Long-distance caregiving

You may live hours away from a parent, spouse, sibling or friend who has dementia. You may worry about them every day and still feel you are not doing enough. Experts call you a long-distance caregiver if you live about an hour or more away from the person who needs care.¹

Distance changes how you help, but it does not stop you from helping. Many important jobs can be done by phone, email or computer. This page explains how to learn what is really going on, build a team near the person, get permission to talk with doctors, use technology, and make each visit count.

What a long-distance caregiver does

There is no single job description. What you do depends on the stage of dementia, who else lives nearby, and your own work and family life. Common roles include:¹

• Managing bills, bank accounts and insurance from afar
• Finding and setting up in-home help or adult day programs
• Giving the main caregiver a break by visiting or paying for respite care
• Planning for emergencies and keeping key papers ready
• Staying in touch with doctors and keeping track of medicines

Care often works best as a team effort, with each person doing what fits their skills and location.¹ If you share care with brothers, sisters or other relatives, see sharing care with siblings and family.

Step 1: Find out what is really going on

Short phone calls can hide a lot. A person with dementia may say "I'm fine" and believe it. Depression, too, can be easier to hide during a short visit than a long one.³ See lack of awareness to learn why some people do not notice their own changes.

Signs that a person living alone needs more help include:³

• Trouble cooking safely, or spoiled or missing food
• Not bathing, or wearing clothes that do not suit the weather
• A messy or dirty home, or piles of unopened mail
• Missed or mixed-up medicines
• Unpaid bills, poor money choices or new "friends" asking for money

Ask the person what help they want. Then, with their permission, ask neighbors, friends, local relatives and doctors to call you if they notice anything worrying.³

What to watch changes with the stage. In the early stage, a person may still live alone. Check meals, the condition of the home, the mail and bills, visits from friends, hygiene and driving.² In the middle and late stages, most people need someone with them around the clock. Then check that help with bathing and dressing is in place, the home is safe, rides to appointments are safe, and the day has activities that mean something to the person.²

Step 2: Build a team near the person

You cannot be there every day, so others must be. Make a written list of local helpers with their phone numbers. Keep it on your phone and share it with family.²

Places to find local help:

• Neighbors, friends and relatives. Ask a few people to stop by or call on a regular schedule.²
• Churches, temples and community groups. Some offer meals, rides or friendly visits.²
• The Area Agency on Aging (AAA). These local offices can help with meals, chores, rides and referrals to other services.² Find the one where your loved one lives through the Eldercare Locator at 1-800-677-1116. You can call, text or chat online.⁸
• Home care and adult day programs. These give help with personal care, meals and medicines, and they give family caregivers a break.² See in-home care, adult day care and respite care.
• The Alzheimer's Association. Its 24/7 Helpline at 800-272-3900 and its online Community Resource Finder can help you find dementia services where the person lives.²

If your loved one lives in Virginia, the state has 25 local Area Agencies on Aging. The state's aging services website has a map to help you find the right one.⁹

Our care circle tool can help you write down who does what.

Step 3: Consider a geriatric care manager

A geriatric care manager is a professional who helps older adults and their families plan and arrange care. Members of the Aging Life Care Association call themselves aging life care managers.^4,5 Most are nurses, social workers or therapists with training in older adult care.⁴

For a family far away, a care manager can:^4,5

• Visit the home and check health, safety, medicines and daily needs
• Make a care plan and suggest services
• Hire and keep an eye on home care workers
• Set up doctor visits and rides
• Help with hospital discharge and moves to assisted living or a nursing home
• Send you updates and act as your contact person nearby

What it costs. Most care managers charge by the hour. AARP reports rates of about $150 to $300 an hour, depending on the region. The first visit and assessment often takes 4 to 6 hours.⁴ Medicare, Medicaid and most health insurance do not pay for care management. Some long-term care insurance policies may pay part. Some employee assistance programs may help too.^4,5 Ask for all fees in writing before you agree.⁴

You can search for one in the person's area with the "Find an Aging Life Care Expert" directory at aginglifecare.org.⁵

Questions to ask before you hire a care manager

• What are your credentials and licenses? Are you a member of the Aging Life Care Association?^4,5
• How long have you done this work? Do you know dementia care?
• What does the first assessment cost? What is your hourly rate? Do you charge for travel?⁴
• How and how often will you update me? Can you join a video call with the family?
• Who do we call in an emergency, at night or on a weekend?⁵
• Can you give references?⁴

Step 4: Get permission to talk with doctors and Medicare

Doctors and health plans can share health facts with family who help with care if the patient agrees or does not object. If the patient is not there or cannot decide, a doctor may share what seems to be in the patient's best interest.⁶ But many offices will not talk to a caller they do not know.

