Rekha Singh and her husband, Col. R.D. Singh, traveling in Turkey two years ago.
CNN  — 

Rekha Singh lives with her husband in a New Delhi suburb. Her sons left home for work four years ago, and the couple has been trying to manage their lives as best as they can.

In India, facilities like public transport and wheelchair assistance are few and far between, meaning senior citizens are often confined to their homes. Singh is worried about her and her husband’s social lives, more than their health. She misses social interaction, entertainment and shopping.

It’s not common for elderly couples to live by themselves in India, as children continue living with their parents after marriage or getting jobs, forming cohesive units known as joint families. But this has been changing as young adults make their way to cities in search of jobs or go abroad for better opportunities.

For parents like the Singhs, that change is difficult to adjust to, but they have set up a routine and pursue hobbies that keep them busy. They spend most of their time in each other’s company, but they have a small group of friends they can count on for social respite.

Everyone needs company

“Company – everyone needs in every age. That company we are missing here. But we have a few friends, and they are easily available,” Singh said.

One son moved to Mumbai, and the other recently returned to New Delhi but still lives 80 kilometers (50 miles) away and so can’t visit regularly.

As a result of situations like these, social interaction is highly coveted among the elderly population, according to a recent survey conducted by home care provider IVHSeniorCare.

The survey also highlighted that fewer parents living alone consider health as a key concern, with only 10% listing it as an issue that they struggle with. Of those surveyed, 36% listed social interaction as their priority, and 19% listed security.

Even though Singh prefers spending time with her husband or with her grandchildren, who visit frequently, she feels the isolation that is slowly increasing for people her age.

“The general population – even the children of elders – have a shallow understanding of what is required for the maintenance of an elder,” said Dr. G.S. Grewal, an elder-care consultant at Max Hospital in New Delhi. “Parents need emotional company and security.”

“Everyone is on their own in the Western world, and most of their needs are catered by government or insurance. However, in India, the infrastructure is not that strong. Elders expect their children to take care of them, as they did for their parents,” said Swadeep Srivastava, founder of IVHSeniorCare.

“Children are more than happy to provide anything their parents need, but the communication gap leaves them clueless about their parents’ true needs.”

A generation gap

The survey sampled 1,000 elderly people in seven states in India to find out about their lifestyles, including activities, forms of assistance they have and how often they go out.

A thousand young adults who have been living away from their parents for at least five years were also interviewed.

The survey gave a glimpse into the disparity between what the elder population wants and what the youth believes they need.

Only 2% of the elderly population believes that their quality of life is good, and 71% say there is room for improvement. Social isolation is believed to be a major factor contributing to poor health.

“The quality of life is affected by these factors: nutrition, frailty, memory loss and abuse,” said Grewal, who is also chairman of the Age Friendly Project.

This can lead to self-abuse, in which the parents do not take their medicines on time or deny themselves good food or enjoyment, said Grewal, who was not involved in the survey.

Among the young adults, 59% thought their parents spent most of their day resting, and 23% imagine them busy with household chores.

The generation gap and an inclination toward Western culture means children are not aware of their parents’ true needs and end up offering them apples when their parents need oranges, Srivastava said.

Get CNN Health's weekly newsletter

Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.

The survey, titled Juj Jug Jiyenge, which means “live longer,” estimates that there are more than 100 million senior citizens in India. This population is increasing disproportionately, and India is expected to add 240 million more senior citizens by 2050, according to IVHSeniorCare.

Singh is lucky. After two lonely years, one of her sons moved back to a nearby city, and her grandchildren can visit more often. She worries about her health, but applying to an elder care program has helped. “This problem is almost solved. The confidence level has also gone higher,” she said.

For now, she keeps herself busy with gardening and reading books. “My husband is happy in my company, and we go out together, and we go shopping together,” she said. “We step out to do small chores every now and then.”