On June 15, when the world observed Elder Abuse Awareness Day, Kerala gave India a timely reason to think harder about ageing. The state’s decision to launch a separate department for senior citizens’ welfare was more than a bureaucratic announcement. It was a recognition that older adults need more than pensions and healthcare schemes. They also need protection, visibility and a system that can respond when things go wrong.
The timing is significant. Kerala has one of India’s fastest-ageing populations and is often seen as a preview of the country’s demographic future.
The state recognises that beyond disease, the most common threats to older people come from neglect, coercion, humiliation, financial exploitation and social isolation. Elder abuse rarely begins with violence. It may begin with a delayed medical visit, restricted access to money, repeated insults, pressure to transfer property, or the quiet withdrawal of care. It often happens where trust is expected most: inside families.
A few years ago, an 82-year-old retired schoolteacher was brought to a clinic by a neighbour. Her son lived abroad. Her daughter called every Sunday. On paper, she was well cared for. Money came regularly. Medicines were bought. A caregiver visited daily. Yet she had lost weight, stopped bathing regularly and was storing stale food in her refrigerator. Only after repeated conversations did she reveal that the caregiver routinely shouted at her and withheld help unless paid extra. She had never complained because she feared being abandoned. Her situation improved only after the neighbour intervened, the caregiver was replaced and her children arranged a local care plan. The lesson was simple: abuse is often detected first by someone who notices.
India is not without legal safeguards. The Maintenance and Welfare of Parents and Senior Citizens Act, 2007 provides a mechanism for maintenance and protection of property. The national helpline for senior citizens—Elderline 14567—offers support and intervention. Yet much of the abuse remains underreported. Many older adults do not want to file complaints against family members. Others fear retaliation, abandonment or social stigma. A purely legal response is, therefore, often too late.
This is where Kerala’s move could make a genuine difference. Its main value will lie in creating a coordinated response system. Countries such as Singapore and Australia have increasingly integrated healthcare, social services and community reporting mechanisms to identify vulnerable older adults before crises occur. Kerala can adapt similar principles to local realities.
For example, a primary-care doctor noticing repeated unexplained weight loss, a bank employee observing unusual withdrawals, a community nurse seeing untreated pressure sores, or a police officer responding to repeated domestic complaints should all know when and how to trigger support. A dedicated department can develop standard protocols, maintain verified caregiver registries, strengthen district-level response teams, coordinate home visits and support families dealing with dementia, disability and caregiver stress. As per Kerala’s Chief Minister V D Satheesan, this new department will first examine the similar model in Japan and then conduct a comprehensive state-wide study to refine its functioning.
Another equally familiar scenario. A 76-year-old widower began visiting his bank every few weeks to withdraw unusually large sums of money. He looked anxious. He avoided eye contact. He kept saying he was acting voluntarily. A bank employee noticed that his son answered most questions on his behalf. Later, during a medical visit, it emerged that the father had been pressured to transfer part of his house. There was no physical violence. No police complaint. Yet the abuse was real.
What changed the situation was not one dramatic intervention. The bank delayed the transaction. The doctor documented concerns. A local senior citizens’ cell became involved. A family meeting followed. The father eventually retained control of his property and moved temporarily to his daughter’s home. The outcome could have been very different.
Cases like these show why elder abuse cannot remain a private family matter. Older people may not always say, “I am being abused.” They may say, “I am tired.” Or, “I am afraid.” Or simply, “Please don’t tell anyone I spoke to you.”
But prevention starts even earlier. It starts with how society views ageing. Ageism remains one of the least discussed drivers of elder abuse. When older people are seen as burdensome, stubborn or “past their time”, neglect becomes easier to justify.
That is why awareness cannot begin only in old age. It must begin in schools and colleges. Canada, Japan and Australia have introduced intergenerational programmes where students volunteer with older adults, document their life stories or participate in community projects together. Such initiatives do more than reduce prejudice. They remind younger people that ageing is not somebody else’s future. It is their own.
Kerala’s new department offers an opportunity to move the conversation beyond welfare. The real measure of success will not be the number of schemes announced. It will be whether an older person in distress knows whom to call, is believed when they speak and receives help before harm becomes irreversible.
Elder abuse prevention needs laws, effective helplines, trained professionals and responsive institutions. But above all, it needs a collective refusal to look away. Ageing should not become a private punishment. It should remain a shared social responsibility.
Dr Debanjan Banerjee | Consultant geriatric psychiatrist
(Views are personal)