From medical tourism to rent-a-womb ~ India and Thailand could also be the last stop for many struggling with elder care.

As medical and health care costs rise beyond what many can afford, more elderly parents and their caregivers may have to consider alternatives for a decent end-of-life care.

Especially in the light of a report in Yahoo news where one Theodore Pressman, forced by circumstance, left his elderly and infirm parents in a sweltering locked car in White Plains, NY while he went to work for 3 hours as a bus driver.  Unfortunately, the internal temperature of the car rose to 100 degress and his 85 year old father died. Pressman has been charged with homicide.

According to the news report, " there was no indication that Pressman intended to harm his parents. The three lived together in Beacon, about 15 miles north of Peekskill and 45 miles north of New York City.

Johansen said a check of neighboring police departments showed that Pressman had often left his parents "at restaurants, delis, McDonald's" while he worked as a bus driver. "This was a frequent practice, but as far as we know he had not left them in a car before," he said.

"It appears they did not have the physical or mental capacity to deal with the situation," he said.

At an appearance in Peekskill City Court, Pressman, looking frail himself, was held on $10,000 bail and was ordered to stay away from his mother.

The 48-year-old argued with the judge over that condition, saying, "I know what she needs. ... I have to make sure she has food."

Sadly, Pressman may have been doing what he could on his limited income to take care of parents who needed close supervision.  Even for those who have sufficient savings, the costs of nursing homes and in-home health care has become beyond painful.  

As parents live longer and families exhaust their last resources on parent care, many are looking at less expensive options as far away as India. Here is an excerpt from an article in Little India by Laurie Goering on one man's last-ditch effort to give his aging and ill parents a quality end of life experience (July 2008 issue):

" Steve Herzfeld (who is single) was ...faced with spending his family's last resources...So he made what he saw as the only sensible decision: He outsourced parents to India.  (His) 89 year old mother, Frances, who suffers from advanced Parkinson's disease, gets daily massages, physical therapy and 24 hour help getting to the bathroom, all for about $15 a day.  His father, Ernest, 93, an Alzheimer's patient has a full-time personal assistant and a cook who has won him over to a vegetarian diet that he no longer needs his cholesterol medication.

Best of all, the plentiful drugs the couple require cost less than 20 percent of what they do at home, and salaries for their six-person staff as so cheap that the pair now bank $1000 a month of their $3,000 Social Security payment.  They aim to use the savings as an emergency fund or to pay for airline tickets if family members want to visit."

For some India or Thailand may be very tempting, especially when the cheapest nursing home costs $6,600 a month in the USA.  For others such countries, hotspots for medical tourism, may be just too far away. That and language may not make outsourcing parent-care a doable option.  Those who can, have already moved south of the border to Mexico where help is cheap and Medicare is easily accessible a few miles north.

But what about the Theodore Pressmans of our country? The men and women who care deeply for their parents and try to give them the best end of life experience they can afford on very limited resources? Why should they be punished?