When it comes to caring for her sister-in-law Bea, who at 62 has had Alzheimer’s for 14 years and lives alone, Janice Kraayenhof has tried to think of everything. She has had medications blister-packed to ensure her sister-in-law takes them as prescribed, organized Meals on Wheels to deliver dinners and arranged for safety assessments to be done at her home in Welland, Ont.

She checks in regularly with her sister-in-law’s neighbour. And, like many Canadians, she’s doing all this at a distance: Ms. Kraayenhof, 54, lives 222 kilometres away from her sister-in-law.

“We try to keep a calendar of her events,” says Ms. Kraayenhof, a teacher who lives in Orono, Ont. “Then I can phone her and remind her: ‘You’re going here today.’”

Ms. Kraayenhof also conducts regular video chats to “see if she’s worn the same outfit all week.”

Ms. Kraayenhof says she also relies on a carefully organized network of caregivers and support workers to allow her relative to maintain her independence while still being closely monitored. She purchases her sister-in-law’s groceries online and has them delivered. She calls in medical appointments. But she realizes that the situation will change as the disease progresses. “She fell a month ago,” says Ms. Kraayenhof, “and she didn’t phone anyone. Her personality is changing. We’re starting to go into a grey area now.”

Long-distance caregivers such as Ms. Kraayenhof are increasing in number. Between 2007 and 2012, the number of caregivers aged 45 and over increased by 760,000, to 4.5 million, representing a 20-per-cent increase over five years, according to Statistics Canada.

The reason is demographics: “This is the first time there are more seniors over 65 than children under 15,” says Audrey Miller, managing director of Elder Caring Inc. in Toronto. “We also see for the first time two generations of retirees living in the same family, we’re living so long.”

In addition to the aging population, “there could be more seniors in someone’s life due to blended families,” says Lee-Anne Davies, chief executive officer of Agenomics, a think-tank on aging. “Our lives are simply more complex.”

In the past, Ms. Davies says, people were more connected to their families and neighbourhoods, creating a natural caring network. Now, fewer people stay in one place. “We move much more than we used to,” says Ms. Davies, who’s based in Victoria.

That puts distance between family members at a time when they may need a lot of help. And many are simply at a loss as to how to go about long-distance caregiving. “Most people do not know where to start,” says Ms. Miller. “A lot of them go off to work every day worried.”

She says communication should be the No. 1 priority for families to ensure that everyone is on the same page in terms of the elderly person’s needs, health status and financial situation. That includes determining what role each family member will play to avoid one family member being overly burdened.

Once roles have been set, an assessment should be done of what the elderly person needs – and wants – for the short, intermediate and long term, which can be done by the family or using a private care manager, says Ms. Miller, who estimates 25 per cent of her clients care for family members who live far away. “Have that talk with the family: What’s happening? How could you do better? What’s out there?”  Continue Reading