1 of 5 siblings lives near our Dad. Others are out of state. How can we help?

You get a county social worker to check in on him now and then. You get the phone numbers of neighbors and make sure they have yours in case you are needed. You make sure his 911 has your contact information. Last but not least you keep in touch with his MD, with his permission.

I think that covers it! And, of course, call him frequently with general social chit-chat and visit him as often as you can manage. And ask your sister if there's anything practical you can do to help, bearing in mind the distance. Best of luck, and from a caregiving youngest sibling: thank you for at least giving it real thought.

And mske sure that your sister knows that as the care duties increase, you're open to helping. Look at some point, there will be a crisis: a fall, a car accident, the doctor will tell you all that he can no longer live alone. At that point, you'll have a family meeting and figure what the plan is. Does snyone have poa for financial and medical. Very important to get those set up before there's a crisis.

My father died in 2012 after several years of my mom, my husband, and me taking care of him. Now my husband and I are taking care of my mom. We live in Oklahoma.

Just like your father, Mom refuses to live with us, but she does live just a couple of blocks away from our house, so she is close. We check on her every single day. We do all the house maintenance, yard work, bill-paying, most shopping, etc. for her. (God bless my husband. He is just the best!) She is doing okay at the moment, but she suffers from depression and diabetes, so there are good days and bad days. I also notice her memory slipping, and since Dad ultimately died of Alzheimer's Disease, I am worried about this for her, too.

My brother lives in Florida, so I am the only child involved in Mom's (and Dad's when he was alive) daily care. I think one of the best things distant family can do is to support the one doing the actual caregiving. I can honestly say my brother has never criticized my husband and me for what we are doing for Mom and what we did for Dad. He is always supportive and appreciative of what we do here. He calls Mom often, and when she is in one of her depression modes (not pretty), he calls and it really helps not only her but us. He offers to do whatever he can, and he's already helped us take care of all the legal and financial things that needed to be done for our parents. Even though he works a stressful job himself, I know he would be here in a heartbeat if things get really bad. He also contacts me weekly to see how my husband and I are doing. If something happens to us, he would step in, move Mom to Florida, and take over the job.

I read about so many people whose siblings don't help out at all. I am so sorry for them! I know my brother can't be here personally to help with the day-to-day care, but he always supports our decisions and offers to help in any way he can. The three of us only want what is best for Mom. We are doing the best we can to make her life the best we can for however long she has left. I hope your distant family is as good to you!

As your sister is bearing the full responsibility, she needs the support of her siblings that are out of town. My sister is is in your position and talks to my mother daily. Almost twice a week, she calls me with a concern that I've already dealt with. I need her input as mom will tell her things that help me and I know I need to keep her up to date on what's happening. I Imagine with 4 of you out of town this would be very difficult.

Who of the 5 has power of attorney and is the health care surrogate. If it's not the sister living close to dad, should it be?

As she makes decisions about dads care, support her and help the other siblings understand the difficulty she is going through.

I would call your local Visiting Nurses Agency or your local Office for the Aging to see if Medicare would pay for someone to check on him once or twice a week. Also, if your father is on Medicaid, they would pay for a family member to look after him. He would have to have a home evaluation and a disability review done.

The fact that you are asking this question is a good start. It demonstrates an acknowledgement that your sister is front line, yet a willingness to share the responsibility. Open and honest communication is key. It is also really important to respect Dad’s autonomy and include him in the process. I’ve written a book about caregiving based on my experience and those of 34 other caregivers. The following excerpt appears on page 54 of What to Do about Mama: “A productive family meeting can build a strong foundation for family caregiving. Do you share common values? Talk about what is most important to all of you—autonomy or safety. Establish common goals. Divide responsibility based on the strengths and abilities you bring to the family. It is important to be specific. Develop a contract that delineates the commitments family members have made, and solidify those commitments with signatures that verify that everyone understands and agrees to the plan. Be sure to date the contract in case changes are needed later on.” I think you would find this book to be helpful.

