New ESRI report projects that long-term residential care and home support requirements will increase by at least 60% by 2040

June 30, 2025

Health and Quality of Life
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A new Economic and Social Research Institute (ESRI) report, released today (30 June 2025), projects that the number of long-term residential care (LTRC) beds and home support hours provided to the older population will need to increase by at least 60% by 2040. The research, funded by the Department of Health, considers a range of scenarios based on varying assumptions about population growth and ageing, the effects of healthy ageing and policy choices (e.g., expanding home support services).

Key findings:

Population change

The projected rise in LTRC and home support requirements is largely driven by the increase in size of the older population. By 2040, 1 in 5 people in Ireland will be aged 65+. The population aged 85 years and over, who use a substantial amount of LTRC and home support, is projected to more than double.

Demand and capacity in 2022 and 2040 requirements

  • In 2022, there were an estimated combined 33,324 short stay and long stay beds in LTRC homes.
  • 1 in 8 beds in residential care homes were used for short term care, such as step-down care following discharge from hospital and rehabilitative care.
  • 7 in 8 beds in residential care homes were for long stay care, with the majority of these beds used by residents funded through the Nursing Home Support Scheme (commonly known as Fair Deal).
  • Almost 29 million home support hours were provided to the older population in 2022, with three-quarters of these hours provided through the HSE’s home support service and a quarter of hours privately purchased.
  • Short stay bed requirements are projected to grow from 3,745 beds in 2022, to between 6,430 to 7,265 beds by 2040, growth of between 72 to 94%
  • Long stay bed requirements are projected to grow from 29,579 beds in 2022, to between 47,590 to 53,270 beds by 2040, growth of between 61 to 80%
  • Home support hours required are projected to grow from 28.7 million annually in 2022 to between 44.9 million to 54.9 million annually by 2040, growth of between 57 to 91%.

Policy implications

Even at the lower end of the projections, the report highlights that substantial increases in LTRC beds and home support hours for older people will be required by 2040. The analysis shows how healthy ageing effects may reduce future requirements, and different policy choices, such as expanding home support services, can reduce LTRC bed capacity requirements. However, the substantial impact of increases in the older population will offset much of the potential moderations in long-term care requirements that may arise out of healthy ageing effects or model of care changes.

Dr Brendan Walsh, Senior Research Officer at the ESRI and lead author of the report, said:

“Ireland has experienced tremendous improvements in life expectancy in recent decades, driven mainly by reductions in mortality at older ages. This means there is, and will be a much larger population at older ages who require long-term care services to support them at home, or within residential facilities. Therefore, plans and policies are needed for long-term care to ensure the health system is in a position to meet the increasing care needs of the older population. Our findings provide policymakers with an important evidence base to help develop these plans and policies.”

Minister Kieran O’Donnell TD, Minister of State for Older People and Housing:

“This analysis from the ESRI will be invaluable for advancing evidence-based capacity planning for residential care and home support. I look forward to ongoing engagement with the ESRI and colleagues in the HSE as we develop and strengthen our future capacity plans in order to meet the needs of our growing and ageing population.”