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More than 22 million Americans juggle jobs and care for the elderly; estimates are that the need for long-term care will double in the next 15 years.

As their parents age and become ill or are no longer able to fully care for themselves, children living at a distance are faced with pressing problems. Most can't travel back and forth to provide sufficient help. Many feel guilty-or regretful. Some aren't familiar with the area's social services and have difficulty arranging assistance from a distant location.

Today, nurses are coming to the rescue. But they often are caught in the middle of this stressful situation. Serving as liaison between the aging patient and the medical staff, they deal directly with their patients' families and adult children. They collect facts and information and report back to the families, assuring them of the well-being of their loved ones.

But their task isn't easy.

According to surveys by the National Alliance for Caregiving and the American Association of Retired Persons, more than 22 million Americans juggle jobs and care for the elderly. AARP also reports that the need for long-term care will double in the next 15 years. The number of adult children who live more than one hour away from their parents or relatives also is steadily increasing.

Prue Smith, MS, CS, RN, a parish nurse and care management team member at Luther Manor, a continuing care retirement center in Milwaukee, believes that communication is key to dealing with long-distance caregivers. She points out that any information the families receive is helpful.

"Many of these people are managing their own jobs and families," she said. "They are feeling squeezed, particularly if a transition is happening, like someone moving into a facility or someone receiving emergency care.

"Nurses sometimes forget that they have good information in this area," she said. "They need to share that information to make the process smoother, so the families realize how the system works."

Clare Wohlgemuth, MS, CS, RN, a nurse manager for the Boston University Geriatric Services at Boston Medical Center, agrees. She encourages her nursing staff to be patient with their clients. Many are unfamiliar with the area's social services, and they need guidance.

When dealing with clients' families, she advises them to "do your homework first" by researching on the Internet, checking out local senior services or contacting the area agency on aging, before talking to the nursing staff.

"Once you gather information, you'll feel like you have more control over the situation," Wohlgemuth said.

Emotional whirlwind

But caregiving from a distance poses other problems. According to mental health experts, physical distance often is affected by a whirlwind of emotions.

"Whenever there's a caregiving situation, the family dynamics break down," Wohlgemuth said. She points out that the burden of care often falls to one child. Usually, the child who was always in charge takes over. To ease this transition, Wohlgemuth recommends families create a plan of action, allocating equal responsibilities to all family members.

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