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End-of-life care needs will nearly double over the next 30 years

Research at Trinity College Dublin, shows that the number of people dying in Ireland with palliative care needs will increase 84% to 2046.

The study, conducted at Trinity’s Centre for Health Policy and Management and The Irish Longitudinal study on Ageing (TILDA), estimated how many people will die from a serious disease such as cancer, heart disease, organ failure and dementia to 2046. The estimated 84% increase compares to 43% for England and Wales in a similar period.

Projected increases are underpinned by two factors of population ageing: increasing absolute numbers of people dying, and increasing proportion of people who experience a serious illness prior to death. Increases are most observable in the 85+ age group, which is growing rapidly. The difference with England primarily reflects Ireland’s population, which is now younger than the EU average and so will have faster-growing needs in the 21st century.

Palliative care is a type of specialist supportive care that aims to improve quality of life for people living and dying with serious illness. It is provided in Ireland in hospitals, by homecare teams and at inpatient hospices.

Professor Karen Ryan, Consultant in Palliative Medicine at the Mater and St Francis Hospice, and Clinical Professor in the School of Medicine at UCD, said that the results indicate an urgent need to address funding and workforce in palliative care: “Ireland is recognised to have a high standard of palliative care provision. Our data show that capacity must increase significantly if we are to maintain that.

People are living longer with more serious illnesses. This is a success story for society but also brings challenges.

Sl√°intecare priorities include a revised national palliative care policy in 2020 and we hope that our results will inform this review, so that people dying with serious illness and their families receive the care and support they need during this unique life event.”

The study also estimated numbers of people who will live with serious illnesses requiring expert support in the years prior to death. They found that the number of people living with a serious disease outnumber those in the last year of life with a serious disease by about 12:1.

Dr Peter May, Research Assistant Professor in Health Economics at Trinity and lead author of the study, said that this has important implications also:

Population ageing means not only more people dying with serious medical conditions but many more people living with them also.

The highest average illness burden and health care need is of course among those near the end of life. But total population needs will be driven by all people experiencing these conditions.

Health care provision has to change to reflect those needs. We need better anticipatory and supportive care to lower avoidable hospital admissions and keep people living at home and in their communities for as long possible.”