home health care
Many opt for such homes offering specialist services for the care of the elderly because the costs of hiring private, full time can be prohibitive and also it can be an insurmountable task to effectively coordinate doctor visits and such.

With vast and growing numbers of Indians in the workforce emigrating to foreign lands, typically to North America, Western Europe, Australia or parts of South East Asia, many Indian families are now experimenting by either taking their elderly parents along with them, or, when that model fails owing to the loneliness of the elderly in a new country and their dependence on their children, they are sent back to India to face their uncertain twilight years more or less alone.

This trend has also accompanied the breakdown of the traditional Indian joint family system, with the result that a growing cohort of elderly Indians have to fend for themselves in old age homes far from any family connections.

“Initially healthcare was not a problem but as they are getting older there are more and more issues to deal with.”

Yet in some cases the elderly refuse to cut their ties to India to accompany their children abroad in the first place. Raghu Srinivasan (name changed) works for a tech company in the U.S. and has lived there for the past 22 years. His parents however, live in Ghatkopar in Mumbai.

“Despite my telling them for many years to move here full time they prefer to live in India,” he said, adding, “Initially healthcare was not a problem but as they are getting older there are more and more issues to deal with. Recently, after my father had a fall we decided to take the step of buying my parents an apartment in a colony for senior citizens in Bengaluru.”

Boom in senior housing

While senior communities in India were originally associated with charitable institutions and even with the rescue and rehabilitation of destitute among the elderly, those connotations appear to be transforming into the more luxury-focused retirement communities, at least for middle class Indians.

Many opt for such homes offering specialist services for the care of the elderly because the costs of hiring private, full time can be prohibitive and also it can be an insurmountable task to effectively coordinate doctor visits and such. In the new class of senior citizen colonies, many of these facilities are taken care of under a single package.

According to a 2015 report by the consultancy firm Jones Lang LaSalle India, India has a senior population of over 100 million and has an estimated demand of 300,000 senior housing units, valued at over $1 billion.

Different models

According to Mathew Cherian, CEO of HelpAge India, a large non-profit organisation working for senior citizens in the country, there are over 4,000 old age homes, of which at least 130 were designed as retirement communities geared towards the expectations and demands of the rising middle class and affluent NRIs. The cost of an apartment can vary from Rs. 25 lakhs to Rs. 1 crore and while some developers consider affordability of this housing to the general middle class segment of urban India, the higher end units are an attractive option for senior citizens whose children are living abroad. There are also different models of ownership besides outright sale including a lifetime lease and a deposit model.

Around three years ago, Bayada Home Health Care, a U.S.-based home health care company, acquired a stake in India Home Health Care, an Indian company. Bayada now offers a package specifically designed for Non-Resident Indians who have parents living in India. The packages range from $20 to $40 per month and are of two types – NRI Continuous Check-up, which aims at ensuring that the senior citizen’s health condition is monitored and health issues are detected as early as possible and acted upon accordingly, and NRI Close Monitoring, for which a closer and more frequent check is required.

The Close Monitoring package is a tailored service for concerned NRIs who want to keep a check on their parents, some of whom prefer to have the option to even monitor via closed-circuit television.

Another company, UberHealth, offers preventive health care packages at an annual subscription rate priced at about $200, but also offers one-time doctor visits which are cheaper.

UberHealth’s preventive health care package takes care of minute details, including booking doctors’ appointments, picking up the elderly parents and dropping them back, and having a representative accompany them to take notes on doctors’ feedback which will be sent online to the children abroad.

Another company called Parental Care India based in Kolkata allows NRIs to book specific services such as an emergency hospital or doctor’s visit at $15.

Yet the problem with all of these arrangements, helpful though they are to the elderly, is that depression brought on by loneliness can be a serious concern among residents at such communities.

According to Mr. Cherian, “There is not enough love and care in these places. Phone calls, Skype conversations, and rushing to India when a parent falls sick are just not enough.”

Networking for elderly

Thus, despite this growing sophistication of elderly care packages available on the market, old-fashioned social relationships with friends and neighbours may ultimately offer as much or more succour for the elderly whose children no longer reside in India.

Dhiraj Mirchandaney lives in Abu Dhabi and his mother lives in an apartment in Mumbai central. He says that for most health care needs he relies on neighbours and relatives whom he describes as a second family, yet he too has taken the innovative step of fixing a CCTV camera in the house that he can monitor remotely, an option that additionally makes his mother feel safer.

Similarly, some among the elderly proactively take steps to build up a network of social contacts that can to some extent mitigate the loneliness that inevitably comes from the distance between these elderly parents and their children settled abroad.

Ramesh Kapadia, a resident of Aurangabad, started the Non-resident Indian Parents Association 12 years ago as a way for parents with children living abroad to keep in touch.

“When I used to go visit my daughter in Canada, I met a lot of other parents who had come over from India and we used to spend time together since our children were busy quite often, with their own lives… When we were back here I decided it’s very important to maintain a social network, so we have telephone meetings and other events and we have members now from all over India,” Mr. Kapadia says.

“The majority of parents of NRIs that I meet spend a part of the year with their kids and some time back in India,” says Satish Rao, a Mumbai resident.

“Since the kids have been gone from a young age that means the parents like us have spent many years alone and so it is always advisable to build a social network where like-minded people can communicate with each other.”

In recognition of the fact that the number of such parents is growing every year, NRI Parents Organisations have been established in several cities and are on Facebook in Mumbai, Aurangabad, Pune, Vadodara, Bengaluru and other metros.

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