The Interdepartmental Report stated that if the target of 4% is not achieved the cost of residential care going forward will be correspondingly greater. It stated that the total spend, public and private, on residential care for the over 65’s is projected to increase from €0.9 billion (0.6% GNP) in 2005 to between €6.8 billion (1.8% GNP) and €9.2 billion (2.4% GNP) in 2051 depending on the residential occupancy rate assumptions used.
 

The target of reducing the number of older people in long term care to 4% of the over 65’s, while laudable, may be over optimistic. The capacity of families to cope with a dependent older person varies greatly. Others do not have the necessary family or social support to live at home.

There is a need to develop integrated services for older persons with a continuum of home care, home support services, sheltered housing, day care, respite and long-stay residential care and acute care. Nursing homes must become part of this integrated service and must be encouraged to offer a wider spectrum of services to older people in their community.

Financial incentives for the building of nursing homes have resulted in new homes being provided throughout the country. Many existing homes increased their bed capacity. While the development of new nursing homes has generally been positive it has resulted in an oversupply in some rural areas. Presently there are shortages of nursing home beds in many of the larger urban areas 

While financial incentives are still essential new thinking will be required if the necessary number of suitable beds are to be provided in the required locations. Recent rulings by An Bord Pleanala, and changes introduced by planning authorities, mean that future nursing home developments will be within, or close to, urban centres.