<p>Traditionally, co-resident living arrangements have been the primary setup within which older people receive care in India. However, the rapid socioeconomic and demographic changes, driven particularly by migration and urbanization, have put pressure on the traditional family setup. As a result, an increasing number of older individuals have started living alone, necessitating a closer look at how such arrangements affect their health and functional care. Based on the evidence from the first wave of the Longitudinal Ageing Survey in India (LASI) on 31,902 individuals aged 60 years and above, the study demonstrates how living arrangements determine health outcomes, functional limitations, and caregiving patterns. For instance, older adults who live with their spouses have better familial support, whereas those living alone rely more on paid and non-family caregivers. Using chi-square and binary logistic regression analyses, the paper identified that older women have higher care needs than older men. The paper highlights the urgent need for targeted policy intervention and care programs, particularly for older women in general and all older adults living alone. Strengthening these frameworks is essential to ensure equitable and effective care for the ageing population in India.</p>