7 steps to mastering long distance elder care

Ever felt that despite your successful job and wonderful family, you aren’t doing enough for your aging parent? What started of as a niggling twinge of regret has now invaded your sleep, and you wake-up agonising about your decision of prioritising your work over family.

If that sounds familiar, then you are not alone because you are part of the nomadic sandwich generation trying to juggle kids on one hand along with aging parents on the other who are now living longer. Add to this, you have a pressing career, a working spouse, and live in a different city or country from your parents. Being the only child can compound your problems manifold.

Good intentions… and a gigantic social problem waiting to be solved

Five years back, I had the same recurring issues. As an NRI, I had an aging mother in India, while I was living in London, working for a prestigious bank. My worst nightmare was the phone ringing at night for someone to tell me that something terrible has happened to my mother. And a quick dipstick survey of my friends and colleagues told me what I believed to be true. Most of them had the same issue as I had – its difficult to keep track and care for your parents long distance.

And unfortunately, there were no solutions at hand. If you were fortunate enough to have an extended family, or a good network back home, you could try to piece together a support infrastructure for your mother. And many of my friends had indeed created this trusted ‘circle of care’ for their parent – with two full time maids monitored by a cousin, and a doctor who would come during emergencies. This seemed like a great plan, till the group dissipated into a rag tag group of carers. The maids played truant all the time, the cousin moved to a flat in another part of town, and the doctor’s visits were at best whimsical. I call this then the Band-Aid Carers

I saw an enormous problem in India that needed to be solved. Seniors comprise 1 out of every 10 persons in India today. This is supposed to grow to 1 in 6 by 2040. Big problems are big opportunities, and my business partner and I decided to turn our back on lucrative careers to find a solution to India’s elderly. We decided to create a elder care company and we would start with aging at home. Seemed foolhardy to many, but in hindsight it was the best decision I could have ever made.

Seven steps that could change your and your parent’s lives?

So, after five years, and growing the start up to one of Eastern India’s largest Eldercare company, what can I tell you about caring for your parents from afar? These small changes can make your life easier, and substantially improve your parent’s lives.

Step 1: Take on your role as a carer today. Don’t wait for something to happen before you do

Take on your role as a carer as soon as you can. Don’t wait for an ‘incident’ or a ‘life event’ to thrust you into this role. Even when your parents are in their mid 60s, and fairly active, you can move gradually in to the role as a carer. And it doesn’t mean that you take away your parents’ sense of independence and self-worth. In the beginning, just help out in those areas where they may need help. Like helping them keep abreast with new technology like Alexa, or connecting them with trusted doctors. In the beginning your role could be just to be an observer, which I will talk about in my next point.

The earlier you get into your new role, the better you will know how to navigate through the role later. Be a ‘low touch’ care provider in the beginning. Over the next many years, you will be pushed towards becoming a ‘high touch’ care provider – fait accompli.

Tip 1: Read up about being a carer. What should you be looking out for? There is a lot of good articles and blogs on the web that you can look up.

Tip 2: Embrace technology early. Firstly, simple tech options like Whats App and Alexa is easier to teach to your parents when they are younger. Or look up simple solutions like a web enabled CCTV linked to the front door or the living room.Communicate every day – without fail

Step 2: Communicate every day – without fail

The quantity of phone calls, WhatsApp is important. So is the routine. I would actually suggest that you speak every day to your parents,even if it’s for 5 minutes while driving to work, or after dropping the kids to school. Speak every single day, even for a short time. Do not drop a day. Even if you are very busy, speak for a minute to say that you are busy and will speak to her the next day. But do not drop a day. I cant stress on this routine enough.Calling your parents should be as effortless as having a morning cup of tea, or brushing your teeth.

Routine is important to the elderly. We have had an elderly gentleman, who passed away a year back, who would wait at the landline telephone without fail every Sunday, waiting for his daughters to call him. He wouldn’t have his bath or his lunch till the calls came.

