Palliative Care in India

A pain free path towards better quality of life

The WHO describes palliative care as an approach that improves the quality of life of patients (adults and children) and their families who are facing problems associated with life-threatening illness. It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual. The WHO data also highlights that among low- and middle-income countries, 78% adults and nearly 40 million people every year are in need of palliative care.

In this essay, you can read about developments in palliative care in the Indian context, and efforts by Government, civil society organizations and sustained efforts of leading care advocates like Dr M R Rajagopal, also known as the father of palliative care in India.

You can access the full essay here: Palliative Care in India


One Day Online Training Program for Physiotherapists (Certificate Program) by Pallium India

Registration Link:

Date/Time: Oct 23, 2021 / 9.30AM

Dental Concerns among Systematically Ill Elderly Population by Seniors Today

Registration Link:

Date/Time: October 16, 2021/ 5pm


The Home Stretch – A Family Caregiver’s Handbook by Sanjay Dattari (Published by Penguin Random House India)

The Home Stretch

About the author: Sanjay Dattari is a software engineer. Over the last seven years, however, he has been working on various initiatives to make the lives of the elderly in the India better. He was a full-time director of India’s first store exclusively for senior citizens called the “Old is Gold Store”, based in Chennai, for five years. Sanjay can be reached on

The book is available on Amazon and Flipkart’s online stores.


Ageingneeds India is India’s first home adaptation service provider for older adults, disabled people, post-surgery support, Alzheimer’s, dementia & Parkinson’s conditions.

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📫 Silver Angels Newsletter

The Silver Angels newsletter brings you news, stories and trends from the silver economy in India, in a short, easy-to-read format. Businesses, brands, investors, startups, researchers and analysts following this space are likely to find it interesting. No advertising or sponsorship.

🧠 Thoughts, feedback or comments? Want to connect?

Feel free to reach out at any time via email:

Silver Angels is an independent platform tracking the Silver Economy in India with focus on ageing journeys, longevity impacts and seniorcare. You can find more information on


Silver Economy: 9 Winning Startups under SAGE

Silver economy, innovation, startups, investments

In June this year, the Ministry of Social Justice and Empowerment (MoSJE) announced the launch of the Senior Ageing Growth Engine (SAGE), a startup fund where the government would bring up to INR 1 Cr as equity contribution in innovative startups. I covered it in this newsletter around the time of its launch.


The nine winners, forming the first cohort of this program, were announced yesterday. They are listed below.

NeoMotion ‘no transfer’ wheelchair

Flexmo wearable hipguard

Ducere smart insoles

Avyantra automated home dialysis device

Life Circle subscription home care services

Karevoyage for 50+ wanderers

Newndra’s Indoknee lightweight corrective support

Mediyatra’s accessible travel solutions for elders

Primate Healthtech’s IoT enabled mobile biochemistry analyzer

For more information on SAGE and to watch short videos of these innovations, visit

National Day of Older Persons

To mark the International Day of Older Persons on 1st October, the Government organized an event in Delhi where the National Award for Senior Citizens (Vayosreshthatha Samman) across various categories were announced.


The Vice President of India who was the chief guest in this event also launched a national helpline for elders – ElderLine (14567) – and a portal for jobs for those over 60 – Senior Able Citizens for Re-Employment in Dignity (SACRED). The SACRED portal link is

You can see more information on the day’s proceedings in the Ministry’s official Twitter page.

📫 Silver Angels Newsletter

The Silver Angels newsletter brings you news, stories and trends from the silver economy in India, in a short, easy-to-read format. Businesses, brands, investors, startups, researchers and analysts following this space are likely to find it interesting. No advertising or sponsorship.

🧠 Thoughts, feedback or comments? Want to connect?

Feel free to reach out at any time via email:

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Dementia Care Resources and Networks in India

Every September, people come together from all around the world to raise awareness and to challenge the stigma that persists around dementia. In this edition, we look at resources and care networks for dementia, and highlight some of the events on September 21st, the World Alzheimer’s Day.

