People now live longer than they used to. Together with delayed mortality comes increased morbidity: that is, there will be an ever-growing number of old people with health problems who are unable, to different degrees, to care for themselves. We have been seeing this trend for some years. In the not-so-distant past, the joint family was the dominant form of household organisation. It had the ‘human resources’ to care for the old. A woman and her daughters-in-law would see to the running of the household, and children could be called upon to help.

The norm today is the nuclear family in which there is little cushioning. There are few hands to begin with; and no person has much time to spare, given that all adults are generally engaged in income-earning work while the young must struggle to prepare for life in a competitive world.

The less a person can do for oneself, the more one needs a carer. Those who can do nothing for themselves need full-time carers. In a middle-class household, the carer is generally someone employed for the purpose; for no member of the family can afford to do anything but care for the aged person. A parallel is the ayah employed to look after an infant. The difference is that infants are not chronically ill or enfeebled; and their condition does not deteriorate.

Unless the person so employed is a trained nurse or is at any rate literate, at least one responsible member of the family must devote time to the care of the old person. In addition, because the person employed cannot usually be counted upon to deal even with minor emergencies, one responsible member of the family is tied down.

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