I’ve been fortunate to live abroad much of the past seven years, first in Spain and now having spent the past four years in Shanghai, China. Mark Twain famously said, “Travel is fatal to prejudice, bigotry, and narrow-mindedness.” I don’t necessarily think you have to live overseas to acquire wisdom, but I do know that my experiences have helped broaden my mind, broken down assumptions and even changed the way I deal with and approach things. Here are just a few of the life lessons (or aging wisely lessons) I’ve learned from living in other cultures and especially from my time in China.

No one (or one culture) has it all figured out.

I learn or observe something new every day, sometimes just going to the grocery store or walking around my neighborhood. I remember being so impressed with the sink setup at the local hairdresser…they have a little headrest in the sink so it’s a lot more comfortable on your neck (it may seem minor but this was a revelation to me!). Here in Shanghai, I love the amazing entrepreneurial spirit and inventiveness to create solutions with a huge population and urban environment. You can get almost anything delivered to your home…the streets are filled with scooters bearing lunch, groceries, and online shopping deliveries (and even a cart full of chairs).

Interesting new services pop up every day and the lightning speed of technology adoption is stunning (most of us now pay for the majority of things, including splitting the bill with friends, with our phones in just a couple clicks).

I love picking up new ideas, as well as gaining an appreciation of the many things the U.S. does so well. Even if you don’t live or travel abroad, just observing and being open to new things (just look at the pace of new technology) can make life easier and better.

You can always make new friends and find new things to do/learn.

When you’re an expat, you have no choice in this (unless you want to be miserable). You have to seek groups and events for your interests and get to know new people. I usually do at least a few new things each month, even though I’ve now been living in Shanghai for four years and have established favorite places and good friends. I’ve been to author talks, elder storytelling, language exchanges, cooking classes, calligraphy workshops, Chinese wine tastings, lectures on Chinese weddings and other aspects of culture, bike and walking tours, film screenings, special interest group discussions and so much more.

A holiday party at our Mandarin school

I use Meetup to find activities of interest and read the local publications for art openings, concerts, new restaurants, markets and events.

Vegetarian cooking class in a local home with new friends

If I’m looking for a group or activity I can’t find, I’ll consider starting one myself. You can do this even if you’ve lived the same place your whole life! It keeps life interesting and expands your mind.

Learning the Chinese yoyo with local elders (plus storytelling)

There’s interesting stuff all around you.

No matter where you live, take time to “smell the roses” as the saying goes. I find one of the best ways to do this is by taking walks. It’s a good way to stay healthy but it’s also fun because you get to take in your environment. When I lived in Spain, I spent an average of two hours/day walking along the Mediterranean coastline, observing the families out for a stroll, soaking in the sunlight and getting a kick out of the way the seaside restaurants hung their octopi out to dry.

In Shanghai, I love walking in the many local parks where I watch families enjoy themselves and older people dance and practice tai chi. Even just strolling through the neighborhood is fascinating, with the mix or urban life and skyscrapers with old markets (live fish and chickens for sale and more of those interesting drying methods) and colorful laundry dotting the windows and trees.

Laundry with a side of chicken

One of my favorite locals

Any time (and place) is good for a nap!

Family is precious and living apart doesn’t mean you can’t be close.

Many multigenerational families live together in China, which is pretty different from how I grew up but doesn’t necessarily make me any less close to my family (even now that we’re several continents away). Here too nowadays, more families are separated for economic opportunities, whether it’s studying or working overseas or more commonly migrating to the larger cities. Since living abroad, I make a point to plan longer visits home and since I’m usually staying with my family, I have actually spent more time with them since living overseas.

A recent visit home with my Mom, aunt and cousin

While everyone’s situation is different we can all stay close to family members in various ways…planning longer visits when possible (and trying not to always go just during hectic holidays), meeting up somewhere (and hopefully welcoming them to visit you) and regularly Skyping, emailing, calling and texting. We also keep in touch and share our adventures with family and friends by sending postcards from all our trips.

Staying active and engaged will keep you “young at heart” (and in body).

When I talk to people about getting older in China a lot of them look to their retirement years longingly. They see it as a time when the restraints of work are gone and they can enjoy favorite activities and spend time with friends and grandchildren. Elders are often integral in child-rearing, taking on active roles in the mutligenerational household in caring for grandhildren and supporting the working parents.

The best place to see the life of older adults in China is in the local parks and street corners. On any given day, there will be a range of activities from dancing to tai chi and exercising on the outdoor gyms. This activity and engagement may very well be a big part of the high life expectancy and low disability rates among elders here (there are now over 1,000 centenarians living in Shanghai).

Elders will gather to socialize, drink tea, and play games. Others will simply enjoy the outdoors with solitary activities like reading, playing a musical instrument or practicing calligraphy (often done with large brushes and water on the pavement, symbolizing that everything in life is fleeting).

I can hardly summarize all the gifts I’ve been given being exposed to different cultures and meeting wonderful people from all over the world. I hope you enjoy these few insights and pictures. As China’s population is aging and less young people are available for caregiving, they’re facing the challenges of eldercare and developing new ways to manage the needs. I will continue to learn and share more on that topic as well. I always love to chat about travels, culture, China and more so I welcome your emails/feedback: shannonmartin(at) agingwisely.com.

