Discuss the challenges faced by the aged people in receiving ‘elder care’. (2026, 10 Marks)
Elder care is a transaction: a need must find a provider who is competent, affordable and trusted. In India all three conditions fail at once. The Longitudinal Ageing Study in India (LASI, Wave 1, 2017–18), covering 31,464 persons aged 60 and above, found 5.2% reporting abuse in the past year — usually from the person meant to be caring for them. The difficulty is not only scarcity of care but the structure of the relationship delivering it.
Supply: a care system that barely exists
- India has no long-term care law. The Maintenance and Welfare of Parents and Senior Citizens Act, 2007 creates a duty on children, enforceable before a maintenance tribunal; it creates no entitlement to services. An old person may sue a son; she cannot claim a nurse.
- The geriatric workforce is minimal — about 31 MD seats in geriatric medicine across nine medical colleges (2024–25) and 18 regional geriatric centres under the National Programme for Health Care of the Elderly. Home care remains an unregulated market of untrained attendants.
- Institutional care reaches under 5% of seniors; industry estimates put senior-living inventory at roughly 20,000 units against demand projected in millions by 2030.
Demand: those who cannot pay, and will not ask
- A 2024 HelpAge India survey of 5,169 elders found 65% financially insecure, one in three with no income in the previous year (38% of women against 27% of men), and only 31% insured.
- Extending Ayushman Bharat PM-JAY to every citizen aged 70 and above regardless of income, through the Ayushman Vay Vandana Card (October 2024) — about 6 crore seniors, ₹5 lakh cover — is the biggest recent advance. Yet it funds hospitalisation, not the chronic daily assistance ageing actually demands.
- Paid care is stigmatised. Erving Goffman’s Asylums (1961) explains the dread of the old-age home as a total institution; placing a parent there reads as filial failure, so demand stays hidden.
The relational barrier: the carer is often the abuser
- LASI records verbal disrespect (66.6%) and neglect (47.5%) as commonest, rural 5.8% against urban 3.8%; living alone roughly doubles the odds.
- The same survey names sons (42%) and daughters-in-law (28%) as main perpetrators, while only 9% of elders knew the 2007 Act existed.
- To complain is to risk losing one’s only carer and one’s home; under-reporting is structural, not accidental.
Conclusion
Peter Townsend’s “structured dependency” (1981) fits exactly: old-age dependency is produced by the design of pensions, retirement and services, not by biology. India made the family the sole provider and gave it neither money, training nor respite. Until care is a claimable social right rather than a filial obligation, the aged will keep needing what the system is not built to deliver.