A caregiver gives care to someone who needs help taking care of themselves. The person who needs help may be a child, an adult, or an older adult. They may need help because of an injury or disability. Or they may have a chronic illness such as Alzheimer's disease or cancer.

Some caregivers are informal caregivers. They are usually family members or friends. Other caregivers are paid professionals. Caregivers may give care at home or in a hospital or other health care setting. Sometimes they are caregiving from a distance. The types of tasks that caregivers do may include:

• Helping with daily tasks like bathing, eating, or taking medicine
• Doing housework and cooking
• Running errands such as shopping for food and clothes
• Driving the person to appointments
• Providing company and emotional support
• Arranging activities and medical care
• Making health and financial decisions

Caregiving can be rewarding. It may help to strengthen connections to a loved one. You may feel fulfillment from helping someone else. But caregiving may also be stressful and sometimes even overwhelming. You may be "on call" for 24 hours a day. You may also be working outside the home and taking care of children. So you need to make sure that you are not ignoring your own needs. You have to take care of your own physical and mental health as well. Because when you feel better, you can take better care of your loved one. It will also be easier to focus on the rewards of caregiving.

Caring for a friend, parent, or other relative who lives far away? If you live an hour or more away, you’re a long-distance caregiver.

You may be arranging care or helping with bills and paperwork. You could be communicating with health care providers. And you’re probably an important source of emotional support for your friend or relative. Doing all this from afar can be challenging.

There are things you can do to make long-distance caregiving more manageable. Start by learning as much as you can about your loved one’s health and treatments. This can help you understand his or her health needs and anticipate those in the future.

Organize important paperwork. That way it’s all in one place and up to date. Also, make sure at least one caregiver has written permission to receive medical and financial information. If possible, one person should handle conversations with all health care providers.

Staying connected is vital. You may want to schedule calls with health care providers and facility staff to discuss the person’s well-being. Update trusted family members on your loved one’s health and needs.

You might also consider caregiving training. Some local chapters of the American Red Cross and other not-for-profit organizations offer caregiving courses.

Anyone, anywhere, can be a long-distance caregiver, no matter your gender, income, age, social status, or employment. If you are living an hour or more away from a person who needs your help, you’re probably a long-distance caregiver. Anyone who is caring for an aging friend, relative, or parent from afar can be considered a long-distance caregiver.

It is not always clear whether an aging parent or relative needs help. Sometimes a person will recognize that they need help and request it, or an emergency or sudden illness will make it clear. Others may not want to cause worry or admit they’re struggling.

If you become aware of the signs that a loved one needs help, you will be better prepared to provide support for their safety and well-being.

The best way to know what someone needs is to ask them directly. But a phone call, email, or text message is not always the best way to tell whether an older person needs help. These signs may indicate that someone needs extra support:

Changes at home. When you spend time at the person’s home, you might notice possible trouble spots. Some examples include:

• Can the person prepare meals on a stove safely?
• Are they bathing regularly and wearing appropriate clothing for the weather?
• Is the home relatively clean and free of clutter?
• Do they have the medications they need, and are they taking them regularly?

Mental health concerns. Changes in a person’s mood could indicate a need for help. Sometimes depression in older people is confused with normal aging. An older person with depression might brighten up for a phone call or short visit, but it’s harder to hide serious mood problems during an extended visit. Seek immediate help if the person says they feel hopeless or have no reason to live, or if you’re worried they may harm themselves. Call or text the 24-hour 988 Suicide & Crisis Lifeline at 988or call800-273-TALK (800-273-8255). For TTY, use your preferred relay serviceor dial 711 then 988.

Other health concerns. Signs related to the person’s general health that can raise concerns include:

• Significant weight gain or weight loss
• Poor hygiene
• Confusion
• Falls
• Loneliness or social isolation
• Trouble walking or getting around

Memory issues. Occasional forgetfulness is a normal part of aging. But more significant memory problems, changes in thinking ability or personality, or poor decision-making could indicate a serious condition that requires medical attention.