Tip: Here, I would like to recommend an idea that I tell carers all the time. Use a method that SJ Scott, a bestselling author has propounded in his bestselling book, Habit Stacking: 127 Small Changes to Improve your Health, Wealth, and Happiness. Add the habit of calling your dad on an already established habit that you have. Lets say that you have certain habits every day, such as ‘make the coffee’, followed by ‘read the Wall Street Journal while having the coffee’. Just add on ‘Call mom’ at the end of ‘reading the Wall Street Journal’. Or ‘call mom’ after ‘dropping the kids to school’. Make calling your mom a habit.

Step 3: Intertwine yourself in your parents daily lives.

The quality of your phone calls to your parents isimportant. Yes, we all have busy lives. The time you spend with your parent is on the downward curve. If you don’t have too much time to spend, spend it wisely, make it count. Speak often, and intertwine yourself into their lives. Ask about what she is doing that day and this way you will move away from cursory pleasantries every week into understanding her daily routine. Ask her today what she is doing, and if she says that she has had a recurring cough, ask her to meet a doctor. The next day when you speak to her, ask if she has met the doctor, and ask about the prescription and whether she has bought the medicines.

This change in your role will take time to undertake, but getting even a little into the next level of detail will make you a better carer. And don’t limit yourself from just talking to your mom. Take time once a week to talk to a trusted neighbour, relative or friend who visits your parents. Triangulate and make connections about how she is doing.

Tip: Make a to-do list, with reminders and people to call/coordinate. Keep a notebook, or any electronic method that you trust, like Google reminders, or Evernote. If in your work life you can maintain a to-do list, you can do the same in this role too.

Step 4: Optimism on a downward street

Optimism with realism. Taking care of an elderly person is largely a one-way street. Things will deteriorate. The person you love, will need to be hospitalised, will fall one day, or start forgetting things. And one day she will die. Sometimes death will be easy and other times it will be suck out the very happiness from everyone.

As difficult is it for the carer, it would be especially hard for the elderly person, who would be slowly losing her independence, her mobility, her hearing, and then her dignity when she will not be able to manage simple things that we take for granted – like say incontinence.As you manage through this, every ounce of your being will be put through the test. Decisions will come up that could impact the fabric of the family that you have built in the different city. Should you leave your job and come back?What happens to your kid’s schooling and your spouses’ job? Who will provide the finances for your mother’s hospitalisation? Insurance, or you or your sibling?

Having the right disposition will be critical during this time, especially when your loved one is ailing for a long time. I was reading a book by James C Collins called Good to Great and it talks about the Stockdale Paradox. I was thinking how this relates to carers and the elderly. To paraphrase in my own words, the Stockdale paradox says that you have to believe that you will prevail at the very end, but at the same time you will need to take stock of your reality. Optimism with realism…

Step 5: Use all available resources – some free, and some at the price of a cup of coffee a day

Use all available sources of assistance to make your parents lives better, and your life as a carer better. Use family and friends to check in on your parents. Make sure that your parents have regular health check-ups. Make sure that their homes are senior safe, and they don’t have falls in their homes. Make sure that they are feeling useful and are content. Are they reading as they used to? Are they meeting with your extended families, or just cooped up at home?

The best advice I can give is to use professionals? For kids to get into good colleges, its normal to get professional help like tutors and coaching classes. Why not for your parents. And I am not talking just about the elder care company my partners and I built. But there are many similar organisations that are doing good work. Talk to them,read reviews and then see if they have a service that can be eased slowly into your situation.

Step 6: Prepare and make all decisions in advance

Talk to your siblings and make all major decisions in advance. Which hospital for emergencies? Who will manage the money? Who can be the person managing the situation on ground. Prepare. Document it. Its no different when a to-be mother has her bags packed so as to be rushed to the maternity hospital as soon as she nears delivery.

Step 7: Share your story and techniques with your friends and colleagues

Share your tips, techniques and stories with as many of your friends. This small act of kindness can make the life of one elderly person so much better. And when you talk about such stuff, you may suddenly get a great idea to make your life all the more easier.

Both sides of the sandwich – One bite at a time

By being prepared you will not be fazed by the looming uncertainties of emergency hospital admissions, and truant nurses. More importantly you will enjoy the remaining time you have with your parents, and at the same time be a great influence to your kids who would have seen their parents effortlessly manage both sides of the sandwich –one bite at a time.