The United Nations estimates that, by 2050, one in six people worldwide will be aged 65 years or older, up from one in ten in 2021. Some low- and middle-income countries are expected to see the fastest increase in numbers. Nations with limited resources must adapt quickly to support the complex health needs of their ageing populations.

As a behavioural health researcher in Singapore, I assess programmes aimed at preventing and managing chronic diseases. Time and again, I hear that the most powerful force in the success or failure of an initiative is the patient’s family. In my view, such involvement needs to become an integral part of health-care plans for older people.

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Behind many health programmes for older adults are an army of sons, daughters, spouses and other relatives. They might manage logistics, talk to physicians and ensure that treatment plans are followed. But they can also unintentionally exacerbate health issues. An older person’s high blood pressure might stem from the salty noodle soup that their partner often cooks or the unhealthy takeaways their child brings home.

Most family-related health-care initiatives focus on enabling professionals to work better with families or on helping both patients and their relatives to manage a disease. Much rarer are family-led approaches, which empower relatives with the skills and knowledge they need to help their loved ones. Yet such approaches could benefit many older adults, who can face social, cultural, technological and logistical challenges in accessing health care or adopting healthier behaviours.

I’m currently testing online training that provides young adults in Singapore with evidence-based strategies to help their families to manage the amount of salt in their diets. Although the programme still in progress, early signs indicate that it works, and that it requires relatively little time or effort from the participants.

Similarly, a study in Thailand tested an educational app to support family members of older adults with diabetes (P. Poonprapai et al. Int. J. Clin. Pharm. 44, 680–688; 2022). Family members were encouraged to relay what they learnt to their relatives, as well as remind them to take their medicine. The app significantly improved patients’ ability to manage their disease and adhere to their medication plans.

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Family-led approaches can be less resource intensive than conventional health-care schemes, making them well suited to regions with scant funds. Yet critics might worry that they ask too much of relatives. Even small tasks, such as monitoring medicine intake or coordinating appointments can add up — particularly for those already juggling work, childcare and other responsibilities.

Scalable, sustainable ways to engage families as partners in health care need to be developed and evaluated. So far, research has been limited to small-scale programmes.

To scale up these schemes, scientists need to compare models of family engagement. These might have a light touch or be more intense — ranging from asking whether a loved one is taking their pills during a regular visit to receiving training that enables them to build a tailored plan that supports a relative’s heart health.