As of 2020, India is estimated to have over 5 million people living with dementia. The treatment gap in India for people living with Dementia is almost 90 per cent. This means that only one in ten patients receive a proper diagnosis, treatment and care.

In 2010, the total societal cost of caring for known dementia patients was estimated at ₹14,700 crores, and projected to increase three-fold by the end of 2030. A 2013 study in the Indian Journal of Public Health mentioned that the annual expenditure to care for a person living with Dementia could go as high as ₹2,02,025 in urban areas and ₹66,025 in rural areas in India. In this essay, we look at key reports, studies and care networks serving people living with dementia, their families and caregivers.

You can access the essay here:

World Alzheimer’s Day Events (September 21)

Webinar on Role of Society in Early Detection of Dementia by Samvedna Seniorcare

Event link: Available on Zoom with meeting code 868 658 37888

Date/Time (IST): 21st September/ 5.30 pm

Webinar on Graceful Ageing by ASSOCHAM

Event registration link:

Date/Time: 21st September, 11am

#KnowDementia: An Interactive Workshop with Experts (Available Online and in person at venue) by ARDSI Bengaluru Chapter

Event registration link:

Date/Time: 21st September, 10:30 am to 4:00 pm

Event location: Hotel Royal Orchid Central, 47, Manipal Centre, 1, Dickenson Rd, Yellappa Garden, Yellappa Chetty Layout, Sivanchetti Gardens, Bengaluru, Karnataka 560042

Launch of the World Alzheimer Report 2021 by ADI

Event registration link:

Date/Time (IST): 21st September, 5.30pm

World Alzheimer’s Day is observed on 21st September every year to raise awareness about Alzheimer’s and Dementia, and theme this year is #KnowAlzheimers #KnowDementia. There cannot be a better time to tune into global and national experts from the comfort of your home. Do register and listen in.

The World Alzheimer Report 2021 will focus on the crucial and timely subject of diagnosis. Diagnosis is still a major challenge globally, with estimates that 90% of cases still go undiagnosed and with long wait times. We are at a pivotal moment with an evolution in diagnostics and potential treatment breakthroughs; meaning this is the perfect time to shine a light on the ‘Journey through the diagnosis of dementia’.

The report includes over 50 essays from leading experts around the world and is supported by findings from 3 key global surveys, including: 1,111 clinicians, 2,325 people with dementia and carers, and over 100 national Alzheimer and dementia associations.

The launch webinar for the report will feature a global panel of experts to discuss the key findings and recommendations, as well as a Q&A session.

📫 Silver Angels Newsletter

The Silver Angels newsletter brings you news, stories and trends from the silver economy in India, in a short, easy-to-read format. Businesses, brands, investors, startups, researchers and analysts following this space are likely to find it interesting. No advertising or sponsorship.

🧠 Thoughts, feedback or comments? Want to connect?

Feel free to reach out at any time via email:

Silver Angels is an independent platform tracking the Silver Economy in India. You can find more information on


Brands focused on the Silver Generation

In this edition, I attempt to highlight businesses and brands catering to an older adult population while also engaging seniors as influencers and actors. While traditional products (mostly around healthcare and finance) have been popular among older adults, a new range of aspirational products and specialized services are being tailored for various customer cohorts within a highly heterogenous population group.

The 2016 article by senior brand executive Ambi Parameswaran has one of the earliest references to this consumer group in mainstream Indian media – the silver generation. Referring to ads featuring elders, he writes,

So, what is happening here? Is it that the aged of India are all on road trips? Are they living a life of leisure, travel and no care? Or is it just wishful thinking by brands? The truth may lie somewhere in between. Brand marketers are waking up to the enormous potential being offered by the affluent aged. The first set of products and services to jump on to this bandwagon are the insurance and financial product marketers. But this is just the beginning.

One can see forward-looking brands projecting an image of a new elder as ‘stylish and confident’. With social media proliferation and WhatsApp providing distribution virality, we are likely to see the rise in such campaigns in the years ahead. While not comprehensive, I have highlighted a few brands offering products and services catering to the senior population to make the case.

