Primary Author: Yash Bhardwaj, PharmD Intern – Kalaza Care | Email:
bhardwajyash2608@gmail.com
Advisor: Dr. Pravinkumar R. Patil, BS, MA, MS, MBA, PharmD – Clinical Pharmacist &
Founder, Kalaza Care Assisted Living & Medical Recovery Homes, Pune | Email:
pravin.patil@kalazacare.com
India is in the midst of a demographic shift unmatched at any time in its history. And even as India remains home to the world’s largest number of young people, it is experiencing skyrocketing elderly population. The United Nations Population Fund (UNFPA) estimates that 153 million Indians are currently in the 60-plus category—a figure that is set to be more than double to 347 million by 2050. In a few decades, nearly a quarter of Indians will be elderly. This “silver tsunami” has sweeping implications: a larger population of retirement-aged people needing income security, health care and support services. Alarmingly, many of today’s elders are already in poverty:roughly 40% of seniors belong to India’s poorest wealth quintile, and 18.7% have no income at all, according to the India Ageing Report 2023 by UNFPA. Strong cultural stereotypes that depict the elderly as a “burden” combined with scanty social safety nets have aggravated their vulnerability.[1]
Changing Family Structures: Solo Ageing and Isolation
Families in India are evolving too. The joint family is being replaced with the nuclear, and there is migration of many young people to the cities or overseas. That has already driven an increasing share of seniors to age alone. According to a recent NDTV/Press Trust of India report, 14.3% of elderly Indians live alone (15% in cities, 13.4% in villages). Many such seniors opt for solitude to maintain independence — roughly 31% mentioned financial or personal independence as a reason — but others have been abandoned by families who have migrated away.The picture is mixed: 46.9% of solo seniors said they were happy with their lives, and 41.5% were dissatisfied.[2]
This phenomenon, known as “solo ageing”, carries both social and emotional risks. It’s no surprise that many seniors feel overlooked: in that study, almost half reported that family members “do not care for their needs”. Among older people living alone, 41% of them said their mental health had declined as a result of isolation, the survey found, while just 32% reported an improvement.[3]
Loneliness is rife — 10.4% of solo seniors reported they always feel lonely, and 21.2% feel lonely often. Another large-scale survey, conducted by the Agewell Foundation in 2017, found that 43% of older Indians said they suffered from psychological distress, including fear or depression due to loneliness or difficult relationship.[2]
The Burden of Chronic DiseasesChronic non-communicable diseases are rampant among the elderly in India. National surveys estimate that 3 out of 4 elderly Indians have one or more chronic diseases . In one study (the Longitudinal Aging Study of India), 75% of elders had been with diagnosed chronic disease and 40% had a disability. The burden of chronic disease increases markedly as we age. For instance, the prevalence of cardiovascular diseases and stroke increases from one age group to the next: 22% of 45–59-year-olds suffer from heart disease, and that percentage rose to 37% of adults aged 75 and older.[3]
Table 1- Prevalence of Major Non-Communicable Diseases Among Older Adults[3] [4]
| Non-Communicable Disease (NCD) | Prevalence Among Seniors (60+ years) |
| Hypertension (High Blood Pressure) | 32% (aged 65–74 years) |
| Diabetes | 14% |
| Chronic Heart Disease | 5.2% |
| Stroke | 2.7% |
| Asthma | 5.9% |
| Chronic Bronchitis | 1.6% |
| COPD (Chronic Obstructive Pulmonary Disease) | 2.8% |
Multimorbidity is an issue faced by many older Indians. The prevalence rates of two or more chronic conditions are roughly 23% for the elderly, which is higher compared to young adults. Multimorbidity can easily become a burden to people and families, and a a complex challenge for care navigators.[3]
Another less commonly noticeable condition in this age group is CKD. In a screening camp conducted during a hospital camp(2018) in Varanasi revealed that 29.3% of individuals were found to have CKD; 40.6% of individuals ≥60 years of age. In our study, Older patients with CKD had significantly higher serum creatinine and proteinuria levels. The results emphasize that the risk of kidney failure rises sharply with age, but early stages of CKD are commonly not detected.[5]
Stroke and Cardiovascular Risk
