Citizens' Issues
Caregiving for the elderly is a challenge that needs to be addressed urgently

As the demand for home-care workers soars, it is necessary to recognise the huge potential of care-givers as a profession that can create livelihoods for many and provide critical help for people who live to a ripe old age

A recent issue of The Economist noted that as more and more people live to a 'ripe old age' in the US, the demand for home-care workers is likely to soar. The report estimated that America will need two million additional home-care givers. And, even in that country, they lack adequate training. It quotes Ai-Jen Poo of the National Domestic Workers Alliance, as saying that "many of them are badly paid, get little or no time off and are vulnerable to injury because they have had no proper training for lifting immobile people… unless the pay and training of home-care workers are improved, ageing baby-boomers may have trouble finding competent people to look after them in their dotage."

How much worse the situation is in India can be gauged from even casual conversations with most urban middle-class, double-income families; most complain about the lack of home-care workers to look after their old parents. It is time we recognise the huge potential that care-givers, as a profession provides for creating livelihoods, especially for women and the consequential development impact it holds. Over the next few years, the changing demographics of India will present a huge opportunity which is waiting to be grabbed-either as business or as service or both.

According to an estimate, by 2050, India will have 335 million people above the age of 60. Assume that 60% of these are in urban areas-i.e., 201 million people. Further assume that 50% of these will require some amount of care-i.e., about 100 million. Of these, assume that 75% will either have some kind of family support or would go in for some kind of community care. So the balance 25% requires personal/individual care at home, and you are looking at a need for 25 million care-givers.

Are we in a position to provide the kind of training and certification that such care-givers require? A very simple calculation would show that each year for the next 40 years, we need to train 625,000 care-givers. Even if 50% of these are women-who need not be highly educated, just 10th std pass may be good enough-you are looking at providing training and, therefore, jobs to nearly 300,000 women each year. Additionally, to train such a large workforce you will require faculty of 7,500 trainers (assuming a ratio of 40:1).
Also, if we consider that each of these care-givers will earn about Rs6,000 (even at the current levels of payment to untrained hands), you are looking at putting some Rs1.8 billion into the economy annually-and this into the hands of women. Gender studies have shown it repeatedly that women's income directly goes into improved nutrition and education of children so the development impact of this activity will be obvious.

I have been talking to a few NGOs and social entrepreneurs and the issues they are mainly concerned with are certification criteria on the one hand and aspirational factors on the other. They don't have any doubts about the 'market' for it. A group of NGOs that worked together to devise the curriculum for such a training programme found that there was 100% placement of these geriatric care-givers within a week of their course completion.

I have also been talking to several associations of the elderly who say that while they are still able and earning, they would not mind even giving a scholarship of say Rs10,000 each year to support each trainee-it would become even more attractive if a tax rebate were available-if they were assured that they would be given a priority in hiring a care-giver for themselves from the institute where they would support such skill development, should the need arise.

Moneylife has commented on several interesting social experiments in its 'Beyond Money' section that have shown that such a model-of training not very highly educated women as home managers, community rural health workers and 'book fairies' from urban slums, etc-does work. (Read, 'Hum Aaapke Saath Hain', 'Dealing With Rural Poverty & Illness', 'Wings of Knowledge'.) To begin with, training care-givers may require to be subsidised through grants or scholarships, but when the trained care-givers find that their earning capacity improves tremendously with the skills gained, they would more than happily pay for the course, as Saath found.

It is time social entrepreneurs take up the challenge of creating livelihoods while simultaneously addressing a crying need of the hour.





6 years ago

SANarayan 4 hours ago in reply to Nagesh Kini FCA
Pl email me at [email protected]. Will give inputs based on my personal experience of caring for the elderly. Incidentally I am an alumni of TISS....
but let us meet to solve the problems..
but those who take over the properties of the old will try to do something with the support of TISS and others
shanker pai
founder president
make-a-will foundation


nagesh kini

In Reply to SHANKER PAI 6 years ago

Yes, let's meet at Money Life Foundation at mutually convenient time.
Look forward to meeting with you.

