The care expectation gap

A care-free future?

Given the limited state support available to help people care, and the financial hit posed by leaving work to care, we might hope that people are aware of, and planning for, the future. Instead, we found that the public underestimates the role informal help, particularly from partners and children, will play in meeting future care needs. This suggests that people are likely not planning sufficiently for the economic and emotional cost of leaving work to care, or caring long-term, for parents or spouses.

In our research, 15% of people with no care interaction believe they will need care in the future. In reality, the NHS estimates that by 80 (around the average UK lifespan), over half of us (52%) will have a care need (NHS Digital, 2023).

Our research shows that compared to the reality, people with no care interaction underestimate the role of spouses and children when imagining a future where they need care. Figure 2 shows the comparison between expectations and reality, taken from Understanding Society. People with no care interaction expect to rely on partners (28%), the social or medical care sector (22%), or children (14%) to support any future care needs, although they are not confident about being able to rely on formal services, rating their confidence at 4.6 on a 10-point scale.

This compares to data from Understanding Society, which shows that of over-65s who need help, a majority rely on informal helpers only (56%), with a minority using a combination of informal and formal helpers (13%) or formal helpers only (7%). Of those who need help, many rely on spouses (40%) or children (28%) for support. Other informal helpers, such as friends (6%) and siblings (2%), were less frequently drawn upon. 24% of over-65s needing help do not use either informal or formal helpers to support them – echoing Age UK estimates that 2 million older people are not getting the help they need with basic daily activities (Reeves et al., 2024).

We also found that people are understating their likelihood of being a carer. 65% of us will care at some point in our lives (Carers UK, 2019), but our research finds that just 32% of people with no care interaction expect to care for someone else in the future.

Many expect government will pay

As we have set out, there is often a financial hit associated with needing care or caring yourself. But we found that there was a large gap between the general population’s expectations of paying for care and the experience of people drawing on care.

People with no care interaction expect to pay for formal care services through savings (62%), income from benefits and/or pensions (35%), or by selling assets (27%), with 23% expecting government to pay for their social care. This is in contrast with the experience of care receivers – of over-65s who receive care and use formal helpers, 11% received government support to pay for care, 6% have a personal budget and 38% pay for care themselves. The remainder – 50% – receive in-kind support for their activities of daily living from sources such as nurses.¹

People’s expectations around relying on caregiving benefits broadly reflected the take-up of carer benefits in our unpaid carer sample. Nearly a quarter (24%) of people who expect to care believe they can rely on caregiving benefits to support them, and in our research, 26% of current carers receive a carer or means-tested benefit.² However, receiving caregiving benefits is not a guarantee of financial security, with carers in our research rating their concerns about care costs highly.³

Care unaware

We find that optimistic opinions about the support government could offer in the event people need help are likely rooted in a lack of awareness about the realities of the system.

People were generally unaware of the high costs of care and believed support was more generous than it is. We found that only 19% of the general public correctly guessed that the cost of professional home care services could cost more than £1,000 per week – most thought the cost was lower, with almost half (47%) thinking costs were between £200 and £599 a week on average (Berg, 2025). Additionally, only a fifth (21%) of people said that the means test savings and assets threshold for social care support was between £23,250 and £36,246 – in reality, it is £23,250. 28% of people thought the means test fell somewhere above £36,250.

The public were also likely to think support was more holistic than in reality – 37% of people thought social care support to stay in a care home covered daily living expenses and utility bills, while 34% thought it included a weekly personal allowance for small expenses – neither of these is true.

There was also a lack of understanding around the challenges of the social care system, suggesting people thought the system would be more reliable and available than it is. The public most commonly thought that waiting lists for social care assessment were between 100,000 and 199,000 (23%) or between 200,000 and 299,999 (23%) – the reality is that over 400,000 are on such a waiting list.

Does the public care about care?

This could, in part, be driven by the lower salience of care in the public imagination, with other national and personal problems more prominent. For the general public, the cost of essentials and the availability of healthcare remain by far the 2 greatest concerns in their personal lives – when asked to choose 3 key issues of personal concern, 62% of respondents mentioned the cost of essentials, with accessing healthcare named by 45% of respondents and immigration by 21%. Care featured less prominently – caring for family was 11% of the public’s top concern, with 10% most concerned about the availability of good-quality adult social care and 7% concerned about accessing childcare.

National concerns were similar, with 26% of the public citing the cost of essentials as their top concern, 21% concerned about accessing healthcare, 17% citing immigration as their top concern and 9% citing the environment. Only 3% placed accessing quality adult social care as their top national concern, and only 1% cited childcare. This means people were more than 3 times as likely to cite adult social care as a personal concern than a national concern.

Income and gender influence expectations

Income

People’s expectations about caring are also affected by their financial situation and their gender. People from lower-income tertiles are less optimistic about their ability to accommodate care in their lives and are more likely to believe they will rely on state services for any care that they do provide. Of people with no care interaction:

• 25% of people on lower incomes believe they will care for someone in the future, compared to 38% of people on higher incomes
• 26% of people on lower incomes expect to rely on benefits related to caregiving for support, whilst only 17% of people in higher incomes expect the same.

This could reflect their economic experience, for example their experience being eligible for means-tested benefits currently. It could also be due in part to demographics: some of the expectation around caring can be explained by a much higher proportion of single households in the lowest tertile (44%) compared to the highest tertile (8%) combined with what we know about who is cared for (significant others or children, but also parents).

We also asked people how they might manage financially if they became an unpaid carer, where individuals, on average, see a financial hit of £134 per month.⁴ Unsurprisingly, those on lower incomes were less confident of their ability to manage – with 11% of those on lower incomes and 17% of those on higher incomes stating that they would be able to manage easily. People on lower incomes were significantly more likely to say they could not manage (40%) compared with those on higher incomes (22%).

