A charity leader has said it is time to think "more creatively"about how we look after our elderly as new figures showed care home fees have doubled in one area of Scotland.
Aberdeen City has recorded the highest growth in weekly rates over the past 10 years, according to a report by Public Health Scotland.
In 2012, elderly residents could expect to pay £823 a week to live in care home in the Granite City, including nursing care.
New figures show the average cost has doubled to £1645 in the last decade.
East Lothian, which takes in rural areas including Musselburgh, Prestonpans, North Berwick and Dunbar, was not far behind with weekly fees increasing by 99%, from £701 to £1394.
The region also experienced the highest annual rise in fees, rising by 99% since 2021 when residents were paying an average of £1084 per week.
The estimated average gross weekly costs were calculated using data submitted by care homes open on March 31 of each year and 70% contributed.
READ MORE: Care home owners 'ripping off' elderly with £69,000 annual fees
Residents with savings and property valued at less than £18,000 are currently funded by their local authority while those with capital between £18,000 and £28,750 will partially contribute.
Anyone with capital worth £28,750 or more is expected to fully fund their living costs but will receive a contribution towards care. .
This year's payment is £212.85 a week for personal care and £95.80 a week for nursing costs.
The Shetland Islands recorded the lowest percentage increase in weekly fees from 2012 to 2022 at 49% but costs are among the highest in Scotland at £1423.
Those who live in the Western Isles are paying the lowest amount for care home places at £926, a 29% rise since 2012 when the average was £720.
Weekly charges in Glasgow have risen by 64% to £1052, according to the data.
The figures also show a widening gap in the amount self-funders pay for care home places compared to local authorities.
Self-funders across Scotland are paying 72% more than they were 12 years ago (£699 to £1200) while the average weekly cost for local authority funded places has risen by 49%, from £574 to £856.
The Scottish Government has said the new National Care Service will aim to support more elderly Scots to remain in their own home.
Henry Simmons, Chief Executive of Alzheimer Scotland said there was a "lot of misunderstanding" about how people find their way into a self-funded care home placement.
He said: "Often what happens is that the person and their family will be doing what they can in terms of supporting someone at home and it reaches a point that the local authority doesn't have any more resources to go any further.
"The families often find it hard to see what alternatives might be able to be put in place.
"There is an assessment process that takes place that will explore what community based alternatives are there. Our view is there isn't a lot of alternatives to your traditional large scale care home.
"We think that is a fundamental flaw in the process of commissioning, particularly when you look at the more rural and remote areas.
He added: "If the assessment determines you need to go into a care home no one says to you at this point that this will cost you £1200 per week or more.
"No one ever says, 'see that money you are going to have to pay for a care home what could we do with that as an alternative?' There are other ways that we could think about for using that money creatively."
He said there was a need for a national debate on the issue and the charity is to host a series of discussion events later in the year, which will inform a major report.
He said:"Everyone is talking about the National Care Service solving all the problems under the sun but what we are not doing is looking at how it is going to solve problems.
"We think that for the amount of money people are being asked to pay and the lack of choice and control they have over that, we need to be talking about different models and approaches.
"Why have we relied on the large scale model that people often have to travel substantial distances for.
"We've just accepted what we have. Most of the care homes will be providing good care but their costs are going through the roof and it's getting passed on to the self-funders."
READ MORE: Dementia will be rare condition within 20 years says Scots expert
The census shows that as of March 31, there were 1,051 care homes for adults and 40,579 registered places – 20% and 5% fewer, respectively than twelve years ago.
Approximately 66% of all long stay residents in care homes for older people in Scotland were fully or mainly publicly funded and 34% were fully or mainly self-funded
Most care home provision is delivered by the private sector. The number of residents in voluntary or not-for-profit residential care has decreased by 868 (27%) and by 1,049 (25%) in the local authority/health board sector.
Cathie Russell of Care Home Relatives Scotland said: "It’s the only area of life where the tax rate is 100% of what you and your partner have accumulated over a lifetime.
"The near total privatisation of the care home industry means that thousands of people who bought their own home or have worked hard to accrue some savings are subjected to massive financial exploitation.
"Other illnesses would be covered through the NHS - but if you take dementia or another neurological disorder, everything you have is up for grabs.
"This has to be looked at through the National Care Service reforms."
An estimated 33,352 residents aged 18 years and over are living in all adult care homes – 11% fewer than 31 March 2012 (37,335).
Residents in care homes for older people accounted for 92% of occupants in all care homes for adults (30,552 out of 33,352).
The Herald is supporting Alzheimer Scotland's Fair Dementia Care Campaign.
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