Beyond Hospitals: Extending Care for an Ageing Society

At a recent event, an expert mentioned that total knee replacement surgeries are now being performed on patients as old as 95 years, highlighting how drastically elderly care has evolved. Life expectancy has increased; medical science has made significant advancements but has our approach to elderly care kept pace with the times?

Why does India need Elderly Care?

With advancements in healthcare and medicine, the populations worldwide are living longer, meaning a growing number of elderly (aged 60 years and above). In India, the number of elderly is slated to grow by slightly more than twice by 2050.^1,2 This is not just a demographic shift but a societal transformation in action which will have far-reaching implications. And this is not an impending shift, its already here.

The urgency of this issue becomes even clearer when we look at the numbers. India’s elderly population today is larger than the total population of Japan and mimics the population growth trends of Japan with a 50-year time lag.³ However, our systems, infrastructure, and workforce are nowhere near prepared to address the scale and complexity of elderly care that lies ahead.

India’s Elderly Care Ecosystem: Key Nuances and Challenges

A matter as intricate as ageing requires a specialised approach. This section outlines the key concerns and challenges facing India’s elderly care ecosystem.

One shoe does not fit all

The term “elderly care” itself is often used very generically, but the reality is far more nuanced. The elderly population is not a single homogenous group, with each age cohort having distinct needs and challenges. Physical health, cognitive ability, emotional needs, and social circumstances vary widely within the elderly age bracket too. Therefore, expecting one standard model of care to serve all these age groups is neither practical nor humane.

Health issues and epidemiological shift

The epidemiological shift from communicable to non-communicable diseases in the country means there are growing number of people with chronic ailments. Age-related mobility issues (falls, osteoporosis) and mental or neuro-degenerative conditions (dementia, Parkinson, Alzheimer’s) are also some health concerns prevalent among the elderly. Approximately 75% of the elderly have one or more chronic diseases, more than 40% of them have one or more disabilities, and about one in four has multiple morbidities.² Elderly are also likely to be at higher risk of co-morbidities and multi-morbidities, requiring comprehensive care.

Influence of changing social structures on well-being

Elderly individuals today face multiple challenges that go beyond medical conditions. Social isolation is becoming increasingly common as family structures change and communities shrink, especially with the decline of joint family systems. Isolation and declining health have a direct impact on their mental and emotional well-being, which, though critical, often remains unaddressed.

Women and Ageing: A dual vulnerability

Ageing impacts women distinctly as compared to their male counterparts. Due to several factors, such as low female labour force participation, persistent gender discrimination, and biased socio-cultural norms, old age women are more vulnerable. Women have higher life expectancy and generally outlive their male companions. Thus, the ingrained lack of financial autonomy among women makes them dependent on their children or extended families in old age. This problem is compounded by their low pension coverage (26.3 percent against 38.7 percent in men globally),⁴ increased susceptibility to diseases with age, lack of sufficient education and awareness of government initiatives, along with gender-based digital divide. Therefore, discrimination mounted against women during their lifetime tends to have a cumulative adverse impact in their old age, calling for a gender-transformative approach to elderly care in India.

Caregiving Shortages and Family Burnout

Elderly care also faces its own set of structural challenges. There is a significant shortage of trained elderly caregivers in India. Most healthcare training is designed around curing diseases, not caring for people over long periods of time. Elderly care requires empathy, patience, and continuity—skills that are not adequately emphasized or imparted currently. The gap between the number of caregivers required and those currently available continues to widen, making quality care increasingly difficult to deliver.

Additionally, despite their critical role, nurses and other caregiving professionals are not accorded the recognition, respect, or compensation that matches the demands of their work. This lack of prestige and support contributes to high attrition rates in elderly care and healthcare, further aggravating the workforce shortage.

An often-overlooked issue in elderly care is caregiver and family burnout. Families frequently shoulder the responsibility of long-term care without adequate support, leading to emotional, physical, and financial strain.

Can Technology Bridge the Care Gaps?

Technology is transforming how care is delivered, offering a significant potential in the integration of technology with elderly caregiving. Some key applications of technology in elderly care include:  

• Remote Monitoring Devices 

Technologies, such as wearables and remote monitoring devices, are revolutionising how healthcare providers monitor the elderly. Voice assistants and sensors improve safety and self-reliance. These advancements in technology make home-based care possible, while use of AI-enabled systems ensures timely intervention if required. 

• Telemedicine 

Connects seniors with doctors from remotely, especially beneficial for elderly with mobility issues and in underserved areas, making healthcare accessible. 

• Community-based care 

Including palliative care, helps the terminally ill receive dignified care outside of hospitals using technological tools.

• Smart Senior Living Spaces 

A blend of technology and accessible design, these spaces ensure independence, safety and convenience for the senior residents by using automation, home monitoring and connected care.

While technology cannot replace human care, it can certainly act as a complementary tool when used thoughtfully.

Emerging Care Pathways

Emerging models such as Continuing Care Retirement Communities (CCRCs) offer a promising way forward. These communities offer a continuum of care—from independent living to assisted and medical care—allowing individuals to ‘age in place’ while their care needs evolve.

Community-based models grounded in principles of sharing and safeguarding vulnerable groups, train, motivate and incentivise volunteers from the community to care for the elderly. These models strengthen neighbourhood support networks and encourage intergenerational co-living. Caregivers and families can leave healthcare facilities confused and unsupported for care after discharge. Caregiver support models provide essential tools and training to families and caregivers, empowering them to take care of their elderly. Such models may hold the key to more sustainable and dignified elderly care in the future.

In a nutshell, elderly care is not just about adding years to life, but about adding life to those years. As India ages, the way we care for our elderly will define not only our healthcare system, but also our values as a society.

*This blog draws insights from the discussion on ‘Extending healthcare beyond hospitals: the future of elderly care’ during ISB’s Healthcare Catalyst 2026 jointly led by Dr. Reema Nadig, Co-founder & Chief Operating Officer at Lifebridge Group and Mr. Shantanu Sinha, Sr. Vice-president, Medicare Products and BPMA, Antara Senior Living.

References:

1. UNFPA India. (2024, February 15). India’s ageing population: Why it matters more than ever. UNFPA India. https://india.unfpa.org/en/news/indias-ageing-population-why-it-matters-more-ever  

2. NITI Aayog. (2024). Senior Care Reforms in India – Reimagining the Senior Care Paradigm: A Position Paper. Government of India. https://www.niti.gov.in/sites/default/files/2024 02/Senior%20Care%20Reforms%20in%20India%20FINAL%20FOR%20WEBSITE_compressed.pdf   

3. Vasavi Ayalasomayajula. (2016, June 22). Is India Aging Like Japan? Visualizing Population Pyramids | SocialCops. SocialCops. https://blog.socialcops.com/intelligence/india-aging-like-japan-visualizing-population-pyramids/ 

4. Bringing a gender perspective to disaster risk finance can save lives and support recovery. (2023). World Bank Blogs. https://blogs.worldbank.org/en/psd/bringing-gender-perspective-disaster-risk-finance-can-save-lives-and-support-recovery