From Family Duty to Trained Profession: The Care Gap India's Ageing Has Exposed

India Keeps Legislating the Family's Duty, but the Family Can No Longer Carry It In 1956, the Hindu Adoptions and Maintenance

Act made it a legal duty to maintain aged parents. In 1973, Section 125 of the Code of Criminal Procedure let parents unable to support themselves claim maintenance from their children. In 2007, the Maintenance and Welfare of Parents and Senior Citizens Act went further, setting up tribunals to enforce that duty.

Three laws over half a century gave the same answer to the same question. Who looks after the old? The family does and the State will make sure it pays. This is not new. What is new is that the answer has stopped working.

Why the

old answer is breaking Each of those laws assumed the missing ingredient in elder care was money. The joint family supplied everything else: hands, time and above all several women in one household to share the work. Care was never really free.

Its cost was spread across a large household and hidden inside it. The nuclear household concentrates that same cost on one or two people. The NSO's Time Use Survey of 2019 measured where it lands. Women spend 299 minutes a day on unpaid domestic and care work, against 97 minutes for men.

NITI Aayog's 2024 update puts women's participation in caregiving at 41 percent of those aged 15-59, against 21.4 percent of men. This is where the parallel with the older laws breaks down. They could compel a son to send money.

They cannot compel skill. A daughter-in-law can be legally made to pay. She cannot be legally made to recognise falling sodium or the signs of early dementia.

The arithmetic of the gap The scale makes the household model untenable.

India had 149 million people aged 60 and above in 2022 and the India Ageing Report 2023 projects 347 million by 2050, about 20.8 percent of the population. NITI Aayog estimates that 10 percent of Indians already provide untrained, unpaid care.

By the authors' reckoning, that is roughly 146 million people. Against that number, the Budget's target of 1.5 lakh trained caregivers over five years is a first step, not a solution. The more important shift is conceptual.

NITI Aayog's Reimagining Care report treats caregiving as economic activity, not as charity or family obligation. It proposes a National Caregiver Council to certify workers and keep a national portal of them. Kerala has already shown what the shift looks like on the ground.

Kudumbashree's K4 Care, launched in January 2024, turns women from self-help groups into certified geriatric, patient and disability care executives. Work they once did unpaid at home becomes paid work in the community. Its reported reach so far is small, which is the real lesson: the model works, but scaling it is the hard part.