Ireland's Ageing Population and the Challenge for Health and Social Care

By 2057, Ireland will have over one million people aged 65 and older. This is not just any statistic, but it represents a shift that will shape how care is delivered to the most vulnerable people in our society. This demographic shift is happening, so the question is if Ireland is prepared for its impact?

The Demographic Reality

The demographic landscape of Ireland is undergoing a transformation. As highlighted in a TASC report The Future of the Irish State 2025 the demographic makeup of Ireland is changing due to an ageing population, increasing life expectancy and low fertility rates. This has resulted in Ireland being classified as having a declining or ageing population, as the proportion of people aged 65 years and older is increasing rapidly in comparison to other age groups.

In Ireland’s most recent census in 2022, out of the total population 781,000 (~ 15.7%) of people were aged 65 and older. Based on the current trends in this age group, the Central Statistics Office (CSO) has projected that the total number of people aged 65 years and older is expected to continue increasing and eventually rise to a total of over 1 million people by 2057. The CSO, as part of its projections, takes into account factors such as immigration and migration and birth rate trends.

This demographic shift goes beyond Ireland. Across the European Union (EU), countries are experiencing the same population changes. On January 1 2021, people over the age of 65 accounted for more than one-fifth (21.6%) of the total population of the EU. Similar projections for this age group are made by Eurostat, which is the statistical database for the EU. The population pyramid below compares the age structure of the EU population in 2019 (solid colours) and the projected population for 2050 (white bordered outline). It shows the percentage of the total population by age group and gender (men on the left in blue and women on the right in orange). By 2050, the pyramid widens at the top, highlighting an ageing population and narrows at the base, showing fewer young people.

The Care Challenge

Keeping these figures and projections in mind, it reveals a critical imbalance. The proportion of people of working age who can provide care is shrinking while the proportion of older people is expanding. This shift has huge and profound implications on many areas of life, but in particular, the health and social care system. The current scale of care demand in Ireland becomes clearer when residential care figures are examined. According to the 2022 census, the CSO found that 23,449 (~3%) of people aged 65 and older lived in either a nursing home or residential facility. This figure will only rise with the population projections, but does Ireland have the workforce capacity to meet this growing demand?

A recent RTÉ Investigates documentary called “Inside Ireland’s Nursing Homes” saw two fully trained healthcare assistants go undercover in two private nursing homes to examine the standard of care provided. This documentary gave an insight into the worrying standard of care that is currently provided by some nursing homes in Ireland. For instance, the documentary highlighted situations where multiple residents required assistance to use the toilet or requested to go outside for a walk, but these needs went unmet due to inadequate staffing levels. The investigation also revealed poor working conditions that compromised care quality, including insufficient hygiene materials that forced staff to improvise and left patients without the proper supplies needed to address their medical conditions. These shortages and poor working conditions have an impact on the patient receiving care, but also the person providing the care. Patients’ needs and preferences often go unmet due to insufficient staff, while care workers struggle to perform their roles effectively under such conditions. 

The Workforce Challenges

There are several interconnected factors to Ireland’s care workforce crisis, stemming from things such as the stigma of elder care, high staff turnover rates, low pay and poor working conditions. These factors have created supply challenges which have a knock-on effect on the current workforce, impacting people’s wellbeing, job satisfaction and staff retention (Thwaites et.al., 2023). The human cost of these shortages is stark and measurable. Forsá commissioned TASC to conduct research into 3,800 health care staff. The research found that 68% of respondents described health staff morale as either being low (43%) or terrible (25%). One of the main sources of these high figures was the crushing pressure on health and social care staff who cannot provide the quality of care they know their patients need due to chronic staff shortages and poor working conditions.

