Leader of Opposition VD Satheesan has proposed creating a dedicated department for elderly welfare in Kerala, drawing inspiration from Japan’s comprehensive model. Japan, which has the highest proportion of elderly citizens (aged 60+) globally, offers valuable lessons in elder care.

The cornerstone of Japan’s elderly welfare system is a mandatory long-term care insurance program. Every citizen aged 40 and above must contribute a portion of their income to this insurance. Once they turn 65, they become eligible for coverage where the government pays 90% of their care costs, with the recipient paying only the remaining 10%. This coverage extends to any age-related health issues.

Japan also employs a structured home care system through professional caregivers who visit 10-12 homes daily. These caregivers assess the physical and mental health of elderly individuals, document their conditions, and coordinate with a medical team comprising doctors and nurses. The medical team then provides treatment at the patient’s home, preserving their familiar environment rather than moving them to hospitals.

Short-term stay facilities are available for elderly citizens when their primary caregivers need to travel. These government-funded facilities provide food, shelter, and medical care for 1-2 days. Additionally, day-care centers offer social engagement opportunities where 10-50 seniors can gather and participate in activities while receiving necessary medical attention.

A distinctive feature of Japan’s system is the use of robotics. Bedridden patients are provided with customized robotic assistants that enable mobility within the home, including access to bathrooms. For elderly individuals living alone after losing their spouse, humanoid robots capable of conversation and emotional interaction are provided to combat loneliness.

While the robotics aspect may be impractical for Kerala in the near term, many other components of Japan’s model already exist in the state. Kerala has numerous old-age homes under the Social Welfare Department and private operators. Many hospitals already provide home nursing and doctor visit services. The key advantage of creating a dedicated department would be the systematic coordination of these scattered services under a unified framework with a dedicated minister and hierarchical structure.

Kerala has a significant elderly population exceeding 20%, projected to reach one in four residents within five years. Previous governments have taken steps in this direction: the VS Achuthanandan government first discussed elderly welfare in 2007, district-level elderly councils were formed in 2008, the Vayomithram project launched under the Social Welfare Department in 2011, and in 2025, under Minister R Bindu, the state established India’s first commission for elderly welfare to address legal grievances and abuse cases.