Grace for the grey

In despair, her eyes searched for warmth. Loneliness clung to her like oil—inevitable, silent. Family had drifted away, and friends were no longer in reach. Pasha, 68, from a Uttar Pradesh village, lived alone with Parkinson’s disease, with little support and no nearby medical facility.

In Bengaluru, Jesina M, aged 82, resides in a shelter waiting for a visit that rarely comes. In Mumbai, Dr Malathi Krishna, 79, still goes to work thrice a week, refusing to let age define her. For Shama Vij, 78, and Andrew Lobo, 65, independence has been lost; everyday life depends on assistance. Each life reflects a troubling truth: elders once seen as guardians of wisdom are now left to navigate systems that scarcely regard them.

More than 140 million Indians are aged 60 and above, and that number is expected to rise sharply to roughly 320–350 million by 2050 — meaning one in five Indians will be a senior citizen. (UNFPA 2023; LASI 2021) Yet an overwhelming portion of this “wisdom generation” faces chronic conditions, loneliness, uncertain finances and inadequate care.

“Elders are struggling: 75 per cent with chronic issues, 25 per cent multiple chronic issues, 50 per cent loneliness… India’s 140 million seniors are expected to reach 340 million by 2047–2050… Our infrastructure is not designed for seniors,” says Saumyajit Roy, founder of Emoha Elder Care.

No country for the old?

India has long called itself the world’s youngest country, but those demographics are shifting fast. With about 13–14 per cent of the population aged over 60 today (LASI 2021), the share is projected to reach about 20 per cent by mid-century (UNFPA 2023). Life expectancy in India is expected to rise from 72 in 2023 to about 77 by 2045, and 83 by 2080 (MoSPI Projection).

But longevity without dignity is no triumph. When oncologist Dr Vishal Rao first visited a destitute elderly home in Bengaluru, he found 20 adults sharing a room — many with dementia, paralysis or severe mobility issues. “They asked, ‘Is it your birthday?’ People remember us only on special occasions. Some slept in urine and defecation,” he recalls. Noting the cruelty of neglect, he adopted the home and improved services. But across India, such intervention remains rare.

Data paints a harsh reality. A report by the Tata Trusts found that about 1,150 elderly-care facilities existed around the 2011 census, with a capacity for only 97,000 seniors (Tata Trusts 2019). Capacity must grow eight-to-ten-fold to meet future needs. According to UNFPA, 40 per cent of seniors fall into the poorest wealth quintile, and nearly 19 per cent have no regular income (UNFPA 2023). Meanwhile, nuclear families are becoming more common and traditional joint-family support systems are eroding.

Dr Rao warns: “If there is no dignity to life in geriatrics, there is no point in talking about longevity.”

The lost wisdom generation

Ageing can no longer be written off as a future problem: it’s here. India’s seniors face prep regimes, medical complications, isolation and invisibility. While affluent urban Indians may access luxury assisted-living or home-care services, many rural and lower-income elders survive on chance.

That said, a new wave of innovators is trying to reclaim ageing as a phase of purpose. Organisations like Vayah Vikas (founded by Kris Gopalakrishnan and Dr Devi Shetty) and platforms such as Emoha Elder Care, WisdomCircle and Dementia India Alliance are building care ecosystems from the ground up.

“The perplexing thing is that India, with the fastest-growing geriatric population, is still unprepared,” says Dr Rao. “Longevity isn’t about popping pills. It’s about dignity, the most fundamental of rights.”

Harnessing connections

Vayah Vikas launched in 2021 with a modest senior-citizen forum; today, it claims 125,000 members across Karnataka, Tamil Nadu and Delhi, and aims for two million by 2030. “We represent the problems of seniors, aggregate services, and champion their health,” says Kris Gopalakrishnan.

Emoha, founded by Saumyajit Roy, now operates in about 40 Indian cities and serves over 220,000 elders. Their model includes home monitoring, doctor visits, sensor-based tech and last-mile care. “We deploy sensors at home for vital monitoring, consultations. Every five kilometres, there’s a local carer,” Roy explains.

Policy reforms are in motion. The expansion of the AB PM-JAY scheme in 2024 covers senior citizens aged 70+ with health insurance up to Rs 5 lakh per family. “Standardisation of senior homes with NABH accreditation is on the agenda,” says Kris Gopalakrishnan.

Still, even as these efforts grow, the social cost looms. “Nuclear families are replacing joint ones, so societal cost will be huge. Nearly four million people have dementia or Alzheimer’s today. We must galvanise services,” says Gopalakrishnan.

In Karnataka, the state government has pivoted libraries into sites of inclusion. “We have initiated over 5,800 libraries… Senior citizens can walk in, interact socially, so they aren’t lonely. We’re in the process of adding 6,600 libraries,” says Uma Mahadevan Dasgupta, Additional Chief Secretary & Development Commissioner, Government of Karnataka.

Rewriting the ageing script

Ageism remains a quiet epidemic. “Society still believes seniors shouldn’t work, that they’ve outlived their utility,” says Neeraj Sagar, founder of WisdomCircle. His vision: make ageing a phase of contribution, not retirement.