Nobel Hygiene, India’s leading adult diaper brand, launched an Instagram Reels campaign to raise awareness around incontinence, by using senior influencers. This article details the campaign #AzadiMubarak and its reach.

In the Reels, these senior influencers asked their viewers to comment on the reels with their own experiences/reviews of how their conversations with the elders at home went. Friends then reposted the content on their page and re-circulated the posts through WhatsApp.

In a more fun and quirkier ad for the Payyannur Eye Foundation, a super speciality eye hospital in Kerala, the ad firm inquiLabz uses two elders helping each other out in an examination hall.

India Post’s senior citizen savings scheme is one of the earliest and most progressive banking products, and open for anybody over the age of 60 with a minimum deposit of Rs 1000, and continues to be very attractive for its high interest rate.

While maternity and child benefits are common among many companies, Intuit, a US-based IT company, through its Maya Program, provides comprehensive care for its India-based employees with elderly dependents who need extra support.

Caravan, a portable music player with pre-loaded collection of songs from Saregama, one of the oldest music labels in India, has evolved over the years and today offers over ten different products, and comes in at least six languages (Hindi, Tamil, Marathi, Bengali, Punjabi and Malayalam). Known for its retro design, it is now on a path to chalk out its post covid growth journey.

Club Mahindra, through its Bliss memberships, offers holidays tailored to a segment they call Empty Nesters or Seenagers. The proposition is quite broad, and while not clear how such stays will be senior-friendly or take into consideration medically dependent members of a family, it recognizes the need to cater to 50 plus whose preferences may be quite different from other generational cohorts.

Tata Sky Seniors, an exclusive channel for seniors, is another interesting addition focused on health, education, financial planning and relationship management.

In conclusion…

An ageing population, and particularly seniors, are looked at as those with needs and support. While this is true for some of them with medical and financial dependencies, they are also increasingly seeking convenience, experimenting with technology, exploring new products, active online and seeking tailored experiences that meet their aspirations (and wallet size).

To say that they will not spend is to literally say we have nothing to offer them, and some of these brands have shown there is an opportunity. One is likely to see progressive brands crafting new narratives, sharpening their proposition, investing in R&D, understanding consumer preferences and personalizing product experiences to cater to the many consumer cohorts spanning entertainment, education, travel, insurance, payments, etc.


Indexing Quality of Life for Elderly

Quality of Life (QoL) is an oft-repeated phrase in conversations around ageing, longevity and elderly, and is also widely adopted across general population in more developed countries. In this edition, we look at a recently launched report focused on India, and other developments in the space.

Report on Index on Quality of Life for Elderly

The literature around Quality of Life (QoL) is quite expansive, and one of the previous Silver Angels essays – Future of Ageing in India – tries to capture the evolution of policymaking both in language and content around this topic, taking cues from the global initiatives and commitments. The recently launched Report on Index on Quality of Life for Elderly by the Institute of Competitiveness could be considered a small yet significant addition to the Government’s thinking around the topic. It adds to the many “Ease of ” indices out there, to inform policymaking at the central-level.

The report itself is over 100 pages but presented in a easily accessible slide format. It identifies 4 major pillars (financial wellbeing, social wellbeing, health system and income security), 8 sub-pillars and 45 indicators to measure quality of life among elderly population in various states. States are classified as aged states and relatively aged states, and ranked accordingly. For example, Rajasthan, Maharashtra and Bihar rank highly among the former while Himachal Pradesh, Uttarakhand and Haryana rank high on relatively aged states. Chandigarh among UTs and Mizoram among North Eastern states complete the leaderboard. All of these rankings are calculated basis Government data, and for the curious among you, rankings are available from page 45 onwards, and the methodology is provided in the Appendix (page 85).


While not current with the broader thinking around ageing or longevity, it does provide a curbside view of how welfare and social sector programs could be designed/redesigned in the future. On the flip side, the report is an academic exercise, does not provide access to the government data used to arrive at the state-level rankings and uses the conventional approach of 60 years as the cutoff age for elders.