Barbara M., Author

Thank you all for your responses. I realize how much each of the 4 living out of state need to be active and supportive. The information is much appreciated

Being the only one left and doing all for my two parents for going on three years now, I can tell you that if the siblings out of town can do ANYTHING to help....learn how to delegate. And, is it time to assure you've got all the financial things in order...living will, POA, medical/durable POA, so that when parents are not making good decisions or cannot pay their bills, handle their own money anymore, you are ready to go with expanding the 'care'? Have those who cannot physically be there, help to do the research by internet or phone to make up a list of resources for your sister who is caregiving....even if you do not need them now....you might in the future and having a phone list all ready to go would have helped me tremendously. I am doing it all long distance myself....and when in the middle of all the paperwork required to try to get my dad qualified for VA benefits and then Medicaid benefits, I could NOT do that while doing all the day to day checking on if Mom was OK at home and how Dad was doing in his facility placement. Mom is very disruptive and needy, sometimes calling me 20 times a day with things that are important to her but not important in the big picture. So, there were two times, I had to pay to fly in a daughter for a couple weeks, to be WITH my Mom and be the eyes and ears down in Tucson, just so I could meet required deadlines for paperwork issues because I was so stressed. And I walked into the situation with the POA, living trust, wills, medical POA all in place. It was still almost a year of hell dealing just with that stuff with the help of a financial person from the lawfirm. I was thankful that my parents had done all this and had an elder care attorney in place to support me. I haven't even yet gotten into formulating the list of resources. I have one person from the Council on Aging who sends people to do simple repairs or mow the lawn, and they TRY to get Mom to join social activities, which she consistently refuses to do...and they bring her donations of fresh foods every two weeks....I know they offer more, but I have no time to make the phone calls and ask the questions...so getting lists of resources is a big back burner thing with me! If your sister is handling parents bills too, that might be something that could be delegated and that is time consuming. I have many of my parents bills on auto pay on computer, but there were many issues doing that. Some utilities will not permit the bills to be sent to a different address; many won't do a thing without getting the entire POA mailed to them or faxed; all the rules are different, yet they want to be paid. And, once on any kind of assistance, there has to be a checking account for each, so that only expenses and income for the one getting assistance are in one place and not mixed...and those agencies want their reports monthly or whenever they choose, to assure that the eligibility is being met properly. And even with Dad in a dementia facility...every 3 months a care conference and paperwork, plus any health issues, calls to me and decisions from me, checking and communicating on issues that arise with his care...all involve me from afar. And about 2 x/mo, I must travel down there (a 5 hr trip) to check on things, stay 4-5 days, go to doctor appoints, or law office appts to stay on top of things....So what ever type of thing that could be done from afar and shared among siblings, to help the physical caregiver, just handle the actual care giving day to day....would be a way to help. And NEVER jump in the middle of what the caregiver is doing....be supportive all ways. It's an impossible job, especially as parents become less and less able, or it comes to making decisions that parents do not really want made.

As others have said, good for you for even considering the question/concern! Often siblings who live far away just excuse themselves totally from any aspect of care. I know because I facilitate a Caregiver Support group in our community. In some areas you can hire a geriatric Case Manager to help monitor and coordinate any care issues/concerns which can sometimes help take some of the stress off any one person. Just a thought.......

Living away and providing some service to a parent can be a tough one. I see family members who are long distance caregivers all the time. Call on a regular basis, send mail such as cards or newspaper clippings of something that would interest your dad. This gives you something 'extra' to talk about when you call so all calls aren't 'what do you need-how are you'. You can call local diners that deliver and have a meal delivered from you to him as a surprise. He may need to feel he is keeping his independence, and that's important. He can get out if he desires to, he just chooses not to go to a senior center for a noon meal. You can visit when you can, while you are there, cook up some meals that can be frozen then either baked or can be heated in the microwave. You can hire a cleaning service to come in once a week, every other week or once a month to do some of the heavier housework. Keeping in touch is the most important, let him know you care about him and want to help where you can.

As others have said, it's great that you are thinking about this. My Dad who was 92 passed away a month ago. I was the sibling who was close and so my partner and I did the day-to-day caregiving. There were times when I felt overwhelmed and wished my siblings would help. Having them call and check in and help make decisions was nice. It felt as though there was shared responsibility. Also, I could call my sister and rant when Dad was doing something frustrating. We made it into a joke. I would call and say, "your Father did..." She would laugh and know that I mostly needed her to let me blow off some steam. By the end of the conversation, we were both laughing.

