State of the Nation: Global Perspectives
Series 3 / Episode 3
Episode 3: Bridging the Gap in Elder Care
In Episode 3 of State of Our Nation: Global Perspectives, Kari speaks with Mansur Dalal, a leading voice in senior living and care. Mansur is a speaker and author, the former Chair of Common Age, which brings together ageing organisations across the 56 countries of the Commonwealth, and the founder and Chairman Emeritus of the Association of Senior Living India.
From architecture to elder care
Mansur originally trained as an architect and spent over three decades in practice before developing one of the earliest senior living communities in Pune in the early 2000s.
At the time, there were no senior living homes in India.
Eventually, the pull of this work became impossible to balance alongside architecture so in 2011 he switched to focus full-time on elder care.
A cultural model under pressure
Mansur is clear that India has long been rooted in a strong ethic of family care. Joint families, shared homes, and intergenerational living were once the norm.
But that model is under strain.
Globalisation, urbanisation, and migration have reshaped family life. Children move cities or countries for work. Careers are more demanding. Even when families live close by, time has become scarce.
“The family duty is still there,” Mansur explains, “but it is not physically possible anymore.”
The numbers make this stark. India currently has 147 million seniors. Within two decades, that figure is expected to rise to 350 million. Yet across the entire country, there are just over 22,000 senior care beds.
“There is no ratio,” Mansur says plainly. “It doesn’t come.”
An infrastructure gap and a missing ministry
Unlike many countries with ageing populations, India does not have a dedicated ministry for senior care.
“We don’t even have a ministry for seniors,” Mansur notes. “And we have 147 million reasons to have one.”
Public provision is limited particularly outside urban centres. With around 70 percent of older people living in rural areas, the scale of need makes state-funded solutions alone unrealistic. For now, elder care in India is largely funded by individuals and families, delivered through independent and assisted living models that are still in early stages of development.
Mansur sees India as being on a similar trajectory to countries like the UK, but several decades behind. His hope is not to follow the same path step by step, but to leapfrog it.
Technology as a bridge, not a replacement
Mansur challenges the question of what technology can be implemented, reframing it instead as how technology can strengthen human connection. His own Alzheimer’s reminiscence therapy app ELD-AR grew directly from caring for his mother.
He describes moments where music unlocked recognition, posture, and ritual, even when other memories had faded. A familiar song prompted humming. A religious hymn prompted reverence, physical movement, and awareness.
“That’s when I realised there is still a connection happening in the brain.”
The app became a personal vault of memories, sounds, images, and rituals that caregivers could use to offer comfort and dignity, even if they had never known the person before. For Mansur, this is what good technology looks like. It supports relationships. It deepens empathy. It does not replace care.
Combating ageism and valuing experience
Mansur is explicit that ageism remains a barrier to progress globally. Assumptions that older people cannot adapt, learn, or engage with technology hold systems back.
He points out that many seniors are highly capable, technologically literate, and eager to remain involved. His grandfather completed a PhD at the age of 89 and continued lecturing until he was 94. Designing care systems that assume decline rather than contribution limits what is possible, both for individuals and communities.
Ethical migration and shared responsibility
As the conversation draws to a close, Mansur turns to one of the most complex global challenges in care: workforce shortages and the ethical migration of caregivers.
Caregivers should be trained, supported, and given opportunities to work internationally, but with systems in place that ensure skills and experience flow back to their home countries rather than draining them.
He shares a powerful example of caregivers who worked in the UK for over a decade, rose to leadership roles, then returned to India to establish a memory care home using the knowledge they had gained.
“That cycle can keep going,” Mansur says. “That is ethical migration.”
A shared global challenge
Throughout the episode, what stands out most is how closely Mansur’s reflections mirror debates happening in the UK and beyond. Different cultures, different systems, but strikingly similar pressures.
Ageing populations, stretched families, workforce shortages, fragmented systems, and the urgent need to move from crisis response to thoughtful, preventative care.
As Mansur reminds us, elder care is not a niche issue. It is a shared human one. How societies respond will shape not only how people age, but how they live.
Association of Senior Living India (ASLI)
https://www.asliindia.org
Common Age
https://www.commonage.org
ELD-AR (Mansur Dalal’s Alzheimer’s reminiscence therapy app)
https://www.eld-ar.com
Episode 3 of State of Our Nation: Global Perspectives is out now.
You can find the series on Spotify or listen to each episode on our website. Just click on the link to the right.
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