This study investigates the changing patterns of elderly living arrangements in India over the past three decades, against the backdrop of shifting socioeconomic, demographic, and cultural landscapes. Traditional familial support for the elderly is undergoing transformation due to factors such as declining fertility rates, urbanization, and a transition from joint to nuclear family structures. The diminishing availability of potential caregivers raises concerns about elderly care, particularly in the absence of robust social services. Utilizing data from five rounds of the National Family Health Surveys (NFHS) spanning 1992 to 2019–21, the research analyses trends in living arrangements among the elderly. Co-residence with adult children remains a critical aspect of elderly well-being, yet it does not guarantee positive intergenerational relationships. The study reveals a feminization of ageing, with a higher proportion of older women living alone, likely associated with widowhood. Economic and demographic changes contribute to variations in living arrangements across states. The delicate balance between perceived costs and benefits shapes the choices of both older and younger generations. The research highlights the need for nuanced social policies to address the evolving needs of an ageing population in the face of economic, demographic, and cultural transitions. This investigation contributes some valuable insights into the dynamics of elderly living arrangements, providing a foundation for the development of targeted and effective social policies in response to the challenges posed by an ageing population in India.