Thiruvananthapuram: The Kerala government is preparing legislation to regulate elderly care in the state, with the proposed law expected to lay down standards for care homes, assisted-living facilities and home-care services, besides specifying qualifications and accountability for caregivers.
Chief Minister V D Satheesan reviewed the draft Kerala State Elderly Persons (Care and Protection) Bill, 2026, along with a proposed Policy for Elders, at a meeting in Thiruvananthapuram on Tuesday. He directed officials to complete the required procedures at the earliest.
After the meeting, Satheesan said the government was committed to ensuring “statutory security, healthcare access, and a life of dignity” for senior citizens.
The draft Bill and the accompanying policy have not yet been made public.
Why Kerala is moving now
The proposed legislation comes as Kerala’s elderly population is projected to rise sharply over the coming decade. The state’s Elderly Budget for 2026-27 cites population projections from the Registrar General of India showing that the number of people aged 60 and above is expected to almost double, from 4.2 million in 2011 to 8.4 million by 2036.
Kerala’s demographic transition is significantly ahead of the national trend. The share of elderly people that Kerala had in 2011 is expected to be reached by India as a whole only around 2030.
The Reserve Bank of India’s annual study of state budgets, released in January, also highlighted the pace of demographic ageing. The RBI classified states according to their age structure and defined a state as “ageing” when at least 15% of its population is aged 60 or above. The threshold is based on 60 rather than the international convention of 65 because retirement and senior-citizen entitlements in India generally begin at that age.
No Indian state fell into the RBI’s ageing category in 2016. By 2026, Kerala and Tamil Nadu are projected to meet the threshold. By 2036, more than half of India’s states are expected to do so, with none remaining in the youngest category. The RBI described Kerala as being “at the forefront” of the demographic transition and characterised its position as advanced ageing.
The change is also expected to have fiscal implications. Kerala’s working-age population is projected to decline from 62% of the total population in 2026 to 59.5% by 2036. It would be the only state projected to fall below the 60% mark, implying a smaller share of the population in the workforce even as the number of elderly dependants increases.
Growing healthcare needs
Kerala’s ageing population is also accompanied by a high burden of chronic illness.
The Union Health Ministry’s Longitudinal Ageing Study in India, based on a 2017-18 survey of more than 31,000 people aged 60 and above, found that 52% of elderly people in Kerala were living with two or more chronic conditions. This was the highest proportion recorded among states, compared with 23% nationally.
More than half of Kerala’s elderly respondents also rated their health as poor, a figure tied with Tamil Nadu for the highest level of poor self-assessed health in the country, reported Hindustan Times.
At the same time, the study indicated relatively high levels of treatment for diagnosed conditions. Among elderly people in Kerala diagnosed with high blood pressure, 91% were receiving treatment, placing the state among the better-performing states on that measure.
The emerging challenge, therefore, extends beyond diagnosing and treating illness to providing long-term care for people living for years with chronic conditions.
What the proposed Bill seeks to regulate
According to the Chief Minister’s Office, the draft legislation would establish standards and accountability mechanisms for elderly care centres, assisted-living facilities, day homes and home-care agencies.
A proposed Kerala Geriatric Care Certification Framework would provide for the training and certification of caregivers. Caregivers would also be subjected to background checks and placed on a state register.
The proposed framework would establish state- and district-level mechanisms for implementation, monitoring and grievance redressal. It would also contain provisions aimed at protecting older people from digital and financial risks.
A key principle of the proposed policy is “ageing in place” — enabling elderly people to remain in their own homes and communities for as long as possible, while ensuring access to appropriate care when they can no longer manage without assistance.
The government also proposes to develop a “silver economy” around ageing, with opportunities in care services, assistive technology and products designed for elderly people.
Existing support network
Kerala already has a network of government and community-based services for senior citizens.
The state operates 16 government old-age homes, while around 680 institutions are registered with the Orphanage Control Board. The Elderly Budget records 37,895 residents in 2024-25.
The state has 95 Vayomithram units providing mobile clinic services to elderly people, primarily in urban areas. Sayamprabha day-care homes have been functioning in 82 local bodies since 2018.
Local governments are required to earmark 5% of their development fund for elderly welfare and palliative care. The social security pension for eligible beneficiaries is ₹2,000 a month.
Kudumbashree, the state’s women’s collective, has also been training members as certified home carers through its K4CARE programme.
Retirement homes plan
Another component of the proposed elderly-care system was announced earlier this year.
The Elderly Budget presented in January included a Retirement Homes project aimed at establishing age-friendly housing in every district on a fee-paying basis. The project envisages government regulation and monitoring of such facilities, providing the state with a mechanism to intervene in paid welfare institutions.
The proposed elderly-care law would add a broader statutory framework to these existing initiatives as Kerala prepares for a demographic shift that is expected to substantially increase the number of older people requiring healthcare, housing and long-term care.
