Summary of this article
ASLI-PwC report urges a unified national authority for senior care.
Senior care market penetration stays low at 1.5 per cent despite 14 per cent growth on the supply side.
Providers face workforce shortages as the primary challenge in offering care services.
The senior care ecosystem in India is changing, keeping with the shift in India’s growing elderly population. However, while institutional investment has started pouring into the eldercare market and senior housing communities, the sector must transition from constructing mere physical real estate to providing an integrated system of professional healthcare, according to a report, titled Silver Surge 2.0: From Places To Care: Building India’s Senior Care Continuum, published by the Association of Senior Living India (ASLI).
Demographic Shifts And Gap In Accessing Senior Care Offerings
According to the report, the elderly population (Aged 60 and above) in India stands at 166.90 million in 2026, and is projected to reach 191.50 million by 2030 before reaching 347 million by 2050. The growing elderly demography requires care, and the care demand is rising faster than the overall population growth due to increasing multimorbidity, typically affecting those above the age of 70.
The report says that people over 70 record 111 hospitalisations per 1,000 people, which is more than 4.3 times the rate observed among people in the 30-44 age group.
Besides this, an estimated 8.80 million seniors are living with dementia, and 12.20 per cent of older adults require palliative or supportive care.
The report highlights that despite the supply of senior care growing at 14.20 per cent annually since 2024, the overall market penetration remains significantly low at 1.50 per cent. It identifies a structural bottleneck, where organised senior-living beds account for under 10 per cent of India’s total organised senior living stock. In mature global markets, it is between 24 per cent and 29 per cent. The lack of penetration leaves a gap in providing care, including assisted care, home care, and memory care, while living independently at home and in an expensive tertiary care hospital bed.
Bottlenecks And The Need For Standardised Care Delivery
While the gaps are there, the report finds a strong long-term confidence among providers for growth in the sector. Around 84 per cent of the providers feel highly optimistic about growth over the next 15 years. The senior housing and caregiving facility operators cite changing consumer acceptance (84 per cent) and family awareness (63 per cent) as the primary reasons behind the demand. Around 8 per cent of respondents attributed regulatory easing as a major reason to drive the demand.
The report says that human capital is the most urgent operational constraint in the sector at present. Around 75 per cent of providers find workforce training as the top operational requirement. The other enablers requested by operators include public-private partnership (67 per cent), increased capital funding (67 per cent), and formal regulatory frameworks to standardise care delivery (50 per cent).
Policy Progress And Financing Gaps
The report notes the policy and legislative progress over the past year. It points out the notable development over one year, such as the issuance of 11.40 million Ayushman Vay Vandana cards, which provide a health insurance cover of Rs 5 lakh to citizens aged 70 and above, the complete exemption of goods and services tax (GST) on individual health insurance policies, and a Union Budget mandate to train 150,000 accredited caregivers.
According to the report, the financial protection in India remains heavily hospital-centric. The long-term out-of-hospital care, assisted living, dementia support, and home-based nursing are mainly paid for out-of-pocket.
To address the issue of affordability, ASLI has recommended piloting long-term care insurance products within the regulatory sandboxes, and expanding public healthcare insurance to cover post-discharge rehabilitation, along with broadening the reverse-mortgage frameworks to finance daily caregiving.
S.C.A.L.E. Framework Recommendation
The report has suggested 14 action points to structure future growth of the senior care sector under the S.C.A.L.E. framework. It stands for:
Standards & Policy
Capital & Financing
Assisted & Continuum Care
Labour & Workforce
Enabling Technology
Under Standards & Policy, it recommends creating a Senior Care Regulatory and Accreditation Authority (SCRAA), introducing the published set of eight voluntary care quality indicators, such as fall-related injuries, pressure sores, 30-day hospital re-admissions, and staff turnover. It also recommends mandating standardised care-transition protocols between hospitals, home care and assisted living providers, and tiered licensing for senior care providers.
The capital and financing framework includes piloting a long-term care insurance product with Insurance Regulatory and Development Authority of (Irdai) support, adding home nursing to PM-JAY and Vay Vandana, allowing National Pension System (NPS) and annuity providers to offer care riders, broadening reverse mortgage to caregiving, clarifying GST treatment of bundled accommodation and care services, introducing care vouchers for low-income seniors to access home care, and establishing district-level integrated senior care centres.
The assisted and continuum care and labour and workforce-related recommendations include introducing routine screening for adults aged 60 and above for frailty, falls risk, and cognitive health through community health programmes, establishing age-friendly community hubs, delivering the 150,000 caregiver target, and adding geriatric modules to medical and nursing curricula.
