The Quiet Crisis of Care in a Young and Ageing India

• by Sonal Jaitly
• Jan 20, 2026
• 4 min

India’s demographic shift demands urgent investment in the care economy—recognizing unpaid care, supporting women, and building inclusive systems that sustain families, productivity, dignity, and healthy ageing across society.

I am often struck by the extraordinary demographic moment we are living through in India. We may be the only country where we are substantially young and substantially old at the same time. Sixty-five percent of our population is below the age of 35, while approximately 150 million people, close to ten percent of our population, are above the age of 60. This is not a distant future, it is the India we inhabit today, and it compels us to think urgently and deeply about the systems and structures that hold families and communities together.

There are several trends that demand our immediate attention. One of the most significant is the rapid rise of nuclear households, driven largely by urbanization and changing economic realities. Nuclear families accounted for around 50% of Indian households in 2022, up from 34% in 2008, signaling a significant shift in family structures across both large and small cities. With this shift, the social infrastructure of care that once sustained generations is diminishing at an unprecedented pace. Traditional forms of caregiving, which were embedded in extended family arrangements and community culture, are weakening, leaving individuals and families with fewer sources of support.

Life expectancy has increased dramatically, and many of us are now living into our eighties. Elderly women live even longer by three or four years on average. But health span is not keeping pace with lifespan. The quality of the years we gain depends on our physical health, our independence, our dignity, and our financial security. Recent data indicates that seventy-five percent of elderly people in India have one or more chronic illnesses, twenty percent face mental health struggles, five percent have experienced some form of abuse (physical, sexual, psychological, or financial) within their own homes, and only eighteen percent have any health insurance. These challenges are further intensified in rural areas, where sustained out-migration of younger family members has sharply reduced the availability of everyday care.

This is why I frame care as a continuum that stretches across childcare, eldercare, domestic work, and even animal care, particularly in rural economies where livestock defines livelihood. Across this continuum, the burden of care is disproportionately borne by women. Care responsibilities account for the exclusion of an estimated 53 per cent of women from India’s labour force.  According to the government’s time-use survey, women spend between five to seven hours a day engaged in unpaid care work, the largest share of which is household labor. In many cases, entry into the workforce is not only constrained by supply of jobs but by the quality of work available. If decent and quality employment opportunities are not available for women, they may choose to stay home for their children or elders rather than accept low paid work. When care remains invisible and unsupported, women’s economic exclusion is not a failure of aspiration or a personal choice, they are economic and structural realities.

We are dealing with a huge care deficit, and its implications are social, economic, and moral. The care economy must be understood as a long-term priority. Care cannot remain a private matter, silently absorbed within families and largely by women. It is a public issue and a shared responsibility of the state, the market, and communities. We also have to consciously move away from phrasing “care” as a “burden”. Care makes us human and is an essential prerequisite for human capital to survive and thrive. Every one of us begins life needing care, and if we are fortunate to live long enough, we end life needing care again. In between these stages, we depend on care more than we often admit.

Care forms the very foundation of human capability and economic development. We must learn to see it not as expenditure but as investment. The single most important investment we can make is in the care of children, the elderly, and families who sustain our social fabric. When governments and markets invest in eldercare, they are investing in their own future, because every one of us is aging. When we support high-quality childcare, we create the conditions for a healthier, more capable generation. When workplaces genuinely support caregiving needs, they not only follow the law but strengthen their own wellbeing and productivity.

Families will always remain irreplaceable in care. No institutional model can replicate what family care provides in emotional depth and trust. But we must build systems that offer dignified, high-quality, and affordable options for families who need supplementary care from outside support systems especially when economic insecurity is a reality for millions. We need multiple models, new imaginations, and pathways that help families balance paid and unpaid work without forcing impossible choices.

The question before us is profoundly simple: What kind of society do we want to grow old in and what choices are we making today to shape it? If we ignore care now, we will inherit a future marked by loneliness, inequity, and exhaustion. If we choose to value care, invest in it, and place it at the center of how we measure progress, we can build a society that is humane, dignified, and deeply connected.

And all of us must decide together—because the future we are building is the one we ourselves will inhabit.

This was first published in “Reimagining The Family” on 14th January 2026.