Ageing population means Ireland will need around 50,000 long-term beds by 2040

THE NUMBER OF long-term residential care beds and home supports for older people will need to increase by at least 60% by 2040, according to research.

The Economic and Social Research Institute (ESRI) found the number of people aged 85 and over, who use a substantial amount of long-term residential care and home support, is projected to more than double in the coming years.

The ESRI published a report today into long-term residential care (LTRC), research which was funded by the Department of Health.

The research found that by 2040, one in five people in Ireland will be aged over 65.

In 2022, there was an estimated combined 33,324 short-stay and long-stay beds in LTRC homes.

Short-stay bed requirements are projected to grow from 3,745 beds in 2022 to between 6,430 and 7,265 beds by 2040, growth of 72% to 94%.

Long-stay bed requirements are projected to grow from 29,579 beds in 2022 to 47,590-53,270 by 2040, growth of 61%-80%.

Almost 29 million home support hours were provided to the older population in 2022, with three-quarters of these hours provided through the HSE’s home support service and a quarter privately purchased.

Requested home support hours are projected to grow from 28.7 million annually in 2022 to between 44.9 million and 54.9 million annually by 2040, growth of 57% to 91%.

The ESRI said although healthy ageing effects may reduce future requirements, the substantial impact of increases in the older population will offset much of any potential moderations.

Lead author of the report Dr Brendan Walsh said: “Ireland has experienced tremendous improvements in life expectancy in recent decades, driven mainly by reductions in mortality at older ages.

“This means there is, and will be, a much larger population at older ages who require long-term care services to support them at home, or within residential facilities.

“Therefore, plans and policies are needed for long-term care to ensure the health system is in a position to meet the increasing care needs of the older population. Our findings provide policymakers with an important evidence base to help develop these plans and policies.”

Health Minister Jennifer Carroll MacNeill said the research will “help us plan better”.

She said the Programme for Government pledges to build more public nursing home beds, create a homecare scheme to help people stay in their homes longer, and increase home care hours.

“We are already making progress in increasing both residential care capacity and home support hours for our older population. This is shown by the €4 million allocated in Budget 2025 to staff and open 615 new community beds.

“The Department of Health and the HSE are also working on a new Long-Term Residential Care Additional Capacity Plan, to be published in 2025.

“This capacity review, commissioned by the Department of Health and the HSE, shows our commitment to planning based on evidence. With the Hippocrates Projection Model and our ongoing work with the ESRI, we can adapt our plans to new data and policies as they come up.”

Minister of State Kieran O’Donnell, who has responsibility for housing and older people, said the ESRI research would be “invaluable” for capacity planning for residential care and home support.

“It is evident that significant action will be required by Government in order to ensure that the appropriate care services are available for our older population and to deliver on Programme for Government, Slaintecare, and Project Ireland 2040 commitments.

“I am absolutely committed to ensuring that this capacity planning is advanced in 2025.”

The Irish Nurses and Midwives Organisation (INMO) today said that any “mass expansion of beds in the nursing home sector must be provided by the public health service”.

INMO General Secretary Phil Ní Sheaghdha remarked that “by current projections, Ireland is on course to have the highest old-age dependency ratio in the European Union”.

“This will place unprecedented pressure on our health service, especially on long-term care systems which are already stretched thin,” she added.

“Today, 74% of all long-term residential care beds in Ireland are in private facilities, and just 14 large private operators now control about 40% of all LTRC beds nationally. The increasing privatisation of these services is not the answer.  

“The care of older people is not a commodity to be bought and sold. It is a public good and it must be treated as such through sustained public investment in the provision of high quality, publicly delivered, residential and care services for older persons. 

“A two-tiered system of care of the older person services is not what Sláintecare envisioned.

“It is not working for the most vulnerable people in our society, those who rely on us to ensure they can continue to live and age with dignity in their own local community.”