When Charles Sterling's 75-year-old mother suffered a stroke earlier this year in Michigan, he was at home in California, three time zones away.
Sterling has spent the weeks since then keeping up with phone calls to his mother and e-mails to his siblings. He also took time off from work to fly to her bedside.
His mother's recovery has been heartening, but the long-distance caregiving has been frustrating.
``There's always that feeling of `Oh God, if I were there, things would be a lot easier,''' said Sterling, a human resources consultant in San Francisco.
A growing number of Americans are logging miles and hitting the phones to help care for ailing loved ones far away.
About 7 million Americans provide or manage care for a relative or friend over age 55 who lives at least an hour away, according to the Family Caregiver Alliance, a California-based advocacy group.
The alliance's Bonnie Lawrence said the numbers are up because of a convergence of demographic trends: aging baby boomers, more women in the work force and people moving around more.
Taking care of an ailing parent can be burdensome whether the patient lives around the corner or across the country. But distance adds to the challenge. Frequent visits can be difficult, arranging for care via phone and e-mail can be hard, and feelings of guilt or helplessness can be sharper.
``You're not there to follow up on everything that's supposed to be done for her,'' said Mary Scott, a Memphis, Tenn., resident whose mother is in an assisted living facility in Ypsilanti, Mich. ``I'm not there to hear about her accomplishments or hear about her day from her.''
The average long-distance caregiver lives 450 miles away from the person being cared for, roughly the distance from Chicago to Buffalo, according to a poll conducted last year for the National Alliance for Caregiving and the MetLife Mature Market Institute.
Respondents to the poll, conducted by Zogby International, reported spending an average of $392 a month on travel and out-of-pocket expenses. They also reported missing days on the job, rearranging their work schedules or dropping down to part time.
Sterling's widowed mother lives in Mount Pleasant, Mich., 2,000 miles from San Francisco, and his brother is in Atlanta. His sister lives in Ann Arbor, Mich., still about 100 miles away from their mother. After scrambling for morsels of information, Sterling and his siblings agreed his older brother would become the coordinator.
``Part of the challenge was to figure out `Who do we go to for information?''' Sterling said.
Then there is the guilt. Lawrence said parents, not wanting to ``burden'' their children, sometimes do not mention problems on the phone that would be obvious in person.
``And if you're just talking to them on the phone, things sound fine,'' Lawrence said. ``When you then pay them a visit ... you suddenly arrive home to find bills stacked up and the house in disarray.''
So how do you care for a loved one from afar?
Experts advise arming yourself with information. Assess your strengths and limits, and work out a plan with friends and relatives who will be your fellow caregivers.
Figure out what can be done from a distance, such as paying bills or calling insurance agents. Use the Web and the phone to get information on things such as medical conditions and community resources.
Investigate community services that can fill in caregiving gaps. AARP recommends contacting the Eldercare Locator at 1-800-677-1116 or www.eldercare.gov.
The Family Caregiver Alliance offers these additional tips:
_Involve the person needing care in decision-making.
_Write or call on a regular basis to show emotional support.
_Identify people close by your loved one who can help out, such as a friendly neighbor or clergy.
_Take care of yourself; don't take on too much or you will risk becoming frazzled or run down.
_ Think ahead; it is easier to gather information about doctors and finances before something bad happens.
Sterling said that is one big lesson his family learned from dealing with his mother's ailment.
``We've always had our heads in the sand a little bit,'' he said. ``She's always been fully capable, but we've always known in the back of our minds that someday we would get this call.''