Planning for the "in case" - how do you manage when 200 miles away ?

[BookWorm45]

Hoping some kind MNer will have some experience or wisdom to share on this...

Visiting elderly FIL at xmas - he is mid 80s and has a bunch of health problems, including difficulty with walking (quite unsteady at times). He has one of those emergency call pendant / necklace things but doesn't wear it very much (only occasionally when at the far end of the garden, not when in the house). He is in a 1930s bungalow, which has some large doorsills / steps / floor height changes in it due to a previous owner's renovations. FIL lives ~ 200 miles away. DP is the only direct relative in this country (DP's sister lives in California so in practical terms no good for any immediate emergencies).

DP is trying to think ahead so that if there is a sudden emergency, we have some awareness of what might be possible. The most likely concern we have been thinking about is a trip / fall / breaking hip etc.

DP's job means it isn't possible to take holiday during certain times of the year (though there is emergency leave, this is normally expected to be only for a couple of days or so).

How have people managed in similar situations if they've had to respond to concerns (imagine elderly parent breaks their hip, post-surgery they need someone around for a few weeks).

Do people typically take unpaid leave for a few weeks so as to have time off (even though a hit to monthly income which is another factor) ?

Or do people liaise with care agencies so as to provide care during the working week, and then visit at weekends ?

Are there any options for nursing homes which will take people on a shorter term basis such as 3 /4 weeks ?

(We are separately having a conversation about what are the best long term options, the query above is really about how people cope in emergency / urgent situations).

Thank you for any thoughts you have !

@EmmaAgain22 mine has some local friends who will run around and help out with lifts, hospital visiting and shopping. She doesn't like 'putting them out' but equally she chose to live near the friends when she moved rather than near me or DB. She's also given them a fair amount of help in the past (including having one of them to stay with her for a fortnight after an operation - friend's operation, not DM's!) so it feels reciprocal.

At the end of the day there are often good reasons why we don't live near our parents - mine is because there were no jobs locally so I had to relocate for work. I have to live in a certain place because of work, and now I have DD and DH they are settled in the area too.

My mum is only 63 but has a health condition that means she might need more. Operations and care in the future. She used to live 300 miles away, but has recently moved to be near to us. She’s now just a 10 minute drive. I know this might sound extreme but she had covid before the vaccines and was very poorly. It really frightened her that we were all far away. My brother was 200 miles away. She had good friends who help drop off shopping etc but it’s not the same as close family. We were really scared too and felt pretty helpless. After that she decided to move to be nearer to us. I know your relative is now very elderly, but could moving closer to you, into assisted living, be a possibility? Sorry if you’ve already said and I’ve missed it.

Oh I know - it's not me saying anything about the distance?

As a neighbour to an elderly couple Im more than happy to keep an eye out for them, as long as it doesnt become a situation where they are entirely reliant on us. We've been neighbours for a long time and they have in the past felt like surrogate grandparents to our dc. It feels natural and right that we should be on hand for them now as a friendly face to drop in on them. I think their adult dc worry about boundaries sometimes and I can understand that, it is a valid concern that Im aware of.

Don't worry, I was answering your question about what to do in an emergency.

We've had two in the last few months and no family member went. She got herself into A and E, then local friends dealt with anything. Realistically we couldn't have done anything they couldn't.

If there's really nobody other than neighbours then presumably the person has to either move into some kind of supported living and/or closer to you or you have to move closer to them?

Yes, it's a bit like that with mum. I love that they feel like family but I suppose I worry that one day it will get too much.

they always tell me not to worry and they are happy to do anything but I am really hoping they don't have to, and that my second attempt at moving will actually work.

the reason I'm seeking an emergency stand in is so they don't have to sit with her for a few hours if she is ill, but paid care in an emergency situation doesn't appear to exist.

Riding I was at the cinema when mum pressed her button (suspected heart attack, now thought to be afib).

so between the time for me to get the neighbours call, and actually arriving there, was about 5 hours. They weren't allowed to go with her in the ambulance as it was during Covid but I felt terrible they had to deal with it at all.

they kept on at me for updates till 1am and were very tearful because they thought she was dying, poor loves. That's when they kept telling me "she is family to us" bless them.

i'd be happy to pay an agency fee monthly or whatever, to supply someone to sit with her when she has a funny turn, till I can get there.

but paid care in an emergency situation doesn't appear to exist.

It does in some areas @EmmaAgain22 - I work in this exact area myself, it's what I do.

That's interesting @DenholmElliot11 - could you tell us what would be the right thing to search on if looking for a local set of people that can provide paid care in an emergency ? Is this the sort of thing that carers agencies do or is there anything specific / different that I should be looking into ?

Technology can be really helpful- ring doorbells, blink cameras in house that you can communicate through. Key box outside the house and if possible a few local people who know the number. A care assessment by council.

Would you mind if I sent a PM?

@BookWorm45 if I'm honest I'm glad you posted this. I am in a very similar situation although parents are younger. We have POA for health and money, and they have advanced directives and wills. I have passwords and know the pin to the key safe but its getting there in an emergency that concerns me and they refuse to move back.

I'm aware of a charity that provides lots of different services to the local (older) community. They have found a certain group of clients are those whose loved ones are very far away.

It's called LifeCare Edinburgh perhaps there's something similar near you?