Recognizing changes if you live far away

If you don’t live close to an older family member or see them often, it may be difficult to notice if the person needs help.

With the person’s permission, you could contact people who see them regularly — neighbors, friends, doctors, or local relatives, for example — and ask them to call you with any concerns. You might also ask if you can check in periodically.

It may be difficult to notice differences in behavior when you don't live close to a family member. A family member may withdraw from activities, forget to take medication, or stop taking care of themselves or their home. These signs may seem small, but they are crucial for an aging parent or relative's safety and well-being. With the person's permission, you could contact people who see the person regularly—neighbors, friends, doctors, or local relatives, for example—and ask them to call you with any concerns. You might also ask if you can check in with them periodically. Look for safety issues and at the overall condition of the home, and try to determine the older person's mood and general health status. Sometimes people confuse depression in older people with normal aging. A depressed older person might brighten up for a phone call or short visit, but it is harder to hide serious mood problems during an extended visit.

When you notice signs that your aging parent or relative needs help, it is important to know what steps to take next. Some issues have a simple fix, like needing a new glasses prescription. But other times, you may need to provide more support.

Your first step may be to talk to the older person about your concerns. Mention your worry without sounding critical, such as, “Mom, it looks like you don’t have much food in the house. Are you having trouble getting to the store?”

Then try to fulfill the person’s wishes to the extent possible. For example, if they want to keep cooking at home, you could ask, “Would you like me to arrange to have groceries delivered on a regular basis?” Try to include practical help with your suggestions and give specific examples of what can be done.

If you’re concerned about the person’s physical or mental health, suggest a visit to a health care provider. You might offer to make the appointment, give them a ride, or go with them to see the doctor.

You don’t have to do everything yourself. In many communities, a variety of services are available to help older people. Depending on the person’s needs, you might hire a home health aide to visit on a regular basis, arrange transportation so the person can run errands, or speak with a geriatric care manager to help coordinate care. You can also find ways to share caregiving responsibilities with other family members, neighbors, or friends.

Long-distance caregivers take on different roles. From a distance, you may be able to:

• Assist with finances, money management, insurance claims, or paying bills
• Arrange for care management or in-home care by hiring formal caregivers such as home health aides
• Order medical equipment, medicines, and other supplies the person needs
• Serve as an information coordinator by researching information about relevant health conditions and medicines, navigating changing needs, and overseeing insurance benefits
• Help with advance care planning, such as choosing a health care proxy and preparing a living will
• Help find, organize, and update important paperwork and records
• Research long-term care options, such as an assisted living facility or nursing home

You will probably be coordinating these tasks with family, friends, or other caregivers who live nearby.

When you don’t live close by, it may take more effort to find out what’s going on and stay up to date with an older person’s needs. Here are some strategies and technologies that long-distance caregivers can use to stay connected:

• Create a list of important phone numbers and email addresses. Keep it in a shared document or spreadsheet online and update it regularly.
• Set up a shared calendar online or in a smartphone app to coordinate with other caregivers.
• With permission, attend the person’s telehealth visits. Telehealth visits are remote appointments with health care providers often done with videoconferencing.
• Participate remotely in conference calls or video meetings with the assisted living facility team or nursing home staff.
• Help the older person learn about the features of their mobile or smart phone, such as texting and video calls.
• If the older person is comfortable using a computer or tablet, set up an email account for them and teach them how to stay safe online.

Talk to the person ahead of time and find out what they would like to do during your visit. Also check with the primary caregiver, if appropriate, to learn what they need. You may be able to handle some of their caregiving responsibilities while you are in town. These conversations can help you set clear-cut and realistic goals for the visit. Decide on your top priorities — that may mean reserving other tasks for a future visit.

Because there’s a lot to do during a short visit, it’s easy to overlook simply spending time with the person and doing things together. Try to make time for activities unrelated to being a caregiver, such as watching a movie, playing a game, enjoying music, or taking a drive. Finding time to enjoy something simple and relaxing together is good for everyone.

