Outsourcing care for the elderly to India

Steve Herzfeld has just spent five years of his life caring for his elderly parents as they succumbed to Parkinson's and Alzheimer's, deteriorated and finally died. But the family's story is extraordinary and even uplifting. Faced with crippling medical costs, Herzfeld took his mother and father from their home in Florida to India and managed to give them such a high level of care in the oceanside city of Puducherry (formerly Pondicherry) that they appeared to regain some quality of life and even dignity.

He began caring for his parents full-time in 2004. His mother, Frances, then 87, was virtually unable to speak coherently, he says, as Parkinson's disease gradually reduced her to "someone who was as helpless as an infant and also, in many ways, as lovable".

His father, Ernest, then 91, despite still being able to converse in German, French, English, Italian and Swiss dialect, was also incapable of looking after himself, as he had lost his short-term memory to Alzheimer's. "Like Mom, his disease was progressive and, towards the end, he was mentally like a two or three-year-old child," Herzfeld says.



Initially, Herzfeld was able to care for his parents in their Florida home. But when his mother had a fall, he realised he needed far more help than he could give them. Putting them in the cheapest acceptable home available would have cost $6,000 (around £3,700) a month, and they did not have that kind of money. More than that, Herzfeld did not want to take this route: he had noticed a marked deterioration in his mother's contentment when she had to spend a few weeks in a home after the fall.

Looking at all possible options, he considered Mexico and India as affordable locations. A host of reasons - including knowing India well and having friends there - made him opt for Puducherry, where the climate is similar to that of Florida and there is a supply of English-speaking care professionals. But every step of the move had to be planned in detail. The airline agreed to take Frances and Ernest only because a doctor friend flew out with them and took responsibility for them door to door. Another friend organised a house for them and set up the electricity, cable TV, air conditioning, furniture and broadband.

Once staff had been found, he could give his parents a much higher standard of care than would have been possible in the US for his father's income of $2,000 (£1,200) a month. In India that paid for their rent, a team of carers - a cook, a valet for his father, nurses to be with his mother 12 hours a day, six days a week, a physiotherapist and a masseuse - and drugs (costing a fifth of US prices), and also allowed them to put some money away.

Full story here.