Shaina’s* metamorphosis from long-distance daughter to long-distance caregiver started with a fall. Before her 89-year-old father slipped off a kitchen stool and shattered his shoulder Shaina traveled between her home in Israel and her parents’ home in New Jersey for twice-yearly visits that she combined with business meetings and get-togethers with friends and family. Her young-for-their-age parents had some medical issues but their lives were filled with activity. Shaina’s father had recently “retired” as his shul’s volunteer handyman and joined a daily program for seniors and her 84-year-old mother enjoyed her daily aerobics workout and part-time job as a paralegal. The fall changed everything. Even after three and a half months in a rehabilitation center Shaina’s father never regained all of his mobility and began to show signs of dementia. Her mother was diagnosed with cancer and then double pneumonia. The couple’s lives became a revolving door of hospitals rehabilitation health aides doctor visits and medical emergencies. They reluctantly began to rely their children’s help coordinating medical visits shopping financial management and some of their meals. “I felt that 5 600 miles was keeping me from sharing the job of helping our parents ” Shaina reflects. “I couldn’t give them the same amount of help as my brother and sisters who live nearby but I felt that I had to come to New Jersey more often and do the most I could for my parents while I was there.” She asked her siblings to schedule as many medical appointments as possible during her stays. Shaina helped tackle her mother’s to-do list of repairs and purchases and stocked up on groceries and nonperishables at Costco and ShopRite. “I also waded through years of papers to help my parents put their records and finances in order. Often I was ‘on duty’ 16 hours a day frantically trying to do as much as possible and still enjoy time with my parents before flying back to my family and work.”