Things like paying bills can be done at a distance. We actually hired someone to do this. We simply changed the mailing address on all of the bills to his address. We sent a lump sum each month to cover the bills. He paid the bills and sent us a monthly statement of what was paid and how much of a balance Dad had. This was a huge help to me. It wasn't the regular monthly bills that I could put on auto pay that caused me stress, it was the random bill from the doctor's office or biannual car insurance that was difficult. If a sibling at a distance can help your Dad with bills (and he will accept that help).

Another thing that you can do is to take a few days (vacation or paid family leave) and go spend time with your Dad. This is as much for you as it is for him. You can help him with things around the house and yard, cook with him, clean out the garage. Two of my siblings came out at different times this summer. Dad died quickly and no one was expecting it, both of these siblings felt good that they had spent time with him. We really appreciated their being here.

Call your sister and check in; maybe even set up a chain email that gives a weekly update to all the sibs that you take charge of drafting and circulating. Set up a calendar where ea sib/family calls one day per week to say hi to dad. If family visits, ask family to give one wked a qtr where they visit and drive dad around, etc and local sister can leave town or stay home with no responsibility or worry about dad.
Gain consensus now before a crisis, that if dad needs more assistance, sis has permission to hire outside help for dad and agree how much each sib can afford to contribute to that expense monthly -- it might be inhome care, or cleaning service, etc.

It's so refreshing to see a post like this! You need to ask your sister and BIL when do you want me there, and you all take turns.

As one poster said eventually something is going to go sideways, a fall or he drove the car through the garage wall(not trying to be dramatic, these things happen), you should also all Skype or do a conference call and see who has what availability in the event your sister needs help in an emergency.

You really can't rely on neighbors these days, and I don't believe you can get Medicare to cover home health visits as someone suggested. That happens if the elder goes into the hospital and the doctor signs an order for HHC. And that only goes on for so long.

Again, nice to see a question like this. In many cases(it did in mine) it all falls to one adult child.

It took our family 5 years to talk to Dad about financial planning, trusts, POA, Advance directives. I don't know it your family has done this yet.

Talk to your sister and see what she wants help with. Maybe you could visit some 4 day weekend and let her family have a vacation. In future, she may need relief for longer if she ends up being a caring more directly for your father.

See if your sister needs financial help for things for Dad. The little items (diapers, meds, grocery, cleaning supply add up.

AND, from experience, don't spend time second guessing her. It doubles her job. Offer a hand, time, a massague, Watch her kids while she goes out, etc.

PS: you can email father's MD without his permission. The MD will not respond, can not respond. So if there are worries about competence, anger, sleep, hygiene, driving, nutrition, email the MD.

Lastly: get an all sibling email system going so everyone is kept up to date.

For the one of 5 siblings doing the care giving, please use the report tool which is easy to set up under the TOOLS tab in "my account" easy to report what's going on to others quickly. My sister responds quickly to new reports and we have good discussion and plan respite support (several hours at a time) and other ideas plus here interest in my health and what I am doing for me. The tool is great but needs a GENERAL COMMENTS field...we have to use one of the unused fields to add other comments...

It would be helpful to support care giving sibling by regular contact, gift cert for local restaurants, $ support for person to share check ins or other services for parent, etc.

I'm in an aging and adult development class and we've talked about these topics lately. I only have experience with my grandmother and non-family members, but I have found these insights helpful:

1) The sibling who takes on the most caregiving can experience significant burnout which can escalate to emotional and physical health problems.

2) This sibling may also be juggling demands for her or his own family.

3) Caring for an elderly parent can put strain on their marriage.

So, things that other siblings can help with include:

1) Offering financial support for meals and other care when needed.

2) Spend time in person or over phone/skype to have a family meeting in which children can ask their parents about their wishes. This includes wishes about where they want to be cared for when that time comes, whether or not they want to be on life support if that becomes an issue, DNRs, burial and funeral wishes and other related issues. This way, siblings all hear the same thing and do not fight about what needs to be done for their parent, as this causes serious rifts in the family.

3) On a similar note, siblings MUST communicate about their parents' finances. Elderly men or women who need help managing financial affairs are at risk of intentional or unintentional exploitation, often from their children caregivers who use their caregivers money a) things the parent doesn't need or want or b) as personal compensation. Having an open dialogue among siblings about where money should go if a parent need financial assistance can be a way of curtailing financial exploitation or other choices and subsequent negative consequences.

