Ireland’s public healthcare infrastructure is facing intensifying scrutiny over its preparedness for a surge in dementia cases, as Health Service Executive (HSE) data reveals a significant reduction in publicly funded bed capacity, despite projections that the number of people living with dementia will more than double by 2050.
Figures released in response to a parliamentary question by Labour Party health spokesperson Marie Sherlock show that the number of HSE-funded beds for dementia patients fell by over 12 per cent between 2020 and 2024. The total dropped from 403 to 353 beds, with long-stay beds declining from 394 to 332. Respite beds, while more than doubling from 9 to 21, remain critically limited.
“It is clear that the Government must invest in greater public bed capacity, including with dementia beds,” Sherlock told Euractiv.
The contraction is most acute in the Dublin and North-East health region, where long-stay bed capacity was nearly halved – from 84 beds in 2020 to just 46 last year.
“There is an appallingly low number of HSE-funded respite beds, despite an ageing population and growing need,” Sherlock said. “I have met older, fit people who are caring for their loved ones and are struggling because they are providing care 24/7. Respite bed capacity needs urgent attention.”
Rising dementia numbers
Dementia, including Alzheimer’s disease, affects cognitive functions such as memory, language, and daily task management. The number of people living with the condition in Ireland is expected to rise from 55,000 in 2018 to 141,200 by mid-century.
“We know that the number of people with dementia will double by 2050. We do not see forward planning but rather a whittling down of public bed capacity,” Sherlock warned.
According to the HSE, 719 individuals with dementia are currently awaiting placement. However, the agency noted that many may have already accessed care through private or voluntary providers or are wait-listed across multiple HSE facilities.
The Health Service Executive is currently implementing a capital investment programme aimed at upgrading Ireland’s community nursing infrastructure. This initiative involves both the refurbishment of existing community nursing units (CNUs) and the construction of new facilities.
Modernisation squeeze
The primary goal is to replace bed capacity lost due to closures required by the Health Information and Quality Authority (Hiqa), ensuring that all facilities meet modern regulatory standards. The HSE explained that as part of this transformation, publicly managed nursing homes are undergoing significant structural changes.
The HSE told the Irish Times that these upgrades have led to temporary fluctuations in the number of available beds, as older units are brought up to compliance or replaced entirely.
Sherlock argues that the state must take a more proactive role in elder care provision. “We need investment and for the state to take a leading role. The state must develop new public long-term residential care, through community nursing homes, to meet the needs of our ageing population. We know that in Ireland, for example, 30 per cent of nursing homes were privately owned 20 years ago, rising to nearly 80 per cent now. The private sector has replaced the state in elder care provision.”
She also called for greater European engagement in dementia-related research and innovation. “The EU has a role to play in terms of diagnostics, research and development, particularly in fostering collaboration between states and through research programmes (such as Horizon Europe) in relation to brain health, diagnostics, and therapeutics,” Sherlock said.
As Ireland’s population ages, the challenge of balancing home-based support with institutional capacity is becoming increasingly urgent. Critics argue that without strategic investment and planning, the system risks being overwhelmed.
(VA)
