Why home care matters in Kerala.
Kerala’s social progress has brought longer lives - and with them, new and complex needs around ageing, chronic illness, and long-term care that hospitals alone cannot meet.
A growing, largely unmet need.
16.5%
of Kerala's population are senior citizens - the highest in India
35 : 100
projected over-60s per 100 working-age adults by 2030
54%
of elderly in Kerala live with one or more chronic diseases
68%
of health expenditure is out-of-pocket - the highest in India
2.7 lakh
bed-bound patients across Kerala needing long-term care
<2%
of Indians have access to structured home care
A model state, facing new realities.
As Kerala undergoes rapid demographic and epidemiological transition, the need for compassionate, sustainable, community-oriented home care has become increasingly urgent.
A double-edged demographic transition
Declining fertility and increased longevity have produced a steadily ageing population. By 2030, Kerala is projected to have 35 persons over 60 for every 100 working-age adults - already 16.5% are senior citizens, the highest proportion in India.
Burden of chronic, life-limiting illness
54% of elderly individuals in Kerala live with one or more chronic diseases. These conditions are rarely curative, involving prolonged decline, persistent symptoms, and psychological distress that demand continuous home-based support.
Economic strain and health-related poverty
68% of total health expenditure in Kerala is out-of-pocket - the highest in India. Repeated hospital visits and prolonged admissions impose catastrophic financial burdens, especially on elderly households with fixed incomes.
Isolation, migration, and caregiver distress
Migration has left many older adults living alone or with equally aged spouses. Chronic illness compounds isolation, while untrained caregivers - often elderly spouses - face burnout, declining health, and financial hardship.
The unmet need
Kerala has an estimated 2.7 lakh bed-bound and over 4 lakh home-bound individuals needing long-term care. In Ernakulam alone, ~68,000 are bed-bound and ~41,000 home-bound. Yet less than 2% of Indians have access to structured home care.
Kerala’s legacy - and its limitations
Kerala pioneered community-based home care, but most services operate only between 10am and 4pm - leaving patients without support during evenings, nights, weekends, and emergencies. The gap calls for round-the-clock, home-centred care.
Less than 2% of Indians have access to structured home care. Arike is changing that, one home at a time.
24/7, home-based, community-owned care.
The Arike model responds to these realities directly: round-the-clock home care coordinated through a central control room, a free care model that denies no one for cost, community ownership through trained neighbourhood volunteers, and a multidisciplinary team supported by technology. In 2025, this approach is estimated to have helped families avoid ₹13.01 crore in hospitalisation costs while keeping patients at home, with dignity.