The standards of care provided for older people in their homes in the UK has been labelled "shocking and disgraceful" by a consumer group.
Which? found cases of missed visits, food left out of reach, medication not given and people being left in soiled beds during its investigation.
It concluded too many faced a "constant battle" to just get the basic help.
The UK Home Care Association said it was never acceptable for people to experience rushed or inadequate care.
Which? said the findings - based on a survey and diaries kept by the elderly - showed the system needed reform.
More than 500,000 people rely on help at home with activities such as washing and dressing.
These include both people who get council-funded care and those who pay for it themselves.
While Which? said there were some examples of excellent care, it claimed too many were being poorly served.
The group asked 30 people to keep diaries over the course of a week detailing their experiences.
One elderly lady was left alone in the dark for hours unable to find food or drink.
Another was left without a walking frame so she was unable to get to the bathroom and one man was not given vital medication for his diabetes.
The poll, of nearly 1,000 people, found one of the most common complaints was missed or rushed visits.
Nearly half of respondents said visits had been missed in the last six months with most not being warned in advance.
One daughter said: "They missed a day just after Christmas. I covered, but mum didn't contact me until early evening by which time she needed a lot of cleaning up.
"You wonder about the elderly with no relatives."
Which? said the situation was only likely to get worse as councils increasingly squeeze funding.
This report is just the latest in a series that has highlighted the struggle the elderly are facing.
At the end of last year the Equality and Human Rights Commission said standards were so bad they even breached human rights.
Which? executive director Richard Lloyd said: "Our investigation found some disgraceful examples of care with elderly people given little time or respect.
"The government can no longer claim to be shocked as report after report highlights the pitiful state of care for older people."
And Michelle Mitchell, of Age UK, said the system was putting the "health and dignity of older people at risk".
The UK Home Care Association, which represents the agencies which provide many of the services, said its members were increasingly under pressure to cut the length of visits by councils wanting to save money.
Mike Padgham, the group's chairman, said: "The report supports our growing concern over state-funded homecare.
"People and their families must be confident that they will receive dignified and effective care.
"They must look to government and local councils to place the needs of elderly and disabled people at the forefront in the current economic climate, to avoid the concerning picture described in today's report."
Councillor David Rogers, of the Local Government Association, said: "This research highlights the very real crisis this country is facing in providing care for the elderly and vulnerable.
"We know there isn't enough money in the system and without fundamental reform the situation is only going to get worse and stories like this will sadly become increasingly common."
The government has promised to publish plans this year to overhaul the system in England. One of the aims of the forthcoming changes is to create a fairer and better-funded system.
The other parts of the UK are also looking at their systems.
Even in Scotland, where care is provided free, services are having to be rationed to only those who are the most in need because finances are stretched.