The Business of Care

After losing her husband to the second wave of Covid-19, Noida-based Veena Oberoi now lives all by herself. She has one daughter who is married and a son who is well-settled abroad. Like Oberoi, there are over 15 million elderlies who live alone, constituting nearly 10% of the total elderly population in the country. This is because either they have no family or because their children are overseas.

Over 15 million elderlies In India live alone, constituting nearly 10% of the total elderly population in the country

To address this need of senior citizens of loneliness, Shantanu Naidu launched a startup named Goodfellows. The startup has seen investment by the likes of Ratan Tata and Niranjan Hiranandani. A subscription-based service, Goodfellows, offers a one-month free trial. “We feel our customers should convert to subscription only if they find value. Another important aspect is to involve existing family members (sons and daughters) in the process to keep everyone in the loop in terms of happenings. But it all boils down to the 7 level vetting process we have before selecting truly empathetic candidates before bringing them on for a probationary period and then finally inducting them. This keeps our recruitment conversion rate as low as 2-3%.”

But isn’t gaining the trust of senior citizens a challenge? “It is. However, we have spent almost a year breaking into this demographic by earning their trust not just through what we offer, but also how we offer it. For example, every single interaction we have from getting a call to closing a subscription is carried out in person, face to face, with the goodfellows themselves,” says Shantanu Naidu, Founder, GoodFellows. Naidu tells us that the response has been overwhelming so far and has waitlists for cities it has entered in as well as cities we haven’t expanded to.

EXISTING STARTUPS NOT ENOUGH
Goodfellows isn’t the lone startup in the eldercare space. According to Tracxn, a market intelligence platform, there are over 70 startups that are in existence. But they are not enough, according to industry experts. This is because this segment of population is growing faster than the total population. Data holds the evidence. While the general population has grown by 18 per cent in 2001-11 and 12.4 percent in 2011-21, the elderly population has grown by 36 per cent each in the two decades. Back in 1961, only 5.6% of the population were 60 years or older. Forty years later, in 2021, it doubled to 10.1%, according to the ‘Elderly in India 2021’ report released last year by the Social Statistics Division of the National Statistical Office, Ministry of Statistics and Programme Implementation. Of the 138 million elderly persons in India, there are 71 million female elderlies vis-a-vis 67 million male ones.

The firms in the eldercare space are broadly categorised in four buckets-senior living (real estate focused), manpower focused – helping getting attendants / nurses etc., care homes (specialized care like dementia homes) and. ageing in place – helping with various services to elders so that they can stay at home and enjoy this phase of life.

Firm like Silver Talkies have community platforms for older adults. Founded in 2014 by Nidhi Chawla and Reshmi Chakraborty, Silver Talkies aims at a target segment of 55+. Through the platform (delivered via a web platform and mobile application), adults connect with each other over various classes and workshops, sing and dance together, learn new art forms, languages etc., and also share their skills and expertise with other members.. It also has a digital magazine that covers various aspects of ageing and also features many positive ageing stories.
“Back when we started there were hardly any players in the eldercare space, many of them being in the unorganised sector. Over time we saw many companies with interesting concepts come and go. Concepts like companionship, second careers and engagement continued to be unheard of. But the landscape has been evolving and hopefully shifting for the better.,” says Nidhi Chawla, Co-founder, Silver Talkies.

“We understand that with each decade of ageing physical and mental health take dominance in an older adult’s life. For a country that is ageing so rapidly we are highly ill-equipped to take care of our elderly,” adds Chawla.

Emoha Elder Care is another startup in this space which offers a one-stop platform for all elder needs. The platform offers elders and their families access to benefits that can help them age in the comfort of their own homes. “In 2010 when I had started JLL’s Alternate Assets practice helping develop senior living across India, there were only about 5-7 major players in India. The sector was considered akin to only old age homes and most investors or stakeholder would look down upon the opportunity.” says Saumyajit Roy. Co-Founder & CEO, Emoha Elder Care.

Startups in Eldercare Space

*This is not an exhaustive list

CHALLENGES

Eldercare space is not without challenges. Of the total startups that existed in this space, 20 are now deadpooled. Says Naidu, “Eldercare is an incredible market to get into, but it has so many nuances attached to the demographic that startups in this space have not taken the time to learn. The same digital offerings and products and channels of go-to-market do not apply for this demographic which is largely technology averse and dependent on traditional ways of decision-making. But with this demographic, all consumer decisions are based on a single question: In this stage of life does it add true value in my life.”

