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Scaling safe, regulated home support in Ireland

Safe Regulated Home Support in Ireland Today

Ireland is ageing rapidly, so scaling safe, regulated home support that works alongside families is one of the smartest ways to help older people live well at home while keeping hospital care for when it is needed most.

Delivery is already growing, with new licensing, HIQA standards, interRAI assessment, and better technology set to build consistency and trust.

In this article, we'll use recent data from ESRI, the Department of Health, HSE, and the Irish Hospice Foundation to show who receives support today, how hours and budgets are changing, what reforms mean for quality and access, and how Comfort Keepers fits within that picture.

Several figures come from presentations delivered at the HCCI Home Care Conference and Awards 2025, organised by Home and Community Care Ireland (HCCI).

Statistics at a glance

  • In 2022, 69,808 people received home support in Ireland across HSE-funded services, intensive home care packages, and privately funded care, totaling 28.7 million hours of support.

  • ESRI projections suggest that by 2040, total home support demand could reach between 45 million and 55 million hours a year, a 57 to 91 percent increase on 2022 levels, with the median age of recipients rising to 87.

  • Actual provision reached 23.76 million home support hours in 2024, representing a 12.5 percent increase since 2022, alongside a 70 percent rise in the home support budget since 2020.

  • Ireland has 2.9 acute hospital beds per 1,000 population, compared with an OECD average of 4.3, and an acute bed occupancy rate of about 90 percent, compared with an OECD average of around 70 percent.

  • Ireland’s Urgent Virtual Care centre recorded 4,200 referrals in its first 10 months of operation, with a recent report showing that 70 percent of those referrals avoided an emergency department pathway through alternative community routes.

  • In 2022, 35,477 deaths were registered in Ireland, and the Irish Hospice Foundation estimates that more than 350,000 people are grieving a death each year.

Who received home support and for how many hours

According to a 2025 ESRI report on national demand for older people’s care (PDF), Ireland delivered a broad mix of home support in 2022 across HSE-funded services, intensive home care packages, and privately financed care.

Walsh's baseline estimates show that:

  • In 2022, HSE-funded home support reached 56,162 people and delivered 20.8 million hours.

  • Intensive Home Care Packages reached 235 people with 0.2 million hours.

  • Privately financed home support reached 13,411 people with 7.7 million hours.

  • Combined, these streams reached 69,808 people and amounted to 28.7 million hours of support.

The same analysis indicates that:

  • 29 percent of total hours were delivered by the HSE.

  • Voluntary or private providers delivered 71 percent of total hours.

Waiting list figures for 2022 show that:

  • 3,795 people were awaiting any service.

  • 2,878 people were awaiting additional hours.

These numbers show that demand came from people waiting to begin support and from those already receiving help who needed more hours.

Projections - Hours needed and rising complexity through 2040

According to the same 2025 ESRI report and Walsh's analysis:

  • Projected demand for home support in 2040 ranges from a 57 percent lift to a 91 percent lift compared with 2022.

  • Total home support requirements could reach 45 to 55 million hours a year by 2040, up from 28.7 million hours in 2022.

  • The median age of recipients is expected to rise to 87.

  • More of the hours will sit in the oldest age groups, where care needs are more complex and support is more intensive.

The projection uses the Hippocrates model, which applies age and sex specific activity rates to population paths to estimate future demand, as described in the 2025 ESRI report.

Demography that drives demand

According to the Department of Health presentation Continuing the Drive for Reform (Larthwell, 2025), two demographic groups stand out:

  • The population aged 65 and older is projected to increase by 29 percent by 2030 (+224,000 people) and 70 percent by 2040 (+550,000) compared with 2022.

  • The population aged 80 and older, which is associated with higher care needs, is projected to grow by 48 percent by 2030 (+88,000 people) and 120 percent by 2040 (+220,000) compared with 2022.

Access, funding, and delivery

According to the Department of Health, Ireland has increased both the hours of home support delivered and the budget for home support since 2020, alongside work on licensing, standards, assessment tools, and ICT to support more consistent delivery across providers.

Hours delivered, budget growth, and waiting list movement

According to the Department of Health presentation Continuing the Drive for Reform (Larthwell, 2025), three signals point to stronger access and delivery:

  • Home support hours delivered in 2024 reached 23.76 million, a 12.5 percent increase since 2022.

  • The home support budget has increased by 70 percent since 2020.

