Help for expats when parents in the UK need care
Navigating the care system in the UK is hard enough, but for expatriates living many miles away, and possibly in a different time zone, the situation can be a nightmare.
Diane Pope from Shears in Harpenden, Hertfordshire, shares some tips and advice for expats. Diane provides an independent ‘one-stop shop’ to help families navigate the issues involved in caring for an elderly relative, and so alleviating much of the anxiety and upheaval families often face.
Diane explains more here…
When the health of a parent or loved one deteriorates, there is also the nagging sense of guilt around the “do I stay” or “do I go” question, to contend with. And asking someone to step in to help is often seen as ‘passing the buck’ or a shirking of one’s responsibilities. So what can be done?
Thankfully there are a number of things that expats can do – but for which plenty of time has to be allowed – and the sooner you start planning, the better.
Here are my top tips for expats:
1. Start with the assumption that care and support will be required at some stage. As advances in medicine continue, people are living longer – but as a result, the chance of them developing a long-term health condition is increasing. It is now widely acknowledged that three quarters of us will need care in our later years, much of which will be provided (especially early on) informally by adult children. If you are unable to do this, you will need to build up a local network of people who can.
2. While your parents are still fit and well, start the conversation about their wishes for the future, should they become frail or be separated. If, for example, they are empty-nesters occupying a house which is clearly too big for them, how will they cope as they inevitably age and become less able to manage? There are many options for downsizing these days and retirement housing has come a long way in design and specification, and can also be an attractive option. Having somewhere smaller and more manageable that they can lock up and leave (for example while visiting you) can open up a whole new world for them. And moving when they are still able to forge new relationships and friendships will pay dividends later. Only last month we reported in Shears News that 60% of older people would downsize if they could – but most leave it too late.
3. If your parents are adamant that they wish to remain independent in their current home, you will want to make sure they can safely do so for as long as possible. So use your visits to them wisely:
- Build up or re-ignite local connections of friends, family, neighbours, advisers or health visitors – and compile a record. Having someone ‘on the ground’ who is able to react quickly, or even better predict and act proactively, is vital – both for your parents’ well-being and for your own piece of mind. It is not surprising that this is one of the things our overseas clients have told us they particularly value about Shears. Such relationships will enable you to remain in touch and keep the lines of communication open – even from a long way away. They may even avoid you making unnecessary trips home.
- Assess the home and check for changes in appearance. For example, is the garden being maintained, is the housekeeping up to scratch, is the fridge well stocked/in date and is paperwork up to date?
- Observe your parents – including their physical state (such as balance, mobility, recent injuries or bruises, sight, hearing and personal hygiene), their mental state, (confusion, mood changes, memory loss) and finally their social state, (relationships, hobbies, routines etc.). You are looking for signs of change that may be early indications that all is not well.
- Address any concerns, however minor, immediately by talking to your parents about them in a way that is supportive and positive, and work with them to identify solutions. Even small changes can indicate the need for some medical (best to eliminate any underlying health issues as early as you can) or other intervention.
- If it looks as though help may be required in the near future, begin to articulate what the needs are and make enquiries about how these can be met. Try to find out what services are available (from companionship to care, meals on wheels, aids and adaptations etc), who provides them and how you can access them. The statutory (particularly NHS and Social Services), voluntary and private sectors all offer a broad range of services but they may take time to implement. Talk to local friends and neighbours to garner their experiences and the names and contact details of any recommended providers.
4. When you return overseas, continue to monitor your parents and look out for cues. They will not want to worry you or admit (or realise) they are struggling – so in many cases, it will be up to you (or your connections) to spot the signs that things are changing. During phone calls, listen carefully to what they say and, just as importantly, to what they don’t say. Ask probing questions (to check that normal activities and hobbies are continuing), and if you Skype, watch for visual signs (such as changes in appearance, weight, behaviour, mannerisms, etc.). All can reveal the tell tale signs of perhaps a physical or mental health issue developing, and the earlier it is identified and eliminated, the better. Keep in contact with their connections and keep each other updated. Very often, older people get lonely and fear becoming isolated – so visits from friends and neighbours and a little bit of TLC can (sometimes surprisingly) make a massive difference.
5. Finally, talk to friends of your own age – many of whom are likely to be going through a similar experience, and use their knowledge and insight to help direct your efforts and provide some comfort. Also involve your siblings and other relations in the UK, to share the emotional and practical loads. But most importantly, involve your parents as much as you can. This will give them the chance to articulate their feelings and preferences (after all, they know themselves better than anyone else does) and this will ultimately make it easier for everyone.
Shears provides bespoke and independent information, advice and practical support to help older people remain in their own home or to move somewhere more suitable, through a unique range of home support and relocation services. Call Diane on 0844 412 0606 or visit www.shears-uk.com for more information.