Aging Well Long Island
Helpful tips for family caregivers

Dementia and long-distance caregiving: Staying connected

It’s challenging to live far from a loved one with dementia. You need the eyes and ears of a local “boots-on-the-ground” team to support them. Once that team is in place, it’s important to stay connected with everyone—your relative and the care team members. It’s a juggling act, for sure. Periodic visits, simple technology, and steady communication can help ensure they get good care, even when you’re at a distance.

Plan visits ahead. Coordinate your visits with the care team. Are there specific issues that need attention? Appointments they’d like you to attend? Tasks where they need support? Plan with them when your quality time with your loved one won’t interrupt the established routine. Aim to meet in a quiet space and at a time of day when your family member has more energy. Simple activities—reviewing photos, listening to favorite music, or enjoying a small treat—may be the most comfortable pace for them these days.

Use technology. Today’s digital options make it easier to stay connected across the miles. A shared online calendar can help everyone on the team track appointments and medications. A caregiving app can do this too. For your loved one, provide a simplified “senior” phone and/or tablet with big icons for initiating or receiving calls. They will likely need help using the device(s) as dementia progresses.

“Smart-home” technology is useful for keeping an eye on daily routines and safety. For example, you might install an automatic stove shutoff, sensors on doors, or smart lights for dark hallways. Wearables such as GPS bracelets or medical-alert devices (some have fall detection) can also give peace of mind. But your loved one must understand how to use them and be willing to consistently wear them.

Maintain communication. Establish and lead weekly or monthly check-ins with those who are providing day-to-day care.  You might ask questions, request observations, and decide together on next steps to ensure everyone is on the same page. As always, sharing what you know about your loved one’s history and preferences also helps the care team give more-personalized support. After each call, post a brief written summary in your shared app to boost coordination.

Even far away, you play a vital role in your family member’s care. Maintain a steady guiding hand while also nurturing compassion and respect, from you to the team members and from team members to your relative.

Protecting your relationship while caregiving

Reduced leisure time, emotional stress, physical fatigue, financial draws, and loss of privacy are a few of the pressures that strain the marriages and partnerships of those who are also caring for family members. But some couples also report a benefit: caregiving prompted a new kind of teamwork that strengthened their relationship. Here are some tips:

Strive for balance. You may feel a debt of gratitude to an aging relative, but your marriage is your future. Arrange your caregiving so your partner doesn’t feel that they are always the last priority. Regularly discuss your shared values and how they fit into your life as a couple.

Ensure your partner feels loved. You probably know intuitively what most pleases them. Quality time together? Physical affection? A love note? A small gift? Handling a chore or errand? (What do they tend to do for you? That’s usually a clue.) Build trust and dedication with frequent gestures of love.

Create relationship time. In most families, one adult child takes on the main caregiver role. If that’s you, make it clear to your siblings that you won’t sacrifice your primary relationship. Create time to be with your partner by asking your siblings for

• respite (spending some of their time taking care of your relative)
• help with chores (handling the checking account, keeping the car in good condition)
• financial assistance (so you can hire help)

Have a Plan B

Watch for signs of distress. If your partner is arguing, drinking more, overeating, or coming home later, a change is in order. Consider

• hiring in-home care
• having your relative live in an assisted living facility
• moving your relative to live with a different family member

An Aging Life Care™ Manager can help you look at options and/or talk with family members about a change in how caregiving is shared.

Remember, love doesn’t disappear under pressure, but it does need intentional tending.

What is bradycardia?

Most adults have a resting heart rate of sixty to one hundred beats per minute. When the heart rate stays below sixty beats per minute, it’s considered slow, or “bradycardia.” (“Tachycardia” is when the heart rate is too fast.) This is an electrical problem in the heart. The heart’s “natural pacemaker,” the sinus node, isn’t sending the electrical jolt that causes the heart to contract and pump at the needed pace.

In active adults, a slower heart rate is usually a sign of fitness. But for older adults, it’s often a sign of a misfiring heart. If your loved one’s heart isn’t beating fast enough, their brain and other organs aren’t getting adequate blood flow and oxygen.

Bradycardia is common in people over age seventy. The risk factors include high blood pressure, prior heart attack, infection, smoking, drug or alcohol use, and stress. Also, sleep apnea, inflammatory disease, and thyroid imbalance. Your relative might not have any symptoms. Or they might feel dizzy, tired, weak, confused, or lightheaded. In the extreme, they might faint or have chest pain and shortness of breath.

If you see symptoms. If you’re observing changes, have your loved one see their doctor. Bradycardia is not an emergency unless the symptoms are severe. But it’s important to have the doctor assess your loved one’s health and rule out other conditions. Tests such as an EKG or an echocardiogram may be ordered to evaluate the heart’s structure and function. To track heart rate, your relative may be asked to wear a portable heart monitor for a few days or weeks.

Treatment is guided by bradycardia severity and its underlying cause. In some cases, a medication change may bring improvement. The most common treatment, however, is having a battery-powered pacemaker implanted in the upper chest to maintain a steady heartbeat.

It is an emergency if your loved one faints, has chest pain, or is short of breath. Don’t hesitate: call 911!