Stroke and heart disease are potential leading causes of death. Stroke is India’s fourth leading cause of death and the fifth leading cause of disability. Indians have a high stroke incidence, approximately 119–145 new cases per 100,000 individuals per annum, primarily due to the widespread prevalence of risk factors.[6] Elderly Indians commonly have ill-controlled hypertension, diabetes mellitus, along with high tobacco use and dyslipidaemia,which are the major risk factors for stroke. Significantly, around 3 out of 4 strokes in India are ischaemic, and the remaining 1 in 4 are haemorrhagic, by comparison to the rest of the world.[7] Risk increases with age: e.g., while ~2.7% of seniors have had a stroke, the annual rate of stroke increases significantly later in life.[4]
Polypharmacy Pitfalls: Medication Errors and Adherence Gaps
With all those chronic conditions, many elders have to take multiple medications each day — a scenario that has a name, polypharmacy. Polypharmacy unfortunately carries a high price of medication errors and adherence failure. Studies have found that a majority of seniors have difficulty adhering to their prescriptions properly. A study was conducted at Bharati Hospital and Research Centre, Pune, over a period of 6 months among 240 patients aged >60 years (all of whom were consuming ≥4 daily drugs) and it revealed that only 5.8% of patients were fully adherent to their treatment. Notably, 74.1% of these older adults reported that the complexity of their medication regimen was the greatest obstacle to using medications correctly. More than half the patients were unable to name the medications they were taking.[8] At the Amrita Institute of Medical Sciences and Research Centre, Kochi, another study reported 82% of seniors were initially classified as being highly compliant with medication (based on a questionnaire). However, during a follow-up visit, this rate fell to 74% as some patients began skipping doses. They added that adherence dropped when regimens were complex or when patients felt better and discontinued their medications on their own. Participants identified complex schedules, unawareness of the disease, cost and mobility as barriers to adherence.[9]
Mental Health and Social Wellbeing
Physical health is only one dimension of the elder care crisis. Mental well-being and social support are just as important as physical health. Ageing is usually associated with social isolation, depression, and a decline in cognitive function. A study titled “Relationship Between Loneliness, Psychiatric Disorders, and Physical Health” emphasizes that over 40% of the elderly in India have some psychological problem due to loneliness or changes in the family roles they experience.Many elders, in rural and urban areas, feel abandoned. A 2017 study by the Agewell Foundation showed 43 out of 100 seniors said they felt psychological distress such as sadness, anxiety or feeling like they were a burden; Many described feeling abandoned by their family.
The article “Affordable residential rehabilitation facilities for persons with chronic mental illness: An emerging need” highlights that in India, families bear the burden of caregiving for individuals with chronic mental illness as a consequence of the country’s collective culture. This family-based model has resulted in better prognosis for schizophrenia in India than in Western societies, as confirmed in the WHO studies in different countries. Despite these favourable results, the burden of care continues to be high, particularly in the backdrop of behavioural disturbance, poverty, and illiteracy.
An examination of 4,935 long-stay psychiatric patients showed that 55.4% were brought in by police or magistrates—often because of homelessness—whereas only 33.1% were brought in by family members. This reflects a wide chasm of community and family support for seriously mentally ill persons.
Caregivers experience a significant amount of distress, especially those care for women with schizophrenia and those with marital separation. Approximately 60% said they were distressed about the patient’s unpredictable behaviour, and 41.3% could not fulfil the needs of other family members because of caring for the patient.
The rising trend of nuclear families (63% in urban and 59.3% in rural households now, compared to National Family Health Survey-3), coupled with growing migration, has led to a decline in the pool of potential carers. These family structural changes create further obstacles for the continued care of people with mental illness.
