Submission to Palliative & End of Life Care Commission
by Ageing Without Children
(charity number 1195122)
March 2025
Our Interest in Palliative and End of Life Care
Increasing numbers of people are ageing without the support of adult children or other close family or friends to support them at end of life. Our aim is to ensure that everyone ageing without children can age well, including having a positive experience of end of life.
What is working well in the provision of Palliative and End of Life Care
No specific comments.
What steps need to be taken to ensure better service funding and commissioning?
No specific comments.
How would you want to address the inequitable access to Palliative and End of Life Care?
Palliative and End of Life Care provision should be subject to “AWOC Impact Assessment” to ensure it is suitable for those without access to informal care and delivers equitable outcomes for them. This should include a focus on the needs of those without informal carers to help manage age-related disabilities and other barriers to access.
In addition, we agree with Marie Curie that “How can palliative and end of life care better meet the needs of people who live alone, or are socially isolated?” should be one of the top ten priorities for palliative and end of life care research.
What do you believe are the top three barriers to delivering optimal Palliative and End of Life Care?
Priority 1
Optimal Palliative and End of Life Care cannot be planned effectively without better data on those who are approaching end of life without the support of adult children, other next generation family support or access to other informal care. It is necessary to #CountUs. Page 2 of 3
Priority 2
Lack of recognition of those ageing without access to informal support as an underserved community experiencing health inequalities that need to be better measured and managed.
Priority 3
Other priorities shared by people with no or limited informal support and those with support from family and friends, eg. level of funding for Palliative and End of Life Care.
What are the top three things that would help the most to improve the service?
Priority 1
Systematic recording of access to informal care and of the outcomes and barriers to support for people without informal care, both for customised patient support and for strategic and operational management planning.
Priority 2
Improved research into how palliative and end of life care can better meet the needs of people who lack access to advocacy and informal care from family and friends.
Priority 3
Improved support for advance care planning, including reliable access by clinicians to advance care plans, for people who are approaching end of life without “someone they trust”. The focus of current advance care planning material on encouraging conversations with “someone you trust” is not suitable for those without this support.
What steps do you believe need to be taken to improve public literacy concerning Palliative and End of Life Care options?
No specific comments.
How do you believe that Palliative and End of Life Care provision could be better co-ordinated?
No specific comments.
If there is research that you would want to draw to the attention of the Commission, which would help to improve Palliative and End of Life Care, please provide or note this here.
Is there other information that you would want to share with the Commission?
Ageing without children is a significant long-term social trend affecting Palliative and End of Life Care.
The number of women in their late 70s ageing without children in England and Wales will double over the next twenty years to one in five. National Statistics birth data says that:
- Women born in 1946 (now in their late 70s) had a 9% chance of never giving birth.
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- For women born in 1966 (now in their late 50s) this rises to 20%.
National Statistics state that the percentage of childless women in England and Wales drops slightly after the peak of one in five (20%) but remains in the upper teens until the present.
There is no breakdown of this birth data to a more local level. And there is no robust data about the number of childless men or about the numbers of either sex who are ageing without children due to estrangement, distance or having a child who is unable to care due to their own additional needs (including mental health and learning difficulties).
This is not an adequate basis to plan support for an ageing population by a health and social care system that currently relies so much on family advocacy and informal care.
See also Office for National Statistics report “Living longer: implications of childlessness among tomorrow’s older population” (2020).
Please provide your name and email below if you would be prepared to give oral evidence or attend one of the round tables:
Organisation name: Ageing Without Children
Contact name: Penny Shepherd
Contact email: info@awoceastkent.org.uk (on behalf of Ageing Without Children, the national charity)
