Regulation of Long-Term Care Homes for Older Adults in India

Abstract

The rising aging population in India has led to an increased caregiving burden, and accordingly, the number of residential care facilities is also burgeoning. There is no regulatory framework or registration authority specifically for residential care homes in India. The article’s objective is to understand the need for a regulatory framework in India in the context of historic and global experiences in the UK, USA, and Europe. Although there is a lack of literature comparing the community home-based care and residential care, one study reported a preference for home-based care in the South Asian context. Elder abuse and deprivation of rights of seniors are common, and there is a need to bring in more safeguards to prevent these from the perspective of the older adults, their family members, the care providers, and the state. While the main priority of meeting care needs in long-term care is a challenge given the lack of trained care staff, the quality control mechanisms also need to evolve. A review of adverse incidents, complaints, and litigations also highlights the need for regulation to improve the standards and quality of care. The article explores lacunae of residential care facilities in the Indian context and provides recommendatory parameters for evaluating the quality of care provided. Relevant sections of the statutory new Mental Healthcare Act of 2017 in India could provide a regulatory framework ensuring rights and liberties of the residents are upheld. The authors propose a state-run model for elderly care homes and commencement of framing regulations appropriate to the Indian context.

Dignity and the provision of care and support in ‘old age homes’ in Tamil Nadu, India: a qualitative study

“…These model guidelines focus on services and physical aspects of the environment rather than the quality of care. The authors are fairly confident that the types of human rights violations observed in this study, would be found elsewhere in India (see also, [ 41 ]). As Tamil Nadu was the first state to introduce a set of Minimum Standards for old age homes in 2016, one may expect provision in this state to be ‘better’ than elsewhere as the standards have become embedded into practice over time.…”

Identifying the impact of social isolation and loneliness on psychological well-being among the elderly in old-age homes of India: the mediating role of gender, marital status, and education

“…However, the adequate implementation of these provisions is a matter of concern. There is a paucity of formal mechanisms in terms of feedback, appraisal, complaints or grievance redressal, that makes it difficult for ensuring the overall well-being of older adults residing in old-age homes [ 47 ].…”

Understanding the “state of play” of long‐term care provision in low‐ and middle‐income countries

“…Few formal LTC services such as old‐age homes, day care centres, residential facilities and domiciliary care services are available, and these services are predominantly provided by private and not‐for‐profit organizations, although a few public facilities also exist (Rajagopalan et al, 2020). Currently, care homes and residential facilities are largely unregulated, with limited data available on their numbers and characteristics (Harbishettar et al, 2021). Some publicly supported LTC services exist, but these are scanty and fragmented under the auspices of multiple government programmes, such as the Integrated Programme for Older Persons, National Programme for Healthcare of Elderly, National Mental Health Programme, and National Programme for Palliative Care (Scheil‐Adlung, 2015).…”