Chapter 2 has shown how the total volume of informal care has been sustained only by becoming more concentrated in fewer hands, causing much stress. This ‘intensification’ of care is due partly to unpaid carers replacing shrunken council services, but it is also rooted in several longer-term social and demographic factors.

This chapter deals with future trends in need, to highlight a growing gap that family care may not be able to meet. The need for care will rise by almost two-fifths up to 2040, and there are many reasons why informal care may not keep pace. These include the rapid relative growth of the oldest age groups, declining family size, labour market factors and the rising rate of disability among younger generations. Support of younger disabled people is in fact the most rapidly rising element in local authorities’ caseload. All these factors underline the case for expansion of formal care. They also pose the twin challenges of how to ease carer stress, while sustaining and expanding informal care to keep up with growing need. This means developing better support services and financial help to family carers. It also invokes the question of how to share informal care more widely, which is the subject of Chapters 5 and 6.

Women have the greatest responsibility for informal care, which compounds their existing disadvantage in the labour market. Mothers are the most frequent carers of disabled adult sons and daughters, although among retired couples, men are slightly more likely to give care to women than vice versa.