“And value for this age group is not as broad as for other markets, understandably with limited spending power. We see a lot of technology startups in this space for a demographic that shies away from technology. What is needed instead is services that make life easier, in its offerings as well as in the method of offerings,” adds Naidu.

Concurs Vaibhav Tewari, Co-Founder and CEO, Portea Medical (In-home medical care provider that also provides exclusive healthcare service for people above 65 years of age), “The elderlies are not very tech savvy and this has two repercussions. One, startups find it difficult to come up with tech-enabled solutions. Second, since the elderly are technologically challenged, they may not be keen to invest in such offerings. Therefore, any new eldercare offering or startups must consider these two factors and create solutions accordingly. Also, the elder care space is still not regulated by any policy measures. An approach that focuses on more public-private partnerships is the need of the hour.”

Chawla, on the other hand, finds dependence on family support to be the main reason behind lower adoption of eldercare services. “There is some stigma in certain sections of the society whereby if an elder’s care is outsourced it means the younger folks are relegating their responsibilities. Scalable, tech-led and breeze to adopt solutions are still far and few,” says Chawla.

But what about awareness in this space? “The good part of the segment is that awareness for the category is now rapidly enhancing which will help several startups increase traction in their respective businesses.” adds Roy.

FUNDING
Unlike the US market where VCs poured over half a billion dollars in startups focused on eldercare and home health care last year, funding to Indian startups focusing on this space remains limited. While funding saw a continuous rise from 2016 to 2019, it dropped significantly thereafter. In 2020, startups attracted funds to the tune of merely $1.43 million, which is a significant drop from $9.59 mn raised in 2019. Of the total startups in this space, only 12 startups are funded, with just one raising series A funding. Another exception is Seniority, an eldercare startup and India’s largest geriatric-centric digital responsiplatform, which has been acquired by HCAH, a health tech company.

“One reason for this space not attracting funds might be the limited spending bandwidth of consumers. However, a problem is truly painful and if you are solving it and making their lives easier, they are absolutely willing to spend,” adds Naidu.

According to Chawla, there could be multi-fold reasons but what stands out is the mismatch in the expectation and time duration of return. “This space requires a long-term commitment as impact and results may take longer to reflect. Finding sustainable and viable business models could be another reason. Many start-ups are trying to follow the volume business model with free or heavily discounted offerings, hence compromising their sustainability. Short-term approaches with expectation of quick returns may not be possible for the start-ups or their investors. This sector is not for the faint-hearted,” says Chawla.

However, Tewari shares another perspective. “There might have only been a few new investments in startups catering to the eldercare segment. However, the overall interest in this space from existing players is witnessing an increase. This is because eldercare has multiple aspects to it including assisted living, homecare and chronic disease management. Further, the pandemic brought into light the huge numbers of elderly requiring care at home – both with regard to their age as well as associated health conditions. This led to an upswing in the number of assisted living facilities in the country. Homecare companies are also looking at new solutions for the elderly. Thus, the overall sentiment is positive and given how this sector is bringing value to the eldercare segment as well as the lives of the senior citizens, we are bullish about the investments in this segment in the times ahead.”

Roy agrees too, “I don’t see it this way. On the contrary we have seen the right kind of startups getting attention from HNI / family offices and funds. There is definitely caution in the air, but the interest in age tech today is very high with several investors watching this space very closely. The segment is new and as it is with any new sector, funds watch this segment. I am sure we will see 2023 as a major year with a significant number of startups witnessing funding rounds as the segment starts getting attention from mainstream funds.”

PUSH BY GOVERNMENT
The good news is that the needs of elderlies in the country is now being realised by the government too. In order to encourage the youth to find innovative solutions to help senior citizens, the government in June 2021 announced a project- Seniorcare Ageing Growth Engine (SAGE) to select, support and create a one-stop access point of elderly care products and services by credible startups. Elaborating on it, the secretary of the Department of Social Justice, R Subrahmanyam said the cause of the elderly has to be taken up at the national level and everybody has to come together for it.

“The sector is still an emerging sector as there are many milestones yet to be covered, both from the demand and supply side. A distant approach to problem solving for this sector is not a viable method. This target group requires empathy, compassion, high interaction and deep understanding,” adds Chawla