COVID-19 impact: Senior citizens struggle to buy term plans as underwriting gets stringent by M Saraswathy in Moneycontrol

Our Take: This is a legitimate issue for senior citizens, and particularly those with chronic conditions or multiple health issues. While there is no silver bullet yet, many financial advisors are suggesting retirement-linked products over term plans. The impact of age-linked medical costs is rising at alarming levels, and this was elaborated from longevity finance planning and long-term care planning perspectives in two previous essays.

When covid-19 forced Gen Y to deal with parents’ assets by Smitha Verma in Mint Lounge

Our Take: Being an extremely sticky topic and considered taboo in many Indian families, the pandemic has triggered more Indians of all ages to write their wills, be it those in their 40s or wealthy seniors. This article brings up this intergenerational issue to the fore, and talks about the professionalisation of these activities. While many elder-focused companies and financial advisors already provide such services to their customers, one is likely to see specialized platforms, aided by technology, addressing this and many other areas (endlife care protocols, estate planning, charity contributions, funeral planning, custodial arrangements, etc) linked to longevity and mortality.

Assisted living breaking the taboo of old age homes in Chennai by Akshaya Nath in India Today

Our Take: While much has been said and written about assisted living arrangements in the general context of seniors, this article highlights a super critical aspect (quoted below).

“While most of the elderly citizens who come for assisted service are 80 years and above, their children are around 60 years either retired or about to get retired. They will be in a situation where they have to take care of their deteriorating health and of their elderly parents and that is when assisted living comes to their aide.”

Dr K Vasanth, geriatric care specialist


Silver Talkies, a community for 55+, came out with this short and fun video – do check it out!

📫 Silver Angels Newsletter

The Silver Angels newsletter brings you news, stories and trends from the silver economy in India, in a short, easy-to-read format. Businesses, brands, investors, startups, researchers and analysts following this space are likely to find it interesting. No advertising or sponsorship.

🧠 Thoughts, feedback or comments? Want to connect?

Feel free to reach out at any time via email:

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Long Term Care (LTC) in India: Key Market Drivers

Welcome back! In this edition, we will look at the evolution of Long Term Care (LTC) in India and the key factors driving it.

Families in India are the primary caregivers for most elders but the the role of secondary support systems, led by home care services, assisted living companies and institutional care facilities, is emerging as possible alternatives for those seeking specialized and long-term care. While such transitions, largely triggered by the pandemic, have brought much needed attention to challenges faced by elders, it is also important to recognize that we are at an early stage in addressing broader needs of a much broader and diverse group, particularly the less affluent.

Long-term care is an expensive proposition but with better policies, higher public health spending, affordable services and innovative solutions, we could lower the overall cost of care. In this essay, I elaborate four key factors driving the long-term care market.

Click here to read the essay.

📫Silver Angels Newsletter

The Silver Angels newsletter brings you news, stories and trends from the silver economy in India, in a short, easy-to-read format. Businesses, brands, investors, startups, researchers and analysts following this space are likely to find it interesting. No advertising or sponsorship.

If you are first time reader, do subscribe to the Silver Angels newsletter.

🧠Thoughts, feedback, questions? Want to share your work?

Feel free to reach out at any time via email:

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Silver Generation: The Original Disruptors

The Silver Angels Essay Series presents a longer format suitable to consolidate research and add fresh perspectives to the conversations around longevity, ageing, eldercare and the silver economy.

Catering to the silver generation is not about just meeting their needs but also stepping up to fulfill their aspirations and building an age-friendly society.

Today’s 70+ adult went through an economic period that had limited opportunities, careers largely driven by a steady job with a fixed retirement age, a much less technologically connected society, slower wealth accummalation, restricted mobility and and limited access to higher education or specialized healthcare. On the contrary, a 55 year-old adult today represents a cohort that were the original disruptors of India, in both the economic and social sense.

