Caring for India’s seniors

India’s elderly population is growing rapidly and is projected to exceed 320 million by 2050, comprising nearly 20 per cent of the total population. This demographic shift highlights the urgent need for reliable, high-quality care facilities for senior citizens. However, in the absence of standardised guidelines, many care homes operate without proper oversight, leaving the elderly vulnerable to neglect and exploitation.

As traditional family structures evolve and nuclear families become the norm, many seniors find themselves without adequate care. The demand for care homes has outpaced the development of regulatory frameworks, leading to inconsistent quality across facilities. Migration, economic pressures, and the breakdown of traditional caregiving systems have further exacerbated the issue, often leaving elderly individuals neglected or abandoned.

A study published in the Journal of Geriatric Mental Health highlights the urgent need for well-regulated care facilities to address these challenges. However, the lack of regulations has resulted in substandard care and, in some cases, outright exploitation.

Several incidents illustrate the vulnerabilities faced by senior citizens in poorly regulated care homes:

In November 2023, a fire at a senior care home in Delhi tragically claimed the lives of two residents. Investigations revealed inadequate safety measures, underscoring the critical need for stricter regulations.

Reports from urban areas reveal several instances of elderly individuals being abandoned due to financial strain or the breakdown of traditional caregiving roles. 

To address these pressing issues, the National Accreditation Board for Hospitals & Healthcare Providers (NABH) - Quality Council of India (QCI) and the Ministry of Social Justice and Empowerment, Government of India, have introduced Accreditation Standards for Care Homes. This initiative aims to establish a benchmark for quality and safety in elder care facilities across India.

NABH, known for its success in improving hospital standards—now in its 6th edition—lends credibility to this effort. Its track record in creating robust frameworks ensures the same level of rigour will be applied to care homes. Notably, this initiative was among the key recommendations of the National Health Conclave on Eldercare held in Bengaluru in 2023.

The NABH standards focus on several critical areas to ensure the safety, dignity, and well-being of senior residents:

Resident-centric care: Ensuring dignity, privacy, and personalised attention for all residents.

Safety protocols: Implementing measures to prevent accidents and effectively manage emergencies.

Staff training: Equipping carers with the skills to meet the physical, emotional, and psychological needs of the elderly.

Hygiene and infrastructure: Maintaining clean, safe, and accessible facilities tailored for senior citizens.

Transparency: Promoting ethical practices, clear communication, and fair pricing to build trust with families.

Despite the introduction of these standards, a significant challenge remains: awareness. Many families are unaware of the importance of accreditation when choosing a care home, often leading to uninformed decisions that compromise the well-being of their elderly loved ones.

When selecting a care home, families must prioritise:

Accreditation: Ensuring the facility is NABH accredited, signifying adherence to recognised standards.

Qualified staff: Confirming caregivers are trained to meet the diverse needs of senior residents.

Safe and clean infrastructure: Inspecting facilities for cleanliness, safety, and accessibility.

Transparent operations: Looking for clear communication regarding services, pricing, and policies.

The introduction of NABH accreditation standards is a significant step toward improving care homes. Families must demand accredited facilities, governments should incentivise compliance, and community organisations need to amplify awareness of these guidelines.

As India progresses, it is our collective responsibility to ensure that senior citizens live their later years with dignity, security, and comfort. These standards are not just guidelines—they represent a commitment to improving care and respecting the elderly.

(Alexander is the founder and governing board member, Vayah Vikas and Atul is the CEO, National Accreditation Board for Hospitals and Healthcare Providers)