An in-person visit is a precious opportunity to connect with your loved one. We never know how much time we have left with the ones we love; this could be the last time you see them! So do what you need to do to handle home and work issues before you leave. Arrange the kids’ schedules, forward your work phone and email, and do whatever else is required to give you the freedom to focus your attention on your loved one.
Try to schedule appointments with some of your loved one’s professional advisors to stay updated and to establish relationships of trust. This includes your loved one’s doctors, attorney, banker, financial advisor, CPA, insurance advisor, or other professionals. Before your visit, plan some time to call these professionals and decide which ones to meet with on this visit. Some advisors may have changes in personnel so you will want to meet the new people. Others may have matters they want to discuss. If nothing else, your phone call will put your loved one back on the ”radar screen” of these professionals.
We will discuss this further in the section: “During Your Visit.”
Before you arrive for your visit, ask your loved one what they would like you to do when you visit. They may just want to sit and talk with you, or they may have a long list of chores and projects.
Also ask your local caregiving team what they need from you. If your local caregiver is a family member, they may want to leave town the minute you arrive and turn the caregiving responsibilities over to you so they can have a break! If that’s the case, helping them do so will be one of the most important ways you can support them! Ask them to show you the routine and fill you in on the details – Mom needs you to lay out her clothes in the morning; Dad’s doctor appointment is at 10:00 on Tuesday. Your professional caregiving team may tell you that Dad needs new shoes or there are some papers that need to be signed.
No matter the issue, your local team will appreciate you asking. In the long distance caregiving world, there is a tendency for the long distance caregiver to become the “favorite” and the local caregivers to become the scapegoats. Even if this is not caused by anything you have said or done, it can still be the source resentment and can bring up old family rivalries. If you encounter this problem, be sure your local caregiver knows how much you appreciate their contribution and sacrifices, and let them be the expert in the local caregiving situation.
Sometimes the care receiver can resent the long distance caregiver for “moving away” and not being involved on a day to day basis. Perhaps your loved one was a local caregiver for their parents or in-laws at great personal cost and doesn’t understand why you aren’t doing the same for them. If this is the case, they may try to make things difficult for you. If that happens, try not to get defensive. Remember that your time with them is probably limited and you want to make the most of it. This might be an opportunity to learn about portions of your loved one’s life that you don’t know much about.
Before your visit, pick up a package of blank thank you note cards and a book of stamps. Tuck these in your luggage – you will need them on your trip back. (See the “After Your Visit” section below.)
As we all get older, we have the opportunity to relate to our loved ones differently. Perhaps there were old hurts or disappointments that can now be set aside. I’ve often been with adult children just after the loss of one of their elderly parents. Even if that parent was difficult, they were still a parent and there is still the wish for reconciliation and understanding. It may not be effective to hash out old history during a visit, but you can try to set aside the past and connect with the living, fallible person that sits in front of you now.
As professional care managers we have known so many older adults and came to love them dearly. Pretty much all of them rankled their family at some point and vice versa. I feel like we, as new people on the scene, without all the history, have an almost unfair opportunity to get to know them just as fascinating people. I wish all caregivers could look at their loved ones through new eyes and spend their last years together in a state of grace.
One way to try this is to ask your loved one about part of their lives you may not know about – what was their first job? Who was their first kiss? How did they get along with their parents? What are all the places they lived? Which place was their favorite? What did they think they would become when they grew up?
Or you can ask about what they have learned through their life. What perspectives changed? What would they tell their younger selves if they could?
The key is to be curious. Being curious requires that we set aside judgement or resentment. We just want to know who this person is and come to appreciate them.
I had a beloved client – a teeny but mighty 94-year-old who lit up every room she entered – who managed to have a really good relationship with her family. I asked her: “what’s your secret?” She said without hesitating: “Don’t expect anyone to change, and emphasize the positive.” Words of wisdom that I will never forget, and which I offer to you now.
When you visit your loved one, be in their world. Accompany them in their routine. Have meals with them in their normal places. Go with them to worship services. Attend social gatherings and meet their friends. Find out what television programs they are watching and what books they are reading. This will help you learn about what brings them comfort and who might want to be included in your informal care team for your loved one.
With our care management clients, we often identify a “safety net” of people who know our clients well and can keep an eye on them – the hairdresser, the receptionist at the senior living community, the maintenance man, the pastor.
If your local caregiver feels they have been saddled with most of the work and is resentful, they may make a point of dumping the caregiving responsibilities on you as a way to show you what they deal with every day. If this happens, I suggest you just roll with it, and take it as an opportunity to get a good understanding of what that local caregiver really does experience! If you have handled your work and home responsibilities before you left for the visit, ideally you will have the time and energy to invest for this limited period.
A visit is an important opportunity to look for changes that could indicate a decline in health or ability. Take special note of:
If you notice these problems or other troubling signs, you may need to add additional services to your care plan or reevaluate your current services or service providers.
If your loved one lives in a senior living community or uses a home care agency, or uses a housekeeper or meal delivery company, ask your loved one how they feel about the service. Older adults often think they have to tolerate problems that could be gently corrected. If they use a computer or a mobile phone, ask them how that’s going. If something seems in need of minor repair – the toilet runs constantly, the light bulb in the closet is burned out – ask if they would like you to fix it.
Also, evaluate the service for yourself. Is it meeting your expectations? Are you receiving the service you were promised? Older adults often have little control over their circumstances, and it is easy for service providers to forget to do their best. Also, many service provider organizations are understaffed and the existing staff is stretched thin. If the service provider is overwhelmed and thinks there is no one local to check on your loved one, they may skimp a little bit on their care.
