For families in Mumbai, a dementia diagnosis can answer what is happening without answering the more difficult question of how care will be organised. The city has specialists who can identify cognitive impairment, a dedicated government Memory Clinic at King Edward Memorial Hospital and some non-government support. Yet the services required after diagnosis remain difficult to find in one place, close to home and at a cost that ordinary households can manage. That gap turns dementia from a medical condition into an urban access problem.
The experience of Itishree’s family illustrates the transition. Her husband’s 87-year-old grandmother was brought to Mumbai after a fall in 2024. The injury initially drew attention, while other changes — delayed responses, a fixed gaze and occasionally unfamiliar names — were harder to recognise as part of a pattern. Medical advice eventually led to a dementia diagnosis. The family then had to find trained help for someone who required continuing attention, supervision and adaptation in daily life.
The family’s difficulty was not simply a lack of information about the condition. It was a shortage of care arrangements capable of translating a diagnosis into everyday support. They looked for full-time assistance through an agency but could not find people trained to care for a person with dementia. After about a month in Mumbai, they moved their relative to Kerala, where more family members could interact with her in a familiar language and where she could have greater social contact.
That decision reveals one of the central features of dementia care: the home and neighbourhood are part of the treatment environment. A person’s ability to remain engaged, recognise familiar surroundings and continue routine activities can depend on the availability of family members, trained caregivers and suitable spaces. In a dense city, the quality and affordability of those supporting systems can determine whether a family can sustain care locally.
The scale of the issue is already substantial. A nationwide study using data from the Longitudinal Ageing Study in India estimated that 7.4% of Indians aged 60 and above — approximately 8.8 million people — live with dementia. The prevalence rises sharply with age, from 2.94% among people aged 60 to 64 to 25.41% among those aged 85 and above. As the number of older residents grows, the demand for services will not be limited to diagnosis or medication. It will include rehabilitation, caregiver training, respite, home-based support and long-term planning.
Mumbai’s existing public capacity shows both what is possible and what remains missing. KEM Hospital’s dedicated Memory Clinic began on September 21, 2022, and has registered 375 patients since its opening, according to Dr. Neeraj Jain, head of the hospital’s Neurology department. The clinic brings together neurologists, neuropsychologists and occupational therapists. Patients undergo cognitive assessment, detailed neuropsychological evaluation and investigations to identify the cause and extent of their condition.
The clinic can also provide or refer patients for occupational therapy, physiotherapy and cognitive stimulation, depending on their needs. These services are important because dementia care is not limited to prescribing medicines. Occupational therapy may help people retain or relearn daily activities, while cognitive stimulation can support people with milder dementia. The clinical objective is therefore linked to the practical objective of helping a person function for as long and as safely as possible.
Dr. Jain described dementia management as a team effort involving different professionals according to the patient’s condition and stage of disease. That model creates a major access challenge when services are concentrated in one location. A patient from Virar who needs regular therapy may have to travel to KEM in Parel. For a person experiencing cognitive impairment, repeated long-distance journeys can be difficult. Paying privately for several professionals closer to home may also be unaffordable.
This is where Mumbai’s geography becomes part of its healthcare system. Distance is not measured only in kilometres. It also includes travel time, the physical strain of accompanying an older person, the cost of transport, the disruption to the caregiver’s employment and the difficulty of maintaining regular appointments. A service that exists on paper but cannot be reached consistently may not function as continuing care for a low-income household.
The timing of assessment adds another layer to the problem. Dr. Jain said many patients at KEM arrive when dementia has reached a moderate stage. Among the lower-income population served by the hospital, cognitive changes may initially be dismissed as a normal part of ageing. That can delay assessment and reduce the time available for families and clinicians to plan interventions and future care.
