The ageing and de-institutionalisation of death—Evidence from England and Wales

• Published in: Health policy (Amsterdam) Vol. 123; no. 4; pp. 435 - 439
• Main Author: Leeson, George W.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.04.2019; Elsevier Science Ltd
• Subjects: Age; Ageing; Aging; Caregivers; Death & dying; Death and dying; Dementia; Falls; Health administration; Home based; Institutionalisation; Institutionalization; Men; Mortality; Older people; Place of death; Projections; Statistics; Very old; United Kingdom > UK; England; Wales; Institutionalisation; Ageing; Death and dying
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2019.01.013

•Increasingly, age of death is postponed until very old age, and care of those who are dying is challenged by medical co-morbidities and the presence of dementia.•Although most people would prefer to die at home, currently in England and Wales only about 20 per cent of those aged 65 years and over die at home, and this proportion falls to about 10 per cent among those aged over 85 years.•To explore recent and likely future trends in age and place of death, mortality statistics from 2006 to 2013 were analysed and projected to 2050 using age- and gender-specific rates.•Results confirmed recent increasing age at death and indicated a trend for increasing proportions of older people to die at home.•Projections indicated large increases in home-based deaths, particularly for men aged 65 and over.•Consistent with people’s wishes, there may be a partial return to the view that dying at home is a normal experience.•Resource allocations are likely to need to shift to support people dying at home and their formal and informal carers. Increasingly, age of death is postponed until very old age, and care of those who are dying is challenged by medical co-morbidities and the presence of dementia. Although most people would prefer to die at home, currently in England and Wales only about 20 per cent of those aged 65 years and over die at home, and this proportion falls to about 10 per cent among those aged over 85 years. To explore recent and likely future trends in age and place of death, mortality statistics from 2006 to 2013 were analysed and projected to 2050 using age- and gender-specific rates. Results confirmed recent increasing age at death and indicated a trend for increasing proportions of older people to die at home. Projections indicated large increases in home-based deaths, particularly for men aged 65 and over. Consistent with people’s wishes, there may be a partial return to the view that dying at home is a normal experience. Resource allocations are likely to need to shift to support people dying at home and their formal and informal carers.