While there are 69 mental health NGOs working in 12 states, residential rehab services are scarce, urban-based, and predominantly cater to people who have the means. To address this issue, the DDRC initiative Deendayal Disabled Rehabilitation Scheme suggested the setting up of halfway homes with 12 such centres financially supported in 2019–2020. But no money was allocated in 2020–2021, leading to doubts as to whether the scheme would be rolled out and its long-term sustainability.
This is where the need for sustainable, community-based rehabilitation models and government-funded residential options comes in. Improvement in these systems are needed not only for the benefit of people with enduring mental illness but also to relieve the significant demands placed on family members.[10]
The Caregiver Crunch and Systemic Gaps
As the needs of elders increase, so too does the load on the family members who care for them — frequently wives, sons or daughters who have to balance work, child care and elder care. Reliable data on caregiver stress in India do not exist, but its strain is evident. The UNFPA report underscores how many families are unprepared:Traditional safety nets (such as joint family support) are unravelling just as the needs of the elderly are increasing.The reliance of seniors’ reliance on family is also a significant economic factor. It is also notable that 40% of elderly people live in the poorest households and one-fifth of them have no income. This means families are often left to bear the burden of elder healthcare costs with few assets. Costs associated with long-term illness can drive households into poverty.
In addition to the financial weight, caregivers bear an emotional and time-related burden.In a fast-paced culture, caring for a frail parent can clash with work and child-rearing obligations.However, the government’s response to this challenge has been inconsistent.Existing measures include the National Helpline for Senior Citizens, the Indira Gandhi National Old Age Pension Scheme, funding for long-term home care, and adult day-care centres—a mere drop in the ocean compared to what is needed to support India’s rapidly growing elderly population.
Key Needs and the Role of Trained Professionals
Addressing India’s elder care crisis requires a multi-faceted approach, emphasizing the following:
- Need for Geriatric-Friendly Infrastructure and Geriatric Care Ecosystem:
Due to an unprecedented increase in the elderly along with the varying healthcare needs of this population, there is an urgent need to further develop an elaborate geriatric-friendly setup. (This includes) building the infrastructure—such as accessible environments, a system of holistic geriatric care—that can accommodate the diverse needs of the elderly, from daily assistance to medical care, instead of the fragmented approach currently in place.
- Need for Trained Healthcare Employees, Caregivers, and Efficient Pay Systems for At-Home Health and Medical Recovery Homes:
Rising strain on families and acute-care providers underscores the urgency of expanding the ranks of trained health workers and caregivers. Medical recovery homes provide an essential bridge by offering safe, staffed facilities for post-hospital restoration, medication stabilization, physiotherapy and palliative care, all helping to prevent readmissions, accelerate functional recovery and reduce the strain on the wider health-care system. A functional pay system for home-based health services is key to sustainably support these critical care models and draw in the personnel needed for the task.
- Critical Role of Trained Clinical Pharmacists:
Polypharmacy, medication errors, and adherence discrepancies illustrate the inherent challenges in the aging population—challenges where trained clinical pharmacists can play a pivotal role. Their understanding of medication counseling, patient education, chronic disease management (e.g. diabetes, hypertension) and palliative care can ease the burden.
- Conclusion: Reinforcing India’s Geriatric Care with Medical Recovery HomeIndia’s ageing population is rising at an unprecedented rate, creating a growing need for specialised post-hospital care. Amid the pressures of chronic disease, polypharmacy, and social isolation—affecting both families and acute-care providers—medical recovery homes offer a crucial link — providing senior citizens with a safe, staffed environment where they can recover, have their medications managed, undergo physiotherapy and receive palliative care after they’ve been discharged from hospital. Through minimizing readmissions, optimizing functional recovery, and easing caregiver strain, such facilities help to alleviate the burden on our health system and provide older adults the focused, compassionate care they deserve.