Befriending might be something that builds a relationship regularly and they might be willing to be an emergency contact?

Some areas have a falls service for instance, which will respond to fallen elderly people and help them up. Might be worth talking to something like Age U.K. as they should be able to signpost to suitable care? Some kind of sheltered housing with a warden on site would be worth looking into too?

I have just had to accept that I can't get there quickly - it's a minimum of 3 hours. Last time she ended up in resus I was travelling for work so would have been about 8 hours if I'd gone.

So pleased I began this thread as it's been very helpful for me. I've summarised the suggestions (for my own benefit) and posted below in case useful to anyone else.

Immediate response stuff:

1. Advising (again !) that FIL must wear the emergency button all the time (he doesn’t really use a mobile, although he has one, but it’s usually not charged);
2. There is already a keysafe fitted to the house but I realise that FIL hasn’t shared the code with us (the cleaner knows it though) so we need to find that out
3. Check our spare key works (we do have one but I suspect the lock may have been changed after the original door handle broke)
4. Investigate paid care in an emergency as per PP’s mention of this
5. Re jobs and time off - check in contract / discuss with management about the “what if” for DP, if an emergency occurred during one of the times in the year when he isn’t allowed holiday. I’m assuming this would mean unpaid leave and deductions from the following month’s salary and that there might be a cap on maximum number of days permitted.

Longer term stuff:
6) Looking up nursing homes that would offer post-op or short term care, so we have some awareness of where these are and what they cost;
7) Encouraging FIL to use the “big clear plastic box” approach, he does have POA set up but all the other papers are who knows where……
8) Age Concern – look up what options they might be able to tell us about local to FIL
9) Start the conversation with FIL about arranging for adult social services needs assessment, I think grab rails / walking aids would be useful
10) Start the conversation about having a daily carer for an hour as a PP said
11) Find out if FIL is using the electronic prescription arrangements so that current prescriptions are easily known about and information can be accessed
12) Investigate whether there is anything that can be done about the raised doorsills / different levels in the property so as to make it easier to walk (not sure if ramps would fit in the available space)
13) Look up the Richard Osman books about retirement living
14) See whether FIL would agree to look at sheltered living options … ( I expect the answer would be no)
15) There are some friends / neighbours local to FIL (though all are also quite elderly), we have the name / number of neighbour next door and probably need to get the details of some others including weekly cleaner.

That's a good list!

Do they have a burglar alarm or similar? We found, as well as only giving spare keys to two people 200 miles away in opposite directions, DM hadn't told anyone how to turn off the burglar alarm...

It’s a good list! I would add that it’s best to be prepared for things to change quickly & that measures you put in place & that work well, can suddenly not be enough (especially if they start to have memory problems).

My mother is quite active still for her age but I do worry about falls as she is not great with stairs/steps. She was due to visit for NY with one of my siblings but that sibling is now ill & I am fretting about airplane steps…

Good list 😊

Remember that you can set up Alexas around the house so that they can call for help and Alexa will dial an emergency contact number eg yours. That means they don’t have to be wearing their alarm (although much better if they do, obviously)

Incidentally the needs assessment isn't something your FIL needs to be involved in - I did it over the phone from my house so it's not remotely intrusive.

We suggested to her some years ago when FIL died that she could move to our town (we’re the only family she has in this UK country) but she refused
Same here ....my suggestions that the parent move closer to me were angrily shot down.
So here we are, them 300 miles away, me the only family a non driver with problems of my own that prevent me from travelling.
My highly intelligent careful strategic parent .....appears to have no plan at all🤷

Sooth in that situation, you can't be expected to do anything much really.

Pp mentioning carers available for emergencies - I have searched high and low online at least, and asked someone in the area who is a carer.

It really doesn't seem to be a service that exists in the area. The Edinburgh link looks like day care, not emergency care?

Thanks Emma I know, but it's still a very uncomfortable feeling, I suspect the real 'plan' was that they feel I am obligated and they have intentionally done nothing thinking that will force me to step in.
I will have to muddle through providing some sort of telephone support 🤷

YY to the ‘no plan’ - except to rely on neighbours, and family travelling long distances on top of their very busy lives. In our case, MIL’s independence is facilitated by others, rather than herself.

I’m terrified of this. My parents seem less capable each time I visit. My dad would be fine on his own but if something happened to my mum she’d not have a bloody clue how to live independently. I have tried to get them to think about a bungalow or something easier to manage but they won’t. I have small children who will have to be my priority and we’ve both got full on jobs. I just am dreading some form of crisis situation. If my dad died my mum would have to move. I don’t think there would be much point going for a flat/bungalow plus carers as suspect assisted living would be more appropriate. I’ve been doing research on the sly but then feel very disloyal doing that.

As someone in their 70s, I sit in the middle. I have experienced the drain of “supporting someone to live independently “. On the other hand, the words “she will be safe” strike me with terror. Safe for what? To spend years in a slow decline through dementia, having my freedoms taken away one by one? Being alive is not necessarily “better than the alternative “.

She had good friends who help drop off shopping etc but it’s not the same as close family. Family will take care of shopping and finances, but will not provide companionship. Moving an elderly person close to you, so that you are there if needed, is going to be a considerable downturn in their life if it mans leaving a network of friends behind.