A 2024–25 field study of 138 residents in two old-age homes in Ponda, Goa, highlights an important gap between family presence and the availability of care. Most residents were aged between 70 and 89, and widowed women formed a particularly large subgroup. Residents reported circumstances associated with their move into institutional care, including the absence of caregivers, loneliness, chronic health problems and changing family configurations. Notably, the absence of caregivers was reported even among residents with three or more children, suggesting that having a larger family did not necessarily ensure support when it was needed.
The study also drew attention to the emotional and financial circumstances of residents. More than 60 percent exhibited symptoms consistent with moderate to severe depression. Many depended on their families for financial support, while few accessed pension or welfare assistance. Although limited to two institutions, these findings illustrate how gaps in caregiving can coexist with mental-health concerns and financial dependence.
The implications extend beyond old-age homes. As Goa's population ages, the availability of family support cannot be assumed from household composition alone. Eldercare planning must consider both the assistance older people require and the support actually available to them
Population Ageing Is Reshaping Care Needs
Goa's changing age structure makes eldercare an increasingly important policy concern. According to the National Family Health Survey (NFHS-6), conducted in 2023–24, 17.2 percent of the state's population was aged 60 and above, up from 14.2 percent in NFHS-5 (2019–21). The proportion below age 15 stood at 18.1 percent, while the total fertility rate was 1.6 children per woman.
These changes have implications for both those requiring care and those providing it. People in their late working years may already be balancing employment and family responsibilities with supporting ageing parents. In the coming decades, they will themselves enter the older population, potentially requiring assistance while family structures and caregiving arrangements continue to evolve.
This creates an intergenerational challenge. As the population ages, the availability of family care will depend on caregivers' health, employment, location and household responsibilities. Demographic change therefore raises questions not only about future care needs, but also about the capacity of families and services to meet them.
Goa's experience may become increasingly relevant to other states such as Kerala, Tamil Nadu and Maharashtra as fertility declines and populations age, although the timing and pressures will differ across regions.
Living Arrangements Do Not Guarantee Care
The need for care also depends on what older people can manage independently. The Longitudinal Ageing Study in India (LASI), conducted in 2017–18, documented substantial health challenges among older people in Goa, including hypertension, diabetes and vision-related conditions. It also identified limitations in activities of daily living, which include basic tasks such as bathing, dressing, eating and moving around.
These indicators show why the question raised by the Ponda study extends beyond institutional care. An older person who needs help with daily activities may be able to remain at home if reliable assistance is available, but face a different set of choices when it is not. The policy question is therefore whether support can be matched to the level of assistance required.
Living with others does not necessarily mean that help is available when needed. A spouse may also be ageing or unwell; adult children may be working or living elsewhere; and relatives may be unable to provide sustained support. Conversely, an older person living alone may remain independent with appropriate health and community services.
Economic circumstances can further limit access to paid assistance. LASI documented continued employment among some older people in Goa, alongside uneven pension coverage. Income security is therefore relevant to eldercare, particularly where households must meet the costs of support alongside other financial commitments.
Eldercare Policy Must Match Needs to Available Support
Goa's existing arrangements include geriatric services under the National Programme for Health Care of the Elderly; geriatric, palliative and mental-health services within the Health and Wellness Centre framework; and old-age homes and social-welfare mechanisms. The challenge is to establish whether these services collectively address the care needs of older people, including those who remain within their families.
The policy priority is to assess both the assistance an older person requires and the support available to provide it. This would involve identifying functional limitations, assessing whether family or community caregivers can meet those needs, and linking older people to appropriate health, social-care and income-support services. A person living with family may still require regular home-based support, rehabilitation or respite for a caregiver, while someone living alone may remain independent with preventive healthcare and reliable community services.
Such an approach would require mechanisms to identify changing needs, coordinate referrals across services and establish whether assistance is reaching those who require it. Mental-health care, income support and institutional care would need to form part of this response where appropriate. The objective is to make support proportionate to need rather than assume that a particular living arrangement guarantees adequate care.
For Goa, this would mean assessing unmet care needs across households, community settings and institutions. The Ponda findings make mental health and financial security particularly important considerations alongside physical care. Such an assessment could help the state identify whether gaps arise from inadequate service provision, weak coordination or barriers to access.
Goa's experience illustrates why eldercare planning must look beyond household composition to the assistance older people need and the support available to them. As the population ages, the challenge is to preserve independence wherever possible while ensuring that appropriate care is accessible when it can no longer be sustained without assistance.