Looking after elderly parents when you live overseas

Looking after elderly parents when you live overseas

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-Pope-photo-croppedDiane 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.
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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.


  1. Susan Middleton 1 month ago

    My mother is stuck in a care home a long way from me ..how can i move her closer..?

  2. Astrid 2 months ago

    Me and my English husband live in Germany and his parents still live in England. Now his mum (81) is really sick and she can’t leave the bed anymore. They have social service visiting them 3 times a day, but still his father can’t deal with it anymore. The mother is nasty and refuses help from the nurses, he doesn’t dare leaving the house anymore, because she permanently needs him. He’s over 70 himself and he’s exhausted. We thought the best solution would be for her to move to a residential home close by, especially because there’s no hope that her bodily constitution will get any better … Unfortunately (even though understanding) the mother refuses to go there and social service says she can’t go unless she does it willingly (which will never happen)… What’s the options? We have to help the father, otherwise a breakdown won’t be far off and we have no idea what to do …

    • Diane Pope 2 months ago

      This sounds like an all too common dilemma Astrid, exacerbated no doubt by distance and your mother-in-law’s (understandable) resistance to go into care. While it is difficult to advise without knowledge of any other facts or mitigating circumstances, as a first step it might be worth contacting social services to ask them to do a carer’s assessment for your father-in-law. This would identify his support needs and may well result in increased support for his wife so giving him some (temporary or permanent) respite. Carer breakdown is a huge issue and his needs are as important as your mother-in-law’s. This was recognised in the 2014 Care Act so he has a right to be assessed and have his needs met too – assuming he agrees of course.

  3. Diane Pope 2 years ago

    The good news Care is that there is a lot of help available through the statutory ( Local Authority), voluntary and private sectors, but it all depends on your mother’s situation. If she potentially or already has care and support needs, her Local Authority has a legal obligation to ‘assess’ her – which could open up a whole array of solutions to help. If she does not, it is never too early to start the conversation about how she might cope in the future, especially if you are unable to step in – so you can begin to make plans together. But you should try to get her buy-in, which might take time, so the sooner you start (perhaps by checking her Local Authority’s website) the better.

  4. Care Donoghue 2 years ago

    I am an only child working abroad and my mother is in her 70s. She is a hoarder and I worry about her but need to keep my job as I have no one to support me. Is there any help I can get?

  5. Cura Domi 4 years ago

    Really enjoyed this post. Thanks Angela. Technology is definitely a great way to communicate via Skype or Facetime as more and more people, including elders are using tablets.

    It is always difficult to bring up a care conversation with your parents. It is something you wish you do not have to do, however it sometime can be the best option for everyone.

  6. Tracey 4 years ago

    Some really great advice here, especially about building up the community connections as these are vital if you cannot be close-by. It is true that parents will often not admit they are struggling and that’s when connections are important. I would stress the important of teaching them online skills too, so you can Skype and communicate visually. Technology is not as always easy to teach if you are not there.

    • Diane Pope 4 years ago

      I totally agree with you Tracey – a great piece of advice, thank you.

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