The delay is not only a matter of public awareness. It also reflects how dementia is understood within households. Early symptoms can be intermittent and easily attributed to age, stress or forgetfulness. Families may seek medical attention only when daily routines are seriously disrupted. By then, the need is no longer simply for a consultation. It may involve supervision, changes to the home, support with mobility and communication, caregiver instruction and arrangements for periods when relatives cannot provide care.
Maharashtra’s policy framework recognises some of these requirements. The State’s National Health Mission says that special Memory Clinic OPDs for senior citizens affected by dementia have been established under the District Mental Health Programme in 34 districts. Staff under the programme have received specialised training, and dementia patients are provided medicines free of cost. However, the NHM website does not provide a district-wise list of these clinics or clarify whether they offer multidisciplinary services comparable to KEM’s facility.
That missing detail matters because the presence of an outpatient clinic does not necessarily indicate the presence of a complete care pathway. A clinic may support assessment and medicines while families continue to search separately for occupational therapy, physiotherapy, neuropsychology, caregiver counselling or day care. Without clear information about the services available at each location, households may not know where to go, what support they can expect or whether they will need to travel to a tertiary hospital.
The Union Health Ministry’s National Programme for Health Care of the Elderly provides a broader institutional framework. It envisages a continuum of geriatric services, including geriatric clinics, rehabilitation and home-based care. Its tertiary-care framework provides for Memory Clinics and day-care services for rehabilitation, respite and dementia care. The policy direction therefore extends beyond diagnosis. The implementation question is whether those elements are available together, consistently and affordably at the level where families need them.
Non-government organisations fill part of this space. Dignity Foundation operates a specialised Dementia Day Care Centre in Mahim with a capacity of 20 people diagnosed with dementia. Its programme includes cognitive stimulation, art and music therapy, physical exercise, reminiscence therapy and group activities. It also offers caregiver counselling, support-group meetings and training for relatives. During World Alzheimer’s Month in September, its “The Empty Chair” campaign reached more than 1,000 students and 200 corporate employees across Mumbai, according to the foundation.
The centre demonstrates the value of combining patient support with caregiver support. Relatives often become the main coordinators of appointments, medication, communication and daily routines, even when they have no prior training. Itishree’s family gradually learnt to keep their relative engaged through conversation, simple questions, old photographs and advice from friends who had experienced dementia care. Their account shows that informal learning can help, but it also shows why families may need trained assistance soon after diagnosis rather than after a crisis.
The city’s institutional gap is therefore not defined only by the number of specialists. It is defined by how those specialists are organised around a patient’s life. KEM’s multidisciplinary clinic offers one model, but Dr. Jain said comparable government facilities are not available elsewhere in Maharashtra. Dr. Harish Pathak, dean of Seth G.S. Medical College and KEM Hospital, said Mumbai needs more dedicated dementia-care homes and affordable professional assistance. Relatively few centres bring all the professionals required for continuing care together in one place.
The evidence supplied in the report confirms three distinct pressures. First, dementia is common enough to be a significant public-health and household concern, with prevalence increasing considerably at older ages. Second, the public system has created important points of diagnosis and treatment, including KEM’s Memory Clinic and the Memory Clinic OPDs described by the NHM. Third, the continuity between diagnosis, therapy, home care, caregiver training and respite remains uneven and difficult to navigate.
The larger urban question is whether Mumbai’s health infrastructure is designed only for acute episodes or also for conditions that require sustained support over years. Dementia exposes the limits of a system that measures access through the existence of a hospital or clinic without fully accounting for travel, affordability, caregiver availability and the need for several forms of assistance at once.
What happens after diagnosis will increasingly determine whether older residents can remain safely connected to their families and neighbourhoods. The immediate evidence does not establish how many of Maharashtra’s district Memory Clinic OPDs provide multidisciplinary care, nor does it provide a city-wide inventory of trained caregivers, day-care capacity or home-based services. Those are precisely the gaps that families must navigate. For Mumbai, expanding diagnosis without mapping and strengthening the care that follows would leave the central problem unresolved.
