Caring for an elderly parent from abroad: a practical guide

Build a local circle around her

NIH advice for long-distance caregivers starts with the people nearby. Identify local family, friends and neighbors who can help in an emergency. Tell them what is going on and make sure they know how to reach you.² For a parent who lives alone, aim for at least two people. One of them will be away or asleep when you need them.

• A neighbor who can knock on her door within minutes.
• A friend or local relative who knows her routine and her doctor.
• Her doctor's office, with your number on file as a contact.
• A key holder who can get in if she cannot reach the door. A key safe is a small coded box that you fix to an outside wall. It lets family, carers and emergency services in without a spare key changing hands.⁹

Give each person your number with the country code and your siblings' numbers. Add a short note on what to do if they cannot reach her. They go round and use the key. They call the local emergency number if she needs help.

Know her emergency number and how to reach help from abroad

Phone networks route emergency calls by where the caller is. In the UK, the caller's location decides which control room receives a 999 or 112 call.³ If you call 112 outside the Netherlands, the call goes to the nearest emergency call centre. It does not go to the Netherlands.⁴ If you dial an emergency number from your own country, you reach your own country's service. You do not reach hers.

112 works across the EU alongside each country's own numbers. Calls to 112 are free from fixed and mobile phones.⁵ Other countries have their own numbers, such as 911 in the US and 999 in the UK.³⁶

From abroad you need a regular phone number. US government advice covers emergencies outside your area. Contact the local law enforcement agency where the emergency is happening, using the 10-digit number on its website.⁶ Look up the equivalent for her town now. Save these numbers.

• Her country's emergency number, for the people near her to call.
• The full number of her local police, with the country code, that you can dial from your own phone.
• The numbers of her neighbor and her key holder.

Agree who calls first

When something looks wrong, siblings in different countries tend to all call Mom at once. Sometimes each one assumes someone else is handling it. Agree the order in advance and write it down.

1. 1
   Call Mom

   The person on duty calls her. If she answers and is fine, they tell the others.

2. 2
   Call the local circle

   If she does not answer within a few minutes, call the neighbor and then the key holder. Ask one of them to go to her door.

3. 3
   Call local services

   If nobody local can go or she needs help, call her local police on the full number you saved. Ask them to check on her.

4. 4
   Tell the family

   Post one message in the family group that says who is handling it. Then nobody else starts the same calls.

Plan for the hours when she sleeps

With siblings in different countries, someone is often awake while Mom is asleep. Write down her day in each sibling's local time. Agree who covers which hours.

• Name one first contact for her morning, her evening and her night.
• Agree quiet hours for each sibling, when only urgent calls should wake them.
• Keep updates that can wait, like how she slept or a note from the doctor, out of the night hours.
• Recheck the plan when clocks change. Countries switch to and from daylight saving time on different dates. Some never switch.

The guides for a parent in the US and the UK include worked examples with real time differences.

Get the paperwork done while she can sign it

Doctors and other health care providers need your mom's consent to share her medical information with you. Ask her for written permission to speak with her medical team.² This permission differs from naming someone to make decisions for her. A health care proxy can decide only when she cannot communicate her own wishes.⁷

Powers of attorney follow the law of the country where she lives. In the US they also follow the law of her state. Check with a local lawyer. See the country pages for the US and the UK. Also make sure someone she trusts knows where she keeps her important papers.⁷

Keep her information in one shared place

NIA suggests keeping important phone numbers and email addresses in a shared online document that you update regularly. It also suggests a shared calendar to coordinate.¹ Put these items in the document.

• Her medications and when she takes them.²
• Her doctors, pharmacy and insurance details.
• The neighbor, key holder and local friend, with their numbers.
• The local police and emergency numbers you saved.
• Where she keeps her legal and financial papers.

If she uses an iPhone, help her set up Medical ID in the Health app with her conditions, medications and emergency contacts. Show When Locked lets anyone read it from the Lock Screen. Share During Emergency Call sends it to emergency services when she calls or texts them from her iPhone or Apple Watch. This works only where Apple offers it.⁸

Make visits and video calls count

Before a visit, ask Mom what she would like to do. If someone helps her day to day, ask what they need from you.¹ With her permission, book doctor's appointments for when you are in town. Meet her local helpers in person.² Leave time that has nothing to do with caregiving.

Between visits, keep up to date with regular video calls. With her permission, join her telehealth appointments.² Regular calls also help you notice when she sounds different.

Talk about scams before one happens

One scam that targets older adults is the grandparent scam. A caller pretends to be a grandchild or other relative in distress.¹⁰ With family abroad, that story can sound believable. Agree with Mom that nobody in the family will ask for money by phone, gift card or wire transfer. If a caller pressures her to act now, she ends the call and phones one of you.¹⁰

Try the free fall-risk and living-alone check to see where her risks are. The check follows the CDC STEADI program.