End-of-life services are “already overstretched” and will face further pressure in the decades ahead due to the State’s ageing population unless capacity is increased, a new report states.
The Irish Hospice Foundation on Thursday published Dying, Death and Bereavement in Ireland 2026, which highlights several “areas of concern” including communications around the end of a person’s life.
About 35,000 people die annually, according to Central Statistics Office (CSO). However, the number of deaths recorded annually is forecast to increase by 40 per cent to almost 49,000 over the next 20 years as the population ages.
The number of people dying in the Republic from conditions that require general and specialist palliative care is set to rise by 57 per cent in the next two decades, from 25,669 to 40,355, the report notes.
A lack of out-of-hours support for people receiving care towards the end of their life may be leading to an increase in people attending emergency departments when medical intervention is required, it adds.
Over a five-year period between 2019 and 2023, almost 5,500 people died in or on the way to an emergency department.
“Investment in primary care to improve access to out-of-hours care for people, regardless of geography, finances, care setting or diagnosis, is crucial,” the foundation said.
“Some hospital admissions will be necessary, but for others, alternative urgent care closer to home should be available to meet their needs.”
There are 14 adult hospices in the Republic, with a combined total of 276 beds. However, there are several areas – namely the midlands and northeast – which have no adult hospices.
Communication around death and subsequent planning were two areas highlighted by the foundation.
According to the report, two in three respondents to the 2023 National End of Life Survey said a relative or friend was not told by a healthcare professional that they were likely to die.
“This lack of communication meant that the person dying missed opportunities to make appropriate arrangements and family members were not fully aware that their loved one’s death was imminent,” the report said.
The report quoted from one woman, whose mother, in her 70s, died in hospital, who said there were “mixed messages about my mother’s prognosis … If I had truly understood how unwell she was, I would have taken off more time from work to be with her.”
The report notes there is no statutory right to bereavement leave in the Republic, which means that employers have no legal obligation to offer time off to workers who are bereft.
Research by the foundation revealed that two out of three people recently bereaved were in employment, and more than half of those surveyed changed their working arrangements after a death.
The report includes a number of recommendations to improve end-of-life services, including the establishment of a register of advance healthcare directives, increasing conversations around death to reduce stigma and delivering hospices for the midlands and northeast regions “without further delay”.
Foundation chief executive Paula O’Reilly said people countrywide deserve the opportunity to experience a good death.
“That requires a set of supports and services that are wide ranging and effective,” she said, adding that the report shows “a need for urgent action and creative thinking across the board”.
Ms O’Reilly said the system is “creaking at the seams” and as fatalities increase in the coming decades, “extraordinary measures will be required to ensure that every death will continue to matter and to provide the level of supports available to those who are grieving”.