Context:

Recently, the newly elected government in Kerala announced the creation of a separate department for elderly welfare, becoming the first state in India to institutionalise governance exclusively for senior citizens. This reflects the rising policy urgency around ageing, both in Kerala and across India.

Kerala: India’s Most Ageing State:

Kerala is undergoing advanced demographic ageing similar to East Asian and European countries. As per the Elderly in India Report 2021, around 16.5% of Kerala’s population is above 60 years, projected to reach 20.9% by 2031.

Old-age dependency ratio:

• • • 19.6% (2011)
    • 26.1% (2021)
    • 34.3% (projected 2031)

The rise in old-age homes indicates weakening traditional family support systems.

Reasons behind Rapid Ageing:

Declining Fertility Rate

Kerala’s Total Fertility Rate (TFR) is around 1.35, well below replacement level (2.1), reflecting a broader demographic shift in India’s southern states.

Increased Life Expectancy

Improved healthcare has raised longevity:

• • • Women: ~78.4 years
    • Men: ~71.9 years

Migration Trends

Large-scale outward migration of the working-age population has created “empty nest” households, increasing elderly vulnerability. Return migration of retirees also adds to the ageing burden.

Key Challenges Faced by the Elderly:

Health Challenges

According to the Longitudinal Ageing Study in India (LASI), over 70% of Kerala’s elderly suffer from chronic diseases such as hypertension, diabetes, arthritis, and cardiovascular conditions. Dementia and mental health issues are also rising.

Feminisation of Ageing

Women outnumber men at older ages, with many elderly women living alone as widows, facing economic and social insecurity.

Economic Vulnerability

Many elderly continue working under MGNREGS due to inadequate pensions and financial insecurity.

Government Initiatives:

Kerala has developed several innovative elderly-care programmes:

• • • Vayomithram – mobile medical care
    • Samayaprabha – daycare centres
    • Smruthipadham – dementia care initiative
    • Kerala Care Palliative Grid – integrated palliative system

In 2025, the state also formed the first State Elderly Commission to safeguard senior citizens’ rights.

Challenges Ahead:

Kerala faces a shortage of geriatric professionals, including doctors, nurses, physiotherapists, and occupational therapists. Addressing this gap is essential for building a robust care economy and age-friendly infrastructure by 2030.

Elderly Population in India:

• • • India’s elderly population (60+) accounts for over 12% of the total population and is projected to reach about 319 million by 2050. Women constitute nearly 58%, with a high proportion of widows.
    • Traditional joint family systems are weakening due to urbanisation, migration, and nuclear families, increasing loneliness and dependency.
    • Common health issues include diabetes, hypertension, arthritis, and cognitive decline. Regional disparities are significant, with states like Kerala ageing faster than states like Bihar and Uttar Pradesh.

Government measures include:

• • Maintenance and Welfare of Parents and Senior Citizens Act, 2007
  • Indira Gandhi National Old Age Pension Scheme
  • Atal Pension Yojana

Conclusion:

Kerala’s decision to create a dedicated department for elderly welfare marks a pioneering governance reform in India. As demographic ageing accelerates nationwide, the Kerala model offers a potential blueprint for integrating healthcare, social security, and dignity-based ageing policies into India’s broader development framework.