This is the third part of our Caring at Distance Series.
Earlier in the series we looked at the information and support you should have available and decisions you should take when you are caring for an elderly parent at a distance. But crises happen and we are not always prepared.
So, what do you do when you get that telephone call that every child dreads? The first thing is not to panic – you will have plenty of time to think and to plan during your journey back to your parents’ home if going home immediately is required. This example assumes a medical emergency requiring hospital admission and a child living at a considerable distance but the principles are the same whatever the crisis.
Airline pilots have checklists of what to do in an emergency – which procedures to test, sequences of what should be done and in what order. When your parent has a crisis, you have to start thinking the same way.
1. You need up to date and accurate facts on the crisis and, most importantly, you need to write down or record the information you are given because there will be an awful lot of information that you will have to absorb in the coming days.
- What exactly has happened? Family members and close friends may be too emotional to give you proper details so talk if at all possible to a health professional caring for your parent.
- What is the problem and what is the prognosis?
- What is happening to your parent at the moment?
- What immediate support does your parent’s spouse/partner require?
It can be very difficult to get an accurate picture over the phone – even from the medical team. There is no substitute for being there in person and talking face to face.
2. Following the airline analogy you should fit your own oxygen mask before helping anyone else to put on theirs, so you need to sort out your own domestic and professional arrangements first. Then you will be in position to concentrate on your parent.
- Talk to your siblings about what needs they have – even if they live just around the corner they will have their own professional and personal lives to re-organise.
- Talk to your parent’s partner/spouse about what they need and what they think your parent needs.
- Decide if you need to go straight to the hospital
- Arrange a family conference and a Care Review Meeting with your parent’s medical team for when you arrive.
3. During the time it takes to travel:-
- make a list of decisions that you think will need to be taken.
- Try to envisage objectively what your parent will want to happen and what they might need.
- Make a list of the organizations you may need to contact; medical insurance companies, convalescence arrangements, domicilary care providers, etc..
When an emergency happens it is sometimes difficult to stand back and be objective. Try to get some rest before meeting your parent’s medical team so that you are in a fit state to take important decisions. Try not to feel rushed into making decisions unless, of course, there is a life-threatening situation or medical emergency.
Make notes of what health professionals and others say so that you can go back and review them which will help you in making longer-term decisions.
Sometimes there can be significant pressure to discharge a patient from hospital straight into long-term care. If that isn’t right for your parent you will need to resist that pressure until you can put alternative arrangements in place. Conversely, many elderly people who are well enough to go home are stuck in hospital because they are not allowed to be discharged until there is a formal Care Plan in place. You do not need to wait for Adult Social Services to do this; reputable care providers will make an independent care assessment and develop a Care Plan.
You will have to do a certain amount of thinking on your feet as you will only be able to judge what is necessary when you are there in person. It can be helpful to go into “project mode” and to be very practical by taking one step at a time. Your parent needs you to be practical for them to make the things happen which will keep them safe and provide the best possible future for them. They will also need your love and emotional support at a time when they may be very frightened about the future.
But this is a very emotional time too so make sure that you give yourself time to deal with your emotions so that you are able to give your parent the love and comfort they need.
Think the unthinkable: If the end has come it can be huge comfort and relief to a parent to know that you will do everything in your power to let them go with dignity and without pain. Some hospitals are better than others in supporting end of life care and helping people have a good death. This is not just for the person who is dying – knowing someone had a good death can be astonishingly important for those who grieve.
Don’t be afraid to ask difficult questions. Don’t necessarily expect definite answers to “How long do we have?” or “How will it happen?” but asking these questions should lead you and your parent’s medical team to open discussions about end of life care. Get an immediate referral to the Palliative/End of Life Care Team. It may be possible for your parent to have end of life care at home or at a local hospice. If these options are not available, it should be possible to have a side room where your parent can be quiet and private and have their family around them. If your parent is a person of faith there is likely to be a Chaplaincy member of their religion on call. Many hospitals also have a bereavement team to provide similar care for people who don’t want faith-based support.
At TimeFinders we understand that caring at a distance can cause great stress and anxiety and can have a detrimental impact on your career and your personal relationships. We know that planning ahead and putting a support network in place can allow you the peace of mind that you need to live your life at a distance from elderly and frail parents.
But we are also here for you in a crisis.