guidance (consultations) to families. She helps them navigate the ageing process of their loved ones as smoothly as possible.
She believes that this ultimate stage in life can be a rich and profound experience for everyone involved. Linda is based in the US and works with families around the world. Her insights into the ageing process are relevant for many of us. Here is a glimpse of her wisdom.
Sandy and Tom have no clue about what’s involved in getting help.
And you might be like them: having no idea where to look, what to pay, how to talk with your parents about it.
What to be aware of before taking action
Linda emphasizes:
It’s important to know that there is no cookie-cutter approach. You and your parents are unique individuals with needs specific to who each of you are.
That said, there are several important and helpful things to keep in mind.
Let’s start at the beginning.
While you’re thinking about what you’ll say to mom and dad about involving outside help, remember that they’re getting ready to move into a new phase of life; a phase that can initially feel very frightening. Other than when they were born, this will be the biggest transition they’ll make.
Accepting that you’re no longer able to perform simple daily tasks is acknowledging a loss. As an expat, you know that dealing with loss involves grief and pain.
It’s asking A LOT for someone to say ‘yes’ to opening their life and home to a complete stranger. It’s accepting the fact that they’re not independent anymore and never will be ever again.
In other words, you might be met with a big resounding “No way!” “Your mother and I are doing just fine on our own and we will not have someone come into our home.”
This kind of response is normal. If you remember this, it will decrease your resistance to it.
Have compassion, empathy and kindness in your heart. No one likes to be approached by someone who comes on like a steam roller.
When you’re worried and scared for your parents, you can come across as pushing.
You know your parents well. You’ve known them your entire life. Trust yourself when you sense they’re declining and need help.
Some common red flags that can alert you are:
pots getting burned on the stove
increase in falls or near falling
poor judgement e.g. insisting on carrying a heavy laundry basket down the stairs into the basement
unable to find their way out of the Post office parking lot that they frequent every week …
Start to look at options before the situation gets worse.
Nobody likes to make decisions in panic mode 10,000 miles away.
Where to find help
When you don’t live near your mom/dad, you have to depend on the occasional visit, phone calls and emails to give you updates. Sometimes you can enlist the help of a neighbor or friend from church. One of these people are often willing to drop in for a weekly visit.
But when your parents need more support, it becomes too burdensome.
According to Linda’s experience, it is possible to trust someone to care for your parents even when you live far away. But it requires time, commitment and frequent ongoing communication.
Once your parents agree to have someone to help, you need to know where to find the right person you can trust and that they will like.
Linda underlines that there are 2 sides in caregiving:
- the actual performing of the tasks to help someone – this is performed by a caregiver
- and the supervision and coordination of daily needs and the healthcare situation (making appointments to the doctors, following up with the results of the scans, blood tests, drug prescriptions) – this is performed by a care manager.
If your parents are still mobile but a bit forgetful and lost in dealing with the numerous health related tests and exams, enlisting the help of a care manager can be quite appealing. It can help them get used to having an outside person coming to the house and gradually increase their confidence in asking for help.
Depending on your parents’ needs, you can can make arrangements to meet a few caregivers or care managers before your next visit.
The most common place people find caregivers in the US is a home care agency. There are also private caregivers (like Linda) and caregiver registries. In addition, you might find someone online. Obviously, there are pros and cons to each of these resources.
When interviewing the caregiver, these are some of the questions you may ask. On the practical side, you may want to know:
- Have they had a background check?
- How long have they been a caregiver and what kinds of care have they provided?
On the ‘softer side”, you may enquire about:
- Do they recognize that their work is a professional agreement and they’re not being hired to just hang out and read a book while your parents watch tv?
- Do they have good boundaries – e.g. do they know it’s inappropriate to talk with you and your loved one about all their life’s woes and challenges?
- Do they engage in good self-care?
- Do they, emotionally, feel like more than just an ok match for your parents?
Once you and your parents hire a caregiver, you need to agree on a way to remain in contact. You get to determine how this will be. For example, you might request that the caregiver emails you after every visit with your parents or emails you once a week.
This time, Sandy feels she has no choice. She arranges, in a hurry, a trip back to the US to visit her mother in the hospital and support her dad. But she has learned her lesson the hard way. So much stress and money involved.
She and Tom have now vowed to take action. They want to hire a care manager who will give them regular updates about their parents health and well-being so that they’ll be better equipped to discuss relevant options for them.
Making this decision has a huge impact on their lives: not only do they feel reassured for their parents but they also feel less guilty.
This is just a brief overview of the complex world of caregiving.
For more information and customized guidance, Linda offers a free 20 min consultation.
Alternatively you can visit her website ‘The Caregiver’s Heart‘.
Caregiving often calls us to lean into love we didn’t know possible.
Tia Walker
Now over to you: do you have any experience you’d like to share or a burning question to ask?