Arranging care for a parent you do not live near

Why this comes up

Say your father lives in Woodbury and you live several states away. You get the reports secondhand, from him and from a neighbor who is kind, with no training, and the two accounts do not match. You come for four days, fix what you can see, and fly home knowing you have handled only part of it.

If you feel behind on this, you have not missed an obvious step. There is no form you were supposed to have filed last spring. Nothing about the way care gets arranged in this country assumes the person arranging it lives somewhere else, so you are doing a job the system does not expect anyone to do, mostly by phone on weekends.

What you can do from far away

The National Institute on Aging says distance does not disqualify you: "If you don't live nearby, you can still provide support and assistance as a long-distance caregiver." Its page on what long-distance caregiving is lists what that looks like in practice, including to "assist with finances, money management, insurance claims, or paying bills" and to "order medical equipment, medicines, and other supplies the person needs," along with hiring in-home help, organizing records, acting as the information coordinator, and researching long-term care options. The page says these jobs get coordinated with people who are nearby.

Some of it has to be done by someone who is physically there, and that person has to be in Minnesota. You can do the rest from where you are: the calls, the paperwork, the records, and the research. No one counts how many people are doing this, so there is no benchmark. Check instead whether someone nearby is handling each thing your father needs, which takes a few phone calls.

Set up the information so you are not guessing

Most of the worry comes from finding things out late. You find out about the fall on Tuesday and it happened Saturday.

Write down, in one place you can reach from your phone, his medication list with doses, his clinic and pharmacy, his insurance details and plan type, the name of anyone who has a key, and who to call first. Get a release signed at the clinic so a nurse is allowed to talk to you. Without one, they will not tell you anything, including on the weekend night when you are the only person calling. The release is usually a short form the clinic keeps at the front desk, and your father can sign it on your next visit.

Ask whoever provides care how you will hear about things, and get specific about it. A way to check in without waiting for a call back matters more to you than it would to a daughter who lives ten minutes away; Abloom Senior Living's family portal page describes what it shares with families. Whatever agency you use, ask before you sign who calls you, when, and what counts as worth a call. Ask what the answer is on a weekend night as well. Asking commits you to nothing, and if they cannot answer on the phone, call someone else.

Who is nearby

The people worth lining up are a neighbor who will walk over, a sibling or cousin in the metro, the clinic, and a paid caregiver on a schedule.

If you have siblings in Minnesota, say out loud early who is doing what. The conversation is uncomfortable to start, and it is harder once one sibling has been doing most of the work for two years. When caregiving falls to one sibling covers how that goes wrong and what tends to fix it. You can carry the bills, the insurance calls, and the appointment scheduling from anywhere.

For paid help, getting started describes how a first visit and assessment usually run, and the service area page lists which East Metro communities are covered. When you are comparing agencies by phone from another state, questions to ask a home care provider is the list to work from. Pay particular attention to how fast they respond when something changes, and ask them to put that answer in the service plan. Abloom Senior Living promises same-day answers, and every agency you call should promise a response time that specific.

You will not get through all of this on one trip, and you do not need to. When you are next in town, spend part of it on the things that only work in person. Meet whoever provides the care, in the house, and stay through part of a shift instead of talking in the kitchen for ten minutes. Walk the bathroom, the stairs, and the route to the car. Introduce yourself to the neighbor you are counting on and trade phone numbers with her. Photograph the medication bottles and the insurance cards so you have them on your phone when somebody asks you a question from two time zones away.

Who signs things when you are not there

Minnesota law lets your father name you in writing as the person the agency has to include. Under Minn. Stat. 144A.4791, a comprehensive home care provider has to finalize a written service plan within 14 days of starting services, and that plan has to be signed off by the provider and by the client or the client's representative. The same statute requires the plan to be reviewed again at intervals that cannot exceed 90 days, and the home care bill of rights at Minn. Stat. 144A.44 gives your father the right to assert his rights personally or to have them asserted by his representative, without retaliation.

