A Week in the Life of a Long Distance Caregiver

A Week in the Life of a Long Distance Caregiver

My name is Karla Scott and I have served as care manager and guardian, making all major decisions, for my invalid, nonagenarian (in their 90's) parents for two years. Importantly, they live in their Chicago house they purchased in 1958 and I am the only surviving daughter and live in Miami, alone. I travel monthly from Miami to the South Side of Chicago to manage their care, oversee home caregivers, and spend quality time with Mom and Dad. I draw upon my personal experience to share advice on how I successfully manage their care.

Week of April 12 through April 18, 2007


In the midst of the Imus racist/sexist radio scandal and the horrors of the Virginia Tech massacre, I managed to care of my two nonagenarian parents from long-distance. I have performed all duties of long distance geriatric care manager for more than two years now.

Here it is a typical week:

It began with Charlotte, the daytime caregiver, calling me to notify me of the latest gas and electric bills. I paid them both online.

Subsequently, she read me a letter from Medco that my moms Alzheimer’s medication, Aricept, had been authorized for another year. It amazes me we must renew it annually, even though Alzheimer’s is a progressive illness.

I contacted my moms endodentist to authorize a root canal. The dentist, her Dad, performed phase 1 of the procedure last week, and I spoke to my mom's doctor to assess whether she has the capacity to recover from such an invasive procedure that will require pain medication and healing in her mouth.

I met with a financial planner for the first time to discuss how to best manage my parents' estate, given that their monthly pension and Social Security income does not cover their care.

Next, I spoke with the weekend caregiver who informed me my mom is suffering from hemorrhoids. She has given her hemorrhoid medication for two days in a row. My mom's incontinence has gotten worse. My dad is losing control over his bladder as well. She feels my mom needs to wear larger diapers that provide greater coverage, and that we should consider putting diapers on my dad. That would certainly change the nature of the caregiver's jobs; currently, they are only taking care of my mom's incontinence. I know how painful it would be for my dad to have women cleaning him down there. It is all heart-wrenching! The weekend caregiver says the anti-itch medication appears to be working again. Mom has such a violent rash that she scratches aggressively until she bleeds all over her body. She has a habit of scratching upon awakening, and during the evening. It is very difficult to watch her breaking her skin, scratching until she bleeds.

I recall when I was there two weeks ago, one morning, my mom woke up wondering where she was, insisting that was not her house, and questioning why her skin was torn and bruised. She had no recollection of her incessant scratching.

I confirmed that both daytime caregivers will be able to take my mom for her root canal appointment. They both work for a state agency; So I don't have to worry about liability and they will be paid hourly for their time. I am so grateful to have those women, and I'm grateful that my parents’ private insurance covers most of the cost of the procedure. I am also grateful that for a change, the weather is not freezing or snowing in Chicago. It is safe for my Mom to go outdoors. It has been the longest winter in a while and record low temperatures have been set during the month of April.

I went to my mom’s dental insurance company’s website where I reviewed her coverage, printed out temporary ID cards, and downloaded the policy. Last week, I had Aetna mail new ID cards to my Mom and Dad. Thankfully, they both have Aetna dental insurance.

On the day of my Mom's scheduled root canal, the dentists’ assistant contacted me to complete a medical history form. I spent an hour on the telephone with her answering all her questions about my mom’s medical history. She needed to go back 10 years. She verified my mom's insurance information. She faxed in authorization form for me to complete. I had her fax it to a friend and he will e-fax it back to me.

Our nighttime caregiver experienced several personal crises this week. This happens often a lot, because she juggles family, personal illness, and handles out of state deaths in the family. Because she is conscientious, she always finds a replacement. The other caregivers cooperate and fill in for her when she is unable to work. At least her job gets done and that's all that matters. I have made several adjustments to her work and I am willing to accommodate her, because whenever there is a crises, the other caregivers contact her and she runs to their rescue immediately. She is like family, we all love her. She is a good person, and we trust her.

I Googled washer and dryer sets from Sears. Both the washer and dryer, 30 year old machines, need to be replaced. There are units on sale. I can order online and shipping and handling and removal of old equipment are all included in the price. I should probably order new machines.

I went to the IRS website to check on the status of my parents income tax refund. I filed their taxes a month ago. The refund is being processed and will be issued April 20.

I called my mom's best friend, Juanita, to discuss her visit with my parents on their 63rd wedding anniversary, April 9. She was happy to see my mom. I had asked her to take down the Easter decorations. I always decorate for the holidays, just as my parents did for my sister and me when we were children. I had visited the week prior and brought Juanita by the house to visit my mom for a six hour stay.

I began writing my book, Doing What’s Best for Your Parents, on Sunday, April 15.