Why India Needs a Trained Elderly Care Workforce?

Every day, Sreeni wakes up at 4:30 am and checks on her mother. If she is restless when she wakes up, he helps her to the raised toilet and waits outside as she uses it herself, assuring her that help is just outside. There is a list of medications, neatly sorted and kept by her bedside. The BP monitor and glucometer reassure him that everything is within range for her age. He learned it all by himself, one hospital emergency after another. Hip pain was ignored until it turned into a debilitating fracture, a sudden loss of consciousness detected as low sodium—each crisis a harsh lesson in the reality of informal, trial-and-error care. Every day, millions of people like Sreeni wake up and do their own homework to take care of their parents or dependents.

As our country’s population ages over the next two decades, the topic of caring and the need for formal training for the task will take on greater proportions, and this is exactly what the 2026-27 Budget highlighted in time when it announced the training of 1.5 million carers in line with the National Skills Qualifications Framework.

The August 2026 NITI Aayog report “Reimagining Care: Strategies for Empowering Caregivers in Viksit Bharat@2047” frames caregiving as an economic activity, not just social work, and is the first time the government has explicitly expressed such an intention at the national policy level, suggesting that the urgency has been recognised.

Also Read: India’s Growing Elderly Population Needs Integrated Care System, Says Report

To put it in perspective, India’s 60-plus population, estimated at around 149 million in 2022, is projected to touch 347 million by 2050, accounting for roughly 20.8% of the total population. Assuming NITI Aayog’s estimate that 10% of today’s population is engaged in nursing, untrained and unpaid, the current total is about 146 million.

The planned 1.5 million formally trained workforce is just a drop in the ocean even by today’s requirements. The caregiving ecosystem will be at a serious tipping point if we don’t plan now.

Gender equality in care

For most of its history, India never needed a long-term care system because it had one: the joint family. Three generations under one roof was an insurance contract written in spirit and practiced willingly. In the current scenario with micro family units, it is mostly housewives who take on the additional caregiving task, have no formal training, learn by trial and sometimes serious error. Combined with the need to manage one’s own household chores, such situations greatly increase stress in the home. The needy and differently-abled elderly, about 26.8 million, survive thanks to the love, care and affection of these unpaid, informal carers.

A survey by the NBU found that women spend an average of 299 minutes a day on unpaid housework and care, while men spend only 97 minutes. We need to appreciate the situation and care requirements that both sexes carry. A formal training program designed exclusively for caregiving, including detection of age-related events requiring attention in the elderly, needs assessment, continuous monitoring protocols, emergency care and psychological interventions, ideally attended by at least two family members, would improve the sharing of duties and responsibilities.

Skill and upskilling

If we need to have large numbers of qualified, formally trained carers within a few years, we need to get serious.

Two structures are in operation in India, albeit on a small scale and untested. Kudumbashree is a state mission based in Kerala that runs a network of self-help groups. In February 2024, it launched the K4 Care training program, which qualifies its members as certified geriatric/patient/disability care managers. Recent figures show that only 838 have completed the course, which is quite slow progress. We can motivate and accelerate the program.

The second group is ASHA workers, for whom NHSRC (National Health Systems Resource Centre) has prepared a training manual on elderly care, with training provided through Ayushman Bharat Health and Wellness Centres. However, detailed details of the number of ASHA workers who have undergone this training are not publicly available. A meaningful intervention here can have a positive impact.

Informal care is not always physical, such as mobility support or medication management. Age-related cognitive decline—as seen in Alzheimer’s and Parkinson’s disease—also includes several emotional problems. Any national curriculum must consider geriatric mental health and behavioral management along with physical care protocols.

The way forward

There are millions of informal, unpaid family carers. We need to validate and upgrade them to recognized caregivers.

Kudumbashree and ASHA workers who are formally trained can serve as trainers to train more people, allowing the chain to continue. The National Council of Caregivers (NCC), as envisioned by the NITI Aayog report, can act as an apex body. It can set benchmarks and oversee skills development, update training modules, standardize curricula, come up with helpful FAQs, and regulate and manage a national caregiver portal with a list of certified caregivers.

Transforming India’s care economy is an economic strategy waiting to be unlocked. By creating such a robust ecosystem, India can turn informal commitment into professional expertise with great economic value. For millions of people like Sreeni, recognition as a caregiver for the elderly and formal training to address related challenges brings dignity to the relationship.

Just as India is recognized worldwide for its healthcare nursing professionals, its approach to managing the challenges of elder care could also be adopted as a compassionate alternative to many models practiced around the world. The fact that this has been announced as a budget item is only a seed and its operationalization at ground level is where the ultimate success lies.

(TC Suseel Kumar Former Managing Director and R. Sudhakar Former Managing Director, LIC. Views expressed are personal.)

Published – 13 Oct 2026 08:00 IST