Explained: Keralam bill proposes first-of-its-kind framework to regulate elderly care

The Keralam government on Tuesday (October 13) presented the Keralam Senior Citizens (Care and Protection of Rights) Bill, 2026, in the Legislative Assembly. If passed, it would establish a framework to regulate elderly-care facilities and services, with mandatory registration of care centres and caregivers, prescribed standards and penalties for violations.

Keralam was among the first states to introduce an elderly care policy in 2006. It updated the policy in 2013 and released a new draft State Policy for Elder Persons in August 2025, proposing a comprehensive response to the needs of its rapidly ageing population. The state also enacted the Kerala State Senior Citizens Commission Act, 2025, and has a separate department dedicated to senior citizens’ welfare.

Keralam is experiencing one of the fastest demographic transitions in the country, with falling birth rates and mortality rates contributing to a growing elderly population. According to the International Institute of Migration and Development, people aged 60 and above accounted for 12.7% of the state’s population in 2011, rising to 15% in 2021. This share is projected to reach 30% by 2051, and the elderly population is expected to outnumber children by 2030.

Here are the key provisions of the Bill:

Ageing in place

A major highlight of the Bill is “ageing in place”, which recognises a senior citizen’s ability to live safely and independently at home or in their chosen community, regardless of income or ability. The Bill seeks to enable senior citizens to remain in their own homes, with family members or legal heirs expected to provide the necessary care. Institutional care is envisaged as a last resort.

Recognition of living wills

A living will sets out a senior citizen’s preferences for medical care if they become unable to communicate their wishes. It may specify preferences regarding intensive-care admission, invasive tubes and other life-sustaining medical interventions.

A senior citizen can execute a living will in the presence of the chairperson of the District Level Senior Citizen Protection Forum or the District Level Senior Citizen Protection Unit.

The responsibility for facilitating its execution will rest with the senior citizen care centre, legal heir or relative.

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The will must be kept in the safe custody of the care centre, relative or family member, with a copy provided to the relevant district-level authority and the local civic body.

Rights, services and a senior-friendly environment

The Bill extends the concept of care and welfare beyond food, clothing, shelter and medical treatment to social services, recreation, and participation in spiritual, social and cultural activities. It emphasises comfort and dignified living, particularly for senior citizens who are incapacitated or have disabilities.

The Bill seeks to make home care, day care, assisted living, hospice care and emergency medical assistance affordable, accessible and non-discriminatory. It prioritises vulnerable older women, including widows, abandoned persons, persons with disabilities, survivors of violence, and homeless or destitute women. Proposed measures to make public spaces senior-friendly include ramps, priority seating and queues, and accessible washrooms.

Broader protection against abuse, exploitation and cyber fraud

The definition of abuse includes physical, emotional, psychological, verbal, sexual and economic abuse, as well as coercive control, breach of trust, and deprivation of essential goods and services. Exploitation includes the illegal, unauthorised or fraudulent use of a senior citizen’s resources, identity, goodwill, reputation or property, including financial exploitation.

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The Bill defines “cyber fraud” as any act carried out wholly or partly through electronic, digital, online or other technological means to harm a senior citizen. This includes online banking or financial fraud, identity theft, and the use of AI-generated content to deceive or defraud them.

The provision is intended to facilitate coordination and support for victims. It does not create any new offence, investigative power or procedure inconsistent with the Information Technology Act, 2000. Prosecution under that Act or the Bharatiya Nyaya Sanhita, 2023, remains unaffected.

Regulation of care centres and caregivers

The Bill provides for the regulation of care centres, retirement homes, hospices, agencies and caregiver-training centres. These institutions will have to meet prescribed standards, provide opportunities for social and recreational activities, and protect residents from abuse and exploitation.

Registration will be mandatory for all categories of elder-care centres. The Director, Department of Senior Citizens, will serve as the registrar. Caregivers must register with the State Senior Citizens Protection Unit. A public register will list each certified caregiver’s name, registration number, certification category, validity and current status. The Bill also provides for caregivers’ rights to fair pay, safe working conditions and social security.

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The Bill proposes a Keralam Geriatric Care Certification Framework to establish graded certification for caregivers. The framework will specify a training curriculum and require background verification, including mandatory police clearance for caregivers deployed in senior citizen care centres or providing live-in care to a senior citizen living alone. Caregivers will also undergo refresher training every three years.

Protection mechanisms and funding

The Bill proposes a State Senior Citizen Protection Unit, District Level Senior Citizen Protection Forums, District Level Senior Citizen Protection Units, a registrar for care-centre registration, and police nodal officers for senior citizens at police-station, district and state levels.

District-level units will handle complaints, investigate the conduct of care centres, inspect facilities and take appropriate action.

The Bill also proposes a State Reserve Fund for senior citizens’ welfare, financed through government grants, local bodies, fees, fines, corporate social responsibility funds and donations. The fund will be used exclusively for senior citizens’ care, welfare, protection and social security.

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It also allows residents of senior citizen care centres to voluntarily donate property, bank funds or other income to the centre, the State Reserve Fund or another party.

Penalties for violations

Operating an unregistered care centre can attract imprisonment of up to one year, a fine of up to Rs 25,000, or both. Obstructing the implementation of the law can result in imprisonment of up to two years and a fine of up to Rs 25,000.

Illegal possession of a resident’s property, abuse or cruelty, and abandonment can each attract imprisonment of up to three years and a fine of up to Rs 50,000. Failure to report suspected abuse when required can attract a fine of up to Rs 10,000. Offences under the Bill are cognizable and bailable.