Nagesh Kini FCA

6 years ago

Tata Inst.of Social Sciences -TISS Mumbai has got together a group of dedicated professionals incl. med. to try to kick start a really workable solution. Readers with inputs are welcome.


6 years ago

i agree it is an issue which demands our attention very urgently, as it is needede by every family regardless of having children staying with them or not , caring for old people is challenge enough and caring for old people who are ill is very difficult and distressfull for the untrained relative as well as the patient. This will also open up more avenues for the unemployed. On the whole it will be very good for society and the sooner it is done the better.

Harsha Parekh

6 years ago

Being aware of the situation and the need we at the Bombay Community Public Trust (BCPT) decided to develop a short term training programme (1 ½ months) for caregivers of the elderly. One of our NGO partners took the lead in developing the training manual and the first course commenced in March 2010. Subsequently two more courses were undertaken by our other partners.
The learnings from this work were many. Though the course was advertised in communities located around each of the NGOs, not many women or girls came forward to enroll. Persuasion and motivation were required. Women in Mumbai easily earn Rs. 4-5000 doing part-time domestic work. They earn even more by being a part-time cook in a few homes. Thus they were not so ready to do full time work for Rs. 5-6000 as a care-giver in one house. The other thing we found was that while jobs were readily available for the trained candidates, they were not willing to travel long distances to work and thus did not take up job offers which were located far away from their homes.
We are forwarding the link to our NGO partners.

Tomal Dattaroy

6 years ago

Perhaps a modified home-science course that encompasses training in nursing, house-keeping and social bonding would help.

kiran sohal

6 years ago

I am an architect specializing in barrier free architecture for elderly. I am associated with Helpage since 1999. I totally agree that this issue needs utmost consideration. In fact there will be a need to put the elderly in various categories depending on their age and condition of health. Accordingly care givers with the appropriate training will have to be arranged.


6 years ago

Yes , the idea for training 'care givers' is the answer to begin with .
May be one can approach the Medical and Nursing fraternity aling with the NGO's to form an expert team for designing the course contents.

bharati sen

6 years ago

While training is essential, the basic nature of the caregiver is very important. I know it first hand because my mother in law is over 90 and forgets. Some of the caregivers do their jobs ok but if she asks same question repeatedly they become very rude and shout at her. At the time of employing one cannot make out and the agency is not truthful.


6 years ago

I agree with the author that caregivers are needed for the elderly, that employing caregivers will greatly benefit both those employed and those cared for. An additional challenge, apart from training, certification etc, is how to screen for caregivers who are genuinely CARING and kind, and who don't simply consider their job as an income generator.


6 years ago

I have another perspective.All of us wish that in our old age we do not become a burden on our children and that we are able to live a life of dignity and self-respect. But wishing for this alone and not doing anything about it is irresponsible. What can we do? Our age old Seers and our Indian heritage has given the world 'yoga'. Today various seekers and masters have evolved various forms of yoga like 'Ishayoga', 'Sudershan Kriya', Yogananda's 'Kriya', BK Iyengar's yoga or Ramdev's 'Yog' etc. All of these ,if practised regularly and with sincerity give us a robust state of health and one would be able to be self-reliant even in old age, atleast as far as our physical and bodily activities are concerned. Irrespective of their religious/secular biases, they are all individually, healthwise beneficial. We owe this to ourselves first and our children next so that we do not become a burden on them or society. Medical science and other aids only enter the scene after one becomes sick. Where people already have become invalid, the various suggestions made by readers need to be worked on for building a cadre of 'Elder Care Givers'. But lets all do what we can for ourselves first. Self-help is the best help!

Mr Aditya Vikram Somani

6 years ago

Thank you for the article.

Lifespans are increasing. Medical diagnosis is penetrating deeper in the country. And medical care through private and Government initiatives are improving. Slowly but surely. The need for manpower is also increasing.

