In the quiet corners of Indian households, a silent storm is brewing—not from loud arguments, but from misunderstood silences, forgotten conversations, and sudden changes in behavior. Over the past few days, I have met several middle-aged individuals struggling with a distressing reality: their once-loving parents or in-laws are no longer the same. And this change is not about their body but in their general behavior.
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These older adults are not inherently difficult or intentionally hurtful—they have simply changed. Their words once appeared to be a guiding pathway full of wisdom but now feel like a sting. Their actions once felt like nurturing the entire family but now feel intrusive or erratic. A closer look reveals a painful truth: many of these older adults are battling psychological issues that neither they nor their families recognize.
In our culture, where older adults are revered as the emotional anchors of the home, it becomes especially difficult to reconcile these changes. And you know what the result is? It’s confusion, emotional burnout, and eventually a heartbreaking distance. We don’t want to push them away—in fact, we ache for the connection we once had. But when understanding fades, conflict grows.
This article is my attempt to bridge that emotional gap amongst the older adults and other family members. To shine a compassionate light on the mental health challenges that quietly reshape the behavior of our older adults—challenges that are often mistaken for stubbornness, negativity, or control. If even a few of us can begin to see these changes not as faults but as signs of suffering, perhaps we can prevent a family from falling apart—or at least bring back a little more patience, empathy, and healing into our homes.
Common Mental Health Issues in the Older Adults that Impact Family Relationships (Indian Context)
As our older adults age, they often face invisible battles within their minds—battles that manifest not through wounds or visible illness, but through confusion, mood swings, withdrawal, or even aggression. Many times, families misinterpret these behaviors as deliberate or difficult, not realizing that there might be a deeper psychological struggle behind them.
Here are some common mental health conditions that silently affect elderly individuals and often become the hidden roots of family conflict:
1. Depression in the Older Adults
The symptoms of depression in older adults are withdrawal from family, lack of interest in the activities they once used to enjoy, irritability in their general behavior, sleep disturbances, and sometimes unexplained aches at body level.
These changes are so subtle that many times other family members may see this as laziness, complaining behavior, disinterest in making social bonds with their surroundings, or even lack of concern about family issues, which further leads to distance and communication gaps.
I am citing a known example where a widowed mother who was left alone at home during the day due to a dual-working family structure stopped engaging in family functions. The daughter-in-law feels unappreciated and sees this behavior as arrogance, without even realizing that her mother is battling silent grief and depression.
2. Dementia (including Alzheimer’s disease)
The symptoms of dementia are forgetfulness, repeated questions, cognitive disorientation like confusion about time/place/persons, misplaced objects, and personality changes.
These behavioral traits lead to frustration and tension in the family, especially if undiagnosed. Loved ones may assume older adults are being careless or stubborn. For example, in a joint family, the grandfather keeps accusing the housemaid of stealing misplaced objects—not out of malice, but due to the early-stage dementia. The other family members start resenting them for creating “unnecessary drama.”
3. Anxiety in the Older Adults
The symptoms of anxiety in older adults are constant worrying (about health, money, property or about children’s future), restlessness or inability to relax, doing repeated phone calls, etc.
This change in behavior of older adults is often perceived as controlling, nagging, over-involvement, or unnecessary interference, causing tensions between generations. For example, a grandfather constantly calls his son at work, worrying that his grandson has not yet arrived from school even when there is no significant delay in the arrival of the school bus. This phenomenon is not to irritate, but because of growing anxiety issues.
4. Paranoia and Delusional Disorders
These are very common mental health conditions found amongst older adults in India. The symptoms of paranoia and delusional disorder are suspicion of family members and irrational jealousy or mistrust of near relatives, causing a false belief that others are plotting against them.
This behavior on a daily basis creates conflict amongst family members or near relatives. This eventually creates emotional distance and feelings of mistrust within the household. For example, a mother-in-law often suspects her daughter-in-law of trying to poison her food or creating family chaos by blaming her in front of others. In this case, what seems like hostility may stem from late-onset Paranoia, and the act is driven by fear, not out of hatred.