The Alzheimer's Association advises that the person sign a release of information form at each doctor's office so staff can talk with you.² Do this early, while the person can still understand and sign.

For Medicare, the person can fill out Form CMS-10106. It lets 1-800-MEDICARE share their health information with someone they name. It can be done online through their Medicare.gov account, or by mail. The person can choose to allow sharing with no end date, or set start and end dates.⁷

Permission to talk with doctors is not the same as legal power to make decisions. For that, see power of attorney and advance directives. An elder law attorney can help set these up.²

Keep key papers ready. Keep copies of legal and money papers, insurance cards, and a list of doctors, pharmacies, medicines and neighbors where you can reach them fast.²

Step 5: Use technology to stay close

Technology cannot replace people, but it can fill gaps between visits. Ideas families use:

• Regular phone or video calls at the same time each day. A routine is easier for a person with dementia to follow. See talking with someone who has dementia for tips on phone and video calls.
• A shared online calendar so family and helpers can see appointments and sign up for tasks. The Alzheimer's Association points families to free care team calendars.²
• Automatic bill pay and bank alerts so you can spot missed payments or strange charges. See scams and financial abuse.
• Medicine reminders or locked pill dispensers. See managing medicines at home.
• GPS devices, door alarms or cameras. These can help, but cameras raise privacy questions. Talk with the person first when you can, and respect their dignity.

Our page on technology that helps covers these tools in more detail.

Step 6: Make visits count

Visits are precious, so plan them. Try not to spend the whole time on chores. The Alzheimer's Association suggests these steps:²

1. Book appointments ahead. Set up visits with the doctor, lawyer or financial adviser while you are in town, so you can take part in decisions.
2. Talk with local people. Meet neighbors, friends and relatives. Ask about changes in behavior, health or safety.
3. Check the kitchen. Look in the fridge and cupboards for enough healthy, fresh food.
4. Check the medicines. See if pills are being taken the right way. Bring questions to the pharmacist.
5. Look around the home. Watch for fall risks, stove safety and unpaid bills. See home safety.
6. Ask the main caregiver what they need. Offer to cover a day or arrange respite.
7. Spend real time together. Talk, play music, take a walk or look at old photos. The visit is about your relationship too.

Before you leave, write down what you saw. Compare it with your notes from the last visit. Small changes are easier to see side by side.

Step 7: Plan for emergencies

Emergencies are hardest when you are far away. Make a plan now:

• Pick one or two local people who can get to the home quickly. Make sure they have a key or a lockbox code.
• Keep a one-page sheet with the diagnosis, medicines, allergies, doctors and insurance. Give copies to local helpers. Our memory notebook can help.
• Know which hospital the person would likely go to. Read hospital stays and emergency rooms.
• Plan for storms and power loss. See emergencies and disasters.
• Decide ahead who will travel if the person goes to the hospital.

If you think the person is being neglected or taken advantage of, see elder abuse for how to report it.

Help through Medicare's GUIDE program

Medicare is testing a dementia care program called GUIDE. It began in July 2024 and is planned to run for 8 years.¹⁰ Doctors and clinics that join assign a care navigator to the person and their caregiver. They also run a 24/7 support line for urgent questions. The program can pay for up to $2,500 a year of respite care for some families, such as in-home help or adult day programs.¹⁰

A 24/7 line and a named navigator can be very helpful when you live far away. As of August 2026, CMS listed 292 programs taking part.¹⁰ Ask the person's doctor whether their clinic is in GUIDE. Read more on caregiver training and support programs.

Taking care of yourself

Many long-distance caregivers feel guilt for not being there, or frustration that others do not see what they see. Travel costs and time off work can add up. Being far away does not mean you are not involved.²

• Talk with other caregivers who live far away. The Alzheimer's Association runs a free online community called ALZConnected.²
• Set limits on what you can do. See setting boundaries.
• If you have a job, read working while caregiving about leave and flexible work.
• Watch for signs of caregiver stress and burnout in yourself and in the main caregiver.

There may come a time when the person can no longer live alone, even with help. Some families move the person closer. A move can raise confusion and agitation, so talk with the doctor, care team or a social worker first.² See moving a loved one and choosing a care place.

For more on every part of the journey, return to caring for someone with dementia.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.