When it comes to palliative care, demand will exceed supply. And it’s going to be hard to watch.

A grey-haired man in a hospital gown

A freight train is coming and we’re standing on the tracks.

I attended a webinar today where social commenter and demographer Bernard Salt discussed palliative care in Tasmania in the next decade. It wasn’t pretty.  

“We need to prepare for the coming surge in the 85+ population, and this includes skilling up the workforce in palliative care”, he said.

As the housing crisis has shown us, Australia’s population is moving and growing, and our infrastructure is not coping. The population is getting older and we’re living longer. (Australians have added 15 years to life expectancy over the last 70 years. Source UN World Pop Prospects 2022). Life expectancy is now 84.

If you were born between 1946 and 1964, you’re a baby boomer, born during the mid-20th century baby boom.  Boomers are in their late 70s now. And here comes the ‘freight train’.

You see, in the next 10 years, boomers will officially be ‘old’. That is, they will reach their 80s and it’s then their health and care needs will increase.

80 is the new 65. This is a screenshot from a seminar I attended today.

Mr Salt said, “By 2033, the boomers are moving en masse into their 80s and into the space of the frail-elderly and high use of health care services and facilities, including palliative care.”

“Just because you’re over 85 does not mean that you need palliative care, but I think it’s fair to say that you’re ‘kind of in the zone’.

Mr Salt has been crunching the numbers and they show a freight train of people needing care is rolling at speed down the track. It’s not a slow increase in numbers.

“This isn’t slowly stepping up. This is ratcheting up. There’s no saying ‘we didn’t know’.”

It’s something service providers such as palliative care agencies have known for a while. They’ve been lobbying government for increased resources and funding for some time.

Using the ABS Population Projections, Bernard Salt said Australia’s 85+ population growth rate will increase three-fold over the next eight years.

“Today this frail-elderly cohort expands by 20k per year but this will ramp to 60k pa within eight years,” he said.

So, who’s going to look after them as they near the end of their life?

Mr Salt wants to see a clearer picture of how many medical professionals are working in the palliative care space. He thinks tweaking the Census is a must.

“Palliative care physicians and palliative care nurses are not recognised in the 2021 census.

“I want to see these occupations measured separately at the 2026 census so I can cross-tabulate it, measure it, and look at the distribution and allocation of palliative care skills and resources across. It’s incredibly important.

“We need to be more focused on the type of skills that we will need into the future.”

Demographer Bernald Salt.

(Bizarrely, the census captures the occupation of ‘bungee jump masters’. According to Mr Salt, there are six, if you’re wondering.)

Positioning palliative care as a core value of the Australian people

I mention this is The Bottom Drawer Book and I’m going to say it again here: Lifestyle vs deathstyle.

Australians love the beach, a BBQ on the patio with mates, watching the footy, playing cricket in the backyard with the grandkids, and looking after one another during hard times. That’s our lifestyle. They’re our core values.

But, when we age, the aches and pains set in, the illnesses come thicker and faster, and we start to fall apart, both physically and mentally. Somebody is going to have to care of us when that happens. And if that can’t be done at home, it’s going to have to be done in a care facility of some sort.

So, what do you want that to look and feel like for the people you love? Every one of us needs to think about whether our lifestyle should include compassionate care and palliative care. Should our ability to deliver this care become a core value of Australian society?

And if so, we (you and me), our communities, and our governments, need to plan for it and allocate resources to it. And we need to start now.

We know the train is coming, and we know how many passengers it’s transporting, but we don’t know how many people are waiting at the station to help them.

Me, Lisa Herbert, death literacty advocate, journalist and author.

The role of volunteers and carers

Already underfunded and under-resourced, the palliative care sector relies on volunteers. However, as we’ve seen above, boomer volunteers may soon find themselves in need of volunteer palliative care assistance.

In the last few years, since the pandemic, the carer workforce has increased substantially. So, here’s another dataset that could be assisted by more targeted questioning in the 2026 census. To get a clear picture of future resource needs, we need to know if the carers, both paid and unpaid, are working in either the aged care, disability, or palliative care sectors.

These data gaps will need to be filled if adequate funding and resources are to be allocated to palliative care by state and federal governments. It’s not clear where the carers are at the moment, and we know policymakers and treasurers like numbers, especially when an election is close.

We’re all going to die. Let’s hope every one of us, no matter where we live, can be well cared for when the time gets close.

About the author

Author Lisa Herbert

Lisa Herbert is a death awareness advocate, a cemetery wanderer, journalist and audio producer, and author of The Bottom Drawer Book: the after death action plan – an informative, modern, and quirky workbook and funeral planning guide for those who want to prepare for the inevitable. The third edition is available in Australia for $29.95.  For international buyers, The Bottom Drawer eBook is AU$11.99 on Amazon, Apple Books, Kobo, Booktopia and Google Books. To purchase, click HERE.

2 Responses

  1. Hi Lisa
    I enjoyed your article and agree wholeheartedly. unfortunately it’s something people in the industry have known for a long time. I worked in the community and aged care settings for over 20 yrs and the things in your article were spoken of then. I’ve been out for 14yrs now because I hated seeing some of the things that were happenning back then.
    NDIS needs to be reined in and overhauled. who wants to work in an aged care facility offering palliative care and just care in general for a pittance when doing NDIS work pays crazy dollars, only the truly dedicated and they’re a dying breed.
    something I found interesting during my time was the number of younger people being placed in aged care facilities due to acquired brain injuries, genetic issues and substance abuse related dementia type issues. I know Service providers outside of facilities pick up most of these now but not all. that’s an extra that will impact the already struggling health care/ care industry in the future.
    I was blessed to have worked with a forward thinking boss who appreciated the palliative care aspect of working in a care facility. unfortunately when she left so did the willingness of the higher ups to provide palliative care training.
    I’m a boomer and I hope never to need care but that’s in the lap of the gods.
    I think your book is a truly fabulous idea and it’s on my mother’s day wish list. too many people don’t know about advance care directives, etc. your book will help adress these issues
    thanks again for an interesting read.
    good luck and God bless

  2. I believe that the elderly should have the right to voluntary assisted death. I have it on my end of life wishes and I am hoping that it is legalised in Queensland Australia soon. I won’t allow myself to be a burden on society or my family.

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