Distance from older adult Under 1 hour away 1 to 3 hours away More than 3 hours away Out of state or difficult travel
Current check-in rhythm Daily or nearly daily A few times each week Occasional or inconsistent Mostly after problems happen
Trusted local helper Reliable local helper is available Some local help, but gaps remain No trusted local helper yet Paid caregiver, agency, or facility staff involved
Most urgent coordination need Daily safety, meals, or home routine Appointments, medicines, or care-team updates Bills, insurance, benefits, or paperwork Housing, home care, or facility decisions Not sure what needs attention first
Communication reliability Phone/video/text works well Contact is uneven or missed Technology, hearing, vision, or language barrier Answers are confusing or changing
Medical appointment coverage Someone can attend or get summaries Some appointments lack a helper Mostly remote follow-up Not sure what is scheduled
Medicines and supplies Refills and supplies are organized Some refill or supply gaps Instructions or responsibility are confusing Not reviewed recently
Home safety and daily needs Mostly steady Some concerns about meals, falls, clutter, or chores Safety or supervision concern is growing Home has not been seen recently
Money and paperwork role Not involved Helps organize bills, claims, or records Has formal permission or role Role or permission is unclear
Emergency backup plan Written and shared Informal but not written Needs updating Missing or unknown
Use broad planning details only.
Do not enter names, addresses, birth dates, diagnoses, medication names, Medicare numbers, Social Security numbers, account numbers, passwords, claim numbers, or private family details. Keep real contact lists, permissions, and records in a secure private folder.
This planner is educational and organizational only. It is not medical, legal, financial, insurance, benefits, tax, care-management, or emergency-response advice. Confirm personal decisions with qualified professionals, official agencies, and trusted local contacts.
Official references:
NIA long-distance caregiving ,
NIA how to help from far away ,
National Family Caregiver Support Program ,
Eldercare Locator .