5. Loss of Control and Identity Crisis
These are the most common mental health conditions found in older adults. Their behavior becomes dominating; they show rigid thinking and strong resilience to change or deny/criticize modern practices.
This behavior leads to generational clashes and power struggles, especially when the younger family members seek independence or challenge existing family rituals and social traditions. For example, in patriarchal families, the father figure struggles to adjust to his post-retirement role, resulting in conflict over decision-making.
Recognizing the Early Signs: How Families Can Respond with Empathy, Not with Conflict
Understanding the root cause of behavioral change in an older adult is the first step to prevent emotional burnout and conflict in Indian households. Often, these changes are subtle and build up over time—but families can learn to spot them early with sensitivity and awareness.
There are some key emotional and behavioral signs that might indicate a psychological concern, rather than mere “difficult behavior.” Let’s understand these signs:
🧠 1. Repeating the Same Story or Question
We often find that older adults tend to repeat their stories or questions. Initially we ignore these changes and tag them as an old age behavioral trait. However, we start getting frustrated and start avoiding conversations with older adults lately.
The nature of repeating the same question again and again or a story, might be a sign of early cognitive decline or dementia. In such a situation, with better awareness, we must empathize and calmly answer again while gently observing the patterns. We should avoid saying, “You just said that a few minutes ago. Are you even listening to yourself?”
😞 2. Persistent Negativity or Complaining
Many a time we have seen our older adults become complainers and constantly talk negatively. These negative emotions may be the outcome of loneliness, hidden depression, or low self-worth.
We may not be initially aware of these signs, and we usually respond saying, “You are always negative, and nothing makes you happy.” Instead, we can respond, saying, “I have noticed you don’t feel like yourself lately. Should we talk to someone together?” It makes an emotional connection with them, and they might open up and convey what they are going through emotionally.
🕰️ 3. Confusion about Time, Place, or People
Cognitive impairment in older adults makes them behave confused about time, place, or people. This may be the sign of Dementia or Alzheimer’s. We should not complain about their forgetfulness; instead, we should gently reintroduce the person/situation without scolding. In such a scenario, frequent confrontations with older adults may make them feel disappointed, and they may feel unheard within the family.
📞 4. Excessive Worrying or Calling Repeatedly
Excessive worrying might be the outcome of anxiety or fear of abandonment. We should not scold them or say, “Stop calling me every 10 minutes! Don’t disturb me; I am at work!” Instead, we can reassure their insecurity by setting fixed check-in times or making them informed about unscheduled movements. Consulting a doctor or a mental health professional is always a better stance if anxiety worsens.
🤐 5. Sudden Social Withdrawal or Refusal to Engage
It is a known fact that with age our body and mind deteriorate due to biological functions. Sudden social withdrawal or refusal to engage in activities (earlier used to enjoy) might be signs of depression or early mental deterioration. Mostly we respond to them saying, “Why are you acting like a stranger in your own house?” Instead, we can spend small but consistent quality time with them. We can encourage open conversation without judgement.
🏥 Mental Health Support Systems for the Elderly in India: A Lifeline We Often Overlook
While awareness around mental health is slowly growing in India, geriatric mental health remains one of the most under-discussed and under-served areas—especially in small towns and traditional families. However, there are resources and systems available, and knowing about them can make all the difference in caring for our elderly loved ones with dignity and understanding.
Here’s an overview of the support systems that Indian families can explore:
🧑⚕️ 1. Geriatric Mental Health Clinics and Services
Major government and private hospitals like AIIMS (Delhi), NIMHANS (Bengaluru), and PGIMER (Chandigarh) have specialized departments of geriatric care. They provide cognitive assessments, psychiatric evaluations, memory clinics, counseling, and family therapy required to address mental health issues of the elderly. A proper diagnosis can prevent years of misunderstanding and distress at home.
