Few retirement planning topics create as much anxiety as care home fees.
That concern is understandable as residential care can cost more than £2,000 a week. The prospect of a six-figure bill in the future can lead some retirees to spend less than they could in earlier retirement.
Care costs are a real risk, but they need context. Public Health Scotland’s Care Home Census helps show how residential care fits into later life in Scotland.
What the data tells us
Most older people are not living in residential care
Scotland has more than 1.1 million people aged 65 and over, but around 31,000 live in care homes for older adults. At any one time, more than 97% of older Scots are not in long-term residential care. That does not mean only 3% will ever need care, but it does show that care home living is not the typical day-to-day experience of later life.
The likelihood increases with age, but remains a minority outcome
The need for care increases with age. Just over half of long-term care home residents are aged 85 or over. Even among those aged 85 and above, only around 12% are living in long-term residential care at any one time. Most continue to live independently, with family support, or with care at home, which comes at a lower cost.
Rates of long-term care home residency have fallen
Although Scotland’s older population has grown since 2015, the proportion living in long-term care homes has fallen. For those aged 85 and over, the rate fell from about 149 per 1,000 in 2015 to 118 per 1,000 in 2025.
This may reflect better healthcare, more support at home, changing family circumstances or different models of care. Whatever the cause, residential care appears less common relative to the older population.
Women account for the majority of residents
Women make up around 70% of older long-term care home residents, largely because they are more likely to live into the ages where care needs become more common.
Lengths of stay are often shorter than many assume
The median stay in long-term care is about 1.9 years (unlike an average, the median is less affected by very long or short stays and gives a clearer picture of the typical experience). Nearly 40% of stays lasted less than a year. Care can still be expensive and significant but spending many years in residential care is not the experience of most residents.
What does this mean for retirement planning?
Care home fees should not be ignored. For those who need residential care, the costs can be substantial, and some stays will last much longer than the median.
But the data also suggests care should not be treated as inevitable, and long-term residential care has become less common relative to the population.
A good retirement plan should make sensible allowance for care costs alongside other risks, including longevity, inflation, investment returns and changing spending patterns and healthcare needs. The aim is to prepare for the possibility of care without letting it overshadow the life and enjoyment that may come first.
If you’d like to discuss how care costs fit into your own retirement plans, we would be happy to help you build a plan that balances preparation with peace of mind.
Important information: This article is for information purposes only and does not constitute financial advice, which should be based on your individual circumstances.