Remote Care: Manage Care from a Distance

The modern caregiver is a magician at multi-tasking. They have to be. More often than not, such caregivers are broadband pioneers, relying on their cell phones, PDAs and the Internet to stay connected at all times and to keep their lives organized.

But meeting the rigorous demands of a successful career, raising their own children and trying to maintain a healthy lifestyle can challenge the most organized and dedicated caregiver.

Now imagine trying to provide effective caregiving services for a parent or loved one who lives in another state, miles away in another county or while you make frequent out-of-town business trips. That is the kind of challenge that a growing number of Americans are meeting successfully everyday as remote or long-distance caregivers.

To be a successful long-distance caregiver means developing a practical plan for remotely managing care duties, knowing what resources you have available, and working with these resources to carry out that plan. To be most effective requires organizing and enlisting a solid team of "people resources," and tapping into the most modern broadband and other high-tech products and services.

Friends, neighbors, relatives, community or church volunteers, paid nurses and geriatric care managers are all individuals you can enlist in assisting a parent or loved one when you are away. They are your "people resources." Creating a reliable network of people you trust can alleviate some of the stresses of managing care remotely.

Emergency Plan of Action

An emergency plan should tap into a network of trustworthy friends, relatives, neighbors and volunteers living near the care recipient.

1. Name a primary emergency contact - perhaps the person living closest.

2. Create a phone chain so that all appropriate parties can be informed quickly in case of emergency.

3. Give the name of the primary emergency contact to patient monitoring and Personal Alert Response System services, neighbors and the landlord.

For the modern-day caregiver, emerging and existing broadband and SMART technologies make remote and long-distance care providing and monitoring as convenient as turning on a PC or logging onto a PDA.

High-tech Ways to Keep Tabs on Mom and Dad

Today's Smart technology enables remote caregivers to check on Mom or Dad from afar, while respecting their privacy.

Smart house systems use a wireless network of motion sensors placed around the care recipient's home. These sensors detect motion and pass information to each other. Then, they send messages about the care recipient's level of activity (or inactivity) to a PC, such as that of the designated caregiver. For example, sensors in the bathroom indicate whether the care recipient has been there that day; those on medicine bottles detect if medicine has been taken. Older Americans prefer motion detector systems to their precursor -- the video camera -- because they are less intrusive.

Motion detector systems also can be used as technologically advanced Personal Emergency Response Systems (PERS), enabling a care recipient to signal for help in an emergency. These upgraded systems send data to a server. Then, if data appears abnormal, the server alerts caregivers by sending a phone or email message.

Several companies are applying this cutting-edge technology to help Alzheimer's and dementia patients remember how to operate kitchen appliances.

Monitoring Vital Signs from Long Distance

• New monitoring systems make it possible for chronically ill patients or their caregivers to check blood pressure, heart rate, blood oxygen, blood sugar, temperature and weight. The systems also answer questions and respond to a physician's advice, then forward the data to a health care provider. Patients are able to access their vital sign information directly from their monitor.

• The Food and Drug Administration (FDA) has approved two devices that use Web-monitored medical technology: implantable defibrillators and pacemaker monitoring systems. The wireless remote heart monitoring system allows heart patients to send data from defibrillators implanted in their chests to physicians over the Internet. The remote, real-time pacemaker monitoring system contains a transmitter that sends data through a cell phone-like device to a central computer. The computer then downloads the data and faxes it to the doctor's office.

• FDA has approved an implantable identification microchip that stores a patient's medical information. This grain-sized radio frequency microchip is inserted under the skin in the upper arm for physicians to scan. The information connects to a database, containing previous medical information, through encrypted Internet access. This technology may be especially useful for unconscious or uncommunicative patients.

• Companies are studying broadband and Web technology to see if they can help with the home delivery of retail products to seniors.

• Watch for Web-monitored medical technology, including equipment that can detect heart failure and perform other diagnostic services.

Long-Distance Medication Management

Today's medication management systems are not plastic pillboxes sectioned from Sunday to Saturday. They are high-tech units that organize and dispense pharmacy-filled medication as prescribed; give the patient and caregiver visual and audio reminders; and alert the caregiver when medication is not taken.

They also signal the pharmacist to reorder medication and create and store an electronic medication record.Some units offer Spanish language services and feature a built-in personal response system. There is even an "electronic pill pet" that uses play and emotion to remind patients to take their medications.

Maximizing Your "People Resources"

Remote and long-distance caregivers can empower themselves by enlisting the help of "people resources" to check on the care recipient and take care of daily tasks.

Paid fulltime and part-time household help can take care of housecleaning, cooking and companionship. Referrals from friends, neighbors and co-workers are good places to start. Place an ad if you have specific needs.

Home nurse care services and geriatric care managers may also fit your needs. The Visiting Nurses Association of America and the National Association of Professional Geriatric Care Managers are two places to begin your search.

You may also consider in-home services, offered to individuals who are homebound because of illness, disability or limitations in daily activities. Local community and faith-based organizations sometimes provide volunteer services such as visiting or helping with driving.

When hiring any individual to assist or monitor your care recipient. Be sure to discuss:

• what services they offer;

• what work they are not willing to do;

• the hours they typically work;

• the charges for services; and

• the names of at least three references.

First, offer a verbal description of the job and your expectations. Provide a written job description outlining their responsibilities if you hire the person. Try to negotiate a rate you consider fair.

After the first day, check in with both the newly hired care provider and the care recipient to see how things went. Remind the care recipient to tell you about any concerns immediately.

You've Got Mail - From Mom and Dad

Companies now sell Web-based software programs that introduce older Americans to the Internet. You can also set up the Internet on your parents' computer in large font, install voice-activated software or connect an electronic writing pad that converts handwriting into text on the computer screen. So, while you're traveling on business, Mom and Dad can converse with you through your Blackberry.