There are so many great technology tools for caregivers, whether you live near or far from your aging loved ones. Our team has worked with thousands of families over the years and we stay updated on the constantly evolving technology tools for caregivers and care management.

From electronic pill dispensers to in-home safety systems and online care portals and apps of all kinds, we’ll help you understand and identify the tools that might be most useful for you. Join us to learn more!

Technology Tools for Caregivers Near and Far

Tuesday, August 2nd, 2016  1pm to 2:30pm

EasyLiving/Aging Wisely Office

1180 Ponce de Leon Blvd., Suite 701, Clearwater

Download the Caregiving Technology Workshop flier for details and share with your friends.

Limited to the 1st 20 attendees. Call to reserve your seat TODAY. RSVP to 727-447-5845 or linda(at)agingwisley.com.

The reasons individuals and families choose (or are chosen for) an expat life are varied, as are their experiences. But, the expat life comes with certain commonalities. One of these is being separated from “home” and most of your family. This can be especially challenging (and guilt-ridden) when your parents or other loved ones have health issues. I shared a little insight from my personal expat life (and tips to be prepared) in the last post and today I’ll share some useful “caregiver hacks” for those living an expat life (and all long-distance caregivers) while trying to make sure things are okay back home for older family members.

Long-Distance Caregiver Hacks

Messaging Apps

What’s App, WeChat or even Facebook messenger can be quite useful when you’re living abroad to keep in communication with loved ones back home. These apps generally use small amounts of data (or you can limit usage to wifi) and provide an easy way to send quick messages to check in. For expats like myself in China, WeChat is ubiquitous and I asked my parents and some friends to add it to their phones so we can chat easily. With WeChat and many of these apps, you can do more than simple texting. We send pictures, video, “walkie talkie” (voice) messages and can even do a VOIP phone call within the app.

VOIP/Video Calling

I highly recommend Skype, though there are other options and iOS users may be able to primarily use Facetime. However, Skype is great for the expat life for a couple reasons: you can get a dedicated phone number and you can get packages (or buy credit) to call phones. I have a $2.99/month package for unlimited calls to the U.S. and Canada. It’s handy for me to call my bank, tax/financial professionals, etc. and can be great if you are helping coordinate care for a loved one to call doctors and more (and to call loved ones who don’t use Skype or Facetime).

I purchased a U.S. phone number on Skype also and pay a nominal fee for it. I ported my old cell phone number years ago to a Google Voice number and I can go into Google Voice and forward that to my Skype # or any other U.S. # (for example, when I return to the U.S. I have a local SIM card and therefore no one has to learn a new phone number to reach me). While this may sound a bit complicated, it is very easy to set up and makes things seamless. Google Voice allows you to get voicemail (which they’ll transcribe and send via email) and text messages.

With this setup, I am never out of reach no matter where I’m traveling (unless I’m asleep due to the time difference). Skype and Facetime are also great because being able to do video calls provides a feeling of closeness (and a useful visual check) you can’t get with just voice.

Being Organized On The Go

When you start off in the expat life, you’ll need to get yourself organized and it’s easy to extend this to working with aging parents to make sure they’ve done the same. Use our document locator list (adapted from the Foreign Service Worker Family Liaison office) to get together your (and your parents’) vital documents. Store these in a secure file and make copies of documents that might be needed by others. For example, we store copies with my in-laws and have the most important documents that we would potentially need with us as well. We keep our advance directives and documents we regularly need for visas, etc. but if we need something else they can scan and send it (or FedEx it if need be).

Store the documents and information you might need access to in secure cloud storage. Even simply having a copy of the basic info (doctors’ contact information and advance directives) on your phone or computer is useful (but please backup and ensure that passwords, financial info., etc. are stored securely).

Medical Record Portals

First, an electronic medical records/care system can be very useful if there are active medical needs (or even to be prepared with a full history and information should there be an emergency…pulling all that together on the spot is no fun). There are a lot of options available. Our EasyLiving/Aging Wisely team has used several systems over the years as they’ve evolved and we’re currently using ClearCare.

Second, most doctors’ offices now offer electronic patient portals, where patients can get their test results, message the doctor and more. Even if your loved one doesn’t want to use it, you can be permitted access if they allow. This can be a lifesaver when trying to help out from a distance.

Care Managers

Of course, I couldn’t leave out the value of care managers when you are caregiving from a distance. You can set up a phone/Skype consultation with a care manager in your parents’ area for help preparing and identifying critical issues. The care manager can carry out tasks so you don’t have to fill every visit with tasks, losing precious quality time with loved ones. You can also hire the care manager to check in regularly, attend doctor’s appointments and be on call for emergencies…all especially useful if there are no local family members.

