Who really cares for the elderly?

In India, caring for the aging parents has long been seen as a natural extension of family responsibility. In recent years, however, this expectation is increasingly being reinforced by legal and policy measures. The Maintenance and Welfare of Parents and Senior Citizens Act, 2007, allows the elderly to claim maintenance from children through special tribunals. This converts what was once primarily a moral-personal-family obligation into a legally enforceable one. Recent developments, such as the Telangana Employees Accountability and Monitoring of Parental Support Bill, 2026, proposes the linking of parental care obligations with employment responsibilities. The law further intensifies the discussions and debates on elderly care.

Other States have introduced schemes that are aimed at improving the well-being of the senior citizens. Kerala’s Vayomithram initiative, for example, provides community-based support, which includes health check-ups, counseling, and social interaction through the local Governments. Tamil Nadu expanded the old-age pension schemes, and operates state-supported homes for the elderly citizens who lack family care. In Delhi, mobile medical units and home-based healthcare services improve access to healthcare for older residents. Similarly, the welfare departments in Karnataka and Maharashtra run old-age homes, and provide financial assistance schemes for the senior citizens.

These initiatives suggest that the issues related to the elderly care are gradually being recognised as all-encompassing ones. Moving beyond the personal and family, they are seen as enveloping the State, and markets, apart from families. The umbrella law establishes the children’s responsibility to support their aging parents. Markets are slowly expanding services such as assisted living facilities, home care providers, and geriatric health services. Despite these developments, and laws and schemes across several states, the everyday work of caregiving continues to be largely carried out within families.

Within the households, however, caregiving duties are rarely shared equally. Elderly care involves assisting with mobility, managing medication, arranging medical consultations, and providing emotional support. These tasks demand time, attention, and physical effort, apart from a sense of moral, emotional, and human obligations. In practice, not surprisingly, most of these works are often carried out by women. In modern families, men do contribute, and many male children do assist, but they do so more in terms of financial help, rather than time and effort. Hence, there are feminist issues involved.

Feminist economists have long emphasised that unpaid care work forms an essential but largely invisible component of economic life. (This is, in fact, true for most of the household and family work by women, which is not considered as work.) Nancy Folbre describes caregiving as part of the “care economy,” a sphere of labour that sustains families and societies, but remains undervalued in economic policy. Similarly, Diane Elson argues that economic systems rely heavily on unpaid household labor, much of it performed by women. However, new studies aim to compute the contributions in terms of productivity and GDP.

Evidence from India reflects this reality. According to the National Statistical Office’s Time Use Survey, women devote substantially more time to caregiving than men. Women spend around 140 minutes per day on caregiving activities, including care for the elderly household members, while men spend almost half the time, about 74 minutes. Participation in caregiving reveals a significant disparity. More than 40 per cent of the women engage in such crucial and sensitive activities, and the involvement of the men is almost half, about 21 per cent.

These figures indicate that while the laws mandate family responsibility for elderly care, the labour involved is disproportionately borne by the women. Systems of family-based care frequently depend on women’s unpaid time. This unequal distribution creates what the economists dub as time poverty. Hours spent on unpaid care reduce the time available for paid employment, education, and skill development. As a result, caregiving duties influence women’s economic opportunities, and participation in the labour force. The fact remains that the latter figure is quite low in India, and abysmally low in several states, although some improvements were observed.

As India’s population continues to age, the demand for elderly care is likely to grow significantly. If institutional support systems remain limited, families will continue to provide most of this care, and women within the households will bear a large share of the burden. Addressing these challenges requires a recognition that elderly care cannot remain solely a private family responsibility. A sustainable system must distribute responsibility more clearly among the State, markets, and families, while

ensuring that the care work within the households is shared more equally between men and women. The State must strengthen the social support systems for the elderly. Expanding social pensions, investing in community-based elder care centres, and improving home-based healthcare services can reduce the caregiving burden placed on families. Public investment in geriatric care infrastructure will help to ensure that elderly citizens receive reliable support. The market can complement these efforts by developing professional care services. There is gradual and noticeable growth in assisted living facilities, trained caregivers, and home nursing services. With laws and quality standards, they can provide families with alternatives to relying solely on unpaid household labour.

Of course, there is no doubt that families will continue to remain an important source of emotional and social support for the elderly. But the growing demand for care makes it essential to reconsider how caregiving is distributed within the households. As the State ensures the higher involvement of the markets, men need to take initiatives to play a greater role so that the burden does not fall disproportionately on the women. This mindset requires changes at homes and workplaces. Workplace institutions can initiate far-reaching policies such as caregiver leaves, flexible work arrangements, and supportive practices. 

Laws do help, as they mandate the families and markets to care for the elderly parents. But without the institutional support, and more equal sharing of caregiving within the households, the burden will be shared unevenly, both within the families, and by the State and markets. The truth is that the country’s demographic dividends are about to change over the next two decades, and the percentage of the elderly will rise. Hence, ensuring dignified aging in India requires a recognition that care work will emerge as an essential part of the economy. Thus, there is a need to create future-looking systems and institutions that can enable the State and markets to intervene efficiently and effectively, and make it easier for family members to distribute responsibilities more fairly. The time to act is now, over the next few years.

(The writer is Associate Professor (Economics), and Director, National Law University, Jodhpur) ; views are personal