High-Quality Eldercare For Families In India

In this series, Sramana Mitra shares chapters from her book Vision India 2020, that outlines 45 interesting ideas for start-up companies with the potential to become billion-dollar enterprises. These articles are written as business fiction, as if we’re in 2020, reflecting back on building these businesses over the previous decade. We hope to spark ideas for building successful start-ups of your own.

The number of millionaires rose faster in India than anywhere else in the world in 2007 – up 22.7% to 123,000 people. Today, in 2020, the number stands at an astonishing 1.23 million. It is this segment that we focused on for our venture, Care.

Simply put, Care was founded to offer a reliable, trained pool of in-home caregivers to address the needs of families with elderly, as well as patients with cancer, Parkinson’s, Alzheimer’s, stroke victims, or mental illnesses such as bipolar disorder, schizophrenia, depression, and myriad other illnesses that require some form of assisted living.

Some statistics would help us frame the problem. There were an estimated 2.5 million identified cases of cancer in India in 2007, let alone those that were not diagnosed. Mental illness was estimated to afflict 65 per 1,000 people, translating to nearly 70 million patients. However, there was only one trained psychiatrist for every 100,000 patients with mental illness. In addition, about 77 million elderly people needed to be looked after. All told, we were looking at a market of hundreds of millions of families that needed care.

Having experienced American society firsthand – an isolated, individualistic society, long on achievement, short on compassion – I believed that as India continued to develop, it would face certain choices about how to address the issue of caring for its non- producing citizens. It is a long, complex subject, and by no means did I have any illusion that Care could solve the entire problem. However, we felt that by training 100,000 women who were otherwise left out of the workforce to provide nursing and in-home care, we could achieve two things: (a) help a segment of the population with means to care for their in-need family members, and (b) train and create jobs for a large number of women who were otherwise unemployable.

In my parents’ household in India, we employed a woman, Jaya Chatterji, to look after my grandmother. She was not educated; in fact, she could not even read or write. But she was kind and competent, had excellent eldercare training, was compatible with our family, and she quickly became a member of the household while caring for my grandmother through her advanced years. It was women like Jaya that I felt could become the cornerstone of Care, providing affluent Indian families high-quality care for their elderly, mentally ill, and otherwise afflicted family members.

In our hiring, we collaborated with the best NGOs in India, many of whom worked with abused and battered women, helping them leave their husbands and become self- sufficient. Our Care venture became one of the ways these women could find a livelihood and self-esteem through training and job placement. It was also important that these women were living at homes, where the dynamic of being part of a family was key to their rehabilitation.

Initially, we piloted the service with just 10 women from Maitreyi, an NGO in Mumbai, and trained them specifically in Alzheimer’s care. We then placed a classified ad in the Mumbai edition of the Times of India, from which we received a few hundred queries from interested families looking for in-home, trained Alzheimer’s care. The 10 women we had on hand were immediately scooped up – each with 20-plus offers to find within their preferred family situation. One of them, Asha Nagarkar, had a three-year-old daughter, who would, of course, need to move with her. Only three of the 20 families were open to this arrangement. So Asha chose a family in Andheri because they too had a daughter, Radha, around the same age, and the two girls first became playmates, then best

friends.
It was a perfect win-win formula. And the families, as we explained our double-

bottom line mission, understood that. As Asha and her nine colleagues found employment, we rapidly recruited another 100 women, training them in Alzheimer’s care as well. By the end of 2010, we had 500 women placed in various affluent households in Mumbai, caring for Alzheimer’s patients.

Gradually, we expanded the training to Parkinson’s, bipolar disorder, schizophrenia, cancer, and other illnesses. And our NGO partnerships also expanded, alongside our advances into other Indian cities.

The stories of Asha and her colleagues spread quickly through NGO circles, and more and more women sought work with Care. The stories also became widely known in the affluent societies of major Indian cities. Asha’s employers, Arun and Sudha Mehta, became great patrons of Care, and they helped us gain visibility out of pure goodwill.

Arun Mehta, in fact, ran a PR agency, and he knew numerous journalists in Mumbai. Soon, Asha Nagarkar of Care became a well-known name, representing the cause of Alzheimer’s patients in India. We started getting phone calls from people looking for someone like Asha Nagarkar to care for their father, their mother, their aunt.

By 2020, our revenue stands at $1.65 billion, with a 20% operating margin. Not bad for being built on word of mouth, for being built on the recommendations of those families we’ve been fortunate enough to help. Together we’ve made Care an integral part of affluent India’s formula for caregiving. And in doing so, we’ve placed more than 350,000 women, some with children, in families and homes where their skills were direly needed and openly appreciated.

Photo credit: Harsha K R/Flickr.com.