Guide to long-distance caregiving for NRIs

Elderly parents of an NRI sitting in a park

How can you help your loved ones maintain their daily routines & health?

Where do you get the up-to-date information, contact details and service charges for clinics and medical labs in India? Most importantly, how do you find the time to arrange everything whilst having your job, house and kids to look after? 

We’ve put this guide together to help you navigate the Indian healthcare and homecare system remotely. Whether you’ve already been looking for ways to support your parents or have not faced this issue as of yet, it’s helpful to know what options you have and how other NRIs deal with long-distance caregiving. 

If your parents need any help right now, please use our WhatsApp chatbot.

1. Are your loved ones in pain? First of all, assess how urgently they need help. For ambulance services, refer to this detailed guide on getting an ambulance in India. It’s always helpful to prepare a list of nearby ambulance services with phone numbers and full addresses in advance and put it on your parents’ fridge or somewhere easy to notice. 

If your parents need primary care

Doctor consultations

2. Make the most out of phone and video consultations. Covid-19 has pushed most of the medical consultations online. This gives NRIs a good opportunity to participate in the calls and support parents in their medical journey. Do try to be available during online consultation calls, your parents would need and love your support. 

3. Ensure your parents have access to a good GP. Did you know that the trend of a family GP is vanishing in India, with people directly approaching specialist doctors? However, the elderly do need that trusting connection who can add the dots from different specialists. Also, approaching specialist doctors directly is usually more costly. The perfect scenario is to find a GP that agrees to do home visits. 

4. Check doctors’ experience before requesting appointments. Mostly, parents in India purely rely on references instead of profiles; and miss the point that everyone’s medical needs are different. Both the profile and references are important. 

5. Try to work with a GP who understands your need as an NRI and updates you or is happy to have you join video consulting calls. 

6. Don’t ignore physiotherapy, it’s a common need in older age and it helps prevent or maintain long-term conditions. People in India tend to compare physiotherapists purely on a medical degree and costs, instead of their experience and their focus within physiotherapy. Please speak to the physiotherapist and ensure he or she is the right person for the kind of treatment your parents need. If not sure, please confirm with the specialist doctor. 

7. In some situations, a second opinion helps. With the internet, you have access to more doctors than your parents do. Do not hesitate to reach out to concerned experts in other cities to take a second opinion – a number of treatments are standardised globally, and it is quick and easy to take a second opinion.

8. Don’t automatically go for the cheapest solution. Bargaining and discounts are a common aspect in Indian society and have split-into the Indian healthcare industry as well. Some segments of the industry offer discounts, but they always cut corners to offer it. Do ensure that you do not miss out on quality service standards to save some pennies. This is mostly seen while purchasing medicines, arranging blood tests or requesting physiotherapy sessions. For example, most of the homecare companies will mostly send a junior physiotherapist while also offering discounts. 

We are here to help you book a doctor consultation if required. Simply start messaging us on the 24/7 WhatsApp chatbot and we will find a quick and on-demand customized solution for your parents.

To help parents with diagnostic tests 

9. Stick to national or regional diagnostic brand chains. A number of diagnostic chains are available in the major Indian metros, and the cost is not a very big challenge for NRIs. But when choosing between testing standards used by a local diagnostic center and a national diagnostic chain, we’d recommend you to always go for a bigger chain. 

10. In pandemic times, do try to get the test done at home with the reports sent via email. You can use your email ID so you are aware of what is happening. 

To help parents with medicine management 

11. Take prescriptions seriously and try to help your parents monitor medicines. The challenge is not to purchase prescribed medicines but to get medicine boxes that are arranged best to be taken on time and in the right order, also medicines are not mixed up and the refills are not missed. There are some medicine reminder apps that can be downloaded on parents phone (not an easy task, we agree), while some companies arrange dose-wise supply of medicines, right to the door. 

To help parents with payments and arrangements

12. Payments are still not easy – only very few service providers accept online credit card payments, while a number of platforms work on OTP systems and most of the offline services prefer cash payments, making it difficult for NRIs. Try staying with service providers that understand your position as an NRI and accept bank transfer of funds, at least.

Some good news if you haven’t had the task of helping your parents with healthcare or maintenance arrangements for a while; it has become easier during the pandemic since the Indian medical industry has moved online.

Be patient with your elderly parents who are facing a new challenge of arranging appointments, coordinating diagnostic tests on the phone or the internet, and getting used to online video consultations. At the same time, fortunately, this presents a good opportunity for NRIs to provide care for parents from outside India, or even get services of a virtual assistant who can do the research and arrangements for you. The latter can start from as little as Rs.300 for half an hour (imagine how much stress it would save you and your parents!)

If your parents need help with care at home 

Home care in India mostly involves nurses or care attendants. Their services can be booked via a local homecare agency or a branded homecare company. Please keep in mind that this part of the industry still remains highly unorganized, compared to hospitals and diagnostic chains in India.

To help parents select a caregiver 

13. Make a list of required tasks before looking for a caregiver. Ideally, consult a doctor beforehand as well. This list would help you decide if you need a nurse or a care attendant. You should ask for a nurse if the tasks involve any kind of medical work (checking vitals every day, injections, etc), whereas a care attendant would be a better choice for the chores such as feeding, maintaining hygiene, exercising, and walking. 

