Professor Joanne Reid’s Platform: Where will we die by 2040 in Northern Ireland?
Hospice Palliative Care Week Ends Today Joanne Reid, Professor of Cancer and Hospice Palliative Care, discusses end-of-life services in Northern Ireland.
More people than ever will live beyond their 100th birthday, which is one of the great achievements of public health, but living longer will contribute to a significant increase in the number of elderly deaths in Northern Ireland. here 2040.
A consequence of the lengthening of the lifespan and the increase in the number of elderly households means that the elderly are much more likely to survive with complex health and social care needs.
This includes significant challenges at the end of life, including staying home as long as possible.
We know that the place of death is important for the quality of the end of life.
Reaching a preferred place of death is important for the patient, their immediate family and caregivers, it can also facilitate the grieving process and is considered a good quality marker for end-of-life care by service providers.
However, very little research exists on the end of life of people living in Northern Ireland and it is not clear whether these needs are being met within the current provision of palliative care in Northern Ireland.
Researchers from the School of Nursing and Midwifery at Queen’s University Belfast, in collaboration with Marie Curie, set out to estimate and better understand the needs for care services for dying people living in Northern Ireland by 2040.
Such analyzes aim to predict future outcomes when we can’t wait 20 years to see what might happen. Data from the past helps predict with reasonable certainty what might happen in the future.
Current analysis shows that a growing and aging population will contribute to a significant increase in the number of elderly deaths in Northern Ireland by 2040.
Data from Northern Ireland also shows that between 2004 and 2018, dying in hospital was the most common setting of end-of-life care. However, in 2018 deaths in hospitals, hospices and “all other places” declined while deaths in homes and care homes increased.
Current analysis suggests that if trends in place of death in Northern Ireland continue, the need for end-of-life care will increase over the next 20 years, particularly in community settings.
By 2040, deaths within the community could account for more than 50% of all deaths. Providing additional and effective community capacity could reduce the number of deaths that occur in hospital settings.
However, with the continued lack of sustainable resources for social care, the number of deaths occurring in hospitals is likely to increase.
These results for Northern Ireland match the death projections for Scotland, England and Wales, which reported a significant increase in the number of people dying outside hospitals by 2040.
These forecasts are aligned with those of other aging countries.
Collectively, these studies draw attention to the urgent need for a transfer of care and resources to care in the community across the UK.
Death at an increasing age has serious implications for the provision of end-of-life care, and it is not clear at present whether health and social care services in Northern Ireland, as they are are currently established and resourced, will be sufficient to meet future demand.
Northern Ireland needs an urgent prioritization of community care resources and increased research capacity to ensure that community settings can meet the basic care and specialist support needs of people at end of life.
This is a timely request given that it is Palliative Care Week across the island of Ireland.
Now in its eighth year, the week ran from September 12 until today to raise awareness of the positive impact of palliative care on the lives of people with life-limiting illnesses and their families; allowing them to live their lives as fully as they can (visit The Palliative Hub website to learn more).
:: Joanne Reid is Professor of Cancer and Palliative Care and Director of Research at the School of Nursing and Midwifery at Queen’s University, Belfast. She is also Chair of the Palliative Care Research Network of the All Ireland Institute of Hospice and Palliative Care.