“In Bengaluru, seniors could solve civic problems — garbage, lakes — while earning an honorarium. The state should support this,” he adds. CEO Jamuna Ravi of Vayah Vikas says education systems must include seniors: “Instead of equating seniors as dependent, initiate dialogue at schools.”

The Ashoka Fellows’ New Longevity Programme and the Aditya Birla Centre for Enriching Lives are bringing these ideas into the policy arena. Loneliness, says Dr Deepak Saini of the Longevity Lab (IISc), “is the biggest killer. We need to harness our large, caring, family-oriented culture into social connection.”

The Dementia time-bomb

The Dementia India Alliance estimates that 9 million Indians live with dementia today; the figure may rise to 17 million by 2036 (DIA 2024). “Memory loss isn’t a normal part of ageing,” says Ramani Sundaram, executive director of DIA. The alliance has set up free online memory screening for 55+ and helped draft a “Dementia-Friendly Hospital” accreditation checklist.

Tech and tenderness

For many seniors, the most powerful device is their mobile phone. Hemanshu Jain founded Khyaal after his father struggled with isolation. “From 10,000 seniors in 2021, we’re now 30 lakh strong,” he says. The platform offers digital literacy, fraud prevention, health access and community engagement.

In Nashik, Saurabh Botra’s Habuild Yoga community records thousands of seniors joining six sessions a day. “It’s not just fitness, it’s movement, laughter, me-time,” Botra says. “Seniors must understand the difference between walking and training; training matters as muscle declines.”

Preventive care vital

India produces only about 31 MD geriatric medicine seats across a handful of institutions. “At least 15 per cent of OPD patients are over 60, and 40 per cent of those have undiagnosed dementia or Alzheimer’s,” says Jamuna Ravi.

Spine surgeon Dr Thomas Kishen says geriatric specialists are essential to prevent double prescriptions and drug interactions. He adds: “Fall-prevention matters: bathrooms need non-slip surfaces, living spaces must be brightly lit.”

Dr Samina Zamindar of Zamindar Eye Centre warns that vision loss affects 73 per cent of people over 50. “Most causes are treatable, yet rural women delay care and treat blurred vision as ageing,” she says.

Caregivers remain under-trained and unsupported. “We need a national certification programme for carers,” says Roy. “Every nurse needs 10 carers; India needs ten times more carers than nurses.” Emoha currently works with 350 trained carers across its network.

Jamuna Ravi notes that many nursing-supplier services are unregulated and low quality. “We’re working with NGOs to start online training for dementia awareness and caregiving,” she says.

Exploitation shadows old age. “Many seniors are preyed on by their own children,” warns Kris Gopalakrishnan. At Vayah Vikas, a legal cell gives confidential advice to seniors on property, finances, and abuse. Khyaal launched India’s first “senior-citizen fintech card”— a prepaid option not tied to bank accounts. “Seniors have peace of mind when they load and spend safely,” says Jain.

What's the way forward?

A dedicated Ministry for Senior Citizens is fast‐becoming a consensus demand. “Right now, seniors are classified under a ministry that also manages differently-abled people… We need a single focal point,” says Dr Rao.

Research is still skewed. “A country that will have the highest number of seniors hardly features in global longevity reports,” says Ravi. “We need India-centred research, so solutions fit our realities.”

Assisted living is growing, but remains the preserve of the wealthy. A resident in a Bengaluru senior home says: “It’s great to connect… but I long to talk to young people.”

Still, hope remains. “People who age better continue to be curious,” says Neeraj Sagar. “Curiosity plus wisdom gets people to live better lives.”

An infra apathy

- About 138 million Indians are aged 60 and above, yet the country’s elder-care market remains extremely small compared to global demand.

- Geriatrics remains a rare speciality — only a handful of institutions offer MD degrees in the field, producing very few new geriatricians each year. 

- Property and family disputes account for a large share of elder-related litigation, estimated at roughly three-quarters of such cases.

- By 2050, seniors are expected to make up about one in five Indians. Many report mental-health issues and loneliness; roughly one-fifth live alone or only with a spouse.

- Around nine million Indians live with dementia, and millions more will require palliative-care support in the coming years.

(Sources: PwC-ASLI 2024, Legal Foundation, UNFPA 2023, Senior Care Reforms, 2024, DIA 2024)

The 7-day framework

- Days 1–2: Work in your area of expertise and earn — maintain independence without dipping into savings.
- Day 3: Teach — share your knowledge.
- Day 4: Give — volunteer or mentor; find your Ikigai moment.
- Days 5–7: Learn, unlearn, relearn. Spend time with family, travel, and nurture your social self.

(Inputs from Neeraj Sagar, Founder, WisdomCircle)

Tackling Dementia

- The Dementia India Alliance (DIA) runs extensive community memory-screening campaigns and online brain-health assessments.
- A Lancet Commission identified 14 modifiable risk factors — including hypertension, diabetes, obesity, and sensory loss — that could delay up to 45 per cent of dementia cases.
- DIA also offers preventive mental-health questionnaires and support groups to improve early detection and care.
- It has developed a “Dementia-Friendly Hospital” checklist, now being advocated for inclusion in hospital-accreditation processes.

Helpline: 8585990990