14. Ask your homecare company to share full details of the caregiver, including work experience and whether they have worked on these required tasks before. Do ask for a call with the person to better understand if he or she is suited for your parents’ needs.

15. Always push for a background verification before hiring. The process should include qualification and work experience proof and a quick police record check.

16. Ask for a trial before committing for a longer term – even if it’s paid trial! In just a few days, your family can get a better understanding if the caregiver is suitable for the medical, non-medical and emotional needs. In the end, it is all about two or three people who need to get along well for a few weeks or months.

17. Homecare won’t always go smoothly, so choose a company that can solve everyday challenges. Are they responsive to your questions? Do they share information or hide it? Are they easily available on chat or a call? Do they focus on patient problems or are commercially inclined? Read our guide to homecare for more important parameters to judge companies. 

To help parents with the management of homecare 

18. Please note and explain to the family the difference between a care attendant and a domestic helper. A domestic helper can also work as a care attendant where no medical tasks are involved. However, unlike a domestic helper, a care attendant is trained as a caregiver and can provide much more. Forcing caregivers to do domestic chores all the time is one of the biggest reasons why they leave a job before the end of the contract.

19. Make sure your homecare company can arrange a replacement if the caregiver has to leave for any reason – this type of situation is very common in India. 

20. Ask for a monitoring system or arrange one of your own. Parents of NRIs could be living alone and sometimes there is nobody to check if the caregiver is doing the right things at the right time.

21. It’s important to understand that homecare companies in India do not have caregivers enrolled on a permanent salary basis. Caregivers work as freelancers, and the same caregiver can work for 2-3 different homecare companies. In the end, the key decision-making factors would be the ability to solve problems without troubling parents, replacement, ease of updates, and costs

Read our guide on selecting the right caregiver for your parents in Insightscare Magazine. 

If you have any specific requirements or need to arrange a few things at the same time, we are always here to help you via our 24/7 WhatsApp chatbot. ParentCare combines a range of services under one umbrella and makes them more accessible to NRIs, from follow-up communications with your parents’ doctors to credit card payments available.  

If you’ve noticed changes in their mental health 

The trickiest part is when there’s no specific healthcare or maintenance need, and yet there’s a reason to worry. Try and be a good listener during your calls with parents to notice any changes in their mental health. 

At times, there are serious external circumstances that need to be dealt with such as the loss of a partner. Many NRIs feel lost as to how they can be helpful in these situations. 

22. Nearly three-quarters of over 75s that live alone feel lonely. The obvious cause of loneliness is suddenly finding yourself on your own – which could happen at any time. Apart from the grief, their entire daily routine could disappear, and this is where you can help. Try to figure out how they spend their day and suggest new routines to help them get through it.

23. Another way to tackle loneliness is to increase human contact (post-pandemic). Investigate creating a social life for your parent outside the home, possibly a new hobby. The success of this approach would very much depend on their personality and willingness to try something new. Read this wonderful story of 71-year old Jai Raheja who explains how music helped him overcome depression after losing his partner and start a new inning.

24. Sometimes your parents aren’t lonely and never will be – but the older they get the more they may watch what’s happening to friends and neighbours and worry about it for themselves. The important thing is to remind them there is still a reason to live for, and there is still time to plan new achievements.

25. Consider hiring a caregiver. It doesn’t have to be a fully qualified medical nurse but just a well-trained care attendant can help with companionship and daily routines. 

26. Be patient and non-intrusive – don’t expect to come up with a good idea and have your parent just fall in with it. They’ve been relying on themselves for their entire life which makes it difficult to accept external help or even admit that you need it. Also, they have known better than you from the moment you were born, so they are unlikely to accept easily when you try to tell them what to do.

27. Leave a little room for unexpected surprises. Brighten your parents’ day with a cake delivery like Geetu from Singapore. Or just give them a call outside of the agreed schedule for no particular reason – simply because you want to hear their voice, as it happened for Darshan from America.

28. Plan for some family time together. Whilst this is harder during the world’s pandemic, it not completely impossible – for example, Geetu reached out to ParentCare to arrange a hosted virtual event with Indian games online for her father, close relatives and friends.

29. Discover meditation and yoga with them. There’s a school of thought that says meditation can help to combat loneliness. A study published in the journal Brain, Behavior and Immunity suggested that 8 weeks of training in mindfulness can help to decrease loneliness. You can do it together on a video call or do it separately and discuss your insights and feelings.  

We hope this guide will help you navigate the Indian healthcare and homecare system whilst also reinforcing that you’re not alone in this – millions of Indian expats across the world go through the same challenges. Indians often have to fight the NRI guilt and suffer from loneliness when caring for their parents from miles away. 

If you have any specific requirements or need to arrange a few things at the same time, we are always here to help you via our 24/7 WhatsApp chatbot. ParentCare combines a range of services under one umbrella and makes them more accessible to NRIs, from follow-up communications with your parents’ doctors to credit card payments available. 

ParentCare has been developed to simplify long-distance caregiving for NRIs through technology and customer care while decreasing the cost compared to regular subscription models. 

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