Every day Sreeni wakes up at 4.30 am and checks on his mother. If she is unsteady on waking up, he will assist her to the raised toilet and wait outside as she independently uses it, assuring her that help is just outside. There is a schedule of medicines, clearly sorted and kept by her bedside. The BP monitor and the glucometer reassure him that everything is in the range for her age. He learnt it all by himself, one emergency visit after another to the hospital. Hip pain was ignored till it became a debilitating fracture, a sudden loss of consciousness detected as low sodium — each crisis was a hard lesson in the trial-and-error reality of informal caregiving. Every day millions like Sreeni wake up and perform their respective self-taught routines to take care of their parents or dependants.
As our country’s population ages over the next two decades, the topic of caregiving and the need for formal training for the task will assume larger dimensions, and this is precisely what the Budget 2026-27 has highlighted in a timely manner with the announcement of training of 1.5 lakh caregivers aligned to the National Skills Qualifications Framework.
The NITI Aayog’s August 2026 report “Reimagining Care: Strategies for Empowering Caregivers in Viksit Bharat@2047” frames caregiving as an economic activity rather than just welfare work, and this is the first time that such an intention is explicitly articulated by the Government at a national policy level, which indicates that the urgency has been acknowledged by policymakers.
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To put it in perspective, India’s 60-plus population, estimated at approximately 149 million in 2022, is projected to touch 347 million by 2050, forming roughly 20.8% of the total population. Assuming NITI Aayog’s estimate that 10% of the population today is engaged in caregiving while being untrained and unpaid, the current total works out to about 146 million.
The planned 1.5 lakh formally trained workforce is just a drop in the ocean even by today’s requirements. The caregiving ecosystem will be at a serious juncture if we don’t plan now.
Gender parity in caregiving
For most of its history, India never needed a long-term care system because it had one: the joint family. Three generations under one roof was an insurance contract written in spirit and practised willingly. In the present scenario, with micro family units, most of the time, it is the housewives who take upon themselves the additional task of caregiving, having no formal training, learning by trial and sometimes serious error. Combined with the need to manage their own household chores, such situations increase household stress considerably. The aged who need assistance and the differently abled, about 26.8 million, are surviving, thanks to the love, care and affection of these unpaid, informal care givers.
An NSO survey has worked out that women, on average, spend 299 minutes per day on unpaid domestic work and caregiving, whereas for men it is only 97 minutes. What is required is an appreciation of the situation and the demands of caregiving being shouldered by both genders. A formal training programme, designed exclusively around caregiving, covering the detection of age-related events needing attention in the elderly, assessment of needs, continuous monitoring protocols, emergency care and psychological interventions, ideally attended by at least two family members, would improve the sharing of the duties and responsibilities.
Skilling and upskilling
If we need to have a large number of skilled, formally trained caregivers in a few years’ time, we need to start in earnest.
Two structures are functioning in India, albeit on a small scale and untested. Kudumbashree is a State mission based in Kerala that runs a network of self-help groups. It launched the K4 Care training programme in February 2024 under which its members qualify as certified geriatric/patient/disability care executives. Recent data shows that only 838 have completed the course, a rather slow progress. We can incentivise and accelerate the programme.
The other group is the ASHA workers for whom the NHSRC (National Health Systems Resource Centre) has prepared a Training Manual on Elderly Care, with training delivered via Ayushman Bharat Health and Wellness Centres. However, granular details as to the number of ASHA workers who have completed this training are not available publicly. A meaningful intervention here can have a positive impact.
Informal caregiving is not always physical, like mobility assistance or medicine management. Age-related cognitive decline — as seen in Alzheimer’s and Parkinson’s disease — involves several emotional challenges as well. Any national curriculum must factor in geriatric mental health and behavioural management along with physical care protocols.
The way forward
There are millions of informal, unpaid family caregivers. We need to validate and upskill them into recognised caregivers.
Kudumbashree and ASHA workers who are formally trained, can serve as trainers to train more people, allowing the chain to continue. The National Caregiver Council (NCC), as envisaged in the NITI Aayog report, can act as an apex body. It can set benchmarks and supervise skill development, update training modules, standardise curricula, come out with useful FAQs and regulate and manage a national caregiver portal with a list of certified caregivers.
Transforming India’s care economy is an economic strategy waiting to be unlocked. By creating such a robust ecosystem, India can turn informal dedication into professional expertise with great economic value. For millions like Sreeni, being recognised as a caregiver for the elderly and being trained formally to deal with the associated challenges bring dignity to the relationship.
Just as India is recognised the world over for its healthcare nursing professionals, its approach to managing the challenges of elderly care too could be adopted as the compassionate alternative to the many models being practised globally. The fact that this has been announced as a Budget item is just the seed, and operationalising it at the ground level is where the final success lies.
(T.C. Suseel Kumar a former Managing Director and R. Sudhakar is a former Executive Director, LIC. Views expressed are personal.)