Elderly care services could go from "bad to worse" unless the government provides more money and overhauls the system, a charity has warned.
Age Concern England says the financial settlement agreed last year for looking after the elderly was "dismal".
Despite the government's positive vision for social care, it had yet to "fully grasp the nettle" of the problem of care for the elderly.
The government has pledged an extra £520m over the next three years.
In its annual assessment of the impact of public policy on old people, Age Concern says the next three years will be crucial in deciding the fate of care services.
"Now is not the time for dithering about the unavoidable costs needed to care for our rapidly ageing society: decisive leadership is urgently needed"
Director general Gordon Lishman said there is a growing gap between aspirations and reality.
"The government set out an impressive vision for social care in 2007 - but the real test now is whether it can deliver it," he said.
"Without sweeping changes, the system will limp on until it breaks completely, leaving millions of older people without the care they need to stay healthy and independent.
"Now is not the time for dithering about the unavoidable costs needed to care for our rapidly ageing society: decisive leadership is urgently needed."
Last year's Comprehensive Spending Review set out the government's expenditure plans to 2011.
Age Concern says the 1% annual real-terms increase in local government budgets fell well short of the expected 4% rise in the cost of providing social care to an increasingly elderly population.
While the report welcomed ministers' promise of £520m to modernise services, along with a Green Paper on social care, it said the government had failed to factor in the rising costs and social exclusion among older people.
The report - entitled Age Agenda 2008 - points to other examples of progress, such as free bus travel and yesterday's launch of a national housing strategy for older people.
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