  • Waiting lists fell by 6.8 percent by mid-2025, to 4,945 people, according to the Department of Health tracking (Larthwell, 2025).

In the same presentation, Larthwell shows ESRI projections for HSE and HSE-funded home support:

  • 21.2 million hours delivered in 2022.

  • Between 33.23 and 40.63 million hours are projected by 2040.

  • An assumed average annual growth rate of 2.5 to 3.7 percent.

Larthwell also reports that actual provision has been growing faster so far:

  • 5.2 percent average growth a year since 2022.

  • 12.3 million hours delivered by the end of June 2025 against a target of 11.9 million hours.

  • 7.4 percent more hours than the same period in the previous year.

Larthwell also reports supplementary community services such as Meals on Wheels and Day Care:

  • A 44 percent increase in the Meals on Wheels budget since 2022.

  • 313 day care services supporting 15,657 registered service users.

Quality and regulation – Licensing, HIQA standards, interRAI, and ICT

According to the Department of Health reform outline (Larthwell, 2025), statutory licensing, HIQA national standards, a single interRAI assessment, and an ICT system are central to an updated home support framework that standardises service user pathways and builds a stronger evidence base.

Statutory licensing of professional home support providers

According to the General Scheme of the Health (Amendment) Licensing of Professional Home Support Providers Bill 2024, Ireland will introduce statutory licensing for all professional home support providers.

A complementary analysis in the 2025 Oireachtas Library briefing paper (PDF) explains that licensing sets a mandatory baseline for governance, quality, and oversight across public, private, and voluntary organisations. This strengthens safety and consistency for people using services and creates a clearer regulatory pathway for providers.

HIQA draft National Standards for Home Support Services

According to the Draft National Standards for Home Support Services (2024) (PDF), HIQA proposes one set of standards that will apply across public, private, and not-for-profit services once the legislation is enacted.

HIQA's public consultation page notes that the standards focus on outcomes people value most: safe support, respectful communication, continuity, reliability, and involvement in day-to-day decisions.

Single assessment tool (interRAI) and data foundation

According to the Department of Health reform summary (Larthwell, 2025), Ireland is introducing interRAI as the single assessment tool for older persons.

The HSE interRAI programme shows how a consistent assessment supports fair allocation of hours, structured care planning, and more reliable outcome tracking.

eHealth Ireland's interRAI project overview confirms that the digital infrastructure will standardise data across community services.

The HSE's Family Carer Needs Assessment evaluation (2024) (PDF) describes the pilot implementation and evaluation of the interRAI Family Carer Needs Assessment in Ireland and shares early learning on using the tool in practice with family carers. Key findings include:

  • 89 family carers completed a baseline assessment and 62 completed a six-month follow-up, showing that the tool can be implemented and repeated in real-world services.

  • More than half of carers reported reduced social participation, and about half of this group felt distressed by that reduction.

  • Practitioners said the tool generated new insights into carers' needs and clarified how caring affects health.

  • Carers and practitioners agreed on the need for a comprehensive carer assessment and highlighted the value of a digital version and a shorter, easier-to-use form.

Hospital pressure – Why home first eases ED and inpatient strain

Ireland's acute hospital system faces ongoing pressure due to low bed stock, high occupancy, and delays in moving older patients from emergency departments to inpatient wards.  O'Connor's HCCI Homecare Conference: How can Technology and Innovation help with Demands presentation (2025) highlights community pathways as one route to ease that strain.

Beds per 1,000 and occupancy comparison

According to O'Connor, Ireland has 2.9 acute hospital beds per 1,000 population compared with an OECD average of 4.3 beds per 1,000.

Ireland's acute bed occupancy rate is about 90 percent, while the OECD average is around 70 percent, as reported in the OECD's Health at a Glance 2023 chapter on hospital beds and occupancy.

Why delays harm older patients, and how community pathways help

According to O'Connor's analysis, a cross-sectional retrospective study of every emergency department in England from April 2016 to March 2018 found that for every 82 admitted patients whose time to inpatient bed transfer was delayed beyond 6 to 8 hours from arrival, there was one extra death.

Longer waits increase avoidable harm for older persons because delays compound frailty, dehydration, and infection risk.

That delay-related risk highlights the value of community alternatives such as same-day assessment and home support pathways as part of wider patient flow solutions to ease pressure on hospitals and support safer care at home.

