Welcome

Older People's Health

8.12.1.1 The South West has an ageing population as a consequence of long life expectancy, falling conception rates, the 'baby boom' generation reaching retirement age and net inward migration. Between 2010 and 2030
the population aged 65 years and over is projected to increase by over 500,000 with 150,000 of this increase projected to be in those aged over 85. This is a doubling in number of the region’s oldest age group (source: ONS). While mature adults in the South West are healthier than those in the rest of England, a growing older population still presents many challenges for the South West. For instance, the population aged over 85 years reporting a limiting long-term illness is projected to increase to over 160,000, and those suffering from dementia to increase to 70,000 by 2030 (source: POPPI).

8.12.2.1 A UK Parliament ‘Early Day Motion’ on 11 January 2005 drew attention to the Marie Curie Cancer Care ‘Supporting the Choice to Die at Home’ campaign, and noted that a 2004 survey commissioned by the charity found that 64% of Britons would prefer to die at home. However, as reported some four years later in the Department of Health’s End of Life Care Strategy (2008), only a minority actually die at home. In 2009, there were about 460,000 deaths in England, with almost two-thirds in people aged over 75 (source: ONS). The large majority of deaths follow a period of chronic illness. A recent report by SWPHO on behalf of the National End of Life Care Intelligence Network, Variations in Place of Death in England, found that 58% of deaths in England in 2005–07 were in hospital and 19% occurred at home. In 2005–07, the South West had the lowest proportion of deaths in hospital (54%) when compared with other regions and 20% of deaths were at home.

8.12.2.2 The quality of care also varies quite considerably. The Department of Health acknowledges that, while some people do indeed die as they wish, there are distressing reports of people not being treated with dignity and respect as well as not dying where they choose.

8.12.2.3 The national End of Life Care Strategy aims include: improving the provision of community services by, for example, making rapid response community nursing services available in all areas 24 hours a day seven days a week, and improving coordination of care between Local Authorities and PCTs; equipping health and social care staff at all levels with the necessary skills to communicate with, and deliver care to people approaching the end of life, and their carers; developing specialist palliative care outreach services by encouraging PCTs
and hospices to work together to provide appropriate support to all adults in the community, regardless of their condition (source: National Audit Office).

8.12.2.4 Future plans for end of life care will have to be mindful of the predicted rise in the number of deaths per year, by approximately 17% between 2010 and 2030. The largest increase is predicted for those aged 85 years or older (source: Gomes, B. & Higginson, I. (2008). Where people die (1974–2030): past trends, future projections and implications for care. Palliative Medicine, 22, 33–41). For the South West this will mean an increase in deaths each year from over 50,000 to over 60,000. This increase impacts on the national End of Life Care Strategy. To maintain the current pattern of place of death, a corresponding increase in provision would be required. The likely greater age at death in the future will impact on the care requirements of the dying as deaths in older people are more likely to be associated with multiple morbidities.