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He uses Skype to speak with his grandmother every day and tries to be there whenever she has a doctor’s appointment. Aides handle many daily tasks and have access to a credit card for household expenses. They send him receipts so he can monitor spending. He has an apartment near his grandmother to make sure he’s comfortable on his frequent visits.

Even for those who live near those they care for, travel for work can frequently make it a long-distance affair. Evelyn Castillo-Bach lives in Pembroke Pines, Fla., the same town as her 84-year-old mother, who has Alzheimer’s disease. But she is on the road roughly half the year, sometimes for months at a time, both for work with her own Web company and accompanying her husband, a consultant for the United Nations.

Once, she was en route from Kosovo to Denmark when she received a call alerting her that her mother was having kidney failure and appeared as if she would die. She needed to communicate her mother’s wishes from afar as her panicked sister tried to search their mother’s home for her living will. Castillo-Bach didn’t think she could make it in time to see her mother alive once more.

“I won’t get to touch my mother again,” she thought.

She was wrong. Her mother pulled through. But she says it illustrates what long-distance caregivers so frequently go through.

“This is one of the things that happens when you’re thousands of miles away,” Castillo-Bach said.

Lynn Feinberg, a caregiving expert at AARP, said the number of long-distance caregivers is likely to grow, particularly as a sagging economy has people taking whatever job they can get, wherever it is. Though caregiving is a major stress on anyone, distance can often magnify it, Feinberg said, and presents particular difficulty when it must be balanced with an inflexible job.

“It’s a huge stress,” she said. “It can have enormous implications not only for someone’s quality of life, but also for someone’s job.”

It can also carry a huge financial burden. A November 2007 report by the National Alliance for Caregiving and Evercare, a division of United Health Group, found annual expenses incurred by long-distance caregivers averaged about $8,728, far more than caregivers who lived close to their loved one. Some also had to cut back on work hours, take on debt of their own and slash their personal spending.

Even with that in mind, though, many long-distance caregivers say they don’t regret their decision. Rita Morrow, who works in accounting and lives in Louisville, Ky., about a six-hour drive from her 90-year-old mother in Memphis, Tenn., does all the juggling too.

She has to remind her mother to take her medicine, make sure rides are lined up for doctor’s appointments, rush to her aid if there’s a problem. She knows her mom wants to stay in her home, to keep going to the church she’s gone to the past 60 years, to be near her friends.

“We do what we have to do for our parents,” she said. “My mother did all kinds of things for me.”