Both these (very) different generations are shaping the silver economy. How are they different from each other and from the other generational groups? How are businesses adapting and creating new products for this consumer segment? Are eldercare startups leading us into a whole new set of opportunities in this sector?

Read Full Essay

🎞 Don’t miss these snippets!

Subscribe to Seniors Today and check out their Anniversary issue. Do not miss this article where 71-year old actor Sharat Saxena talks about scarcity of roles for older people in Bollywood, and why Amitabh Bachhan may be doing more harm than good!

Stroke is the third leading cause of death in India after heart diseases and chronic obstructive pulmonary disease. Dementia is the fastest growing neurological disorder. To know more, read the original Lancet report.

Read this Business Today article on the Business of Elders, by Ajita Shashidhar. Takes you through some private sector initiatives in the space.

Has the pandemic triggered elders to shift to retirement communities? Find for yourself in this Mint Lounge piece by Preeti Zachariah.

A bold proposal, why funders need to take bigger bets on the social sector, by R Sriram and Vanessa D’Souza in the India Development Review

Lastly, check out this viral story about a Mumbai-based couple that rides around the country in their Bullet with a super cool sidecar.


🌆 Senior Zone – Online events and programs

Online activities for seniors are on 🔥

Heritage Foundation is hosting an international webinar on geriatric care with participants from 15+ countries. You can register with this link.

CovaiCare is hosting an intergenerational dialogue on eyecare (in Tamil)

Date : 18th July 2021 | Timing : 5:00 pm to 6:30 pm |Panelists from Sankara Eye Foundation: Dr Meenakshi Swaminathan, Dr Kaushik Murali & Dr Rajesh | Joining link

Samvedna Senior Care co-founder Dr Jayashree Dasgupta will be speaking on “Suspecting Dementia – What should you know?” at the NIMHANS.

Date July 19, 3.00 pm – 4.00 pm | Zoom Meeting Link: | Meeting ID: 84612019327 | Passcode: 123

Emoha is hosting the #EldersFirstFestival online. Read more about it here.

📪 Silver Angels Newsletter

The Silver Angels newsletter brings you news, stories and trends from the silver economy in India, in a short, easy-to-read format. Businesses, brands, investors, startups, researchers and analysts following this space are likely to find it interesting. No advertising or sponsorship.

If you are first time reader, do subscribe to the Silver Angels newsletter.

Thoughts, feedback, questions? Want to share your work?

Feel free to reach out at any time via email:

Silver Angels is an independent platform tracking the Silver Economy in India. You can find more information on


Grandparenting: Caring or Caregiving?

Joint families, urbanisation and intergenerational communication

Thanks for reading! In this newsletter, we will look at new family groups and older adult development through the lens of grandparenting.

Now, let’s dive in!

Joint vs Nuclear Families: What are we missing in this debate?

In the 2011 census, the share of nuclear households was 52.1% — 12.97 crore nuclear out of 24.88 crore households. From 54.3% of the urban households of 2001, nuclear families have fallen to 52.3% of all urban households while they have seen a rise in rural areas. The 2011 census further introduced new categories of nuclear families, adding more complexity to the mix.

According to the government yardstick for classifying family size, a subnuclear family is a fragment of a nuclear family, such as a widow with unmarried children, or siblings living together. Supplemented nuclear families include a nuclear family’s members plus other relations, without spouses. Broken extended nuclear families comprise a head without a spouse with other relations, of whom only one has a spouse. A joint family can be of various compositions, including parents with married children.

According to the National Sample Survey data, the overall increase in nuclear households is at best modest. Moreover, the rise in the number of nuclear or fragmented households is actually a rising trend in rural areas (due to rural-urban migration, non-family employment and female employment) while similar shifts are lesser in urban areas, likely attributed to cost of housing. The need for childcare and the ability to provider better care for parents also helps reverse the trend and drives the rise in urban joint families. With increased lifespan, one can witness multi-generational households living in shrinking spaces and negotiated living arrangements in age un-friendly cities and older adults in rural areas living by themselves. While India on an average is urbanising much slower than other countries that have gone through similar demographic trajectories in the recent past (South Korea, China, etc), certain states and union territories are urbanizing much faster than the rest. This is as much a challenge with urban planning as it is about affordable housing in cities.

