Public Health Minister Shona Robison believes that housing will have to be redesigned to allow services to help those living in “clusters” and that care homes will have to specialise in dementia or end-of-life care.

Speaking exclusively to the Sunday Herald, she explained that demographic challenges will make such changes necessary.

Her comments follow a week-long campaign by our sister newspaper, The Herald, to raise awareness of elderly abuse in Scotland and will fuel the forthcoming Re-shaping Scotland debate on how to manage the country’s ageing population.

There is growing concern that care homes – which currently house 38,000 older people in Scotland – would not be affordable because of growing numbers and a perception that they tend to “­disable rather than re-able”.

The number of people in Scotland over 65 is projected to be 21% greater in 2016 than in 2006 – and 63% greater by 2031.

Government figures estimate yearly costs for health and social-care services for older people will increase by £1.1 billion by 2016, and £3.5bn by 2031, if care continues the way it is now.

“Institutions will have a different role in future and will become more specialist – they might focus on dementia or end-of-life care,” Ms Robison said.

“When I was a home-care organiser, people would be in homes for 10 years but now go in for much shorter periods. They may in future be used more for rehabilitation or respite care, but the expectation would be that people don’t lose their independent skills and don’t become institutionalised.

“If we continue to go on as we are, we’d be building a new care home every three weeks. We don’t want people in hospital beds. We don’t want people in institutions.

“There will be a different role for the care-home sector. They will have to have more specialist dementia training. Local authority services will change too. The future is about re-enablement and maximising someone’s ability and then putting in services to do what they can’t do, maximising their independence.”

Ms Robison wants to see innovative housing to tackle people’s changing needs and far greater use of telecare technology.

“The use of technology and telecare are simple ways of keeping people safe at home and alerting others if there is a problem,” she said, “such as pressure detectors on beds and at front doors, or alarms if someone has fallen, the bath is too hot or the kettle has boiled. We need to roll it out more systematically. We need to think about bringing the housing sector on board.

“Dumfries and Galloway are doing a lot of work on extra care housing, the principle being that you build housing with the ability to be flexible.

“You might need sheltered housing at only one stage in your life but 20 years down the line you need much greater support so the services can go in around a cluster. Services can grow as the person requires it, because people come in all shapes and sizes and their needs change. It helps minimise wastage and maximise independence and flexibility.

Ms Robison commended the Herald & Times Group for its investigation into the abuse of the elderly.

“I think anything that raises this issue and awareness is a good thing,” she said. “It is also an opportunity to look at society we envisage in future.

“Those who are 50-plus now are going to be the next generation of older people whose expectations are very different.

“They are going to want to live at home and be more active so we need to redirect, redesign and reform services to respond to that: the housing and the services we provide as need increases, moving away from institutional care to care at home through technology and the right preventative services.”