Gender

Care also has a gender component. Our findings show that women are less optimistic and more realistic about accommodating care in their lives than men – this could be down to enduring gender norms, or the makeup of households themselves.

The expectation of receiving care in the future is similar amongst genders. We asked people with no care interaction whether they expected to receive care, and the same proportion of men and women responded yes (15%).

However, among people with no care interaction, women are more likely to believe they will care in the future (36%) than men (28%). These women are less confident about relying on formal care services than men.⁵ They are also less likely to believe that they will rely on benefits for caregiving (22%) than men (27%). Even women who believe they can rely on benefits to support their caregiving are less confident about the adequacy of that benefit support than the same group of men.⁶

Some of the differences might be explained not only by current gender norms shaping a belief in future circumstances but also by current household composition: more men in our sample (24%) are in single adult-only households than women (20%), so they may be less likely to imagine a future caregiving scenario.

The gender disparity in care expectations suggests that women expect to carry disproportionate care responsibilities in the future as compared to men, risking the perpetuation of gender inequalities.

Bridging the care expectation gap

People tend to overestimate the generosity of the care system and understate their likelihood of providing care in the future. While this is not a widespread crisis right now, it may become one as more people find themselves in need of care and encounter high costs or long waiting lists for support.

These findings indicate a crucial need for better public understanding of care realities and costs, particularly regarding the limited role of state support and the significant reliance on informal care networks – this will help people plan for the future, where possible.

But it is unlikely that most people will be able to plan for all eventualities, such as leaving work to care, or to build enough savings to cover the massive costs of paid care. Nor should we accept a system which perpetuates outdated gender norms and needlessly and randomly makes people suffer financially. The best solution to these systemic problems is to change the system itself – so decision-makers should be focusing on building a more supportive care system.

We have asked the public what they want from this system – and they told us they wanted a supportive system which valued carers and care workers, and balanced affordability, choice and quality of care.

What kind of care system does the public want?

Gender and care

First, a care settlement which gives people agency and does not entrench gender norms is crucial. Our research finds that views have changed significantly from traditional, gendered beliefs about who should care – we asked people to number, from 1 to a 100, whether people thought women should be the primary caregivers (1) or whether anyone could be a caregiver (100). The mean score was 72, showing how, at least in the minds of the public, care should not be gendered.

Building better care systems

We asked people to tell us whether they supported a range of policy interventions to support carers and those who draw on care. These policy questions were drawn from conversations with sector experts, existing policy reports and government policy, and we attempted to word them as plainly as possible to better understand the actual policy preferences of voters.

In the adult social care sector, the most popular policies amongst the public were changes to how care would be delivered – technology improvements to help people live independently (94%) and support to have care in the home (93%). Paying workers for travel time (90%) was also popular, as was creating a National Care Service (91%). Expanding fee support was overall slightly less popular (84%), as were curbs on provider profits (85%), but still commanded significant public support.

To better understand the public’s views on the trade-offs between different policies, we asked a series of either/or questions to understand people’s priorities. We asked whether people valued affordability over a number of other characteristics, such as the experience of care workers, fewer visits, lower quality, or fewer face-to-face visits.

On average, the public was equally divided between prioritising cheaper care for less frequent visits, and prioritising care affordability over quality more broadly. There was more support for technology to make care cheaper at the expense of face-to-face interaction, though conversely, less support for choosing less experienced care workers at a lower cost.

Unpaid carers

Around unpaid carers, the general public was most supportive of policies that would offer free support to unpaid carers looking to get into work (94%), provide small grants in times of crisis (93%) and that would provide higher incomes to carers through a guaranteed income (91%). The public were slightly more supportive of increasing benefits payments for the worst-off carers (91%) rather than all carers (87%), and the Government’s recent reforms to Carer’s Allowance, which let carers earn more while still working, were also popular (88%).

Who should pay for care?

Reforms to our care systems deliver huge value to families and local communities, but they can incur upfront costs to the Government and could increase taxes – help to meet care costs is likely to be the most expensive, while workforce reforms could also increase costs, depending on how they are structured. We wanted to know how the public wanted government to pay for and fund social care.

When we asked people to tell us whose responsibility it was to pay for care services, there was strong public support for government funding. In line with other research, we found that people thought that government and individuals had a part to play in paying for care (Read et al., 2021). We found that the public was most supportive of government funding for care for disabled people (68%), social care for children (63%) and elder care (63%). For social care for children, people were more than twice as likely to think government should fund support (63%) rather than people paying themselves (23%). This means that the public’s position on funding for social care is out of step with the reality of support available, with most people unable to access elder care subsidies.

Paying for the social care system

When asked how any future adult social care settlement should be paid for, the public was most supportive of a new insurance system, and then somewhat supportive of other options, including a new tax and increases to inheritance tax or National Insurance. People were most supportive of creating a new insurance system (30%), with less popular options being a new tax to fund care (16%), an increase in inheritance tax (12%), an increase in National Insurance (13%) and an increase in income tax (10%). Some members of the public would prefer for people to pay for care themselves (14%).

Finally, we wanted to better understand the public’s views of the trade-offs policy-makers would likely be making when making decisions about how to fund adult social care in the future.

We asked the public where they thought responsibility lay for paying for social care, and where they thought it was appropriate for people to use their own assets. We found that the public was more likely to think that adult social care reforms should be funded by the Government rather than people selling assets, and that people were somewhat more likely to think that people should not have to save to pay for their own elder care. People also told us they were somewhat more supportive of the most generous support going to the poorest.