Narendra Kumar, 70, lives in Pitampura and plans her day around the needs of her ailing husband who has trouble moving. She gets up at 7am to test his blood glucose, gives him medicines, helps him get ready and serves him breakfast.“I have to take care of him; give him medicines on time; help him go to the bathroom, clean the house, and cook. I cannot leave him alone. I hardly get time to step out. If at all, I talk to my neighbours from the balcony or my doorway,” said Kumar, who worked as a school teacher before she retired and is not used to staying at home all day.To pass time, she reads. She used to watch television, but that stopped because her husband complained of the sound. Her husband, CL Seth, 77, cannot walk properly or stand for long or get up without help since he had fall last year, after which they hired full-time help.Their daughter lives a few kilometres away and visits frequently, with groceries and vegetables for her parents. Their son is a software engineer in the US.The Seths are one of at least one lakh people over the age of 60 living in Delhi, according to census 2011, who accounted for 6.8% of the state’s population at the time.With people living longer and families growing smaller, the percentage of older adults is steadily increasing. Between the 2001 and 2011 census, the population of those over the age of 60 went up by 1.63 percentage points while those between the ages of 0 and 14 went down by 5.25 percentage points.With many older adults living on their own after their children have moved out to work or after getting married, service providers have moved in to help them cope with daily chores.IVH SeniorCare is one such service that provides medically-skilled and unskilled helpers. “We recruit ex-defence personnel who undergo training before being assigned as care buddies. They will take care of the elderly —make sure they get their medicines on time, give them a massage, buy things from the shop, accompany them for a stroll, or even just talk to them, whatever is needed. We also hire nurses who can provided more specialised medical care to people who need to be given insulin shots, need catheter, or have had a tracheotomy etc,” said Janardan Yadav, general manager at IVH SeniorCare. Hiring a person for basic help costs ₹600 a day, and a skilled caregiver charges ₹1,500 a day.Recently, a 45-year-old from Gurugram decided to hire a caregiver from the services when her parents moved to Rajouri Garden to be near other relatives. “My mother has a chronic lung condition and cannot go too long without oxygen and my father’s health is also deteriorating. This is why I needed to hire someone to take care of them after I move. Loneliness is a big issue, I am able to go and meet them only about twice a month. Our relatives also try and visit them as often as they can but everybody has their own commitments,” she said, requesting anonymity.Whether it was zeroing in on an old-age home or hiring a fulltime caregiver, the lack of government programmes for the elderly worried her. “I am quite happy with the caregiver we have now. But, we were very apprehensive about hiring people from these private companies because who knows what they will do. But, there is no other option, there are no government programmes,” she said.Besides medical support, the caregiver is more needed to give mental support, she said. Experts agree. “The recent economic survey shows that the rate of increase in population of people over the age of 60 is now higher than the rate of increase of the total population. And, the number of elderly is expected to double to 16% from the current 8.9%. Now, all the government programmes put together are not equipped to deal with this,” said Dr GS Grewal, who is working on setting up a community-based initiative in Srinivaspuri.The initiative plans to connect 36 primary care physician trained to treat the elderly, with neighbourhood nursing homes, and then a tertiary care hospital. The programme would also recruit and train people who have completed their senior secondary education in taking care of the elderly.“They will provide home-based care and also accompany them for their healthcare needs. And, when we are talking about primary care, it is not just managing their diabetes and blood pressure. It will be holistic care that focuses on nutrition, frailty and mobility, mental health, immunisation and abuse. Loneliness is a disease,” said Dr Grewal.