Only 8.5% of people aged over 85 who die from cancer do so in a hospice, compared with 20% of all people with cancer, says the report. Urgent action is needed to address inequality in care at the end of life for elderly people and provide access to high quality palliative care, it says, and it calls for more specialists in palliative care.
 | Figure 1 Access to good quality end of life care gets harder the older you are |
“Good quality end of life care must be available for all who need it, regardless of their age or medical status. Rationing care at the end of life on the basis of age is appalling,” said Paul Cann, director of policy and research at Help the Aged.
“Older people are the single largest group of health service users. They have made a huge investment in the NHS, and it is a perverse system that denies those who have been paying for it the longest.”
The report says that the opportunity to go into a hospice declines with age.
“There can be little doubt that many of the difficulties and barriers faced by older people at the end of their lives are a consequence of inherent age discrimination, which affects the way in which support services at the end of life are often designed without reference to older people's needs,” it says.
“It is a tragedy, and a sad reflection on our society, that for many a `social death' occurs long before physical death, with a sense of isolation, disenfranchisement, and loss of control too often common features of the ageing process and the approach to death,” the report continues.
It says that better end of life care for elderly adults should be seen as an urgent public health issue and that consideration should be given to providing specialist palliative care for elderly people. The specialties of palliative medicine and geriatric medicine should also be more closely coordinated, with shared training posts and joint education initiatives.
The charity Help the Hospices welcomed the report and said in a statement that more NHS funding for hospice and palliative care is needed. But it added: “Access to hospice care is via referral—usually by a GP, hospital consultant, or district nurse—and acceptance for care is according to clinical need and capacity to care for that person. It is not according to age. It is important that we try and find out what lies behind [the figures] and to what extent referral practice, patient choice, needs, or availability of services are factors.”