Caring for an elderly parent in the US from abroad

Know which emergency numbers work from abroad

In the US, the emergency number is 911.¹ For a mental health or suicidal crisis, the 988 Suicide & Crisis Lifeline answers calls, texts and chats 24 hours a day. The service is free and confidential. It also supports people who are worried about a loved one.³

From abroad, 911 will not reach her local responders. Even within the US, official advice covers an emergency outside your area. Contact the local law enforcement agency where the emergency is happening, using the 10-digit phone number on its website.¹ Look up that number now for her city police department or county sheriff. Save it with the +1 country code.

Request a wellness check

If you cannot reach Mom and nobody nearby can go to her door, call her local police department or sheriff's office. Use its non-emergency 10-digit number and ask whether an officer can check on her. Keep 911 for emergencies. Non-emergency calls to 911 can delay help for people in real emergencies.² Have these details ready.

• Her full name, address and any gate or door code.
• When you last heard from her and what is unusual.
• Health details that matter, such as medications or recent falls.
• Who has a key and your own number with the country code.

For help that is not urgent, such as transport or local programs, use 211. It connects people to community services. Find her local 211 at 211.org.⁴ The US Administration for Community Living runs the Eldercare Locator as a public service. It answers calls and texts at 1-800-677-1116. It also offers online chat and email at eldercarelocator@USAging.org.⁵⁶

Find local services that help her live at home

Start with her Area Agency on Aging. The Eldercare Locator connects families to these agencies and to the services in her community that help older adults live independently at home. Search by her location on eldercare.acl.gov.⁵

• Meals. Local Meals on Wheels providers may offer home-delivered meals, community dining, transportation and social connection programs. Most providers need an application and may assess her needs first. Demand is high. Response times vary.⁷
• In-home care. From a distance you can arrange care management or in-home care, for example by hiring home health aides.⁶

Get consent and legal authority on paper

Under the HIPAA Privacy Rule, her doctor may share information with family who are involved in her care. The doctor may do so if she says so or does not object. The rule does not require the doctor to share unless you are her personal representative.⁸ Ask Mom to give her doctors permission in advance to talk with you. That removes the guesswork. She may need to sign a form at each office.⁹

Two documents give someone legal authority.⁹

• Durable power of attorney for health care names a health care proxy who can make medical decisions if she cannot communicate her own wishes.
• Durable power of attorney for finances names someone to make financial decisions when she is unable to.

Both documents follow her state's law. Most states provide advance directive forms for free. NIA suggests talking with a lawyer about powers of attorney.⁹ Check with a lawyer licensed in her state. Have her sign while she can still make her own decisions. Keep copies in your family's shared folder.

Plan calls across time zones

Take one family as an example. Mom lives in Columbus, Ohio. Jane lives in London, John in Austin, Texas, and Ana in Singapore. The table shows the differences in November, after US clocks go back to standard time.

• Mom's day, 7 a.m. to 6 p.m.: John is first call. Jane is awake for most of it.
• Mom's evening, 6 p.m. to 10 p.m.: John is first call. Ana is starting her morning.
• Mom's night, 10 p.m. to 7 a.m.: Ana is first call. For her it is 11 a.m. to 8 p.m. Jane is backup from 3 a.m. Columbus time, which is her 8 a.m.

These gaps shift during the year. The US and the UK change their clocks on different dates. For a few weeks in March and about a week around the start of November, London is 4 hours ahead of Columbus instead of 5. Singapore does not change its clocks. It is 12 hours ahead of Columbus in summer and 13 in winter. Austin stays 1 hour behind Columbus all year.

Put people on the ground near her

• A neighbor who is usually home and can reach her door in minutes.
• A key holder or a key safe. Give the code only to people on your list. Change it when someone leaves the list.
• A local friend or relative who knows her routine and her doctor.
• A home care agency for regular visits if she needs help with daily tasks. Her Area Agency on Aging can tell you what is available locally.⁵

Make these people easy to reach. Give each person your number and your siblings' numbers with country codes. Tell them the call order. If she uses an iPhone, add them as emergency contacts in her Medical ID. First responders can then see who to contact from her Lock Screen.¹⁰

Work through this checklist

• Save her local police department's 10-digit number with +1.
• Have two local contacts and one key holder, all with your number.
• Ask her doctors' offices to record her permission to talk with you.
• Talk to a lawyer in her state about durable powers of attorney.
• Save the Eldercare Locator number, 1-800-677-1116.
• Set up her Medical ID with her medications and emergency contacts.
• Share a written time zone plan with your siblings.
• Take the free fall-risk and living-alone check together.

See caring for a parent from abroad for the country-neutral version of this plan.