In many cases, one person takes on most of the everyday responsibilities of caring for an older person. It tends to be a spouse or the child or sibling who lives closest. If you are not the primary caregiver, you can still play an important role in supporting that person.

Here are some ways you can help, even if you don’t live nearby:

• Ask what you can do that would be most helpful.
• Stay in regular contact with the primary caregiver by phone or email. Just listening may not sound like much, but it can mean a lot.
• Travel to stay with the older person for a few days so the primary caregiver can take a vacation or just have some time off.
• Arrange for regular respite care in the form of a volunteer, an in-home aide, or an adult day care program.

In time, the older person may have to move to a residential (live-in) facility, such as assisted living or a nursing home. If that happens, the primary caregiver will need your support. You can work together to select a facility and coordinate the move. The primary caregiver may need extra support while adjusting to the person’s absence and to living alone at home.

To get started:

• Ask the primary caregiver, if there is one, and the care recipient how you can be most helpful
• Talk to friends who are caregivers to see if they have suggestions about ways to help
• Find out more about local resources that might be useful
• Develop a good understanding of the person’s health issues and other needs
• Visit as often as you can; not only might you notice something that needs to be done and can be taken care of from a distance, but you can also relieve a primary caregiver for a short time

Many of us don’t automatically have a lot of caregiver skills. Information about training opportunities is available. Some local chapters of the American Red Cross might offer courses, as do some nonprofit organizations focused on caregiving. Medicare and Medicaid will sometimes pay for this training. See Where can I find local resources for my family member? to find local services for older adults and their families.

Experienced caregivers recommend that you learn as much as you can about your family member or friend's illness, medicines, and resources that might be available. Information can help you understand what is going on, anticipate the course of an illness, prevent crises, and assist in healthcare management. It can also make talking with the doctor easier. Make sure at least one family member has written permission to receive medical and financial information. To the extent possible, one family member should handle conversations with all health care providers.

Try putting all the vital information in one place—perhaps in a notebook or in a shared, secure online document. This includes all the important information about medical care, social services, contact numbers, financial issues, and so on. Make copies for other caregivers, and keep the information up to date.

When visiting your loved one, you may feel that there is just too much to do in the time that you have. You can get more done and feel less stressed by talking to your family member or friend ahead of time and finding out what he or she would like to do. Also, check with the primary caregiver, if appropriate, to learn what he or she needs, such as handling some caregiving responsibilities while you are in town. This may help you set clear-cut and realistic goals for the visit. For instance, does your mother need to get some new winter clothes or visit another family member? Could your father use help fixing things around the house? Would you like to talk to your mother's physician? Decide on the priorities and leave other tasks for another visit.

Try to make time to do things unrelated to being a caregiver. Maybe you could find a movie to watch with your relative, or plan a visit with old friends or other family members. Perhaps they would like to attend worship services. Offer to play a game of cards or a board game. Take a drive, or go to the library together. Finding a little bit of time to do something simple and relaxing can help everyone, and it builds more family memories. And keep in mind that your friend or relative is the focus of your trip—try to let outside distractions wait until you are home again.

Many families schedule conference calls with doctors, the assisted living facility team, or nursing home staff so several relatives can participate in one conversation and get up-to-date information about a relative's health and progress. If your family member is in a nursing home, you can request occasional teleconferences with the facility's staff. Sometimes a social worker is good to talk to for updates as well as for help in making decisions. You might also talk with a family member or friend in the community who can provide a realistic view of what is going on. In some cases, this will be your other parent. Don't underestimate the value of a phone and email contact list. It is a simple way to keep everyone updated on your parents' needs.

For one family, having a private phone line installed in their father's nursing home room allowed him to stay in touch. For another family, giving Grandma a cell phone (and then teaching her how to use it) gave everyone some peace of mind. These simple strategies can be a lifeline. But be prepared—you may find you are inundated with calls or text messages. It's good to think in advance about a workable approach for coping with numerous calls.