Urgent Virtual Care and digital supports

According to O'Connor's HCCI Homecare Conference presentation (2025) and the Department of Health reform outline (Larthwell, 2025), Ireland is testing new urgent virtual care and home-based technology models that can divert some older persons away from emergency departments and support care at home as part of the wider reform programme.

Early Irish UVC experience

  • According to O'Connor's analysis (2025), Ireland's Urgent Virtual Care centre received 4,200 referrals in its first 10 months.

  • Around 70 percent of those referrals avoided an emergency department pathway through rapidly responsive alternative routes such as community clinics, diagnostics, and telephone advice.

  • Referral sources included 55 percent of referrals sent through Healthlink, 41 percent from GP calls, and 4 percent from 999 calls.

  • Age range data show that 26 percent of referrals were for people aged 75 and older, 63 percent for those aged 15 to 74, and 11 percent for children and young people aged under 15.

STOP@Home pilot and enabling tech

According to the Department of Health presentation Continuing the Drive for Reform (Larthwell, 2025), STOP@Home is a Sláintecare Integration Innovation Fund pilot in CHO 5 and the Ireland East Hospital Group that uses smart devices, digitally inclusive tablets, and a 24/7 expert care team in people's homes and has been operational since May 2024.

The STOP@Home eTenders notice confirms that the pilot is now operational and aligns home-based monitoring and rapid community response with national reform goals.

End of life care at home – Practical resources for families in Ireland

Murphy's Irish Hospice Foundation Dying Well at Home report (PDF) (2023) describes national resources that provide practical guidance, free training, and tools for people providing care at home.

The Dying Well at Home programme

According to the Irish Hospice Foundation's Dying Well at Home programme overview (Murphy, 2025), the programme gives families, paid carers, and community teams practical information to help someone remain at home at the end of life. 

The programme page Dying Well at Home notes that it aims to provide clear guidance and reassurance during a difficult time.

Free eLearning for families and care teams

The free Dying Well at Home online training course is designed for family carers, home support workers, and community professionals. It includes short modules on communication, preparing the home, practical care, and recognising changes, and it signposts an Irish Hospice Foundation support line for further help.

Why these resources matter

Official mortality statistics from the Central Statistics Office (CSO) and national analysis from the Irish Hospice Foundation show the scale and pattern of deaths in Ireland and the reach of bereavement.

According to the Irish Hospice Foundation's 2025 national update and Murphy's HCCI presentation (2025):

  • 35,477 deaths were registered in Ireland in 2022, close to 100 people every day.

  • 83 percent of those deaths were among people aged 65 and older.

  • Irish Hospice Foundation estimates that up to 10 people are significantly affected by each death, so more than 350,000 people are grieving a loss every year.

According to the CSO Vital Statistics Annual Report 2023, 35,649 deaths occurred in Ireland in 2023, equal to 6.7 deaths per 1,000 population, and around one quarter of those deaths happened at home, with another quarter in hospices and nursing homes.

Irish Hospice Foundation also reports that many families say they would prefer end-of-life care at home, even though this is not always possible.

The 2025 announcement positions Dying Well at Home within a wider strategy that invests in clearer information, practical supports, and digital tools for families and staff who want to care for someone at home.

Comfort Keepers Ireland – Service alignment and next steps

According to the Department of Health reform outline (Larthwell, 2025) and Irish Hospice Foundation resources (Murphy, 2025), national reforms aim to build safer and more consistent homecare. Comfort Keepers aligns its standards and practices with this direction so those we support receive reliable, person-centred care.

How Comfort Keepers aligns with reform and quality standards

  • Licensing readiness: governance, reporting, and quality processes reflect the expectations set out in the Department of Health licensing framework.

  • HIQA standards alignment: day-to-day practice mirrors the draft HIQA standards through safe support, respectful communication, and dependable visit patterns. Learn more about our homecare services.

  • interRAI-led planning: assessments guide planning so that hours delivered reflect identified levels of need.

  • Continuity of care: schedules support familiarity by reducing the number of different Home Support Workers visiting a person.

  • Dementia capable care: training helps teams support a person living with dementia and adapt routines to their needs. See our training and accreditation standards.

  • End-of-life support signposting: teams direct families to the Irish Hospice Foundation's Dying Well at Home resources when someone wishes to remain at home.

Thinking about support at home?

Comfort Keepers focuses on timely visits, structured assessments, dementia-capable practice, and clear communication so families know what to expect.

Families, healthcare professionals, and community teams can contact Comfort Keepers to learn about homecare options and how support can be arranged safely and promptly.

References and Citations

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