This paper conducts a comparative and exploratory study on altruistic and pay-to-stay care systems, exploring the intersection of tradition and contemporary society. The research delves into the underlying mechanisms of both care systems, shedding light on the daily lives, challenges, and vulnerabilities of older women residing in care homes. Emphasising the state’s and market’s evolving role in the older care system, the study highlights the relatively recent market invasion. Employing an exploratory and descriptive research design, the sample comprises fifty-six women aged 60 and above in Lucknow city’s (Uttar Pradesh, India) care homes. Given the heterogeneity among women in care homes regarding social and moral values, the study utilises multi-stage random, stratified, and purposive sampling techniques as needed for the analysis. Data had been gathered from two care homes— one not charging residents and another a paid facility catering to lower-middle and middle-income groups. The researcher spent a year and a half working in these homes, conducting interviews with all respondents. The paper uncovers distinctions in care homes based not only on altruism and pay-to-stay but also on caste and class dynamics, contributing to social inequality and limiting social mobility. The stratification of the State and market results in varying quality of life for older women. While the market holds potential for innovation and improved service quality, economically dependent women often defer this choice to their family members. Socioeconomic status significantly influences the decision to lead a dignified life, with some women reluctantly relying on the state for survival after being abandoned by their families, leaving them hapless and hopeless.