How to look after elderly parents in India while living in the USA

A practical plan for NRIs in the US: the 9.5–13.5 hour clock, FMLA leave, money, insurance and a daily check-in — without asking your parents to install an app.

By the Athnova Care team · Updated 2026-09-29

Want to see the daily check-in before you read on? Send DEMO to our WhatsApp and the exact message a parent gets arrives on your phone — in any of 21 languages, no account needed.

What is different when you live in the USA

Most families we speak to in the US have the same worry: nobody would notice for a day or two if something went wrong. Calls happen on weekends, parents say "all fine, beta", and the first sign of trouble is a neighbour’s message or a hospital bill.

Distance is only half of it. The clock is the other half. When your mother takes her morning tablets — and when most falls at home happen — it is late evening or night for you. You are asleep for the most important hours of her day.

The clock: when their morning happens for you

India is between 9.5 and 13.5 hours ahead of the mainland US, depending on your coast and on daylight saving (India does not change its clocks).

Where you are	Time difference	Their 8:00 AM check-in is your…	Good time for a live call
New York, Boston, Atlanta (Eastern)	9.5 h (summer) · 10.5 h (winter)	10:30 PM or 9:30 PM the evening before	8–10 PM your time = their early morning
Chicago, Dallas, Houston (Central)	10.5 h · 11.5 h	9:30 PM or 8:30 PM the evening before	7–9 PM your time
Denver, Phoenix (Mountain)	11.5 h · 12.5 h	8:30 PM or 7:30 PM the evening before	7–9 PM your time
Bay Area, Seattle, Los Angeles (Pacific)	12.5 h · 13.5 h	7:30 PM or 6:30 PM the evening before	6–9 PM your time, or 7 AM before work = their evening

Set up a daily signal, not a weekly call

A weekly call tells you how your parent sounded on Sunday. It tells you nothing about Tuesday. The signal you want every day is small: my parent is reachable, took their medicines, and is not feeling unwell.

From the US this works in your favour: a check-in sent at 8:00 AM in India lands in your evening, so you see the answer before you go to bed — and if there is silence, the reminder and the phone call happen while you are still awake.

Pick one fixed time in their morning, after they are normally up and before the day gets busy.
Ask one question with buttons — "Yes, taken", "Not yet", "Please call me" — instead of asking them to type.
Decide in advance what happens when there is no reply: a reminder, then a phone call, then a message to you, then a neighbour.

Build a local circle of two

Every parent who lives alone, or as a couple, needs at least two people nearby who can physically go to the door: a neighbour, a relative, the society manager, a trusted driver. Ask them plainly whether you may message them if your parent does not respond for a few hours, and save their WhatsApp numbers.

From the US you cannot be at the door in under a day. That makes the local circle the most important part of the whole plan — more important than the speed of your flight.

Time off work: what the USA gives you

The federal Family and Medical Leave Act gives eligible employees up to 12 weeks of unpaid, job-protected leave in a 12-month period to care for a parent with a serious health condition. You generally need to have worked for the employer for 12 months and 1,250 hours, and the employer needs 50 or more employees. Federal FMLA covers your own parent, not a parent-in-law.

Several states — California, New York, New Jersey, Washington and others — add paid family leave on top. Ask HR what documents they need from the hospital in India; a letter from the treating doctor on hospital letterhead is the usual request.

Leave rules change and depend on your contract. Treat this as a starting point and confirm with HR before you book a ticket.

Money from the USA

Set up the money route before you need it. A remittance service you have already verified, and an emergency float in an Indian account that a sibling or your parent can reach, mean that an admission deposit at 2 AM is a transfer rather than a scramble.

Many Indian banks now let NRE and NRO account holders use UPI with an international mobile number from a list of countries that has grown since 2023. If your bank offers it, you can pay a chemist, a lab or a hospital counter in India directly from your phone — ask your bank whether your number qualifies.

Health cover for your parents

US employer plans and Medicare do not cover your parents while they live in India.

Look at an Indian health policy in your parent’s own name. Since April 2024 the insurance regulator has removed the old upper age limit of 65 for buying a new policy, and the longest waiting period for existing illnesses is three years — so a policy bought now starts covering a known condition sooner than it used to. Parents aged 70 or over can also enrol for the government’s Ayushman Bharat senior-citizen cover in states that have joined the scheme.

When you have to fly

Non-stop flights link New York, Newark, Chicago and San Francisco with Delhi, Mumbai and Bengaluru in roughly 14 to 17 hours; from most other cities add a connection. Door to door, plan on 20 hours or more — so name the person in India who acts for the family until you land.

Keep your passport and OCI card valid. If you hold a US passport without an OCI card, know how India’s e-visa works before an emergency, not during one.

Keep the medical basics in one place

Current medicine list with strengths and timings — a photo of the latest prescription is a good start.
The last 12 months of lab reports, in date order, so trends are visible.
Blood group, allergies, main doctor, preferred hospital and its emergency number.
A one-page emergency card you can send on WhatsApp in one tap.

How Athnova Care fits in

Your parent gets one WhatsApp message a day in their own language and answers with one tap. If they do not reply we remind them, then phone them. If they still do not answer we alert you, and then the local contacts you chose. Reports they photograph are read and trended, refills are arranged with your approval, and you get a doctor-ready summary every month. It costs $12 a month for the whole family, and your parent installs nothing.

Athnova Care tracks and coordinates. It does not diagnose, prescribe or replace a doctor, and it is not an emergency service.

Questions families ask

Can I monitor my parents in India from the US without an app on their phone?

Yes. WhatsApp check-ins work on the phone they already use: they tap a button, and a phone call follows if they go quiet.

What time will my parent’s check-in arrive in US time?

A check-in at 8:00 AM India time is 10:30 PM Eastern or 7:30 PM Pacific the evening before in summer, and an hour earlier in winter.

Does FMLA cover caring for a parent who lives in India?

FMLA is about your relationship to the person and their serious health condition, not where they live. Eligibility depends on your employer’s size and your length of service, so confirm with HR.

What should happen if my parent does not answer?

Agree a ladder in advance: reminder, phone call, alert to you, then a neighbour or relative who can go to the house. Save 112 and the nearest hospital’s emergency number.

Athnova Care tracks and coordinates care. It does not diagnose, prescribe or replace a doctor. In a medical emergency in India call 112.