The article focuses on how 60Plus India solves the demands for home healthcare problems for the elderly in India.
India’s elderly population (aged 60 and above) will touch 194 million in 2031 from 138 million in 2021, a 41% increase over a decade. But are we prepared to support and care for our ageing parents?
It turns out we’re not.
In May 2021, Raj (from Austin, Texas) received news that his elderly dad was admitted for Covid-19 and had to spend weeks in the isolation ward. His mother (also a senior citizen), being married to his dad for over 40 years, felt intense pangs of fear and worry, all alone at their home in India. Raj felt helpless.
And he’s not alone.
India had the world’s largest diaspora population of 18 million as of 2020. That’s the number of Indians living outside the country — most young adults moving out for higher education or lucrative jobs.
Older adults are left feeling isolated and lonely, while the young grapple with family and financial struggles. Add to that, there are hardly any vetted caretaker services, and everyday cases of robbery, extortion, deception by fraud, and even murder create general distrust in senior citizens’ safety.
What can you, as children, do when parents who looked after you can no longer do the same for themselves?
It’s time to understand better the grave problems senior citizens face across social, health and economic ecosystems, and know there’s hope and help to get your family through.
3 Focus Areas for Senior Citizen Care
| SOCIAL | HEALTH | ECONOMIC |
| Declining social support system Increasing day-to-day dependency Lack of social infrastructure | Progression of diseases and disorders Underdeveloped healthcare system | Financial insecurity |
Social Ecosystem
Declining social support
When young adults move to another city or country for education and work, they often leave behind ageing parents without support while figuring out their own lives.
Parents are left to their own devices, having to live independently with little backing from family or friends. Some children, unable to support ailing or widowed parents any longer, often abandon them without financial, medical or emotional care. For those who don’t have any children at all, the situation is grimmer.
As of 2018, 5.7% of India’s senior citizens (aged 60 and up) live alone, while 20.3% live with their spouse (another senior citizen). This number could be higher in 2022, but India lacks consistent reporting in senior citizen data, which doesn’t give us the latest picture.
For the elderly, living alone is becoming the norm, with nuclear families taking over a joint family structure, particularly in urban areas. Consequently, companionship and security are far-off possibilities for the elderly, who continue to be trapped in a vicious cycle of isolation, affecting their emotional and physical well-being.
And amidst it all, senior citizens also need to self-monitor their health, remember medication schedules, and repeat it daily, all by themselves for the rest of their lives. However, unfortunately, most aren’t tech-savvy to simplify their day-to-day activities, either.
Social support systems for the elderly are slowly dying out.
Increasing day-to-day dependency
Our bodies degenerate as we age, and very little we can change. Problems like loss of sight, hearing difficulties, low bone strength, mass muscle decline, and loss of mobility and agility are, in fact, common in the older generation.
Over time, even day-to-day living becomes a significant challenge when everyday tasks like cooking food or reading are obstacles. Sometimes, senior citizens are so sick that they cannot call for help during emergencies like a heart attack or stroke. And without health monitoring systems in place, we know the result is fatal.
Beyond 60 years of age, complete independence continues to be a growing problem, placing strain on the caregiver of the family member (typically women) who also has multiple responsibilities. At times, the pressure is unbearable, leading to caretaker burnout that causes abuse and neglect of senior citizens.
In reality, caregivers must undergo specialised training to give proper attention to senior citizens who need help. But that’s unlikely to happen when the caretaker is within the family.
There are nearly zero public discussions and awareness on caring for the elderly. But some times are dire. They need psychotherapy and special medical attention. Instead, their condition attracts frustration.
Then comes the question of how we can add more years to their later life. One way is to enhance the elderly’s social participation. The more active the elderly population is, the more they can contribute to society. However, pursuing their hobbies or simple activities like exercising is way beyond imagination for most.
Social participation is yet to be a focus of ageing in India.
Lack of social infrastructure
In 2007, the Indian government passed the Maintenance and Welfare of Parents and Senior Citizens Act. This act allows those aged 60 years and older, unable to care for themselves, to take legal action against adult children or grandchildren who don’t provide necessities (housing, food, clothing, medical care, etc.)