As per another study published early this year, the number of seniors living alone is highest in Tamil Nadu, and likely accelerated due to migration of young adults for education, marriage and business. The same survey also highlights that most elders prefer to move to smaller towns or move out of their houses when their children start their own families. Kerala, with the highest proportion of senior citizens, continues to see rise of old age homes in urban pockets, attributed to rapid urbanization and high levels of outward migration.

All of these factors, along with the acute impact of the pandemic on the elderly (restricted mobility, social isolation, anxiety, limited health access, etc), makes intergenerational communication an important factor in maintaining strong intergenerational relationships.

Grandparenting: Generativity vs Stagnation

Care for older adults is at the heart of most family conversations, and particularly more so during the pandemic.

The Swedish psychoanalyst Erik Erikson coined the term Generativity, in the 1950s, as part of his theory around human development set in 8 stages. In his book, the Eight Ages of Man, he demystifies the fashionable insistence on dramatizing the dependence of older generation on the younger one, and argues how mature adults also need guidance and encouragement from those before them to truly mature. Generativity is simple terms defined as the concern in establishing and guiding the next generation, and this quite likely is at the heart of grandparenthood.

“I wouldn’t say we were caregivers; we were just caring for them”

This line that I read in a blog post is likely how most Indian grandparents would define their role in taking care of their grandchildren.

Studies around grandparental caregiving, particularly around their physical and emotional health, are uncommon in India although grandparents contribute disproportionately towards child and family care. While the importance of the role of grandparents in the developmental phase of children is widely understood, the changing parenting styles and choices lead to more contemporary issues. From 24*7 grandparents in joint families, the role of many can now be described as supportive on-call grandparents.

Ageing parents who are economically self-sufficient are increasingly choosing to reside separately, and those that are grandparents among them, spend a considerable part of their post-work lives as (primary or secondary) caregivers for their grandchildren. During this phase, which can last from a few years to a decade, they turn to adaptive living arrangements that includes moving between multiple quarters. Such adaptive arrangements are also common among older adults splitting time between their home and that of their children. Many older adults also provide care for the oldest among them thus extending their role as caregivers.

Understanding the changes in family compositions can help understand the impact on the quality of life of older adults, and grandparenting is one such critical phase in older adult development and evolution. Given it completes a certain intrinsic desire, to be grandparents, it is also a time to reflect upon late-stage care and living arrangements for sustained wellbeing.

UNFPA/HelpAge Report

15th June is World Elder Abuse Awareness Day. Read the recent UNFPA sponsored report by HelpAge – Bearing the Brunt – about the impact of COVID-19 on Older People across low- and middle-income countries through data, case studies and individual stories.


Seniorcare Ageing Growth Engine (SAGE) is accepting applications

Government equity participation of upto Rs. 1 Crore in senior-focused startups

In this newsletter, I will provide an update on the startup fund (Seniorcare Ageing Growth Engine) launched by the Government of India. More public interest and less coverage or analysis.

Seniorcare Ageing Growth Engine (SAGE) is an Initiative for promoting aged-care products and services by Ministry of Social Justice and Empowerment (MoSJE), Government of India.

It will identify, evaluate, verify, aggregate, and deliver products / solutions / services directly to the stakeholders, giving them wide choice to select the products / solutions / services that would suit their requirements, thereby improving their quality of life. The Ministry would act as the facilitator in the process while ensuring that the products / solutions / services are made available to a large number of needy people.

Selected Companies would be supported by Government equity participation of upto Rs. 1 Crore and showcased on the platform, developed by MoSJE, thereby enabling wide outreach among the users.

