India's Dementia Burden Is Rising: Can Kin Care Close The Elder-Care Gap?
· Free Press Journal
The views expressed are personal.
She still knew the recipes. Every single one – the proportions, the sequence, the small adjustments her mother had taught her sixty years ago. But she had forgotten her daughter’s name. She would ask for her three times in an hour, each time with the same hope in her voice, as if the answer might be different. Her daughter would answer, each time, as if it were the first.
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This is dementia in an Indian home. Not a clinical condition contained to a ward, but a presence that reshapes every relationship around it – quietly, irreversibly, and almost always without adequate support.
India currently has over 8.8 million people living with dementia. By 2050, that number is projected to cross 17 million. We are talking about a condition that strips away identity, imposes round-the-clock caregiving demands, and leaves families – most of them completely unprepared – to figure it out alone. And yet, dementia remains one of the least discussed, least funded, and least planned-for health challenges in the country. Dementia doesn’t announce itself. It arrives slowly, then all at once.
A crisis families discover too late
The challenge is not only medical. It is structural. Most families in India discover dementia not through a diagnosis, but through a series of moments that don’t quite add up – a missed appointment, a gas stove left on, a familiar route suddenly unfamiliar. By the time a neurologist is consulted, months have often passed. By the time the family understands what they are dealing with, the primary caregiver – almost always a daughter or daughter-in-law – is already exhausted.
What dementia care demands, more than any other condition I have encountered, is continuity. Not a visit when something goes wrong. Not a doctor on call for the crisis moments. It needs someone who shows up on the ordinary Tuesday, who knows that this particular person gets agitated around evening time, who understands that the way she holds her tea cup tells you everything about how she is doing today. That kind of care cannot be prescribed. It has to be built, relationship by relationship, over time.
Why we built Anvayaa around “kin,” not “clients”
This conviction – that care is a relationship, not a transaction – is the reason I started Anvayaa ten years ago, when most of India’s startup ecosystem was chasing food delivery and e-commerce. Anvayaa means “family” in Sanskrit, and the model we built around it, kin care, rests on a simple premise: that older people deserve to be known, not just managed. Care is not a service you activate in emergencies; it is a presence you maintain across the whole of a person’s life. For someone living with dementia, that distinction is the difference between a life of fear and a life of dignity.
In practice, this means a dedicated Care Manager assigned to each family – a single, consistent point of contact who tracks routines, moods, medication schedules and the small behavioural shifts that matter most in dementia care, and who coordinates everything from doctor visits to daily assistance to emergency response. Today that model supports over 1.5 lakh seniors across 38 cities in India, has delivered more than 80 lakh hours of home care, and has managed over 5,000 medical emergencies with a 97% lives-saved record. Under our NISHCHINT home-care umbrella, families – whether they are down the street or across the world – get on-demand medical and non-medical support without having to manage caregivers themselves.
This July, on our tenth anniversary, we marked the occasion – an evening we called Kritagnya, “gratitude” – not by looking back, but by expanding what full-circle elder care means: Curapod for pain management, 3000 BC Therapeutics for therapeutic wellness, and Punyaka, a platform for spiritual and devotional support, because dignified ageing is not only about the body. It is also about wellbeing and faith. These additions exist because dementia and frailty rarely show up alone; they arrive alongside pain, isolation, and a longing for familiar rhythms of faith and community, and any serious elder-care model has to answer all of it, not just the medical piece.
What it will take to close the gap
None of this, on its own, is enough. India’s caregiving infrastructure is not ready for what is coming. We have too few trained dementia caregivers, almost no respite care for exhausted families, and a cultural framework that still treats asking for help as a form of failure. The family that is managing a parent with dementia – often doing so from another city, often while holding down jobs and raising children – is not failing. They are doing something enormously difficult, largely without support.
Closing the gap will require more than awareness campaigns. It will require trained caregivers at scale, accessible specialist care in tier-2 cities, corporate policies that acknowledge dementia caregiving as a workplace issue, and families willing to have the hard conversations early – before the crisis, while there is still time to plan. At Anvayaa, that is the bet we made ten years ago and the one we continue to build toward: that “care” should mean being known, not just being managed.
The woman who remembered every recipe but forgot her daughter’s name deserved better than improvisation. So do the millions of families who will find themselves in that kitchen in the years ahead. We know what good care looks like. The only question is whether we – as an industry, and as a country – will build it in time.