A significant drawback of this act is that it leaves out vulnerable senior citizens who are widows, low-income individuals, childless adults or those subjected to abuse, neglect and ill-treatment. It also doesn’t clarify the Indian government’s responsibilities to the elderly.
Then there’s also the problem of no social infrastructure for the aged. The elderly need support when travelling in public or even living at home. Just a walking stick or a wheelchair doesn’t solve the issue.
India doesn’t encourage environment-modified infrastructure (or inclusive infrastructure) on a large scale yet.
These are very few homes built with ageing and disabled persons in mind and come with features like rods (that people can grab onto for support) and ramps (for improved mobility). Nor are there enough public ramps for the elderly with disabilities. They need better access to physical infrastructure at home and in public spaces.
The challenges of an ageing population are far more complex for a developing country like India, which doesn’t yet focus on a longevity economy. As a result, a positive life outlook, third careers, senior citizen universities and lifelong learning are missing.
Health Ecosystem
Progression of diseases and disorders
Several health complications characterise old age, also called geriatric syndromes or disorders.
As the human body undergoes a gradual decrease in physical and mental capacity, ailments and illnesses start setting in. Conditions like hypertension (a severe problem in India), diabetes, cardiovascular diseases, chronic respiratory diseases, neurological disorders, urogenital-blood-endocrine diseases, osteoarthritis, cataracts and other non-communicable diseases are more commonplace among the elderly. Furthermore, older people are at higher risk of multimorbidity, i.e., multiple chronic disorders simultaneously exist.
Mental health is still not openly spoken about in India today, much less with the older generations that follow conventional thought processes. Therefore, rising anxiety, depression, Dementia, Parkinson’s disease and Alzheimer’s rates often go unnoticed.
Adding to this problem, researchers have predicted that by 2030, there will be more than 7.6 million dementia patients in India who are senior citizens — a considerable number to tackle with current healthcare standards.
Psychological or neurological conditions can lead to unusual behaviours among the elderly — impulsive actions, anger outbursts, hallucinations, as well as refusal to comply with others. They could also regress or experience shock when presented with a traumatic event.
Sensory impairment also creates multifold problems. For one, it restricts mobility and socialising. A more severe problem is when elders can’t communicate their pain or other health complications, resulting in delayed diagnosis.
Older adults are more vulnerable to physical, verbal, financial, sexual abuse, abandonment and neglect, leading to life-changing loss of dignity and respect. The problem is severe; 1 in 6 senior citizens experience elder abuse globally.
Underdeveloped healthcare system
The elderly population will increase to 300 million by 2050, making today the most critical time for medical facilities to pay attention to geriatric care.
Even though demand for doctors specialised in medical care for the elderly is on the rise, lesser medical students are interested in pursuing this path. It’s one of the main reasons for substandard geriatric care in India. And also why there are very few exclusive treatment programs for the elderly.
Facilities for home nursing and medical care are far fewer. Senior citizens can live with their families if elderly care can bring medical equipment and personnel home. They also cut expenses for travel, nursing home services and hospitals and fight isolation.
Alongside India’s population structure, the nation’s health profile is changing rapidly. The senior citizens will be a significant group to cater to, and the lack of healthcare infrastructure will only burden the country’s progress.
The absence of a long-term care policy only exacerbates social inequality, lack of medical infrastructure and diminishing access to affordable and available healthcare. We cannot afford to ignore such a broken ecosystem for the senior citizens anymore.
Economic Ecosystem
Financial insecurity
Once adults move past the retirement age, employment opportunities decline. The official retirement age in many public sector organisations remains around 57–62 in India, even though senior citizens still have much to offer.
Prolonged post-retirement years strain individual saving capacities, so the elderly turn to their family to finance their consumption, day-to-day expenses, health insurance and medical bills. As a result, the old-age dependency ratio is significant, from 11% in 1961 to 14% in 2011 and a projected increase to 20% by 2031.
