Indicator 1B.2. Care services for older people
Summary
Older people rely on social care to live independently and with dignity. While Scotland has long-term legislation and strategies for older people’s care, access remains inconsistent and often delayed. Women are more likely to be older care recipients, live alone in later life, and rely on support services, meaning gaps in provision disproportionately affect them. Delayed discharge, limited availability of care at home and persistent workforce shortages all contribute to a system under significant strain.
Section Scores
What this indicator measures
This indicator assesses the accessibility, affordability, consistency, and regulation of care services available to older people in Scotland. It looks at the availability of care at home and residential care, waiting times, delayed discharge, funding, and how effectively national policies and strategies are implemented.
Key findings
- Older people experience some of the highest rates of delayed discharge since records began, reflecting limited capacity in community and residential care
- Eligibility criteria for care services vary across Scotland, creating unequal access and inconsistent outcomes
- Workforce shortages and recruitment challenges reduce the availability and continuity of care
- Long standing underinvestment has created fragility across the sector
- Significant policy work has been undertaken, but implementation remains weak
- Demand for care is rising in line with demographic change, putting further pressure on services
Impacts on families
Delays in accessing care place significant pressure on families, especially women who are most likely to provide unpaid care for older relatives. Long waits for assessments or care at home often force family members to step in, reduce paid work or take on unsustainable levels of care. Delayed discharge also has a major impact on older people’s health, wellbeing and independence, increasing the risk of deterioration while in hospital.
Accessibility considerations
Older people living in rural or deprived areas experience greater difficulty accessing support. Lack of care at home capacity is a consistent barrier, particularly for older women living alone. Variation in eligibility criteria and charging practices creates financial and practical obstacles, especially for those on low incomes.
Budget context
Although investment in adult social care has increased, long term underfunding continues to affect service availability. Local systems face rising demand, increasing costs and limited flexibility to invest in prevention. The lack of robust national data on unmet need makes it difficult to plan effectively or allocate resources to the areas most in need.
Lived experience
A significant proportion of older people remain in hospital longer than medically necessary due to delays in arranging care. People aged 75 and over account for most delayed discharge bed days, highlighting the scale of the challenge for older people and their families. Source: Audit Scotland
Overall interpretation
While Scotland has strong policy intentions around supporting older people, the system is not yet delivering consistent or timely access to care. Delayed discharge, limited care at home capacity and insufficient funding for care homes reflect structural weaknesses that affect older people across the country. Substantial and sustained reform is required to ensure older people receive the care and support they need to live well and independently.