OECD countries are rapidly ageing, and Estonia is not an exception. Estonia’s elderly are one of the poorest and most vulnerable segments of the population, as health and social care expenditures are lower and reported health problems among the aged higher than in other European countries. In light of increasing needs, poor health and social outcomes for the elderly, and limited financial means to reinforce inputs, Estonia needs to change the way in which it delivers care to the elderly population, in particular by working as a single government – across levels of government, among municipalities and care providers, and across sectors – in order to reduce the fragmentation of resources, capacity, and knowledge about elderly needs. Such a joined-up approach is necessary to find a sustainable response to Estonian social, cultural and economic circumstances and to meet the goal of equality of access to services for all citizens across the country.