4) Siblings can help the caregiver sibling. Even if a child is estranged with their parent, they can help their sibling in many ways. Other siblings can offer to take care of family reunions or gatherings; they can help the caregiving sibling financially in order to take pressure off of work responsibilities; they can take turns caring for a parent if the parent can no longer live in their own home; and more.

Lastly, as others have said, it is wonderful that you are asking that question and being sensitive to both your parent's and your sibling's needs.

Set up a caregiver contract, and PAY your sibling. This is from me, in a similar family of 5, I am the only one who does anything for my parents. However my sibs are not nice to me at all. They could be sending me a gift card for Starbucks, or asking me when I would like a 4-day weekend, and not whining or whimpering about how "difficult" their jobs are.....my job is 24/7 and I'm on call too (besides my other career and my own kids).
How I wish I had siblings that cared enough about their own parents, to consider they would be in a facility 5 years ago, if not for Me. I've saved my parents probably $100, 000 and they've never paid me an hourly rate.

As the one sibling that is doing the primary care, I would like to stay that the most important thing you can do is support that sister in whatever way she needs. Often it is just an understanding ear that can make all of the difference, and letting her know that you appreciate what she does and you know it is not easy on her. I have a sibling or two that criticize everything that I do, second guess me all of the time and make me feel like it is "me against them" in a situation where everyone should be working together. I have basically given up my life to be round the clock caregiver and support from them would make all of the difference in the world to me. Instead I am frequently put into situations where I have to justify and explain my every actions. This makes me feel anger and resentment because as we all know - it is easy to say what someone should do when you are not the one doing it :( Kudos to you for caring and trying.

To Samara....you have saved way more than $100,000 of your parents money! We put out nearly $75,000 of my Dad's investments just for 1 year as private pay in a dementia facility. Rates were between $4800 and $5200/month for just him, plus security deposits and other supplies that had to be purchased for him, such as linens and towels, hamper, personal care supplies that are not provided by the facility...extra seating and other items for his room and more. And there should be no arguments from siblings, as I, as the only child left, providing only long distance care and handling all finances for both my parents, was told by the eldercare attorney right in the beginning that I could pay myself an hourly rate that was the going rate for hiring someone in that would do whatever I was doing. I didn't need any approval...just notations in the checking account. I do not do it because I am the only one....but I do charge their account for gasoline to travel back and forth to Tucson, and for meals and supplies while I am down there. Mom is with me for most meals anyhow, and she would never offer to pay ordinarily so it certainly helps my personal budget to know I don't have to pay personally to get there and back and to eat out with her. She hoards food, so I won't eat from her fridge ever! And we mostly live on our social security, so spending better than $100 on gas for twice monthly trips to Tucson is a major expense for us. I am glad we can have her accounts pay for some things....but I would not take advantage ever.

My husband is the one that is here for his mom. She is in Ass't Living. Be careful to avoid the words 'You should ......" Word it differently, so it doesn't seem like you are giving your sister more work.

Let your sister know you appreciate everything she does! The most touching show of appreciation I received was a gift card to a spa so I could pamper myself even if just for a few hours. And it was given to me by a health provider to my mother, not my siblings that could afford it. If my siblings would make a similar or any gesture, bring in a dinner so I don't have to cook, much of the stress from family dysfunction would be decreased. What can you do that would be appreciated and a treat for your sister that takes on most of the responsibility?

Joannes is correct the savings of a family caregiver is phenomenal! I have cared for my Mom for 40 months now. Without me here, at $4,000 a month, which is conservative, I have saved my Mom $160,000.00. And while the parent benefits from the one on one care by someone familiar, so do siblings in terms of less stress from their own non-involvement in care, and their inheritance.

Its so nice to have gotten hugs from a couple of you, just wanted to share that with the wider community, if you see a commenter here that you connect with, there is a neat feature where you can send "hug" directly to the poster. Believe me, compared to my sibs, this website gives me MORE support than they do, and I continue to hope they will wake up and see the Light, but for now it has been so wonderful to hear feedback from you all.

Based on experience, I would advise that ONE of you take charge and become Durable Power of Attorney or perhaps Guardian if necessary.

The others should fully support this sibling, including financial compensation for expenses and time invested. Do not try to do this by committee. Present a united front to your father and lovingly encourage him to cooperate with the person in charge.

The first order of business might be to consult with your father's doctor and see if medication would help.

Here's hoping for a beneficial outcome to this challenge, all parties blessed.