India’s pension system is the second least sustainable one in the world and is biased towards the organised sector. Average income earners can’t replace pre-retirement earnings with a pension or other passive incomes.
Senior citizens also find it challenging to manage their properties single-handedly. Unfortunately, these situations leave older adults susceptible to fraud and scams if children or caretakers aren’t around.
Poor social security measures and a weak pension system push most of the elderly population to live below their means or in poverty. Moreover, poverty-driven financial insecurities further limit healthcare utilisation for senior citizens, leaving a wide gap in health services.
Ultimately, in India, the increased burden on healthcare, decreased labour supply, and growing need for social protection can discouragingly slow economic growth.
How 60Plus India is addressing these problems
Going back to Raj and his parents, he found help with 60Plus India. Arasi, Oli and Vivek (the founders) stationed a nurse with his father in the Covid-19 hospital ward and a companion with his mother at home. Raj’s parents stayed in touch via video calls daily through the caretaker and companion.
And their reunion after 15 days of staying away? Unforgettable.
That’s what 60Plus India does, and then some more.
60Plus India is a one-stop, age-tech aggregator platform providing elderly care. Spread over four categories — personal care, emotional care, medical care, and products/medical equipment for sale or rent — it aims to be the first aggregator in this highly unorganised sector with a hassle-free AI-driven app, web interface and telesupport.
60Plus India’s services
| Personal Care | Emotional Care | Medical Care | Products for Sale or Rent |
| Paying electricity, internet and other bills Sending a attender for hospital visit Getting household repairs done Concierge services Grocery shopping and other errands | Caretenders (travel, walking, talking and reading companions provided exclusively by 60Plus India) | Home delivery of medicines Medical maintenance record Availability of 60Plus India medical insurance Home blood collection Online doctor consultations Home doctor and nurse visits Diet and nutrition guide Delivery of customised diet food Home X Ray Home Eye check up Home hearing aid fixing | Bathroom, bedroom, toilet and kitchen aids Home security and safety kits Mobility aids Wearable apparels |
SDG Focus
Its model is unique and currently the only one in India providing products and services for senior citizens under a single roof. In addition, 60Plus India also abides by three sustainable development goals (SDGs). The first two are SDG 3 (Good Health & Well-being) and SDG 10 (Reduced Inequalities). The third, SDG 9 (Industry Innovation & Infrastructure), is by way of creating geriatric-friendly inclusive spaces and environment modification for homes as well as bettering the country’s healthcare infrastructure by providing senior care services at doorsteps.
The most important goal for 60 Plus is building an inclusive, holistic home health care ecosystem for the elderly in India. While services for the elderly exist in the country, none are as comprehensive and follow a people-first approach as 60Plus India. It understands the difficulty in caring for ageing parents from the children’s and elders’ points of view.
The founders have firsthand experience of providing care for the senior citizens in their family, often for those from cousins and friends’ families who were themselves living abroad.
And therefore, it provides 360° parent management services and products under a single umbrella. The family doesn’t have to physically visit service centres or scour the internet for multiple service providers. Nor does the patient have to visit the hospital or doctor for the smallest of things.
That said, the founders understand that they can’t fulfil all requests. So instead, they identify critical healthcare and home care requests that the elderly would need and address those to make their services more qualitative.
The platform also thoroughly verifies trained service providers and caretakers and only shortlists those who are best suited. In addition, service providers must follow protocol, not abuse their patients, and undergo police verification, proprietary psychometric assessments and on-field evaluation.
60Plus India has served over 1,000 senior citizens with 3,000+ services ranging from doctor visits at home, isolation help, hospitalisation, companionship for walks, and food supply to insurance claims.
Currently, it services seven customers for comprehensive parent management. Patients are ailing elders with cancer, severe arthritis, amnesia, dementia and other chronic or terminal illnesses or disorders. And it plans to open up a subscription-based service from September 2022. There are also long-term plans to tie up with corporations to extend parent management support for employees of such organisations.
60Plus India is incubated at Crescent Innovation and Incubation Council (CIIC) and a recipient of the Startup India Seed Fund Scheme (SISFS).
