Unnecessary Suffering for Older Irish People in Last Year of Life

As an organisation that deals primarily in probate genealogy, Finders International Ireland was interested to note that new research has suggested that many older Irish people experience unnecessary suffering during the last year of their lives.

The Tilda (The Irish Longitudinal Study on Ageing) paper published recently found that pains, falls and depression affects almost half of Irish people in their final year. The report is thought to be the most comprehensive survey to date on Irish people and dying.

Some 41 percent of people experienced falls, 50 percent suffered regular pain and 45 percent depression. The Tilda survey sampled some 8,000 adults aged 50 and over. The biggest killers of older Irish people were cancer and heart disease, which accounted for two-thirds of deaths. Fifteen percent of people died suddenly and 14 percent within a month of being diagnosed with a severe condition.

Healthcare use increases in the last year of life, but there isn’t a pattern of highly intensive end-of-life care that is seen in countries like the US and is associated with a poor end of life experience. Significant numbers of people, though, needed community care services and couldn’t access them. However, this is attributed to a lack of awareness and a reluctance to apply for the services.

A substantial number of people received help or care from family members and friends. On average, people underwent two hours of care a day, but 10 percent had 24-hour unpaid assistance. If the costs of informal care are estimated next to the formal healthcare costs in the last year of a person’s life, unpaid care accounts for 42 percent of the total cost of care that is received.

As you might expect, older people living alone experienced the last year of their life differently from those who lived with others. People living alone received less informal care with everyday activities, but there was no increase in their use of formal healthcare, so on average, they received less care.

People living in rural areas were less likely to die in a nursing home than those in urban areas, and people with heart disease or depression were more likely to have been unable to get the services they needed.

The report says that old age itself is not a driver of health service use in a person’s last year of life. The factors are a disability and chronic health conditions. But old age is associated with much higher levels of informal care.

Professor Charles Normand of Trinity College Dublin, the report’s senior author, said the findings showed that falls among older adults could be prevented by modifying the homes of those at risk and that the number of people dying in hospitals was too high.

Padraic Grennan, Finders Ireland’s manager, said: “Ireland’s population is ageing fast – within a decade, there will be more than a million people aged over 65 in the Republic and it’s a massive challenge for the Seanad.

“We agree with Professor Normand – too many people die in hospitals. We see this a lot in the work that we do when someone dies without apparent next of kin and a valid will, and it’s an issue that we find distressing. Hopefully, the research carried out will help inform future policies and provision of care and services for older people in Ireland.”

For more information about our services in Ireland, visit our website www.findersinternational.ie.