Introduction In Sri Lanka’s mountainous communities, steep terrain and remoteness constrain everyday life, particularly for older people. Many homes are accessible only via narrow footpaths or long flights of uneven steps. Public transport is often distant, limiting access to health care and other essential services. Ageing in mountainous areas presents distinct challenges compared with ageing in the plains. While younger residents may find these conditions demanding, for older people they can become limiting. Younger family members often leave for education or employment, leaving older relatives in increasingly fragmented households. Over time, geographic isolation can evolve into social and economic isolation. Although systematic evidence on Sri Lanka’s mountain communities remains limited, findings from Himalayan countries indicate that poverty in such areas is deeper and more multidimensional, with slower rates of reduction. Physical inaccessibility, limited basic services, and high dependency ratios heighten vulnerability. Remoteness constrains access to services, income opportunities, and social support, creating intersecting disadvantages. These pressures have created a less visible but growing problem: care poverty. Care poverty refers to a situation in which people who need care do not receive enough support from family members, communities, or formal services. In poor and isolated households, care responsibilities often fall on family members who are already struggling financially. This highlights the need for care systems that better support older people living in poor and geographically isolated communities. How Care Poverty Affects Families Field observations from hill villages in Kandy, central Sri Lanka, provide a grounded perspective on these dynamics, illustrating how ageing, poverty, and geographic isolation intersect to produce care poverty. In many households, care responsibilities fall on family members who are already struggling financially. One older man, partially paralyzed after illness, depended on his wife, who also had mobility difficulties. Their son, who struggled with alcoholism, repeatedly pressured him for money and sold most of the family’s assets. The household survived largely on a Rs. 2,500 (about $8) allowance from Aswesuma, Sri Lanka’s social welfare program. Wildlife had destroyed their crops, making even subsistence farming unreliable. The man later attempted suicide due to fear of the future. Another elderly woman in her eighties described spending entire days without support. “Even if I stay hungry for seven days, there is no one to give me a single meal,” she said. Although educated, she had spent most of her life doing unpaid domestic and care work. In old age, she depended on a Rs. 5,000 (about $16) elderly allowance that covered barely half a month’s expenses. Declining health further limited her mobility and independence. These experiences reflect broader patterns of poverty in the hill villages. Young people who gain access to education and stable employment often leave for urban areas. Those who remain usually depend on insecure work, such as daily wage labor, garment factory employment, or migration. Many enter old age without savings, pensions, or stable support systems. Access to care becomes even more difficult during emergencies. During the recent Ditwah cyclone, one man caring for his immobile parents refused repeated evacuation requests. “How can I carry them? On my back?” he asked. The incident illustrates how geography can turn aging into a crisis of survival. Older people living in isolated mountain communities often cannot respond to emergencies without assistance, yet support systems frequently fail to reach them in practice. These cases point to a larger problem. Care poverty is becoming increasingly acute, while the capacity of families to meet care needs is weakening. Geographic isolation limits access to transport, health care, and essential services. Informal livelihoods create economic insecurity, while migration fragments households. Elder care in Sri Lanka continues to be treated primarily as a family responsibility, even when families lack the capacity to provide adequate support, and this expectation is reinforced within prevailing legal frameworks. Strong cultural norms also frame care as a family duty, while institutional care is often stigmatized as abandonment. Sri Lanka’s aging population adds urgency to these challenges. The share of the population aged 60 and above has risen from around 12% in 2012 to nearly 18% today and is expected to reach one in four by 2042. Yet care remains largely absent from development planning. The problems seen in Kandy also reflect wider regional trends. Across Asia’s mountain regions, aging increasingly intersects with geographic inequality, climate vulnerability, informal labor markets, and weakening family support systems. Care poverty in these settings is therefore not simply a household problem. It is a development challenge shaped by geography, aging, and unequal access to support systems. Policy Priorities for Aging Communities Addressing care poverty requires moving beyond small-scale welfare assistance toward stronger and more accessible care systems. First, Sri Lanka needs more community-based and home-supported care services. In isolated villages, older people often cannot travel easily to hospitals or service centers. Local care networks, mobile health services, and home-based support can help older people remain in their communities while reducing pressure on families. Second, care policies must account for geography. Steep terrain, poor transport, and climate-related disasters shape how older people access health care, food, and emergency support. Disaster preparedness and social protection programs should include specific measures for older people and caregivers living in remote areas. Third, unpaid caregivers need greater recognition and support, especially women, who continue to shoulder most care responsibilities. Caregiver allowances, respite services, and flexible support mechanisms could reduce the physical and financial strain on households already facing hardship. Finally, reducing care poverty also requires stronger income security throughout life. Many families in the hill regions depend on informal and unstable livelihoods that provide little long-term protection. Expanding social protection coverage for informal workers through improved livelihood security would reduce vulnerability in old age. The experiences of older people in Kandy’s hill communities reveal the limits of relying entirely on families to manage aging. Most older persons are not asking for institutionalization. They are asking for basic conditions to live their later years with dignity, including support for food, health care, and mobility. Meeting these needs requires a broader understanding of care. Care should not be treated solely as a private family responsibility. It should be recognized as an essential part of the social support systems needed for human development, economic participation, and intergenerational wellbeing. This piece is based on field observations collected during a CEPA project on the Care Economy Roadmap for Sri Lanka, supported by a grant from the International Development Research Centre (IDRC), Ottawa, Canada, through the FutureWORKS Asia research network hosted by LIRNEasia. Ask the Experts Nilupulee Rathnayake Senior Research Professional, Centre for Poverty Analysis, Sri Lanka Nilupulee Rathnayake is a senior research professional working in the Livelihoods and Employment thematic area at the Centre for Poverty Analysis (CEPA), Colombo. She holds an MSc in Development Economics from the University of Nottingham, United Kingdom. Follow Nilupulee Rathnayake on Leave your question or comment in the section below: View the discussion thread.