New Delhi, Oct. 24 -- There comes a time when the people who once held our hands as we learnt to waddle and walk may need someone to hold theirs. It may begin with a fall, difficulty climbing stairs, a forgotten medicine or the realisation that an elderly parent can no longer manage alone. One day, the roles we have taken for granted begin to reverse.
A daughter lives in another city. A son has a demanding job and children of his own. A spouse is struggling with similar health problems. Hiring help is an option, but finding a reliable caregiver is not always easy and the expense can be substantial. Moving a parent into a care facility may be financially difficult or emotionally unacceptable.
Nobody necessarily wants to walk away. Yet wanting to look after someone and being able to do so are two very different things. Somewhere between the two lies a question millions of Indian families will confront: what happens when love alone is not enough?
For generations, India has relied on families to care for older people. But families are smaller, children move away and women who traditionally shouldered much of the unpaid care are balancing jobs and households. Meanwhile, people are living longer, sometimes with conditions demanding years of assistance. Growing old is no longer simply a family matter. It is a test of whether society is prepared.
A Greying India
India likes to think of itself as a young country. But another demographic reality is gathering pace. The number of Indians aged 60 and above is projected to rise from around 10 crore in 2011 to 23 crore by 2036, with their share of the population increasing from 8.4 per cent to 14.9 per cent. Behind these numbers are households negotiating retirement, illness, money, distance and responsibility.
Growing old does not automatically mean becoming dependent. Many older Indians remain active, financially independent and capable of managing their lives. But age can bring frailty, chronic illness, impaired mobility and cognitive decline. Everyday tasks-bathing, preparing a meal, getting out of bed or remembering medication-can become a struggle. A hospital can treat an illness. Insurance can cover eligible medical expenses. Neither necessarily ensures someone will be there the next morning to help an elderly person dress, eat or move safely around the house.
Nor is the caregiver always young. A 65-year-old may be caring for an 88-year-old parent while managing health concerns of their own. The person holding the family together may be approaching the age at which they will need help. India's challenge is not simply to add years to life. It is to ensure those years do not become a lonely struggle for survival.
Care Has a Cost
When a daughter gives up work to look after her mother, the sacrifice is described as love. When a professional is hired to do the same work, it becomes an expense. Either way, somebody pays. A caregiver may be needed for a few hours a day or round-the-clock assistance. Costs depend on the person's needs, the training required and where the family lives. Add medicines, transport, assistive devices, home modifications and lost earnings, and the bill can stretch across years.
For a family with limited savings, there may be no good choice. One person gives up a career. Another dips into retirement savings. Relatives take turns and hope the arrangement holds. Often, one family member-frequently a woman-carries far more than the others. But what happens when there is no family to share the responsibility, or when the family cannot afford to provide care?
Government support does help, but different schemes meet different needs. Health coverage under Ayushman Bharat for eligible people aged 70 and above is significant. Yet hospitalisation cover is not the same as paying someone to provide daily personal care at home. A family may manage a hospital bill and still struggle to afford a caregiver for the months or years that follow.
Love may be priceless. Care, unfortunately, is not. If India expects families to shoulder much of the responsibility, it must confront the cost.
Who Provides Care?
There is another person in this equation who is easily overlooked: the caregiver. India relies heavily on family members and informal workers who learn on the job. A daughter may suddenly have to manage dementia without knowing what to expect. A domestic worker may become responsible for an elderly employer without training in safe lifting, medication routines or emergencies. The work can be exhausting, yet remains poorly recognised.
NITI Aayog's August 2026 report, 'Reimagining Care: Strategies for Empowering Caregivers in Viksit Bharat@2047', proposes a more organised system, including a National Policy on Caregiving, a National Caregiver Council and stronger training. The Union Budget for 2026-27 has also provided a platform for training 150,000 multi-skilled caregivers.
But the real test is not how many people complete a course or how many policies are announced. Can an elderly couple find a competent caregiver they can trust and afford? Will workers receive the protection and recognition they deserve? Care cannot be built on goodwill alone. It needs skills, standards and accountability-for the person giving care as much as the person receiving it.
Beyond the Home
Families will remain central to eldercare. But expecting them to manage everything, whatever their circumstances, is neither realistic nor fair. Between caring entirely at home and moving into a residential facility lie other possibilities: day-care centres, respite services for family caregivers, home-based assistance and accessible public transport. Better geriatric services can help older people remain independent for longer.
Kerala's Keralam Senior Citizens (Care and Protection of Rights) Bill, 2026, introduced in the Assembly on October 13, reflects growing recognition that eldercare needs a formal framework. The proposed legislation seeks to strengthen older people's rights, regulate care services and support ageing at home. It remains a Bill; its eventual provisions and implementation will determine its impact.
The need extends beyond food, medicine and shelter. Older people can face neglect, abuse and exploitation, sometimes at the hands of those entrusted with their care. They must be able to make decisions and seek help when something goes wrong. An affluent urban family, a rural household with limited health services and an older person living alone face very different realities. But needing help in old age must not mean losing dignity, independence or the right to be heard.
The Years Ahead
Perhaps the hardest part of growing old is that we spend much of our lives imagining it will happen to somebody else. The young professional building a career today may eventually find that a parent needs daily assistance. The middle-aged couple caring for children and ageing parents may one day need the same help themselves. The elderly person who refuses assistance for fear of losing independence may be the one who needs it most.
Ageing is not a separate chapter in life. Children grow up, parents grow old, and the roles we occupy change. How we respond says as much about us as individuals as it does about society. Savings, health, housing and conversations can help us prepare. But no household can create a trained workforce, affordable services or a safety net on its own. India needs to train caregivers, establish standards, expand community services and make home-based care more accessible.
Not every older person has children who can or will provide care. Some have been abandoned; others are estranged from their families; still others have outlived everyone they depended on. Their claim to dignity cannot be weaker because they have nobody to speak for them. A society is judged not only by how it treats its youngest, but also by what it offers those who can no longer fend for themselves.
Living longer is an achievement worth celebrating. But the measure cannot be birthdays alone. It must include whether we can spend those years with security, companionship and dignity-and whether the people caring for us can do so without sacrificing their own lives. The question is not whether we will grow old. It is whether, when we do, there will be someone to hold our hand-and whether we will have built a society in which no one is left reaching for a hand that never comes.
Published by HT Digital Content Services with permission from Millennium Post.