In the urban sprawl of Bengaluru, Hennur Road, towards the east of the city, has all the signs of an up-and-coming neighbourhood. Apartment complexes, in various stages of construction, jostle next to newly opened supermarkets. The road itself is being rebranded as the New Airport Road, offering an alternative route to the city’s airport in faraway Devanahalli.
Nestled just off this road is a grey and white building, where a bunch of elderly people, in the autumn of their lives, stay.
Many of them spend their days blissfully unaware of the hustle and bustle of the city some of them once helped build, talking to other seniors and caregivers, eating specially curated food, watching the tele, and at times, singing songs from their
youth.
This is KITES Senior Care’s dementia and Alzheimer’s care, a 50-bed facility, run by LifeBridge Senior Care founded by Rajagopal G, the group CEO, along with Reema N, the group’s COO.
LifeBridge is among a clutch of companies that are looking beyond the conventional narrative that India is a young country, and instead building businesses based on the realisation that India is also an ageing nation.
These include companies specialising in real estate for the older generations, those offering post-hospital care, palliative care, home care, and a cluster of companies that can be clubbed under the age-tech moniker.
It is in this context that Ranjan Pai, the chairman of the Manipal Education and Medical Group (MEMG), investing INR45 crore in LifeBridge assumes significance. Pai is among India’s most influential investors.
So, when he makes a move into senior care, it is time to sit up and take notice of the sector.
Pai’s Senior Strategy
Over the years, Pai, who according to Forbes is worth USD2.8 billion, has invested in the likes of Byju’s, PharmEasy, Firstcry, Bluestone, Purplle, and Meolaa. He was among the first to realise the business potential of combining education and technology before ed-tech became a buzzword, having invested in Byju’s at a time when education was the choice of impact investors, not venture capitalists.
While Byju’s may have had its ups and downs, Pai has become something of a white knight for troubled startups, swooping in to prop up both the ed-tech company and PharmEasy, when both were in trouble in recent months. Through his family office, he pumped in money at highly discounted valuations from their respective peaks.
All of this has made Pai a key name to watch out for in India’s venture capital investment
landscape.
Pai’s intent to invest in senior care looks astute for multiple reasons, one of which is the rise of the grey economy.
1. According to Niti Aayog, the elderly in India currently comprises a little over 10% of the population, translating to about 104 million, and is projected to reach 19.5% of the total population by 2050. That makes one in five Indians a potential customer for businesses targeting them.
2. Migration over the last few decades has propelled the rise of nuclear families, with individuals often relocating to different cities or countries. Consequently, elderly family members are increasingly living independently. This has highlighted the need for specialised products and services that help maintain their quality of life.
3. With rising affluence, both seniors who have stashed away savings, as well as their kids who are earning good money in their careers, have enough dough to invest in ensuring better quality of life. That means willingness to spend.
The senior care industry is already estimated at USD7 billion by the Niti Aayog, with the sector, covering both senior living and out-of-hospital senior care, expected to breach USD30 billion by 2030. That is a juicy market, waiting for smart entrepreneurs.
Ask Pai about it and he is clear about how he views it. “The thematic view here is about how India is ageing. As India moves from a 4 trillion dollar to a 20 trillion-dollar economy, the kind of problems they (seniors) will have will be in the same direction of what has happened in the West,” he says.
With little by way of solving these problems currently, Pai wants to move fast.
Combining Living and Care
One of Pai’s moves has been to mesh his latest investment in KITES with adjacent businesses. He has already facilitated the merger of Columbia Pacific Communities, a real-estate play aimed at seniors and a company Pai knows well having acquired parent company Columbia Pacific Investment’s hospital assets in India, with KITES Senior Care.
Nate McLemore, managing director of Columbia Pacific Investments, reckons that the integration of the two models – one dealing with senior living and the other with senior care – gives the combine a strong play that can offer a better quality of life
to the ageing.
Columbia Pacific currently manages over 1,750 residential units across south India, with plans to add a further 2,200 units over the next couple of years. The company is also likely to offer rentals, to add to its current sales-based senior-living offerings.
