Not Another Old Age Home: Building Care into Everyday Life
The real crisis in elder care is not housing, but everyday medical support. Closing that gap could ease burdens on families and the health system alike.
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SDG 3: Good Health and Well-being
Institutions: Ministry of Health and Family Welfare | Ministry of Social Justice and Empowerment, Insurance Regulatory | Development Authority of India.
India’s elderly population is growing fast, but its systems to support them remain stuck in the past. When Prem Kumar’s mother met with an accident during her Amarnath yatra, the panic that followed made something painfully clear: most elders have no dependable fallback when health emergencies strike.
That realisation didn’t lead to outrage - it led to design. Over the past year, Prem and his small team have been building a service that aims to solve a deceptively simple problem: how to ensure the elderly receive timely, accessible care without relying solely on family or institutional infrastructure.
A Care Model That Fits Around People
At its core is a mobile application that nudges elders to take their medicines and follow hospital discharge instructions. For those with visual impairments, the prompts are voice-based. When family members are away, a trained network of medical students provides in-person support: checking vitals, accompanying them to appointments, or simply ensuring they are not alone.
“This isn’t about creating a new place for the elderly to go. It’s about helping them live where they are - with dignity,” Prem says.
The decision to work with medical students is both pragmatic and strategic. Doctors and nurses are expensive and often unavailable for routine follow-ups. Students, by contrast, bring energy, local knowledge, and ambition. They receive modest compensation, clinical exposure, and a chance to build a community service profile, especially valuable for those aspiring to study abroad.
Students are trained to monitor vital signs, ensure adherence to discharge instructions, and act as first responders for low-risk care needs. Their work is supervised and coordinated with local providers wherever possible.
What makes the model work, Prem argues, is that it doesn't try to replace formal care, rather it fills the gaps that families, hospitals and insurance systems often leave behind.
Scale is Not Just About Size, But Structure
A pilot with 500 elderly participants, many of them from defence families, showed strong demand. Interest came not just from metros, but also tier-II and tier-III towns. One retired teacher in Lucknow told Prem:
“My children are in Delhi, but I don’t want to move. I just want someone who checks in when I am unwell.”
The most common wish expressed by users was simple but revealing:
“Wherever I go, I shouldn’t have to worry.”
Scaling the model is not straightforward. The elderly are widely dispersed, and care systems vary by region. Prem spends much of his time travelling across the country, talking to hospitals, insurance firms and local medical institutions.
The bigger challenge, though, may be mindsets. Elder care in India is still largely imagined through the lens of retirement homes or family caregiving. But Prem’s field visits suggest otherwise.
“People keep asking about housing. But that’s not the urgent gap. Medical follow-up is. The hospital discharge isn’t the end of the story - it’s where the story begins.”
Where Policy Leaves Space Empty
Policy design compounds the problem. In the United States, hospitals are penalised if patients are readmitted within a certain period. That system is backed by evidence: if patients take their medication as prescribed, 30-day readmission rates drop by 30% to 50% percent. Similar data does not exist in India, which makes the first blind spot for policy or design of incentives.
Government hospitals remain hesitant to integrate digital care tools, even when evidence shows improved adherence.
“There’s no hostility,” Prem says, “just a lack of systems thinking. Nobody owns the space between hospital and home.”
One sector that shows promise is insurance. Several companies have signalled interest in tracking patient behaviour and improving outcomes. Prem sees an opening here:
“Right now, IRDAI (Insurance Regulatory and Development Authority of India) caps annual premium hikes at 10% for elderly population. If insurers were allowed a slightly higher cap, say 15%, given they partner with elderly care service providers for better outcomes - that would reward long-term thinking and give customers a clear benefit.”
When Care Becomes A Productivity Multiplier
But the larger win, Prem says, is social. Helping elderly people stay medically independent also frees up others in the household, particularly women.
“Let’s be honest. It’s usually the daughter or daughter-in-law managing everything. If she knows her parent is being looked after properly, it opens up possibilities for her.”
What looks like a healthcare intervention is also an economic multiplier. It enables women to return to work, reduces hospital costs, and improves health outcomes: all through low-cost, low-friction changes.
Small Shifts, Lasting Impact
The smallest shifts are often the most powerful. Prem says,
“We think technology means dashboards and diagnostics. But for an elderly person, it could just mean switching a reminder from a text to a voice message or nudging them right before their teatime so they remember taking their pill.”
India has invested in highways, digital identity, and financial inclusion. It is time to treat elder care with the same seriousness, as essential infrastructure for a healthier and more dignified life.
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Prem Kumar is the co-founder of vKutumb, a healthcare initiative that focuses on elderly support systems in India. The information in this article is drawn from his account and has been reviewed and approved by him for publication. The piece was prepared with the assistance of Ms. Ananya Rathour, member of the editorial team at The Policy Edge.