Current and Future Needs for Hospice Care:: an evidence-based report
Our society is also aging and the consequences are hugely significant. In 2010, 1.4 million people were aged 85 or older and deaths in this group represented 36% of all deaths. By 2035, this figure will be 3.5 million and deaths in the over 85s will represent half of all deaths in the UK. As we live longer we are more likely to die as a consequence of chronic disease with a greater number of us living with cancer and dementia. Indeed, in ten years time the number of deaths caused by cancer is expected to increase by 30% for men and 12% for women and in just eight years the number of people living with dementia will rise to over a million.
In short, the demand for care at the end of life will rise and the nature of that care will become more complex. Hospices will need to take inevitable changes in the future shape of our population into account as they plan future service development. However, these are not the only challenging messages in this report. The authors take us under the demographic headlines in order to identify the future users of hospice care and rightly urge hospices to better understand their needs, preferences and wishes both now and in the future.
First amongst those whose future needs and preferences hospices need to understand are the oldest old. Currently, older members of our society express a preference to die in a hospice but are more likely than other groups to die in a hospital or a care home. This data does not allow for a more subtle interpretation of this preference or the actuality of who may have been involved in end of life care whatever the physical setting. However, it will be important for hospices to consider alternative and innovative ways in which their care might be brought to the individual and consider if a ‘hospiceenabled’ death achieved in a range of settings from home, care home or hospital could meet their needs and preferences.
The report also highlights the evidence that tells us that older people and people with non-malignant conditions are less likely to receive timely referrals to palliative care. It suggests that hospices need to continue work to establish the partnerships necessary to support new models of care that reach out to people in their communities, earlier in their illness, and connect with their existing specialist care. Crucially, the report emphasises the need for such innovation to be rigorously evaluated for effectiveness and cost-effectiveness as well as being speedily spread and adopted. Hospices have much to do to meet this challenge.
Published : 29th January 2013
Author : Natalia Calanzani, Irene J Higginson and Barbara Gomes [ More From This Author ]
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