KEY POINTS:
Families who are struggling to pay the spiralling costs of care for their elderly relatives could soon have a new cheaper option: outsourcing to India. Extreme though this idea may sound, one man has already made the move successfully with his parents and the concept is being regarded with interest by care charities.
American Steve Herzfeld, 56, had been caring for his elderly parents for three years when, at his wit's end over finances, he decided to relocate them to India last November. The three of them rented a house in Puducherry. With the help of a friend, Herzfeld organised a team of six staff to nurse, massage and care for his parents.
They pay £1000 ($2920) month for the house, bills and medication - leaving them with money to put aside for a rainy day. Had they stayed in the United States, they would have faced nursing-home fees three times that amount. Herzfeld's parents would not have been able to afford such charges - and, anyway, he could not face the prospect of putting them in a home.
Frances Herzfeld, 89, was suffering from advanced Parkinson's disease and Ernest Herzfeld, 93, has Alzheimer's. Steve Herzfeld had retrained as a nursing assistant, not so much to nurse them himself but to know enough to manage their care. However, by late 2006, he knew that they were so fragile that they could not continue as they were.
In the Florida nursing home he found for his mother, he knew she would spend her time "in a wheelchair, with five others in a room, while a nurse read the paper all day".
When a friend suggested the idea of relocating to India - for its far lower nursing costs and the promise of some quality of life for his parents - Steve, who is a disciple of Maharishi Mahesh Yogi, founder of the Transcendental Meditation programme, could see a lot of merit in this apparently outlandish idea. He had spent five years in India before, knew the country and also could count on considerable help from his friend. So they moved to Puducherry.
Frances died in May but Steve still feels the move was worthwhile. "The big benefit was seeing my parents still had some dignity in their life," he says.
However, he would only recommend that others took the same route if they had family or friends there or had lived in India before. "I don't want to encourage people to do it when they could be unhappy," he says. "This is an environment that some Westerners thrive in and others don't like particularly." Finding English-speaking staff has been difficult, as most of them can get better-paid jobs abroad.
Nonetheless, wages for a nurse amount to about £125 a month and drugs cost a fifth of what they do in the US. Instead of using every cent to pay for care, the father and son are now actually able to put some away.
Despite his own reservations, Steve Herzfeld is clearly a pioneer and others - potentially millions - may want to follow him to warmer climes and more affordable care.
Nevertheless, there may be more pressure soon from a demanding baby-boomer generation of pensioners that is prepared to question authority and traditional stances.
When the issue starts being debated, it will have to be an international discussion, not a national one. Within Europe, pensioners are tending to move from northern countries - such as the United Kingdom and Germany - to the south, to Spain, Greece and Italy. Sooner or later, this will need to be addressed on a European or global level. The World Demographic Association says the global population of 80-plus-year-olds is set to soar from 90 million now to 400 million by 2050.
Healthy Outcome
* The American family, parents and son rented a house in Puducherry.
* The son was able to hire a team of six to nurse, massage and care for his parents.
* The cost is £1000 a month for house, bills and medication.
* Had they remained in the US, the nursing home fees would have been three times that amount.
- Observer
