Caring for a parent with memory loss when you live abroad

Somebody local has to be real, not theoretical

Care at a distance fails in the same place every time. There is no named person within thirty minutes who can walk in. A cousin who visits when asked is not that person. A neighbour who has your number and has actually used it is.

Whoever it is needs three things from you before anything goes wrong: your number saved under a name they will recognise in a panic, permission to act without checking first, and a reason to keep saying yes. Paying somebody properly is not a failure of family feeling. It is what makes the arrangement survive its second year.

Put the ordinary days on a rhythm

Families abroad tend to organise the emergencies and leave the ordinary days to chance. The ordinary days are the ones that decide how your parent actually feels, and they are also the ones you can shape from six thousand kilometres away.

Rhythm beats intensity. The same person calling at roughly the same hour, a fixed day for the grandchildren, one small predictable thing in the evening when the house goes quiet. Your parent may not be able to tell you the schedule and will still settle into it.

• Pick times and keep them, even short ones. Predictable beats long.
• Split the week with your siblings out loud and in writing, so nobody is waiting for somebody else.
• Tell the people on the ground what the rhythm is, so they are not working against it.

The paperwork you will wish you had started earlier

Bank access, a power of attorney, the Aadhaar and PAN details, the building society contact, the name of the doctor who has known your parent for years, the pharmacy that delivers. Every family gathers these eventually, and almost every family gathers them during a crisis at three in the morning.

Get them into one place that you and one sibling can both reach. It is dull work and it is the highest return thing you can do with a week of leave.

The guilt is not information

Most people reading this have a background hum telling them a good son or daughter would have moved back. The hum is not evidence. It says nothing about whether your parent is safe, whether the arrangement is holding, or what would actually change if you were in the same city.

What helps is asking the answerable questions instead. Is somebody with them. Does the week have a shape. Are the bills paid. Did they hear a familiar voice today. Those have answers. The hum does not.

What your parent will actually remember

Not the money, and not the arrangements. Families report the same thing again and again: what lands is contact, in a voice belonging to somebody they love, in the ordinary part of the day rather than on the occasions.

That is the part distance takes away first. It is also the part that is easiest to rebuild on purpose, once you stop waiting for a free evening that keeps not arriving.

Where else to look

These are other people’s pages, not ours. Our own published work and the neurologist who reviews it are on the research page.

• Cultural adaptation of Alzheimer’s disease assessment scale-cognitive subscale for use in India and validation of the Tamil version for South Indian population.
  The cultural adaptation of the same questionnaire for use in India.
• Hindi Version of Addenbrooke’s Cognitive Examination III: Distinguishing Cognitive Impairment Among Older Indians at the Lower Cut-Offs.
  A Hindi memory questionnaire validated for older adults in India.
• Alzheimer’s and Dementia Support, India
  The Alzheimer’s Association’s own pages for families in India.