Our Medical Recovery Home in Pune, Kalaza Care, is a living testament to our vision:
- 24×7 Skilled Caregiving & Post-Hospital Recovery (medical stay, palliative care, physiotherapy)
- Personalized Wellness Plans & Nutrition Support (healthy meals, medication management apps)
- Adult Day-Care & Dementia Care Services (safe environments, memory-care activities, holistic-healing programs)
- Family-Centric Approach: Kalaza Care adopts a family-centric approach, addressing minute details and needs throughout the transition from home to hospital, to medical recovery home, and back to home
To fulfill India’s demographic imperative, we must expand medical recovery homes nationwide and integrate them into discharge planning, creating market incentives for hospitals, insurers and home-care providers to work together. Both Families and policymakers need to understand that investment in such elder care solutions, rehabilitation after surgery, and senior health recovery centers not only enhances senior wellness and dignity but also delivers measurable cost-savings by preventing avoidable complications and rehospitalizations.
Visit www.kalazacare.com to to see how Kalaza Care’s medical recovery home is transforming geriatric recovery care—and join us in building a future where each aging adult comes out of recovery stronger, healthier and more independent.
References
- UNFPA India. India’s ageing population: Why it matters more than ever [Internet]. UNFPA India. 2024. Available from: https://india.unfpa.org/en/news/indias-ageing-population-why-it-matters-more-ever
- India. Elderly Population In India Shifting Towards Solo Ageing, Reveals Study [Internet]. www.ndtv.com. NDTV; 2024 [cited 2025 Jun 1]. Available from: https://www.ndtv.com/india-news/elderly-population-in-india-shifting-towards-solo-ageing-reveals-study-6684821
- Sharma NC. 75% elderly suffer from chronic diseases, quarter live with co-morbid conditions [Internet]. mint. 2021 [cited 2025 Jun 1]. Available from: https://www.livemint.com/news/india/75-elderly-suffer-from-chronic-diseases-quarter-live-with-co-morbid-conditions-11609952001889.html
- Gaurav Suresh Gunnal, Ojha A, Singh NM. India’s burden of heart diseases: Study says elderly, women more at risk [Internet]. Down To Earth. 2021. Available from: https://www.downtoearth.org.in/health/india-s-burden-of-heart-diseases-study-says-elderly-women-more-at-risk-74993
- Rai P, Rai P, Bhat R, Bedi S. Chronic Kidney Disease among Middle-Aged and Elderly Population: A cross-sectional screening in a Hospital Camp in Varanasi, India. Saudi Journal of Kidney Diseases and Transplantation. 2019;30(4):795.
- Behera DK, Rahut DB, Mishra S. Analyzing stroke burden and risk factors in India using data from the Global Burden of Disease Study. Scientific Reports. 2024 Sep 30;14(1)
- Bureau O, ET HealthWorld. Rising number of stroke cases among youngsters and children, a growing concern in India [Internet]. ETHealthworld.com. ETHealthWorld; 2023 [cited 2025 Jun 1]. Available from: https://health.economictimes.indiatimes.com/news/industry/rising-number-of-stroke-cases-among-youngsters-and-children-a-growing-concern-in-india/104799306
- Roy NT, Sajith M, Bansode MP. Assessment of Factors Associated with Low Adherence to Pharmacotherapy in Elderly Patients. Journal of Young Pharmacists [Internet]. 2017 Apr 5 [cited 2020 Jun 3];9(2):272–6. Available from: https://www.jyoungpharm.org/sites/default/files/10.5530jyp.2017.9.53.pdf
- Vijayakumar P, Punnapurath S, Platty P, Krishna S, Thomas T. A study of medication compliance in geriatric patients with chronic illness. Journal of Family Medicine and Primary Care [Internet]. 2021;10(4):1644. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8144798/
- Kartik Singhai, Gowda N, Sivakumar T. Affordable residential rehabilitation facilities for persons with chronic mental illness: An emerging need. 2022 Jan 1;64(5):520–0.