Steps to fill SAGE Expression of Interest

  • Step 1 – Fill Company Registration Form
  • Step 2 – Company can log in to fill the application
  • Step 3 – Company may add more than one product / service (Expert Committee
  • Evaluation will be carried out on a product basis and not on a company basis)
  • Step 4 – Fill the Financial details of the Company
  • Step 5 – Fill Profile of professionals/employee details

This website is compatible with desktop only. (Registration through Mobile is not compatible)

Last date for Registration: 30 June 2021

Last date for Submission of Application: 10 July 2021

For any details related to submission. Please write to us on email: / Mobile No: +91 70601 33531

For more information, visit

Some relevant posts about this emerging market

Subscribe to the Silver Angels Newsletter to stay updated on latest developments.

quality of life Uncategorized

What is the right ‘old age’?

Elderline, longevity, happy ageing and quality of life

Thanks for reading and subscribing to the Silver Angels Newsletter. I cover news focused on the Silver Economy, with a focus on research, media, entrepreneurship and impact. In this newsletter, I attempt to expand the language around ageing in the context of developments over the last three decades, and why retirement age doesn’t define old age.

Let’s dive in!

📣 Language of ageing

The wellbeing of senior citizens is part of the Constitution of India, under Article 41. India came up with its first ever policy centered around well-being of older persons in 1999, also declared the year of older persons by the UN. This policy laid out strategies to improve the quality of life of senior citizens through interventions in areas of financial security, healthcare and nutrition, shelter, continuous education, protection of life and property, and welfare of the programs to the most vulnerable among the older persons. In 2011, a national policy on senior citizens that integrated various services and benefits (pension, travel concession, etc.) to improve access and provisions for seniors was published. Drawing from active international efforts in the space, the policy advocated for dignified life for older adults through ageing-in-place services, financial support for assisted living facilities (old age homes), protection against abuse and neglect, and much more.’

The UN declared 2021-2030 as a decade for healthy ageing, defined as “the process of developing and maintaining the functional ability that enables wellbeing in older age”. It identified four areas for action – age-friendly environments, combatting ageism, integrated care, and long-term care – and this was followed by the WHO’s 2016 global strategy, which lays out an action plan to meet these goals centered around ageing and health. These and many other developments around the world have helped evolve the language around ageing over the past two decades– positive ageing, productive ageing, healthy ageing, happy ageing, active ageing, better ageing – into something more nuanced, relevant and futuristic.

One of the interesting aspects of studying ageing is the evolving language and context of usage, and how it impacts the way we frame a problem or an opportunity. The intergenerational changes further alter the perception around ageing, and strengthen the movement away from the binary of working and retired lives, which is largely a creation of formal workforce arrangements.

In the Indian context, a senior citizen is somebody over the age of 60 and thus acquires special rights under law, is eligible to avail certain entitlements and concessions, and gets credits in the Indian government tax system. A senior citizen dependent is also a tax-saver for a family, as highlighted in the article. Simply put, the definition of a senior citizen influences the financial and non-financial aspects of the elderly in India, and it is all the more relevant in the case of those dependent on the government for basic needs and protection. It is estimated that old age pension covered 28 million individuals across the country in 2019-20, the largest of the three major disbursements under the National Social Assistance Protection (NSAP).

🎈 Age in the context of longevity

Imagine this. The average lifespan of general population in India (longevity) has increased from 62 years in 2000 to almost 70 years in 2018. That is a rise of 8 additional years post the age of 60, termed as the cutoff age for senior citizen qualification!

In short what we have is a single standard cutoff age for a moving average for a population demographic with multiple indices around general wellbeing. You are more likely to see an active 75 year old Indian person raring to make her next youtube video than you did three decades ago.

Now, let us look at a few other countries.

Senior citizens in South Korea are those with a chronological age of 65 years while in the US, it could vary for different provisions and benefits. The federal health insurance (Medicare) kicks in at the age of 65 while getting policies around driving licenses vary from one state to the other, between 64 and 80. Taking a completely different view, Denmark categorizes people between 60 and 80 years into the third age group and those over 80 years into the fourth age group. The paper Think Tank – The 3rd Age from a reputed Danish think tank articulates 7 key challenges and 33 recommendations to develop what it terms as a good life for the third age group. A joint committe of the Japanese geriatrics and gerentology societies proposed to increase the age of elderly to 75 years and above considering those between 65 and 75 years continue to be active and feel uncomfortable being treated as elderly.