After getting selected for the Accelerating Asia cohort — 60Plus India has acquired seed funding of INR 25,00,000 plus USD 100,000 — with its support and ingenuous service roaster.
It was also chosen as the Overall Best Startup of 2021 and received the SHESTAR award for its exceptional business growth and range of services.
The success so far is only the beginning of a changing narrative for senior citizens. 60Plus India’s vision for the future will give hope to the nation’s vulnerable older population and improve their quality of life to a large extent.
About the founders
Arasi Arul graduated in computer science and engineering and later pursued an Executive MBA at LIBA, Loyola Campus – one of India’s top-rated business schools. Shortly after, she started ‘Zha’ (ழ)Café, the world’s first and only Tamil ethnic-themed coffee shop. During the Covid-19 lockdown, Arasi’s several friends reached out to her with requests to take care of their ageing parents, which she successfully did. And thus, 60Plus India was born.
Oli Arul is a serial entrepreneur with close to 15 years of startup and management experience. After completing his Bachelor of Engineering in Computer Science, Oli founded his consulting business and, ever since, has never looked back. He also co-founded Shycart.com alongside Vivek.
Vivek Raja has amassed a wealth of technical experience after graduating in engineering and information technology and post-graduation in computer software engineering at the National University of Singapore. After that, he held key leadership positions in technology roles. In addition, he’s no stranger to the entrepreneurial world, having co-founded Shycart.com with Oli.
Credits
Authored by Ayesha Tari and Ravi Gupta
Conceptualised and strategised by Deepa Sai (founder of ecoHQ)
Ayesha comes with 5+ years of experience in the online marketing industry. She’s a freelance writer & editor, working with B2B clients in SaaS, Sustainability & Education sectors. Previously a social media manager for notable brands, now she loves writing long-form and website content. When she’s not being a wordsmith, she’s reading thrillers, watching MCU films, and cooking up new dishes. Connect with her on LinkedIn to keep up with her.
Ravi is an evangelist for sustainability and an agent for change who thrives on creating an impact with his words. Professionally, with his expertise in end-to-end marketing, he helps to grow businesses (that are conscious of the ecosystem).
References
- https://www.downtoearth.org.in/blog/health/lonely-twilight-highest-rate-of-seniors-living-alone-in-tamil-nadu-nagaland-75346
- https://www.iipsindia.ac.in/sites/default/files/LASI_India_Report_2020_compressed.pdf
- https://www.60plusindia.com/service/caretenders-services-travel-companion-talking-companion-reading-companion-walking-companion/10/
- https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
- https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
- https://www.downtoearth.org.in/news/health/almost-70-senior-citizens-in-india-have-a-chronic-illness-74944#:~:text=About%2018%20per%20cent%20of,be%20high%20among%20the%20elderly
- https://www.businesstoday.in/magazine/cover-story/story/india-lags-in-financial-security-pension-sector-reforms-37023-2012-11-17
- https://www.indiatoday.in/magazine/cover-story/story/20070716-greying-of-india-has-become-a-horrifying-and-miserable-plight-for-old-neglected-and-abused-parents-they-are-the-most-vulnerable-groups-of-people-748104-2007-07-16
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4470031/
- https://www.f6s.com/60plusindia.com
- https://yourstory.com/companies/60plus-india/amp
- https://www.livemint.com/news/india/building-a-robust-ecosystem-for-seniors-is-the-need-of-the-hour-11619259438453.html
- https://www.businesstoday.in/magazine/cover-story/story/india-lags-in-financial-security-pension-sector-reforms-37023-2012-11-17
- https://www.sciencedirect.com/science/article/pii/S2667032122000099
- https://devotedguardians.com/behavioral-problems-in-older-adults/#:~:text=Most%20common%20age%2Drelated%20concerns,t%20like%20being%20around%20others.
- https://theprint.in/india/indias-elderly-population-to-rise-41-over-next-decade-to-touch-194-mn-in-2031-govt-report/710476/
- https://tribecacare.com/2022/07/12/challenges-faced-by-the-elderly-in-india/