Death is not a cheerful subject, yet it barely features in political discourse about care. As the UK considers a National Care Service focused on living well, the question of what it means to die well remains unaddressed. This is not about assisted dying or underfunded hospices, but about confronting how death and dying have changed since the 1940s.
Dementia and frailty have replaced cancer as the typical route to death, with dementia now the single largest cause of death. Most end-of-life care frameworks assume a person can consent, but an increasing share of dying people cannot. Where people die has shifted too — most prefer to die at home, but increasingly home means residential care. Care homes have no statutory duty to provide end-of-life care, leading to costly and distressing hospital admissions.
The economics of care homes sharpen this problem. Some homes operate as property businesses backed by private equity, prioritising occupancy and turnover over resident wellbeing in their final weeks. The institutionalisation of death also distances communities, straining carers and increasing emergency calls.
In the last year of life, healthcare spending reaches nearly £12bn, of which 81 per cent is spent in hospital. Bureaucratic delays and poor coordination persist, and neither statutory provision nor charity alone can fix this. A proper conversation about death is overdue.
Source: Financial Times Companies · Summarized by HeadlinesBriefing