In short, there is no universal senior citizen and old age is not defined by one number.

⚡ Marketplace to improve Quality of Life?

It is well identified that a lot of factors contribute to increased life expectancy among general populations including sustained investment in health, education and so on. A developing and emerging country like India measures its progress over time by the improvement in access to basic and essential needs (food, shelter and clothing) of a larger population and improvement in overall standard of living (rights, life expectancy, safety, income equality, environment conditions, etc.). While standard of living comparisons help benchmark globally, they do not necessarily reveal the quality of life among those living longer.

It has been observed that subjective wellbeing is crucial for later life satisfaction and is an important determinant of quality of life. Aside from meeting basic needs, financial security, continuing participation in societal activities, better geriatric care, availability of supportive and assistive devices, better living arrangements and general life satisfaction play a crucial role in enhancing the quality of life among older adults.

Looking at the eldercare market from the perspective of quality of life improvements can help build a vibrant silver economy and a marketplace of reliable services spread across various needs. Affordability and access to such services are going to be key to ensure such improvements reach the next half billion.

Here are three such opportunity areas –

  1. The Alzheimer’s and Related Disorders Society of India (ARDSI)’s 2018 Dementia India Strategy Report estimates 14.3 million Indians with dementia by 2030 and the cost of care to touch 0.5% of the GDP. Given elderly are particularly vulnerable for dementia and other chronic conditions, this space needs better attention given its impact on the quality of life.
  2. In a previous article, I touched upon the transition from one-size-fits-all approach of old age homes to various formats of care and living arrangements, and in another article, about the growing ageing-in-place services in India. These efforts help improve the quality of life of older adults while presenting a clear opportunity for the future.
  3. While the shortage of doctors and nurses in India is well covered, the estimates around demand for caregivers for an ageing population is not fully understood. With global shortage of caregivers for elders, investments in this space can result in disproportionate improvements in quality of life. According to official estimates, Israel, a country of around 9 million, is home to 15000 Indians out of which 13500 are registered caregivers. While the Government, through industry partnerships, has developed certain standards for this industry, this is an area with immense opportunity to create jobs.

🖨 Mainstreamed

Articles from mainstream newspapers and magazines that touch upon the Silver Economy in India, and our short take.

Launch of Elderline by Government of India

The dedicated number 14567, along the lines of similar efforts in the past for children, is operational in UP, MP, Rajasthan, TN, Karnataka & Telengana through public-private partnerships. The service will be rolled out in other states over time and in the first three weeks, received 475 actionable calls seeking emotional support, information on pension, old age homes and other issues.

Eldercare while working from home, blog post in People Matters

“It is much more common and comfortable for people to talk about their children at work than it is to talk about aging and/or ill parents. So you cannot assume that your boss or peers know or understand your situation. Eldercare is also highly unpredictable and can therefore be highly disruptive to your workday. So tell your coworkers about your caregiving status and ask for their compassion during this time.”

These lines resonate across offices everywhere and drive the benefits programs in even the most progressive organizations, undermining the role of employees in the wellbeing of their parents/elders in the family.

Zero-sum game of caregiving by Rahul Desai in Firstpost

In this interesting personal journey, the author ventures into the world of caregiving through characters in three movies, and looks at his future self as possibly being one (or not) for his parents. I will also add the Netflix show, The Kominsky Method, to the mix of movies covered in the article – Solos, The Father, and Dick Johnson Is Dead.

Medical emergencies and lonelineness by Anubhuti Matta in Forbes

Emoha Eldercare, a Gurgaon-based eldercare company with 3500 members, launched a bike-based first responder to attend to accidents, perform CPR and offer first-aid. The company claims to have saved 40 lives through this service, and has also launched active ageing programs online to keep elders engaged.

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