The number of people getting social care support in England has fallen by a quarter in four years, figures show.
The drop comes despite the ageing population placing more pressure on the health and care system.
In 2008-09, the number of elderly and younger people with disabilities being cared for was 1.78 million but by 2012-13 it was 1.32 million, Health and Social Care Information data showed.
The fall has been blamed on budget cuts to councils, which provide social care.
By 2015, local government will have lost a third of its budget this Parliament.
And while the government has tried to protect social care - £1bn of NHS funding each year is ring-fenced for social care - these figures make it clear services have been hit.
The data covers both care provided in people's homes and the community as well as care home and nursing home places.
The biggest fall has been seen among the number of over-65s getting support.
Last year alone the numbers fell by more than 10% to under 900,000.
The number of 18- to 64-year-olds getting help stands at 432,000, down from 566,000 four years ago.
'Devastating effect'Richard Hawkes, chief executive of disability charity Scope and chairman of the Care and Support Alliance, said: "This is further evidence of a social care system on its knees and in desperate need of reform.
"Chronic underfunding has seen hundreds of thousands of older and disabled people lose their support for even basic tasks, like getting up, preparing meals and doing the shopping.
"Without that support, older and disabled people become isolated, fall into crisis and end up in A&E.
"Cuts can also have a devastating effect on families, who without good quality social care can be condemned to a life of no work, poverty and ill-health."
Caroline Abrahams, of Age UK, said the figures showed how "desperate the care crisis" was.
A spokeswoman for the Local Government Association said councils were struggling to protect services.
"Unless adult social care funding is put on a sustainable footing, social care services will remain substantially underfunded and will suffer as a result," she added.
But Care Minister Norman Lamb said social care remained a "priority" for the government.
He said as well as the extra money being provided now from the NHS, from 2015 a new pooled budget of £3.8bn would be established between the NHS and local government.
"Councils are best placed to decide what services are needed in their area but we are clear that they must use resources effectively to ensure that the care people receive meets their needs and gives them more control over their daily lives," he added.
However, Shadow Care Minister Liz Kendall said ministers "were out of touch with the scale of the crisis".
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