For decades, India’s social contract rested on an assumption that required little intervention from the state: families would care for their elderly. Public policy focused on pensions, healthcare and poverty because emotional support, companionship and day-to-day caregiving were presumed to come from within the household. That assumption is now under strain, and nowhere is the change more visible than in Kerala.

The state’s demographic profile places it at the forefront of a transition that the rest of India will eventually experience. Longer life expectancy, declining fertility and sustained migration have produced a society where parents increasingly outlive the traditional family structure that once sustained them. Their children have not necessarily abandoned them. Many have moved elsewhere in pursuit of education, employment or better incomes. Yet the result is the same: ageing parents find themselves alone even when they remain financially secure. This distinction is significant because it changes the nature of the policy challenge.

Financial assistance can pay bills, but it cannot accompany an elderly person to a hospital at midnight, repair a leaking roof, collect medicines or simply provide........

© The Statesman