Travel Tips

1. Plan longer visits. Jet lag is part of the expat life, but that alone makes it worth spending longer times when feasible (and with expensive flights or companies providing limited paid home visits, it’s best to take advantage of the time when you can). Don’t rush the time with your family members, as you will surely have tasks to complete along with observing how things are going and spending some much-needed time together.
2. Try to get airline status (if possible, picking one primary airline and looking into which credit card and partner programs are worthwhile). When living overseas, having a preferred status makes travel a lot easier. I’ve never been to the level of getting business class upgrades on the overseas flights, but I do get to join the priority line, bring more luggage for free…and the reality is that the service level is better when you need help. I’ve never done it, but it is probably worth it to join programs like Global Entry as well (or check out the brand new Mobile Passport app, rolling out in various U.S. airports). There are other beneficial programs like the APEC business traveler card.
3. When you need help from the airlines or travel companies, social media can be a useful tool. I’m not suggesting going on to Twitter to blast them, but many times the people charged with social media are more responsive than the general customer service staff, as they have the public image in mind. I’ve had good success reaching out (particularly via Twitter) when I’m running into difficulties.

Contact us for help with long-distance caregiving concerns. Our care management team is highly experienced helping caregivers all over the world and we’d love to share our insights and resources with you!

My Personal Story as a Long Distance Caregiver

Our team works with long-distance caregivers every day, so we have been through all kinds of situations that families needed to face from far away…from a middle-of-the-night hospitalization to the parent who is found lost on the highway. Even having worked with many families over the years, my personal experience as an expat caregiver really drove home the points we often shared with caregivers. I was living in Spain when my Mom broke the news that she had been diagnosed with a brain tumor that required immediate surgery.

Shock, tears, fear, and a frenzy of planning followed. Within a few hours I had to deal with changing flights on less-than-sympathetic airlines, figuring out if I could even make it prior to the surgery and how to rearrange various plans. Within a short space of time, my world (well, our world) was turned upside down and I found myself back home spending nights in the hospital while still adjusting to the time change. Fast forward a few years and thankfully (and mostly thanks to the great doctors at Johns Hopkins) my Mom is doing well, but living in China we’re even further away from our parents. I meet many expats who travel home frequently to take care of tasks for aging loved ones or do daily Skype calls to check up on things. Even those not actively involved in caregiving, like myself, can’t ignore the reality that we are far away from loved ones who might need us any time.

Long Distance Caregiver Tips and Resources

As a long-distance caregiver, you face special challenges. Not seeing your loved one on a regular basis can make it easy to miss things.  There’s added guilt at not being there and worries about what is happening. But, one of the most difficult things may be dealing with emergencies. There’s a feeling of panic when the phone rings at an odd time and the incredibly stressful reality of quickly arranging a trip when you just need to be there as soon as possible.

You can’t control emergencies, but there are some things you can do to better prepare, whether you’re caregiving now or may be called upon to do so in the future.

• Know local resources. Who would you call when you get “the call” and what resources can help now? Reading blogs like Aging Wisely’s can help you be attuned to things that might help. You can do a little research through the local Area Agency on Aging and providers, and a consultation with a professional can help you understand which resources you might wish to access.
• Establish a support system, especially people who can help in a crisis and be there until you can get there. I’m lucky to have a brother who lives near my parents, but neighbors, friends and trusted professionals can help too. If you are actively caregiving for parents who need help (whether they live at home or in a care facility), consider services like on-call geriatric care managers (for example, our team offers an annual plan which gives you access to our on-call care managers should an emergency occur, meaning your loved one doesn’t have to be alone in the E.R.).
• Check in regularly. Some emergencies can actually be avoided by spotting signs that things are changing. Regular phone calls (or better yet, Skype or Facetime) are useful but also plan sufficient time when you visit to spend time together and observe things. Check out our Warning Signs handout.
• You have to be even more prepared and organized when you’re living far away. Expats tend to be good at this. We had to figure out international health insurance, coordinate housing and schools in a foreign country, organize our records, deal with taxes long-distance and more. We need to use those skills to help our parents (P.S., It’s a good way to spark the conversation too–“I did it, let’s do it for you”). Organize medical records and advance directives, and store them securely online for easy access. Make sure someone local knows where/how to access them. Put all the important contacts into your system/phone. Use an online system to communicate with other family members. (We use a great system at Aging Wisely called ClearCare and each client gets his/her own “Family Room”. My family has also used Caring Bridge for keeping friends and family up-to-date on the person’s health journey.)
• Don’t forget actual disaster preparedness. Check out our recent Disaster Preparedness post and our library of resources at EasyLiving. Go through a disaster checklist process on one of your visits.
• Create a crisis plan. You might not know what will happen when, but you can work with your support system to create a plan for what to do if a crisis occurs. This goes back to who can get there immediately, as well as how you communicate with each other. Know who to contact at the airlines if you need to take an urgent flight (I’ve found certain airlines are much better than others and they tend to respond well on social media when you’re having trouble getting a good response with customer service). It’s easy to find information online even in the moment of crisis, but if you have a few things thought out ahead of time you can save the added stress.

This is just an overview to get you started, but stay tuned for more “long distance caregiver hacks”…resources and ideas that our team has found to be truly helpful. If you’re not already, sign up for our newsletter or join us on Facebook for the latest!