Rohit Arora works in Delhi, but his ailing mother was alone in Kolkata, and he used to feel helpless about it. When he managed to get a health worker, Rajesh (name changed), to look after her, it was a great relief for him. “He visited every week, looked after her health, talked to her, took her to the doctors. Later on they developed sort of psychological bonding. She was so happy,” he says. Arora’s mother passed away recently.
MP Pai and his wife in Bangalore looked forward to the daily visit of their nurse, Nitya. For them, it was not just about medical care, but about social bonding and a daily dose of advice. Both their sons are settled in the US, and “having her come home and check on us has made a huge difference in our lives,” Pai says.
Rajesh and Nitya are symbols of healthcare care focussed on the elderly, still an emerging industry in India valued at about $7 billion (R43,000 crore), of which home-based care is estimated at between $2 and $3 billion (R12,800 and R24,600 crore).
Compared to about $290 billion that is spent on eldercare in the US, this is miniscule. However, with income levels rising and young professionals no longer able to care for their parents willing to dip into their wallets, companies such as Portea, TriBeCa Care, Medwell, and HealthCareAtHome are sniffing a business opportunity with high growth potential.
As per Census 2011, India has 103.2 million ‘60-plus’ people – next only to China – constituting around 8.6% of the population. Given the increasing longevity and high population growth, it is expected to reach 300 million by 2050 – a fact that is not lost on the industry.
“Currently, the private healthcare sector, especially corporate hospitals, perceives older persons as a non-profitable segment. They are not tapping into the potential that elder care services offer,” feels AB Dey, head of department, geriatric medicine at AIIMS.
“The market is small compared to the US, which is worth billions,” says Tamojit Dutta, Co-CEO of TriBeCa Care. “The reasons are, one, that there are not enough companies in this segment right now and, two, now the segment is dominated by informal sector and government-based services.”
The elderly have different healthcare requirements. They generally suffer from multiple and chronic diseases and need long-term and constant care, according to the National Programme for Health Care for the Elderly (NPHCE) report. But medication is not their only need – the elderly need emotional support, counselling and often, legal support.
“Along with medical needs, we also address their non-medical needs,” says Meena Ganesh, CEO of Portea Health care.
The companies, apart from giving medical and nursing services, offer legal support, help in day-to-day activities such as shopping and paying bills, and going outdoors. Some also offer products such as wheelchairs, beds and walking assistants that can be purchased online.
So far, cities are the focus of such companies. The last two NSSO (National Sample Survey Organisation) sample surveys on the elderly have shown that the numbers of urban elderly who report poor health has increased, and among these, women are more vulnerable. In many cases, senior citizens live alone as their children work away from the home, or owing to family disputes (Agewell Foundation survey in 2010).
“Our clients include children living within and outside India, and at times in the same city as their parents. Sometimes the (aged) parents themselves ask for our services,” says Gaurav Thukral, vice-president, HealthCare at Home India, a joint venture of the Burman family of the Dabur brand, and UK-based HealthCare at Home.
Portea, which was established in 2013, is present in 22 Indian cities and is looking to get to 50 within the next two years. HealthCare at Home is present in four cities. Both companies, with their focus on expansion, are yet to break-even. TriBeCa care, founded in 2013, is expanding to the national capital region from Calcutta, where it is just breaking even, according to co-founder and CEO Tamojit Dutta.
“The biggest challenge I see for the sector is not strategy, but finding the right staff -- sensitive people with the right skills,” he says.
Such healthcare companies employ people below the level of doctors, such as attendants and nurses. They either hire experienced staff, or recruit and train people on their own.
In India, there is in fact a dearth of doctors specialising in eldercare. Even nearly half of the miniscule trained manpower migrates to other countries, as opportunities are better there, says the NPHCE report.
Leveraging technology, all these companies have a centralised database, and the care-seekers and their relatives can access their records from anywhere in the world.
For the modern-day professionals who have little time even for themselves, the fledgling industry is a boon.
“Given the current social situation I see it as a great service and a good business opportunity,” says Satindra Sen, a former banker and a businessman in Delhi, who uses the services of a company for his 84-year-old-mother, a dementia patient who lives alone in Calcutta.