If that seems like small numbers, they are. It is akin to just scratching the surface. Retirement communities are a USD95 billion market in the US, with assisted living adding USD97 billion on top of that.
The demand for secure post-retirement life in India is only expected to grow, with the median age in India expected to rise from around 29 to 38 by 2050, according to a Colliers report. Similarly, the proportion of elderly people (those above 60) is projected to increase from approximately around 11% in 2024 to 21% in 2050.
According to a report from real-estate consultancy firm CBRE, key players in the senior living segment are Ashiana Housing, Covai Care, Columbia Pacific, Paranjape, Primus Life and Antara, who together contribute to around 40% of the total inventory in India. For senior care and assisted living, companies growing the market include Athulya Assisted Living and Kites Senior Care. Some players in the senior living segment also offer senior care as add-ons.
The audience for the kind of services being put together by Lifebridge and most such businesses tend to be the affluent. That is because these services do tend to be on the expensive side. For example, the monthly fees at the dementia care facility in Hennur are above INR50,000, with additional services adding up to that baseline.
While that makes such services the preserve of the privileged, there are enough people willing to pay the money, as evidenced by the high occupancy of the facilities that we visited.
Interestingly, the audience targeted by the two sides of the business – senior care and senior living – is different. As Rajagopal G points out, “When it comes to sickness management, most of the decisions are taken by the children and in 96% of our cases, children pay for it. On the retirement home side, there is a great amount of participation from the seniors themselves.”
Reema N says that the senior care part of the business will have three buckets – one specialising in transitional care, which is essentially post hospitalisation rehabilitation and recovery; palliative care; and dementia care.
The CBRE report also highlights that the senior care landscape in India is rapidly evolving, with 18,000 units across the country. The southern region, known for its favourable climate, improved connectivity, prominent healthcare providers, and a higher percentage of parents of NRIs, holds a market share of 62%. Most senior living projects are concentrated in the southern cities of Coimbatore, Bengaluru, and Chennai, which together contribute to approximately 40% of the nation’s total inventory.
Rise of the Age-Biz
The realisation that India is also an ageing society is slowly permeating into a broader ecosystem. This is certainly most apparent in the case of senior living where the likes of Ashiana Housing have been building a strong play for well over a decade.
The demand will only go up. As Reema N points out, a person who is at 60 right now could have as many as 30 or even forty years of his/her life left. That is a lifetime.
Startups too are taking notice of the opportunity, with specialised plays popping up along with buzzwords like age-tech.
Take the case of Ivory, a company that focuses on “early detection of neurodegenerative risks” and on providing “personalised brain-health solutions”. The co-founders of Ivory, Issac John and Rahul Krishnan, don’t come from a medical background, with the former leaving a marketing career and the latter a product-management career to take up entrepreneurship in age-tech.
Wearables are another area with significant potential. Reema N adds that KITES has been exploring the possibility of developing wearables that are specifically designed for seniors.
The Government’s Role
There is a need for the government to get a move on as well, and a good start would be a comprehensive senior care policy.
There have been welcome changes happening in bits. Previously, people over 65 could not buy new health-insurance policies. The Insurance Regulatory and Development Authority of India (IRDAI) removed this age limit starting April 1. This change aims to extend health benefits to the elderly, although premiums may increase every few years based on claims.
In February 2024, the Niti Aayog released a paper stressing the need for financial and social reforms to improve senior care in India. It also highlighted the importance of retraining the elderly, expanding the public-fund coverage, and encouraging savings for those who can afford it. It proposed increasing funds for the senior care industry, protecting the elderly from financial fraud, and enhancing digital inclusion through affordable devices and better digital literacy.
Currently, the government provides healthcare for the elderly through the National Programme for Health Care of the Elderly and the National Action Plan for Senior Citizens. However, there are no national provisions for old-age homes, and the benefits under various senior schemes are insufficient to keep up with rising costs.
There is only so much that private industry can do here. Most of what it does, like the companies Pai is investing in, is aimed at the more affluent part of India’s population. The real change for senior care in India will come when the government makes it a policy priority.