Palliative care needs projected to nearly double over next 30 years

Research out of Ireland suggests end-of-life care needs will nearly double over the next three decades, corresponding to an increase of 84% by 2046.

The study, conducted at Trinity College Dublin and published in HRB Open Research on Feb. 6, drew on data from the Irish Longitudinal Study on Aging (TILDA) and applies only to Ireland. When Karen Ryan, a palliative medicine consultant, and her colleagues estimated palliative care needs in England and Wales over the same time period, they predicted a 43% increase by 2046—a 41-percentage-point difference compared to Ireland.

The team said the gap is likely a reflection of population differences between Ireland and England; Ireland’s population is now younger than the EU average and will have faster-growing needs in the coming decades. Government statistics and projected mortality data were used to calculate estimates.

“Ireland is recognized to have a high standard of palliative care provision,” Ryan said in a release. “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.”

Ryan noted that Sláintecare, the 10-year program designed to overhaul Ireland’s health and social care services, is expected to draft a revised national palliative care policy in 2020 and said she hoped her team’s results would help inform the review.

In addition to estimating palliative care needs for patients with chronic illnesses like cancer, heart disease, organ failure and dementia, Ryan and co-authors estimated numbers of people who live with serious illnesses requiring expert support in the years leading up to their death. They found the number of people living with a serious disease outnumber those in the last year of life with a serious disease by around 12:1.

“The highest average illness burden and healthcare need is of course among those near the end of life,” Peter May, lead author of the study, said in the release. “But total population needs will be driven by all people experiencing these conditions.

“Healthcare 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 as possible.”