Organizing paperwork is one way that a long-distance caregiver can be a big help. An important part of effective caregiving depends on keeping a great deal of information in order and up to date. Often, long-distance caregivers will need access to a parent’s or relative's personal, health, financial, and legal records.

Getting all this material together is a lot of work at first, and from far away it can seem even more challenging. But once you have gathered everything together, many other caregiving tasks will be easier. Maintaining current information about your parent’s health and medical care, as well as finances, home ownership, and other legal issues, lets you get a handle on what is going on and allows you to respond more quickly if there is a crisis.

As you're getting started, try to focus on gathering the essentials first, and fill in the blanks as you go along. Talk with the older person and the primary caregiver about any missing information or documentation and how you might help to organize the records. It is also a good idea to make sure that all financial matters, including wills and life insurance policies, are in order. It will also help if someone has a durable power of attorney (the legal document naming one person to handle financial and property issues for another).

Your family member or friend may be reluctant to share personal information with you. Explain that you are not trying to invade their privacy or take over their personal lives—you are only trying to assemble what will be needed in the event of an emergency. Assure them that you will respect their privacy, and then keep your promise. If they are still uncomfortable, ask if they would be willing to work with an attorney (some lawyers specialize in elder affairs) or perhaps with another trusted family member or friend.

Whether you are the primary caregiver or a long-distance caregiver, getting some caregiving training can be helpful. As with a lot of things in life, many of us don't automatically have a lot of caregiver skills. For example, training can teach you how to safely move someone from a bed to a chair, how to help someone bathe, and how to prevent and treat bed sores, as well as basic first aid. Information about training opportunities is available online. Some local chapters of the American Red Cross might offer courses, as do some nonprofit organizations focused on caregiving. Medicare and Medicaid will sometimes pay for this training.

Learn as much as you can about your family member’s condition and any treatment. This can help you understand what is going on, anticipate the course of an illness, prevent crises, and assist in healthcare management. It can also make talking with the doctor easier.

Get written permission, as needed under the HIPAA Privacy Rule, to receive medical and financial information. To the extent possible, the family member with permission should be the one to talk with all healthcare providers. Try putting together a notebook, on paper or online, that includes all the vital information about medical care, social services, contact numbers, financial issues, and so on. Make copies for other caregivers, and keep it up-to-date.

From a distance, it can be hard to assess the quality of your family member’s caregivers. Ideally, if there is a primary caregiver on the scene, he or she can keep tabs on how things are going.

Perhaps you have already identified friends or neighbors who can stop in unannounced to be your eyes and ears. Sometimes, a geriatric care manager can help.

You can stay in touch with your family member by phone and take note of any comments or mood changes that might indicate neglect or mistreatment. These can happen in any setting, at any socioeconomic level. Abuse can take many forms, including domestic violence, emotional abuse, financial abuse, theft, and neglect.

Sometimes the abuser is a hired caregiver, but he or she can also be someone familiar. Stress can take a toll when adult children are caring for aging parents, or when an older person is caring for an aging spouse or sibling. In some families, abuse continues a long-standing family pattern. In others, the older adult’s need for constant care can cause a caregiver to lash out verbally or physically. In some cases, especially in the middle to late stages of Alzheimer’s disease, the older adult may become difficult to manage and physically aggressive, causing harm to the caregiver. This might cause a caregiver to respond angrily.

But no matter who is the abuser or what is the cause, abuse and neglect are never acceptable responses. If you feel that your family member is in physical danger, contact the authorities right away. If you suspect abuse, but do not feel there is an immediate risk, talk to someone who can act on your behalf: your parent’s doctor, for instance, or your contact at a home health agency. Suspected abuse must be reported to adult protective services.

Many older adults find it helpful when a family member or friend goes with them to the doctor's office. In some cases, all the person needs is a ride, and you can wait in the lobby. Other times, the person may want or need you to talk to the doctor with them. This article provides tips that will help you be an ally and an advocate when you accompany someone to a medical appointment.