Moving Forward

Addressing Ireland’s care challenge requires reform across multiple areas:

1. Updated regulations and legal framework

The regulations and legal framework governing nursing homes need to be urgently updated. Residential care in Ireland is regulated under the Health Act 2007; however, the last time it was updated was in 2013 (Behan et.al., 2024). The lack of change leaves a gap that potentially compromises patient safety and care quality. Ireland can look towards its EU neighbours for guidance. For example, Finland recently introduced a legally binding bill that stipulated nurse-client ratios of 5 nurses per 10 patients (Kangas and Kalliomaa-Puha, 2021). While implementing similar mandatory staffing standards in Ireland would help ensure adequate care delivery, the Health Information and Quality Authority (HIQA) would likely be responsible for enforcement. However, effective monitoring of enforcement across facilities in Ireland may present challenges due to HIQA’s capacity and powers.

2. Staff Recruitment

Ireland must make careers in the health sector more attractive and accessible. The Irish Nurses and Midwives Organisation Pre-Budget Submission 2025 outlines several recommendations for staff recruitment that extend to nursing home staff and the wider care sector. They call for the ending of recruitment freezes and expanding education capacity through increased undergraduate and postgraduate nursing places. Central to retention efforts is their recommendation to review and enhance pay structures, working conditions and collective bargaining rights for nursing home staff, who have historically been undervalued. They emphasise streamlining international recruitment by improving integration, orientation and support for overseas staff while reducing bureaucratic barriers. If incorporated, these measures would make Ireland’s health sector a more attractive and accessible career choice.

3. Staff Retention

There is a need for investment in training and career development for carers. Revealed in the research TASC conducted for Forsa, 63% of respondents were dissatisfied with the opportunities for career development in the health sector. This clearly indicates that the sector must create meaningful pathways for professional growth to retain workers. Alongside this, establishing clear roles and responsibilities is equally as important to prevent exploitation and harm of workers (Morrow et al., 2024). Without role clarity and the investment in career progression, the sector risks burning out workers and failing to attract people to the workforce.

4. Working conditions

Improving working conditions requires both physical and psychological support systems. Support for personal well-being, such as an increase in support systems for workers to alleviate the physical and emotional burden of work, is needed. Research has shown that there is a need for policies to be created in healthcare settings that integrate mental health support, such as making psychological support services accessible to workers and implementing programmes that build awareness around the importance of mental health among workers (Frias et al., 2025). Incorporating such supports into Ireland’s healthcare system is needed to ensure that workers are given the support that they require. Together, these recommendations have the potential not only to improve the quality of care for older people but create fulfilling and sustainable careers within the health and care sector. The question now is whether Ireland will rise to this challenge with the necessary urgency and investment to prepare for the future. This is not just a matter of addressing demographic shifts; it is a test of Ireland’s commitment to its most vulnerable citizens.

References

Behan, L., Grogan, C. and Keyes, L.M. (2024) ‘The impact of regulation on the quality of care in nursing homes in Ireland: A time-series analysis of change in compliance’, HRB Open Research, 7, pp. 23.

Frias, C.E., Samarasinghe, N., Cuzco, C., Koorankot, J., de Juan, A., Rudwan, H.M.A., Abdul Rahim, H.F., et al. (2025) ‘Strategies to support the mental health and well-being of health and care workforce: A rapid review of reviews’, Frontiers in Medicine, 12, pp.1530287.

Kangas, O. and Kalliomaa-Puha, L. (2021) ‘Finland to improve the quality of long-term care by increasing the number of nurses per patient’, ESPN Flash Report, 2021/13.

Morrow, E., Kelly, C., Killeen, C., Naessens, E. and Lynch, M. (2024) ‘Exploring a career pathway for home support workers in Ireland: A systematic scoping review of the international evidence’, Frontiers in Health Services, 4, pp. 1360920-1360920.

Thwaites, C., McKercher, J.P., Fetherstonhaugh, D., et al. (2023) ‘Factors impacting retention of aged care workers: A systematic review’, Healthcare (Basel), 11(23), pp. 3008.

Posted in: Health

Clodagh Lynch

Clodagh Lynch is a master's student in Politics and Data Science at UCD. Additionally, she holds as a BA in History and Politics from UCD. As part of summer semester, she is interning at TASC in the health stream. She has a personal interest in providing data-driven solutions to policy challenges through quantitative analysis and evidence-based research.