When our aging parents need our help but we live abroad, there are many things we can do from a distance. In a previous post I shared about the caretaking options there are whereas in this one I focus on other aspects we need to know about and organize.
Here’s a guide to help you provide support and plan for sensitive circumstances with your aging parents whilst living abroad, or in another country.
1. Understanding Legal and Financial Frameworks
One of the first steps is to understand the legal and financial structures of the country where your parents reside. Inheritance laws, family laws, and eldercare regulations vary greatly between countries. For instance:
- Inheritance Law: Countries like France operate under forced heirship, meaning portions of the estate are legally reserved for heirs, while others (like the UK) have more flexible inheritance rules. Make sure to know which law is applicable for your parents and if there is a will which states otherwise.
- Family Law: Some jurisdictions impose a legal obligation on children to provide financial support to elderly parents (e.g., Germany’s Unterhaltspflicht), whereas others do not. Furthermore, it is important to know if this Unterhaltspflicht applies also to children who live in other countries, and if so, what consequences this could have for the children (e.g., an international move to stay closer to the aging parents).
- Power of Attorney: Establishing a durable or lasting power of attorney ensures that decisions about health and finances can be managed when parents are unable to do so themselves. When children live abroad, i.e. not close enough to manage health and finances, parents can hire a lawyer who functions as power of attorney in addition to the children, to allow quick actions should this be necessary. In our case, our father appointed a lawyer (in Germany) who, together with my sister (in Switzerland) and me (in the Netherlands) have power of attorney. This made many decisions, legal and administrative steps, much easier.
Tip: Consult a lawyer specializing in eldercare and inheritance law in your parents’ country to understand your rights and obligations.
2. Health Care and Elderly Services
Healthcare systems differ widely across countries. It is crucial to familiarize yourself with the options available in your parents’ locality. Key considerations include:
- Accessing Services: Check whether your parents are eligible for public healthcare or need private insurance. For example, Nordic countries have extensive state-funded eldercare, while in the U.S., Medicaid may cover certain services if eligibility criteria are met.
- Eligibility for Services: To access eldercare, each country has a clear procedure that involves regular assessments that determine the level of care. Get informed about how this works and prepare your parents for it!
Experience: Assessments to establish the level of care take little time (in my parents' cases about 15-20 minutes) but have a major impact on the care they will be entitled to receive and that is covered by their insurance.
To make sure to avoid fawn responses which are very common among elderly, we can prepare our parents for the interviews by explaining the importance of these assessments to get the support they need, and that they help us take better care of them. Usually, these assessments can only be taken every 4 to 6 months, which means that if the parents' response is not indicating any need for action, we need to find alternative solutions that can be very complicated and costly!
- Long-Term Care: Options can range from in-home care to assisted living or nursing homes. Research their costs, standards, and waiting lists. It is not uncommon to wait 2-6, in some cases even 1 year to get the expected help. By involving the parents in the decision making process we can avoid resistance and misunderstandings. Nursing homes can differ considerably and some have restrictions about who they can or can not accept. So, for example, if a person has been diagnosed with Dementia, some nursing homes might refuse to accept them as not all nursing homes are equiped for this kind of patients.
Tip: Establish a local support network. Consider hiring a care coordinator or geriatric social worker to help navigate the system on your behalf. To do this you will need to spend some time in the country!
3. Creating a Care Plan
Distance requires a clear and adaptable care plan that addresses immediate and long-term needs. A well-structured plan should include:
- Regular Check-ins: Schedule video calls or phone conversations to maintain emotional connections and assess their wellbeing. Every now and then, try to call your parents at different times than those you agreed, to see how flexible they are. A lack of flexibility or understanding can be a sign for cognitive decline.
- Emergency Preparedness: Ensure there is a contact list of local caregivers, doctors, and neighbors who can respond in your absence. Especially when you live abroad, you will most probably not make it on time to accompany your parent to the hospital. Make sure that this is neither affecting you or your parents.
- Financial Support: If your parents need monetary assistance, work out how to transfer funds effectively, considering exchange rates and tax implications. This will require you to go through the different tax systems in your and your parents' countries of residence. If you have power of attorney you may be able to take care of the payments also from afar. Setting daily or weekly limits for regular expenses can help keep an eye on the finances. This is particularly important for elderly with cognitive decline of some sort, and when the in-house caregiver also does the shopping or accompanies your parents to withdraw money and take care of other expenses.
Tip: Use technology to monitor care remotely. Apps like Carely or MyMeds can keep you updated on appointments and medications. You can also use GoogleDrive to share lists about expenses. This, of course, if your parents are able to use GoogleDrive. Your parents might need help with taking care of their finances and insurances: make sure you have power of attorney to access to their emails and bank accounts remotely.
I invite you to also read this post:
Taking Care of Aging Parents from Abroad: Caretaking Options
