The 82-year-old man said he wanted to remain anonymous. Then he spent half an hour telling me about the increasing difficulty of his day-to-day life. “I feel helpless,” he said. He lives alone around 40 minutes from London, and has a neurological condition that leads to long spells of physical weakness. He uses a wheelchair, and depends on the care workers at his sheltered housing development for assistance with some of life’s most basic tasks. Of course, it’s not just him. His flat is just one of 44.

Until recently, he said, there were several care workers there, but the numbers were cut. Seven or eight people once worked a busy morning shift; now there are never more than five, falling to two or three at other times, and a lone person at night.

Growing numbers of people who are continent but have mobility troubles are being ‘left to wet themselves'

In mid-November he was called for an interview – “more like an interrogation”, he told me – during which he was told that the help he gets was also to be hacked back. Care workers still assist at mealtimes and just before bedtime, but whereas he could once call for help outside those times using a pendant he wears around his neck (“I did it once, maybe twice a day at most,” he said. “I’m not a nuisance”) that is now strictly limited.

As of last Monday, extra help with going to the toilet is only available between 10.15 and 11.45am, and 2.15 and 3.30pm; after 6.30pm only if staff are deemed available.

The other day, he dropped his phone (“my lifeline”), and was told to wait four hours before someone arrived to recover it. Once he could call for help with refilling his flask of drinking water; now he has been told that outside set times, he will either have to somehow help himself, or wait.

This man’s problem is “social care” – or the shortage of it – and he describes a crisis that is getting worse by the week. He also highlights two questions about social care (a term surely so cold and technocratic that it dehumanises everyone) that no one seems able to answer: what are we going to do about this escalating emergency now? And what will happen as all those projections of an ageing society become a reality?

Last week Philip Hammond, the chancellor, omitted any mention of social care in his autumn statement. Howls of protest followed, made louder by the unease and anger of Tory MPs and councillors. And once again we heard two big figures: the gap between need and supply now reckoned to be £5bn; and real-terms cuts to local councils’ care budgets since 2011 that stand at 30%.

But never mind the numbers, consider the real-life ramifications. If you are old and infirm and still manage to live at home, but need help washing, dressing or going to the toilet, the help may no longer be there. One insider at a charity that works in this area recently told me of growing numbers of people who are continent, but need help with mobility, and are these days repeatedly “left to wet themselves”.

If you have a fall, and go into hospital, the paucity of help available from your council increasingly means that your discharge is likely to be delayed, and you will end up staying there for fear of something worse happening at home. And such fear is well grounded; already the NHS also has to deal with the consequences of far too many vulnerable people being left to fend for themselves – witness the threefold rise since 2006 in admissions to hospital for malnutrition, adding to chronic overcrowding on the wards.

The popular belief is that adult social care is exclusively bound up with older people, but there is also a mass of issues around adults with disabilities.

The lives of many of these people have been enriched by what officialspeak describes as “supported living”. You might think of that as people being allowed the dignity and independence they deserve. But with the supported living model under threat, more and more people may be looking at the dread prospect of life in residential or institutional care. That sector, as we know from instances such as the Winterbourne View abuse scandal, has itself been plagued by crises.

This week I spoke to a woman from a charity that supports around 2,000 adults with learning disabilities across England. It has just pulled out of one of its local authority contracts because of funding cuts. She reminded me that, unlike many elderly people who need care, the people helped by her organisation are completely dependent on what councils can provide.

We’re going backwards, she said. “We don’t want people living in big groups of 15, or 20. We want them to be in twos and threes, supported by staff who know them.” This model, she said, lends itself to “life in the community”. Institutional care shuts the door on all this.

Other services that have long been part of the basic social fabric are also disappearing at speed: 46,000 older people are reckoned to have lost their access to meals on wheels since 2012. Many are left instead with such arrangements as a fortnight’s worth of microwave meals being delivered in bulk. Meanwhile day centres, which often provide a lifeline to human contact and shared experience for elderly and disabled people, are going fast. Scan the recent news, and you find the same story in Durham, Haringey, Leeds, Doncaster, Stoke, Birmingham, and scores of other places.

Government blundering makes everything worse. Last year George Osborne announced the introduction of the so-called national living wage, apparently conceived with no thought of any extra money to pay for care providers contracted on impossibly tight council budgets. Now it is causing many companies to either fold, or pull out of care contracts altogether. The over-hyped social care precept, whereby local authorities can put up council tax to meet some of their costs, raised £380m last year, whereas these extra wage costs alone totalled £520m.

Speak to the people involved in social care and one message recurs time and again: the services they provide have innovated, contracted-out and de-personalised to the point that virtually nothing has been left untouched. Now, in the face of impossible pressures, they simply need money. And in a new era when deficit reduction is said to be less urgent than it was, they have a very moral question: where is it?