“Vriddha Mitra” – ”Friends of Older People”: Advancing Community-based Care for Vulnerable Older Adults through Aging in Place

Background: As populations age, India is projected to have 20% of its population aged 60+ by the year 2050, with much higher vulnerability tied to socioeconomic and access barriers. Traditional institutional elder care is neither scalable nor accessible in urban slum and peri-urban communities. There is thus a pressing need for community-centered models that support aging in place. Objective: To document the evolution, implementation, and core components of Vriddha Mitra – a community-based mechanism mobilizing local caregivers as “Friends of Older People” – designed to deliver holistic, home-based essential care to vulnerable older adults in India. Intervention: Piloted in two Pune slum communities in 2019, Vriddha Mitra expanded across eight cities and rural geographies between 2020 and 2025, currently reaching nearly 50,000 older adults. It focuses on training local youth and creating a cadre of “Vriddha Mitras” – Community Officers that provide individualized care based on the World Health Organization’s six domains of quality of life, assessed through the Saving Life Checklist (SLC) and implemented via tailored Individual Care Plans (ICPs). Each Community Officer manages a cohort of ~300–400 older adults, classified by care intensity. Services include home health visits, social protection linkages, facilitation for social security and insurance, physiotherapy, and referrals. Outcomes and Learning: Program scalability was accelerated during COVID-19 through microplanning and stakeholder partnerships across urban local governments. The model demonstrated feasibility and community acceptance at scale, even during public health crises. Its modular care framework facilitates replication across geographies. Key enablers include structured caregiver training, multi-sectoral collaboration, use of simple tools (SLC and ICP), and integration into existing municipal infrastructure. Conclusion: Vriddha Mitra exemplifies a scalable, community-based mechanism that enables aging in place and creates an age-friendly ecosystem. Its implementation across diverse urban and rural contexts provides valuable insights for policymakers and practitioners pursuing inclusive models of elder care in the resource-constrained environments.