Yes, there is a huge requirement for vocational training in this sphere. It has tremendous potential to be a large income generating career option for a lot of people. It is likely to, especially, benefit unemployed middle aged women because a caregiving career option is viewed positively, even in conservative societies. Taking care of the elderly comes naturally to Indians. We are used to extended joint families and community living.

The Government can include this in their vocational and training program or as part of NSDC or other such. They can subsidize interest on loans to training institutes and NGOs that will build content, certification and delivery mechanisms for this specific vocation. Something similar to what they are planning for ITIs and corporate driven programs for skill and income enhancement amongst our population.


Nagesh Kini FCA

6 years ago

The problem is that the Senior Citizens do not constitute an substantial vote bank that matters.
Estate Duty was abolished even when it continues in the UK and US to get revenue from HNI.
Though the Finance Act 2011 has lowered the age for senior citizens from 65 to 60, consequential amendment to S.197A remains and confusion of Forms 15G & H.
Just because the Hon.PM is touching 80 for him and some 15,000 80+ the special "Super" category is created.
The little interest from bank FDs that is peanuts once it exceeds Rs.10,000 is subjected to TDS while crores of dividends of fat cat tycoons get is free of tax.
Congress ka hath aam aadmi ko thappad and not saath eh?

S H Subrahmanian

6 years ago

India a country of ‘olds’- Indians, living in homes with eternal alarm….
Is it that the ‘government by the old’ has woken up to the fact that we are not a young nation? At least, on paper, a programme has been charted to address our needs! Indeed we are a fast greying nation. A ‘National Programme for the Health Care of the Elderly (NPHCE)’ is in the offing. Union Health Ministry has sounded the danger bell. The clue lies in the numbers. But it will take quiet some time to have a satisfactory environment. That will be when quality medical facilities hospitals and geriatric specialists are available. First we must have enough courses, seats and students and faculties too!
The elderly in the 60+ group is going to touch 100 million by a couple of years. We’ll become home to the second largest population of elders in the world. And the most vulnerable are elderly women than men. By 2025 nearly 12% of population would be elderly. 10% will be bedridden and worse still 80% living in rural areas!
In addition to ‘silent killers’ like heart attack and diabetes, security too is totally missingresulting in: “Home is where the alarm is”. Last week alone four senior citizens – all women - were murdered in Mumbai. A meagre percentage of elders have registered with the police. And the police’ are busy with VVIPs and its interests in us also is only marginal. Also fears exist of this information on ‘lonely elders’ being passed on to elements!
There’re ten million elderly living in Mumbai, one million living alone and only 1,305 ‘registered domestic help’. Do the police keep a track on these domestic helps’? It must regain trust, sooner the better. Only after an incident the police appear in the scene. Police helpline for the elderly has been shunt down.
Helpage India is now is planning for a ‘Toll Free’ help line next month.
A senior citizen myself, had never seen the kind of prise rise as now. Prices never get stabilised! There’s a big gap between the double digit inflation and the meagre interest rates around 9%. Isn’t it that we must give up to live in our home, even if we can cope up with, has become hackneyed? Are townships, well advertised as ‘serene’, a solution? But, how many can afford?
Or will a network of seniors alone help? There’s one in Chunabatti, Mumbai. Aundhe, President of Senior Citizens’ Association of India, is managing the show. He keeps regular visits, keeps track of their needs and routines and requests neighbours to keep tabs on elderly neighbours. Also he has a database of reliable cab drivers.
Finally will this be the only solution? Our old-age homes at best provide beds, bhojan and bhajan. But don’t the elderly have other needs too? It’s best to help them to enable them to live at home.

R Nandy

6 years ago

I think the whole problem has to be handled at two levels.(i) senior services like retirement homes,financial services ,geriatric care etc which has to be based on a sound business model for it to be sustainable.
(ii)NGO's and govt welfare depts who have to act as regulators of the services to safeguard the interest of the seniors.

