With the rising numbers of the elderly population in India, policymaking did gain some form of attention in the early 1990s. However, what seemingly went unrecognized is the question of differential needs of the elderly who have largely been viewed as a homogenous category reflective in the policy documents. The elderly serve to be the segment of the population whose needs vary in accordance with their nature of vulnerabilities, illnesses, and issues confronting them. This chapter majorly concentrates upon the terminally ill elderly population in India and analyzes the concerns and policy framework pertaining to them. The elderly terminally ill segment serves to be among the most susceptible and dependent of the aging lot. Terminally ill population largely implies those patients whose state of illness is irreversible in nature and will culminate into their death in few months duration or so. They suffer illnesses which necessitate acute care and support. They are heavily reliant upon others to serve them, to lead a minimal existence being on the brink of end of life. The chapter proposes that a comprehensive policy framework considering the specific needs of the terminally ill elderly through a mechanism of palliative care is imperative for them. Given the democratic setup of the Indian state, it remains significant to examine the plight of the terminally ill elderly and explore whether this section is perceived of political significance and matters of policy concern. This chapter makes a modest attempt in this direction and inquires whether the terminally ill elderly population has their basic dignity for survival met through the Indian policy structures.