Ageing, care economy and India’s next demographic challenge

India stands at the cusp of a profound demographic shift that will redefine its social and economic landscape. The country is transitioning from a youthful population structure to an increasingly older one. This transition is fast enough to alter social and fiscal arrangements within a single generation. 

Recent population projections by the International Institute for Migration and Development and the Population Foundation of India indicate that one in five Indians (20.6%) will be 60 years of age or older by 2051, doubling their share from 9.6% in 2021.

This transition will unfold unevenly across states. States such as Kerala already show advanced ageing patterns, and others, including Tamil Nadu and Delhi, will follow suit. By 2051, the share of older persons is projected to rise to 31.1% in Tamil Nadu, followed by 30.7% in the NCT of Delhi. In contrast, Bihar and Uttar Pradesh are in the early stages of demographic transition and will witness this shift in age structure later. 

Understanding ageing in India requires looking beyond demographics to the lived health and economic realities of older persons. Referring to evidence from the Longitudinal Ageing Study in India (LASI), NITI Aayog stated in its 2024 position paper that 75% of elderly people have at least one chronic disease, 40% have a disability, around 20% have mental health issues, and about one in four has multimorbidity.

The feminisation of ageing adds another dimension, as many older women, especially widows in rural areas, live without assets, income, or access to basic healthcare. Therefore, any policy response to an ageing society must be anchored in robust caregiving and social security systems.

In India, the concept of caregiving has historically been built around families, with women carrying a disproportionate burden of the responsibility. Time-use survey (2024) data reveal that women spend 137 minutes a day on unpaid caregiving and domestic work, compared with 75 minutes by men.

Yet their efforts have remained largely invisible without formal recognition, structured support or direct fiscal cost. However, smaller families, migration, and changing social norms are weakening traditional support systems, exposing the limits of a care framework that relies almost entirely on women in households, requiring a deliberate shift towards building formal care systems. 

India introduced the National Policy for Older Persons (1999), which recognised the growing vulnerabilities of the elderly, particularly around income security, health, and overall well-being. While the policy was comprehensive in design, an assessment of its implementation over the past decade has revealed several gaps, including a lack of coordination among ministries, limited and fragmented financing, and the need for stronger institutional leadership, particularly for bodies such as the National Council for Older Persons. There are also critical gaps in income security, particularly for marginalised elderly populations, and in addressing the specific vulnerabilities of older women.

Around 78% of the elderly population has no pension security. While public health spending has increased, long-term care remains outside most coverage frameworks.  

Rather than viewing an ageing population as a fiscal and social burden, India must recognise its potential for a “silver dividend”. The following recommendations outline key priorities that should be considered and implemented to advance this agenda:

First, in a flexible and evolving labour market, it is crucial to develop effective tools to assess, certify and recognise skills and competencies that workers acquire throughout their careers. This will enable older workers to remain employable, transition across roles, and continue contributing productively to the workforce. India should learn from ageing societies like Japan and Germany, which have implemented mechanisms to ensure the active participation of older people in the economy through flexible work arrangements, age-friendly workplaces, and incentives for employers to retain and hire older workers.  

Second, India needs a comprehensive eldercare framework that includes a robust pension system and social security schemes, a focus on creating age-friendly healthcare systems, and measures to empower older adults to remain economically active.  

Expanding existing programmes and creating targeted interventions for marginalised population groups, such as elderly women and unorganised sector workers, who often lack retirement savings, is equally critical. States like Kerala and Tamil Nadu, which are in advanced stages of demographic transition, can serve as early sites for policy innovation, and models developed in these states can then be adapted for states at earlier stages of demographic transition. 

Third, urban planning and public infrastructure must adapt to cater to the elderly. This includes accessible public transportation and senior citizen-friendly housing.

Fourth, as family structures shift towards nuclear households and informal caregiving capacity declines, there is a growing need for a trained care workforce. Investing in skilling, certification, and decent working conditions in the care sector can both meet rising care needs and generate large-scale employment.

The central question for India today is how it defines the ageing challenge. If ageing is measured only by the number of older persons, policy responses may remain limited to pensions and healthcare. If ageing is understood in terms of functional need, the focus shifts to building a comprehensive care system. Moving forward, there is a need to mainstream ageing across sectors, strengthen institutional capacity, and build greater public awareness and empathy, so that ageing is not treated as a standalone issue but integrated into the broader development agenda.

(Sanghamitra Singh Chief of Programmes, Population Foundation of India and Varun Sharma, Senior Specialist (Monitoring and Evaluation), Population Foundation of India.)