More than a million over-65s will need round-the-clock care by 2035, experts predict

The number of adults aged 65 and over needing round-the-clock care will rise to more than one million over the next 20 years (Picture: PA)

The number of adults aged 65 and over needing round-the-clock care is set to soar to more than a million by 2035, experts have warned.

The rise of over a third over the next two decades comes with a warning that health and social care services need to adapt adapt to the unprecedented needs of an increasing older population with complex care needs.

A new modelling study published in The Lancet Public Health also found that the number of over-85s requiring 24-hour care will almost double to 446,000 in England by 2035.

The research, carried out by Newcastle University and the London School of Economics and Political Science, said the estimates predict a rise in the number of people living into old age with multiple long-term conditions, with the majority (80%) of older adults with dementia and in need of substantial care in 2035 likely to have two or more other diseases.

Relying on the informal carers who provide around £57 billion worth of care in the UK is not a sustainable solution, the researchers warned.

Professor Carol Jagger, from the Newcastle University Institute for Ageing, said: “The challenge is considerable. Our study suggests that older spouse carers are increasingly likely to be living with disabilities themselves, resulting in mutual care relationships that are not yet well recognised by existing care policy and practices.

“On top of that, extending the retirement age of the UK population is likely to further reduce the informal and unpaid carer pool, who have traditionally provided for older family members. These constraints will exacerbate pressures on already stretched social care budgets.”


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The research found there will be plenty of people living independent lives, with the number of over-65s living without care needs set to rise more than 60%, from 5.5 million in 2015 to 8.9 million.

This increase in independence will be seen mainly in men, they predict.

Independent – the number of older people leading independent lives will also increase, the model found (Picture: Getty)

The team developed the Population Ageing and Care Simulation (PACSim) model as little research had previously been done on how levels of dependency might change for different generations of older people.

The model takes into account risk factors for dependence and disability, including sociodemographic factors like education, health behaviours such as smoking, as well as 12 chronic diseases and geriatric conditions including coronary heart disease, stroke, hypertension, diabetes, arthritis, cancer and depression.

Using data from three large studies of adults aged 35 and older, the study modelled future trends in social care needs for the population aged 65 and older in England between 2015 and 2035.

Adults were categorised as high dependency if they required 24-hour care, medium dependency if they needed help at regular times daily, low dependency if they required care less than daily and were generally looked after in the community, or independent (without care needs).

According to estimates, the number of people over 65 will increase by just under 50% from 9.7 million in 2015 to 14.5 million in 2035, with differing future care needs predicted for men and women.

The research has led to warnings over the crisis in adult social care.

Nick Forbes, senior vice chairman of the Local Government Association (LGA), said: “This report is a further warning of the crisis in adult social care and the urgent need to plug the immediate funding gap and find a long-term solution on how we pay for it and improve people’s independence and wellbeing.

“With people living longer, increases in costs, decreases in funding, care providers closing and contracts being returned to councils, the system is at breaking point, ramping up pressures on unpaid carers who are the backbone of the care system.

“Adult social care services face a £3.5 billion funding gap by 2025, just to maintain existing standards of care. The likely consequences of this are more and more people being unable to get quality and reliable care and support, which enables them to live more fulfilling lives.”

Alzheimer’s Society chief executive, Jeremy Hughes, added: “These new estimates paint a challenging future, with the number of people needing constant care – the majority of whom will be living with dementia – starkly increasing in the next 20 years.

“After decades of starved funding, the social care system is buckling under the strain.

“Through our helpline we hear of people with dementia being forced to choose between a wash or a hot meal due to the limited time of a homecare visit, and ending up in hospital with an infection because they didn’t have the support to shower each day.”

A spokesman for the Department of Health and Social Care said: “In the Autumn we will set out our plans to reform adult social care alongside our long term plan for the NHS, so we can address the challenge of our growing ageing population head on and ensure services are sustainable for the future.”