So if your father wants you in that role, say so in writing at the start, get a copy of the signed service plan, and put the 90-day review on your own calendar. Once your father has named you in writing, the agency has to include you in the plan it is required to produce and in the reviews that follow.

Two other documents matter: a durable power of attorney and a health care directive. Those get written with an attorney, and they decide who can speak for your father if he cannot speak for himself. There is no comfortable time for the conversation, and waiting until your father is in the hospital makes it worse. There is no rush to do it this month, though it has to be done while he can still sign.

Free help in Minnesota

The Minnesota Board on Aging funds caregiver consultation, which it describes as "a personalized, goal-oriented service" delivered one to one by a trained Caregiver Consultant. The board's page on family, friends and neighbors caregiving says that "other services are available to people caregiving in Minnesota including respite, training and education and more," that "certain eligibility requirements may apply, and availability varies from community to community," and that "generally, this service is offered free or at low cost." The way in is Minnesota Aging Pathways at 800-333-2433, which can find a Caregiver Consultant in your father's area.

Call that number yourself rather than asking your father to do it. A consultant who knows Washington County can tell you in one conversation what exists near him, and free help for East Metro families arranging care describes what else that service covers. If what you need is respite, meaning a stretch of time when someone else is on duty so the regular caregiver can stop, start with the state and the county. A home care agency staffs regular scheduled hours, which is a different service from respite. A consultant can tell you which of the two you are looking for, and that is a fair question to ask before you have decided anything.

What to do with the guilt

Most people in this position feel they should move home, and most cannot, for reasons that are about jobs and children and money. Your arrangement has three parts that can keep a parent at home: paid hours, help from people nearby, and you on the phone.

Whether you move, or whether he does, is a fair question, and it can wait a year. For now, work out who can get there within twenty minutes when something happens.

Where to start

If your father lives in Woodbury or the East Metro and you want to work out what regular hours would look like, you can request in-home care from wherever you are and describe the situation in the form. Someone will visit the house and walk through it with your father, and you can be on the phone for that conversation. You can call just to ask what a week of regular hours would involve, without being ready to start anything. Abloom Senior Living may not be the right fit for your family, and if that is how it turns out, you will be told so and pointed toward someone better suited.

This article is general information from a care provider in Woodbury, Minnesota. It is not legal, financial, or medical advice. Powers of attorney, health care directives, and program eligibility all turn on specifics, so check anything here with an attorney, your father's clinic, and the plan or program involved.

Frequently asked questions

Can I arrange home care for a parent in Minnesota if I live in another state?

Yes. You can research agencies, make the calls, and handle the paperwork and the bills from anywhere. The assessment visit happens at your parent's house, and you can join by phone. If your parent wants you to act as his representative, say that at the start so the agency has it on record.

What does the agency have to give me in writing?

Under Minnesota law a comprehensive home care provider must finalize a written service plan within 14 days of starting services, authenticated by the provider and by the client or the client's representative, and must review it at least every 90 days. Ask for your own copy of the plan each time it changes.

How do I find out what help exists in my parent's community?

Minnesota Aging Pathways at 800-333-2433 is the statewide service for that, and the Minnesota Board on Aging also funds one-to-one caregiver consultation, which it says is generally free or low cost, with eligibility and availability varying by community.

What should I ask an agency that I cannot visit in person?

Ask who calls you and when, what their response time is for a change in condition, how overnight hours are staffed, what happens when a scheduled caregiver cannot come, and whether they will put the answers in the service plan. Any agency worth hiring will answer all five without being pushed.

Related reading

• Caregiver burnout, and what actually changes it
• Working full time while caring for a parent in Minnesota
• How to choose a home care agency in Minnesota

Sources

• National Institute on Aging, What Is Long-Distance Caregiving?
• Minnesota Board on Aging, Family, friends and neighbors caregiving
• Minnesota Office of the Revisor of Statutes, Minn. Stat. 144A.4791
• Minnesota Office of the Revisor of Statutes, Minn. Stat. 144A.44, home care bill of rights