📞 2. Mental Health Help-lines for the Older Adults
There are help-lines available across India which provide free counseling, crisis intervention, and emotional support — anonymously. Few help-lines are listed with currently available numbers as found on their websites:
- Helpage India: 1800-180-1253
- iCall (TISS): 9152987821
- Sumaitri (Delhi-based emotional support): 011-46018404
If your elder is hesitant to visit a clinic, these help-lines can be a gentle first step.
🧓🏽 3. NGOs that Support Senior Citizens
There are NGOs which provide daycare centers for elders with dementia, home visits by trained professionals, counseling, and social support. Few of them are listed here:
Their services reduce caregiver burden and bring structured emotional care into the lives of elders.
📚 4. Free Government Schemes with Mental Health Coverage
- National Programme for Health Care of the Elderly (NPHCE) under the Ministry of Health and Family Welfare, Offers physical and mental healthcare at district hospitals.
- Mental Healthcare Act (2017): Thee act recognizes the rights of elderly individuals to mental healthcare without discrimination.
Families may visit their local district hospital or Ayushman Bharat wellness center for check-ups and referrals.
💻 5. Online Counseling Platforms
MindPeers, YourDOST, BetterLYF etc are some trusted names in the field of mental health support, counseling and therapy services. They offer services suited to elderly mental health, especially for urban families.
Families may help elders navigate simple tech setups so they can engage in Tele-counseling or online counseling with ease — many of the centers offer vernacular language options also.
🙌 Family’s Role in Accessing Support
In India, older adults may resist help due to stigma related to mental health issues. The caregivers should take guidance from professionals and introduce services gently and respectfully. Family member may offer to go with them for the first consultation. Families may also create a supportive home environment where therapy or treatment is normalized and not ridiculed.
🌏 Cultural Shifts and Emotional Costs: Why Understanding Mental Health of Older Adults is a Social Responsibility
In Indian culture, we have always revered our elders — touching their feet for blessings, quoting their wisdom and calling them the “pillars of the family.” But somewhere in the rush of modern life and changing family dynamics; that pillars have begun to crumble. And it’s not because love for our elderly has faded, but because we are unprepared to face what aging truly brings — especially to the mind.
The truth is: mental health challenges in old age are not signs of weakness or failure. Its natural — biological processes compounded by isolation, physical decline, and emotional loss due to cognitive decline.
⚠️ The Emotional Cost?
When we do not address these issues of older adults:
- Family bonds start to deteriorate.
- Middle-aged caregivers experience burn out, emotionally and physically.
- Elders feel unheard, helpless and become isolated.
- And generations grow apart — not out of choice, but due to misunderstanding and lack of required communication.
🧭 The Cultural Shift We Need:
- From Judging to Understanding: We should not assume or judge what’s happening around with them, instead — we should ask, observe and learn behavior pattern of elders and our own response towards them.
- From Endurance to Empathy: We should not just tolerate the behavioral changes of our older adults but we should consciously engage with them compassionately. There is a limit of tolerating anything. It is seen that too much tolerance without concious awareness about household conflicts, creates anger issues among caregivers. It further leads to severe family conflicts.
- From Silence to Support: Last but not the least; let — therapy, counseling, and elder care become as normalized as school, work, or parenting.
In Indian society, where family is everything, we must evolve our definition of care. It’s no longer enough to provide food, medicine, and shelter. We must also acknowledge the invisible wounds that mental health issues bring to our older adults — and stand by them with the same devotion they once gave us.
🙏 Conclusion: A Small Step toward Big Change
If even a few families begin to pause, observe, and act with awareness — the ripple effect could be immense. This article isn’t about blame. It’s about recognition, reconnection, and repair of our bond with elders.
Our elders are not just aging — they are changing. Let’s not walk away from them in confusion or frustration. Let’s walk toward them — with understanding.
You can also read my article on “Aging Gracefully” to know more about successful aging with science-backed tips, positive psychology, and lifestyle habits for happiness, longevity, and meaningful living.