Talking with health care providers

First, you will need to make sure that the person’s health care providers have permission to speak with you. There are federal and state laws that protect a person’s private medical information. If the person would like their health care providers to share information with you, here’s what you can do:

• If you go with the person to an appointment, they can tell the doctor verbally that they agree to have you there. The person can also tell the health care provider that it’s okay to share information with you later.
• If you want to access a person’s medical records or speak with a provider when the person isn’t there, you will need to get legal permission.
• Most doctor’s offices and hospitals have a consent form (sometimes called a HIPAA release or a HIPAA waiver) to specify who can have access to a person’s private medical information. Ask the older person to provide your name and contact information on this form at each provider’s office.
• In some cases, it might make sense to get a medical power of attorney. This will enable you to access information and make health care decisions on the person’s behalf. Make sure all the person’s health care providers have a copy of the legal document.

How to prepare for a doctor’s visit

Gather important information beforehand and take it with you to the appointment:

• Take the person’s insurance cards, names and phone numbers of other doctors they see, and their medical records if the doctor doesn’t already have them. You may want to ask the doctor to send you all the forms the person will need to complete for their visit.
• Bring a list with the names, dosage, and schedule of all medicines, vitamins, herbal remedies, over-the-counter drugs, and dietary supplements the older adult is taking. Don’t forget to include those prescribed by other doctors.
• Make sure the person remembers to take their eyeglasses or contact lenses to the doctor’s visit. If they have a hearing aid, make sure that it is working well and they’re wearing it. Tell the person to let the doctor and staff know if they have a hard time seeing or hearing.
• Make a list of any questions or concerns that the older adult or other caregivers would like to bring up with the doctor.

If the doctor doesn’t speak the person’s language, ask the office staff to provide an interpreter. Call the doctor’s office ahead of time because they may need to plan for an interpreter from the same area or country to be available. Ensuring that the older adult can easily understand and talk with the interpreter is important for getting good care.

What to do during a doctor’s visit

Here are several ways you could be helpful during the appointment:

• Bring your list of questions, starting with the most important ones, and take notes on what the doctor recommends. Writing things down will help both you and the older person remember what the doctor said, and you can share the information with other caregivers later.
• When the doctor asks a question, let the older adult answer unless you have been asked to do so.
• It’s easy to get into a two-way conversation between you and the doctor — try not to do this. Always include the person you care for when you talk with the doctor.
• Respect the person’s privacy and leave the room when requested. The person may want a chance to ask questions or discuss sensitive topics privately with their doctor. Read more about talking with your doctor about sensitive issues.

What to do after a doctor’s visit

There are many ways to follow up after the appointment. For example:

• If you live out of town, talk to the doctor about how you can keep up to date on the older adult’s health. With the person’s permission, it might be helpful to get access to their electronic health records.
• Ask the doctor for written materials to take home and see if they can recommend community resources, if needed.
• Find help and support. Larger medical practices, hospitals, and nursing homes often have a social worker on staff who may have valuable suggestions about online or community services.

Try to find people who live near your loved one and can provide a realistic view of what is going on. This may be your other parent. A social worker may be able to provide updates and help with making decisions. Many families schedule conference calls with doctors, the assisted living facility team, or nursing home staff so that several relatives can be in one conversation and get the same up-to-date information about health and progress.

Don’t underestimate the value of a phone and email contact list. It is a simple way to keep everyone updated on your parents’ needs.

You may also want to give the person you care for a cell phone (and make sure he or she knows how to use it). Or, if your family member lives in a nursing home, consider having a private phone line installed in his or her room. Program telephone numbers of doctors, friends, family members, and yourself into the phone, and perhaps provide a list of the speed-dial numbers to keep with the phone. Such simple strategies can be a lifeline. But try to be prepared should you find yourself inundated with calls from your parent.