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Rising life expectancy and shrinking family support systems warrant urgent, inflation-adjusted pensions and care policies for India’s oldest citizens.
Image Source: Getty
The recent case involving the abandonment and gross neglect of an elderly couple in Gurugram, Haryana, has turned the spotlight on one of the most pressing development concerns of contemporary India—elderly care. In 2025, elderly individuals comprise about 10.1 percent of India’s population, and their share is likely to increase further to 13.1 percent in 2031 and 20 percent by 2050. Across states, Kerala has the highest proportion of elderly persons in its population at 16.5 percent, followed by Tamil Nadu (13.6 percent), Himachal Pradesh (13.1 percent), and Punjab (12.6 percent). Despite their growing numbers, India’s elders are largely absent from public discourse. Although some welfare initiatives have been undertaken by governments both at the centre and state levels, elderly concerns seldom find prominence in news coverage, nor have elders emerged as a political force. For a country whose politics has primarily been dominated by elderly persons, this certainly comes as a surprise. Just as in this case, it is usually the cases related to abuse that prompt us to sit back and reflect on the safety of elders.
Octogenarians—who have significantly higher medical expenses—are facing greater problems in the absence of targeted care and financial security.
As a country that values elders and places a deep faith in filial piety, children have traditionally been solely responsible for the care and maintenance of elders. Demographic and socioeconomic transformations of the past two to three decades warrant change. First, Indians now live much longer than they did earlier. India’s life expectancy has grown remarkably since independence. As shown in Figure 1, life expectancy at 60 years is currently estimated at 17.5 years and 19 years for men and women, respectively. The number of octogenarians—the oldest among the old—has also increased rapidly. As per the India Ageing Report 2023—between 2000 and 2022—the population of 80+ persons grew by 128 percent compared to 34 percent growth in the total population. Population projections indicate that the population of persons aged 80+ will increase by 279 percent between 2022 and 2050, while total population growth will decline to only 18 percent in the same period. Furthermore, highly dependent old women will constitute the bulk of the oldest population. As a result, care needs will expand rapidly.
Second, the joint-family system—bedrock of India’s care system—is disintegrating rapidly due to greater migration for work and weakening of intergenerational ties. Third, though India’s female workforce participation rates are relatively low and women continue to bear the greatest responsibility of care, women engaging in paid labour outside of their homes is now quite common, particularly in urban areas. Moreover, with smaller family sizes, division of care responsibilities between siblings is no longer possible, placing greater pressure on one or two children.
Figure 1: Life Expectancy at 60 years differentiated by sex across states, 2015–19
Source: India Ageing Report 2023
Financial vulnerability among elders is extremely high as pension coverage in India is low, with nearly 73.7 percent of the elderly men and 89.2 percent of elderly women who have ever worked in the organised sector not receiving any pension. Lump-sum savings made during the working years are often the only source of survival for elders. Inflationary pressures and lower interest rates on fixed income assets post-2000 have significantly eroded the purchasing power of lump-sum savings of elders. Consequently, octogenarians—with significantly higher medical expenses—are facing greater problems. Given that children of octogenarians are usually themselves senior citizens who have retired from service and lack the financial resources and capacity to support their parents, the state and community must step up their role in caring for them.
The state and community must step up to care for India’s oldest citizens—most of whom outlive savings, family support, and existing welfare systems.
Currently, the social pension under the Indira Gandhi National Old Age Pension Scheme (IGNOAPS) is only extended to the very poor. It fails even to cover basic expenses in many states. This is because the centre’s contribution is merely INR 500 per month. As shown in Figure 2, there is significant variation in pension amounts across states in India, with elders in states such as Haryana (INR 3,000), Andhra Pradesh (INR 2,750), Delhi (INR 2,500), and Sikkim (INR 2,500) receiving higher pensions due to higher state contributions. On the other hand, in Andaman and Nicobar Islands, Bihar, Daman and Diu, Goa, Manipur, and Nagaland, elderly persons above 80 years only receive INR 500, as these states and union territories do not contribute at all.
Figure 2: State-wise cash transfers under IGNOAPS for persons above 80 years
Source: Parliament Question, Ministry of Labour and Employment, Rajya Sabha, Unstarred Question No. 2495, 10.08.2023
Note:
*Darker regions signify lower pension amounts received
**Map made by author using Flourish
The Madrid International Plan of Action on Ageing and Political Declaration—adopted at the Second World Assembly on Ageing in 2002—stresses building a ‘society for all ages’ and serves as a good template for shaping policies. It stresses three key policy priorities:
iii) ensuring and enabling supportive environments.
The Indian government has taken small steps towards developing a comprehensive care programme for the elderly. These include social pensions for the poor, such as the Indira Gandhi National Old Age Pension Scheme (IGNOAPS) and the Indira Gandhi National Widow Pension Scheme (IGNWPS), offered under the National Social Assistance Programme. The government also prioritised elders during the COVID-19 pandemic by granting them first access to vaccines. Most recently, it announced universal health insurance coverage for all senior citizens above 70 under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. It has also brought in legislation to ensure the protection and welfare of senior citizens through the Maintenance and Welfare of Parents and Senior Citizens Act and a series of policies for senior citizens. Several states, notably Kerala, have also instituted policies and schemes for senior citizens.
However, to ensure India’s oldest citizens spend their last years in dignity, good health, and contentment, the country needs a targeted care programme for octogenarians based on the three policy directions identified in the Madrid International Plan of Action. First, to ensure octogenarians share development benefits, the centre must institute an inflation-indexed universal pension for all persons above 80 years, not just those below the poverty line. This income should sufficiently cover basic expenses—including food, medicines, medical tests, doctor’s consultation charges, shelter, and warm clothes. This is extremely important, as even several affluent families are finding it increasingly difficult to cope with the rising medical costs of elderly patients, especially considering their primary caregivers are often retired themselves.
A universal, inflation-adjusted basic income and a localised care model are essential for securing the dignity of India’s ageing population.
Second, though the recent announcement of a universal health insurance programme for elders above 70 years of age is laudable, it only covers hospitalisation. Octogenarians need a health policy to support the entire gamut of medical services, including OPD, medicines, medical tests, and physiotherapy, which often result in high out-of-pocket expenses. Third, local governments must work with civil society organisations to develop a community-based care model that provides a supportive environment for elders and assists families involved in elderly care. Greater cooperation between local governments and civil society institutions will help provide support services to caregivers (for example— training, information, and sharing of care responsibilities), emergency help for elders, and minimise risks of abuse. This is especially critical in urban areas where—unlike India’s villages—traditional people-to-people ties are weak or absent. Unlike the West, India has a large and youthful population that can be harnessed to provide long-term support to elderly persons with severe disabilities or living alone through effective volunteer programmes. Regular visits by social workers, promotion of closer ties between neighbours and extended family members, and encouraging younger persons to volunteer for elderly care are some ways to support elders during their last years. If home care is not possible, there must also exist an option of institutional provision of end-of-life care. In a nutshell, India must institute a universal inflation-adjusted pension and a community-led care model to ensure a dignified life for its oldest citizens.
Malancha Chakrabarty is a Senior Fellow and Deputy Director (Research) at the Observer Research Foundation.
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Dr Malancha Chakrabarty is Senior Fellow and Deputy Director (Research) at the Observer Research Foundation where she coordinates the research centre Centre for New Economic ...
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