Elderly Care in India: Challenges & Support Systems

India’s elderly population will hit 300M by 2050. Explore challenges in healthcare, pensions, abuse, and policies, and the way forward for robust elderly care.

Context:

The traditional Indian family structure, often romanticised in the West as a self-sufficient unit for elderly care, is undergoing a seismic shift. India faces a daunting challenge as it prepares for a massive demographic transition, with its senior citizen population projected to reach 300 million by 2050.

What is the status of the elderly in India?

According to the UN World Population Ageing Report and India’s own data, the country is ageing rapidly:

• Rapid Growth: India’s population of senior citizens (aged 60 and above) is one of the largest in the world and is growing at an unprecedented rate. It is projected to reach 300 million by 2050, (20% of the total population).
• Feminisation of Ageing: Women tend to outlive men, leading to a higher proportion of elderly women, many of whom are widowed and financially dependent.
• Ruralisation of Ageing: ~70% of the elderly population resides in rural areas (Census 2011), where access to healthcare and social security is even more limited.
• Economic Dependency: A large section of the elderly is not part of the formal economy and lacks pension benefits, making them financially vulnerable and dependent on their families.

What are the challenges faced by the elderly, state, and society?

• For the Elderly:

• • • Financial Insecurity: Lack of regular pension, inadequate savings, and rising healthcare costs lead to economic dependence and poverty.
    • Health Issues: High prevalence of age-related non-communicable diseases (NCDs) like dementia, cardiovascular issues, and arthritis. Dementia India Alliance estimates ~9 million people with dementia, with care costs expected to triple by 2036. 

• Lack of Healthcare Infrastructure: Elderly populations, with pre-existing health conditions and weaker immunity, face heightened vulnerability during pandemics along with the lack of accessible healthcare infrastructure.

• • • Social Isolation: Migration of children, loss of spouse, and the breakdown of community ties lead to loneliness, depression, and mental health issues, further exacerbated by digital divide. 
    • Elder Abuse: Vulnerability to physical (Senicides), emotional, and financial abuse, often within families or by untrained caregivers.
    • Lack of Old Age Homes: According to NITI Aayog, old age homes are present in less than 500 districts across the country.

• For the State and Society:

• • Healthcare Burden: Strain on the public health system to provide affordable, specialised, and long-term geriatric care.
  • Fiscal Pressure: Designing and funding sustainable pension schemes and social security nets for a massive population.
  • Interstate Variation: Southern and Western states are ageing faster with larger elderly populations, while Central and Northeastern states remain relatively younger, creating uneven policy and resource challenges.
  • Unregulated Care Sector: The private home-care and nursing home industry is largely unregulated, leading to variable quality, exploitation, and abuse.
  • Workforce Shortage: A severe lack of trained geriatric caregivers, nurses, and medical professionals specialising in elderly care.
  • Gendered Care Burden: Responsibility for elder care within families is mostly taken up by daughters, leaving them doubly burdened with domestic and caregiving roles.

What measures have been taken by the state? 

Constitutional provisions like Art 41 and Art 47 mandate the state to cater to the elderly section. 

• • National Action Plan for Senior Citizens (NAPSrC):
    It aims to create an ecosystem where senior citizens can age gracefully and live a life of dignity addressing their current and emerging needs.

• Health:

• • • National Programme for Health Care of the Elderly (NPHCE): Aims to provide dedicated healthcare facilities at district and regional levels.
    • Ayushman Bharat-Vayo Mitra: Provides health insurance coverage of ₹5 lakh per family per year for secondary and tertiary care hospitalisation. However, it does not cover critical long-term costs like home-based care, nursing homes, or palliative care.
    • Rashtriya Vayoshree Yojana: Caters to BPL elderly with assisting devices. 

• Financial Security:

• • • Atal Pension Scheme: Caters to unorganised sector (vendors and daily wage earners). 
    • Pradhan Mantri Vaya Vandana Yojana (PMVVY): A pension scheme for seniors offered by the Life Insurance Corporation (LIC).
    • Senior Citizens’ Saving Scheme (SCSS): A savings instrument offering higher interest rates for those above 60 and tax exemption on investments made (tax applicable on Interests gained).

• Support & Community:

• • Maintenance and Welfare of Parents and Senior Citizens Act, 2007: Makes it a legal obligation for children to provide maintenance to parents and provides for the establishment of Old Age Homes.
  • Elder Line (14567): A national helpline for senior citizens to address non-emergency cases related to care and support.
  • Home Voting Facility: Special provision for elderly citizens above 85 years of age, benefitting nearly 80 lakh voters across the country.
  • SACRED Portal: Senior Able Citizens for Re-Employment in Dignity (SACRED) connects skilled elderly citizens with employment opportunities; also promotes Elderly SHGs.
  • SAGE Initiative: Senior Care Ageing Growth Engine (SAGE) provides a single platform for credible start-ups offering products and services for elderly care.

What more needs to be done?

• Regulate the Care Economy: Establish a regulatory framework for nursing homes and home-care agencies, mandating standards, training, and certification for caregivers.
• Geriatric Training: Integrate geriatric care into the curriculum of medical, nursing, and para-medical courses to build a skilled workforce.
• Promote Financial Literacy & Products: Encourage financial planning for old age and develop more innovative and accessible pension and annuity products.
• Community-Based Models: Develop and support community day-care centers, helplines, and support groups to combat isolation and provide respite for families (e.g. Manavlok community kitchen (Maharashtra), ‘Sponsor a Grandparent’ scheme by Abhoy Mission in (Tripura)).
• Formal Health Pathways: Establish systematic linkages between households and public health facilities for routine health screening and referral services.
• Affordable Care Packages: Encourage hospitals to design special, subsidised healthcare packages tailored to elderly needs.
• Elder-Friendly Infrastructure: Ensure urban design, public buildings, transport, and civic amenities are accessible and elderly friendly.
• Elderly SHGs: Integrate senior citizens’ Self-Help Groups with the National Rural Livelihoods Mission to provide income and social engagement opportunities.
• Awareness Drives: Launch nationwide campaigns to raise awareness of legal safeguards—currently, only 12% of the elderly know about the Maintenance & Welfare of Parents and Senior Citizens Act (LASI Survey).
• CSR Engagement: Channelise Corporate Social Responsibility (CSR) funds into elderly care initiatives such as healthcare, skill development, and community support systems.

How do the elderly stand to benefit the nation?

The elderly are not just a dependent demographic but a vast reservoir of human and social capital:

• Longevity Dividend: Longer life expectancy translates into higher output per hour worked, per worker, and per capita.
• Employment in Skill-Shortage Sectors: Older workers help fill gaps in sectors with labor shortages (e.g., Japan’s initiatives to employ seniors)
• Social & Emotional Support: Strengthens family structures by providing guidance and emotional stability. They provide crucial childcare support, enabling their children to participate in the workforce, thus boosting the economy.
• Knowledge Retention: Preserves critical skills, expertise, and continuity in traditional industries like craftsmanship.
• Custodians of Culture: Safeguard traditions, languages, and historical knowledge for future generations.
• Driving Innovation & Silver Economy: Their presence boosts economic diversification and creates markets targeting older populations.
• Political & Civic Wisdom: Offer balanced perspectives in governance, policymaking, and community leadership.

A robust elderly care system is not an expense but an investment that creates a virtuous cycle of economic stability, social cohesion, and intergenerational well-being.

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The Source’s Authority and Ownership of the Article is Claimed By THE STUDY IAS BY MANIKANT SINGH