Barriers to social care and carers’ needs assessments in dementia

Key messages

• many unpaid carers and people with dementia are unaware of their entitlement to social care and carers’ needs assessments
• limited knowledge of services and complex systems make assessments difficult to access
• time pressures and resource constraints affect professionals’ ability to carry out assessments
• carers often report unmet needs even after assessments have taken place
• poor integration between health and social care contributes to fragmented support.

Policy implications

• clearer information may be needed to improve awareness of assessment entitlements
• assessment processes could be simplified to improve accessibility
• additional resources and training may support professionals to conduct timely assessments
• stronger integration between health and social care could reduce unmet need after assessment.

Gaps

• limited evidence on which approaches improve awareness and uptake of assessments
• lack of evaluation of interventions to address unmet need post-assessment
• limited insight into how barriers vary across different groups of carers.

Commentary
This study highlights inequities in access to social care and carers’ needs assessments for people with dementia and unpaid carers. Lack of awareness about entitlements and complex systems mean that support needs often go unidentified or unmet.

Barriers are reinforced by system pressures. Professionals conducting assessments face time and resource constraints, which can limit the depth and effectiveness of assessment processes.

The persistence of unmet needs after assessment points to wider structural issues. Fragmented coordination between health and social care services reduces the likelihood that identified needs translate into practical support.

From a care equity perspective, improving awareness, accessibility and integration is central to ensuring that carers and people with dementia receive support based on need rather than ability to navigate complex systems. Without addressing these barriers, existing inequalities in access and outcomes are likely to continue.