Before concluding that your service provider is lacking, get the whole story. And as you resolve issues, do it gently so your loved one doesn’t fear ill will from staff once you are gone. But if your loved one is not being cared for properly, make a change!
A visit is a wonderful opportunity to connect with informal team members and add new ones to your local caregiving team. This includes neighbors, church parishioners, old friends, etc.
If you already have informal team members, be sure to see them when you visit, ask if there is anything you need to know, and bring them a little gift or do them a kindness. Be sure you have their phone numbers and mailing address (you may want to send them a thank you note later.)
As you accompany your loved one in their routine, you are likely to meet their “fans” who will gladly join your informal team. Give them your contact information and urge them to call you if they notice a concern, or recruit them to help your loved one in some part of their life!
Try to time your visit to coincide with a doctor’s appointment, or try to make a doctor’s appointment for when you are there. Use the appointment to get to know the doctor and the doctor’s staff so you will have a warmer personal connection with them if your loved one has a medical emergency, a new diagnosis, or a decline in health. Your presence will show the doctor that you are present and interested, are trustworthy, and are ready to help.
We discuss this in more detail in our lesson: “Get the Most Out of Your Loved One’s Medical Appointments.”
You can also schedule routine maintenance appointments for the time of your visit – have hearing aids serviced and adjusted, have glasses prescriptions updated, have walkers, wheelchairs, or scooters serviced, etc.
As we discussed in the “Before Your Visit” section, it’s a good habit to meet with some of your loved one’s other professional advisors when you visit.
If you haven’t already done so, use this opportunity to handle any paperwork necessary to give these advisors the permission to speak with you about your loved one’s matters. Even if you have a long standing relationship with these folks, it’s good to have the permission paperwork on file so any new staffers know they are authorized to share information with you. Even if you are your loved one’s agent under power of attorney, most professionals will have other internal paperwork they will want your loved one to sign. Refer back to our lesson “How to Get Access to the Information You Need to Help Your Loved One.”
One of the purposes of the visit should be to establish you as someone the advisor can trust. Unfortunately, not everyone has their loved one’s best interests at heart, and the advisor could be wary at first about why you are becoming involved. Once they meet with you and see that you are there to help, not to take advantage, they will be more forthcoming.
It’s always a good idea to ask how you can help make things better and easier for your loved one and for the advisor. And be sure to ask if the advisor has recommendations about changes or enhancements your loved one can make.
If you are meeting with the CPA, get a list of the documents they will need to prepare the tax return, when the information is due, and how you can most conveniently submit it.
If your loved one thinks you are getting too involved in their affairs, you can always back off. But one way to break the ice is to talk to your loved one about your own planning steps.
This is a great time to establish or review your own advance medical directives, burial arrangements, estate plan, long term care insurance decisions, etc. Many people don’t make these plans at all or wait too long, so this could be your nudge to finish your own plans. And by discussing your own plans with your loved one, the conversations become more about good practices in general vs just about them and their impending demise!
Here are some things to NOT do during your visit. Yes, we have seen them all and it is easy to fall into these traps. People hate it when you do these things. You’ve been forewarned, so don’t:
After your visit, I suggest you do the following:
Let your siblings or other family members know that you recognize the sacrifice they are making and the contribution it is to your loved one and to you. Most local caregivers accept their role because they care, and your genuine appreciation will mean a lot to them. If it’s appropriate, you might send a small gift like flowers, chocolates, or a spa gift certificate.
Ask them what you can do to help and support them.
You may have noticed things that you think could be better or need to be changed. Don’t mention those things in your thank you letter. That should be done separately; we will discuss that below.
For each of your local team members that are doing a good job, write a personal note thanking them for their contribution to you and your loved one. For informal members, consider an old fashioned physical note in the old fashioned postal mail! If you know about their interests, you might even send a small gift – a packet of seeds for the gardener; a dog toy for the dog lover.
For professional caregivers, send an email to the employer, praising the employee by name and thanking the agency. Be specific about what makes this employee and this agency special. Professional service providers will particularly appreciate acknowledgements they can use as testimonials.
If you are traveling by plane or train, you can use your travel time to write these notes – it’s easy to forget them once you get back to the hustle and bustle of your normal life.
During your visit you may have noticed that your loved one has additional needs, or you may have ideas about how things can be done better. This is a good time to revisit your loved one’s care plan and consider changes.
Approach this carefully if your local caregiver is a family member. They may feel that you don’t have the whole story, and maybe you don’t! Let your local caregiver know that you have some ideas you’d like to run by them, and be open to their perspective.
If you haven’t already taken our course “How to Create an Elder Care Plan that Works for Your Whole Family”, this is the time!
If you have taken our course, I suggest you revisit it now and make any needed adjustments to your Care Plan.
In the Lesson Materials I have included a worksheet called “Making the Most of a Visit.” Review this now to reinforce the concepts in this lesson. Fill it out a few weeks before your next visit as a way to remind yourself what to do before, during, and after your next visit.
If you haven’t already taken our course “How to Create an Elder Care Plan that Works for Your Whole Family,” this is a perfect time to do so.
If you are arguing with your loved one or others about what the care plan ought to include, take our course “Finding Common Ground: How to Gain Agreement on Eldercare Decisions Even if You Have Failed in the Past.” If you’re having trouble implementing portions of your care plan, browse our library of courses about individual solutions, or contact us about a private coaching session.
I’ve included links for those resources in the Lesson Materials.