The problem I see is that even though there is a market for senior services,it is only the affluent who will be able to afford it.Most of the seniors will not have the wherewithal to afford these services.


nagesh kini

In Reply to R Nandy 6 years ago

Speaking of supply, Paranjape Constructions of Pune are into building quality Sr.Citizen specific complexes with anti-slide floors++. I've seen one in Bengaluru.
Yes reality does need a regulator.

shanker pai

6 years ago

we need to solve the problem-
the elders need to take part
in arriving at solution.
They ( elders ) should contribute
and dhan
so that the solution comes from the elders and solution are not imposed by others.

Air India to go ahead with acquisition of Boeing 787s

A strong case for the acquisition of the Dreamliner as per the original 2005 order was made in the presentation and a case made out that the medium-capacity, long haul aircraft was absolutely necessary for the expansion of Air India

New Delhi: Air India would go ahead with the acquisition of Boeing 787 Dreamliner aircraft as part of its overall expansion programme and seek Indian government’s nod for it, reports PTI.

A decision to this effect is understood to have been taken by the Air India board which met here on Thursday in the backdrop of civil aviation minister Vayalar Ravi’s statements that the ailing airline did not have enough money to go in for a massive fleet acquisition plan.

While the airline has placed orders for 27 Boeing 787s with the first delivery expected later this year, the Group of Ministers (GoM) headed by finance minister Pranab Mukherjee, which is reviewing its turnaround plan, is likely to take a final decision in this regard, the sources said.

At the meeting, the board also reviewed the airline’s liquidity position and infusion of funds from the government, an airline spokesperson said, adding that Air India has so far received Rs1,200 crore by way of equity infusion in 2011-12.

On the aircraft acquisition issue, the board reviewed the modified turnaround plan prepared by SBI Caps in which suggested ‘a scenario for expansion’ if Air India was to grow as per the growth rate of the aviation market, he said.

The acquisition of Boeing 787 deal is understood to have been part of this modified turnaround plan and expansion programme and a presentation on the Dreamliner acquisition was made at the board meeting.

The turnaround plan was based on the recommendations of the committee of officers from the finance and other ministries, which had earlier suggested that “a scenario for expansion should be prepared if Air India was to grow as per market growth rate”.

A strong case for the acquisition of the Dreamliner as per the original 2005 order was made in the presentation and a case made out that the medium-capacity, long haul aircraft was absolutely necessary for the expansion of Air India, the sources said.

They said the planes, made of composite materials and are known to be very fuel-efficient, were an inalienable part of the route expansion plan of the ailing carrier.

Air India’s 68 aircraft deal, included the acquisition of 27 of these aircraft which was at that time on the drawing board. The list price of a Boeing 787-8 last year was $185.2 million.

This was the first meeting of the Air India board which was attended by the new CMD Rohit Nandan.

The board also reviewed the performance of the national carrier in August and noted the ‘significant achievements’ after the turnaround plan has started being implemented.

While passenger revenue increased by 12.3% from Rs889 crore to Rs998 crore between August this year and the same month last year, its passenger count went up from 1.07 million to 1.09 million, a growth of 1.8%, the spokesperson said.

The passenger load factor rose from 64.3% to 73.1% on domestic sectors and on the entire network, including international, from 67.7% to 70.3%.

The yield per revenue kilometre (RPKM) went up by 15% on international sectors, while on domestic sectors, it grew by 23.2%.

As part of a formality, the board approved the nomination of new CMD Mr Nandan on the various committees of the board and on the board of the AI-SATS, a joint venture of Air India and Singapore Airport Terminal Services for ground handling.


Will the world face another Lehman-like crisis?

John Stephenson, senior VP of Toronto’s First Asset Management says that a Lehman-like crisis is expected over the 12 months and “when it happens, it’s going to happen fast, it’s going to be ugly and very deep,” says this analyst.

Read Article...


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