Q Just as I returned here from a summer visit in Michigan to my 82-year-old mother, she fell down some steps and injured herself. Her recovery has been very slow, making me realize that I can no longer take for granted her good health and ability to care for herself. Though I've lived away from her for 23 years, it breaks my heart, now that she may really need me (she is a widow) that I can't look after her. I know there are many people in my situation, and just wonder how they cope and if there are support groups on that subject in Paris.

A One quarter of US households, according to one estimate, are faced with caring for an elderly family member. Being far from your mother of course adds extra weight to this burden - not only the anxiety due to distance, but also guilt at not being able to do what you think is called for. When people are emotionally close to their old parents, the pain is even more intense.

Though I know of no support groups in Paris on that subject, there is lots you can do on your own to insure that your mother is well looked out for, even if you, personally, are not present. Because this issue has become so prevalent, there are scores of organizations providing abundant advice and information on all aspects of caring for the elderly. A/PACT (Aging Parents and Children Together) puts out a number of booklets dealing with the legal, health, and financial issues facing old people, as well as supplying concrete suggestions for alternative living arrangements, finding geriatric care, tapping into community resources etc. Even if your mother is still mentally agile, documenting yourself thoroughly in advance on all these eldercare issues will stand you in good stead if the situation deteriorates suddenly. The Web is an excellent place to start your search.

Many communities are amazingly active in the services they provide to the elderly, and you should definitely look into what's available where your mother lives the next time you visit. If you're thinking of moving her into a group living situation, tour the options and arrange for interviews. Even if it seems premature, this advance preparation is a way of taking care of and protecting your mother.

If she has not expressed concern about her future to you, you will have to bring up the subject, and this can be difficult, especially when your time together is limited and you want it to be pleasant. Older people often resist such conversations, sometimes aggressively, as it vectors the idea of their deterioration and death. If this is your mother's case, try turning things around, making it seem as though she is caring for you by agreeing to discuss her future, rather than the other way around. Stress that you want to make sure to respect wishes that she expresses while she is still in good health. At the same time, your own prior research should enable you to channel the discussion in constructive and realistic directions.

Isolation is one of the worst problems for the elderly, so start now lining up a support system for your mother. Call all her relatives and friends to find out who can be depended upon to visit regularly or occasionally. It's amazing how fast people - even so-called close friends - melt away in the face of adversity. Check around for paid helpers, too. If treated fairly and with respect, they can be a life-saver when adult children live far from their aging parent. If your budget permits it, consider more frequent - if shorter - visits back, and of course regular phone calls and notes or cards mean a lot to older people who are not computer-savvy.

Being an active participant in your parent's care is possible from a distance, and can mitigate the sense of powerlessness that many expatriates feel in this area.

Jill Bourdais is a psychotherapist practicing in Paris both privately and in a hospital setting. A specialist in couple/family problems, she organizes workshops dealing with improving relationship skills and building self-esteem. Tel: 01 43 54 79 25. Questions for the Close-Ups column may emailed to her directly at This e-mail address is being protected from spambots. You need JavaScript enabled to view it