The number of long-term residential care beds and home support hours for older people will need to increase by at least 60% by 2040, according to the Economic and Social Research Institute.
The projected rise in requirements is largely driven by the increase in size of the older population, according to new research.
By 2040, one in five people in Ireland will be aged over 65, while the population aged 85 years and over is projected to more than double.
The research, funded by the Department of Health, considered a range of scenarios based on varying assumptions about population growth and ageing, the effects of healthy ageing and policy choices like expanding home support services.
In 2022, there were an estimated combined 33,324 short-stay and long-stay beds in long-term residential care.
One in eight beds in residential care homes were used for short-term care, such as step-down care following discharge from hospital and rehabilitative care.
Researchers have found that short-stay bed requirements are projected to grow by between 72% and 94%.
At the moment, seven in eight beds in residential care homes are for long-stay care.
The majority are funded through the Nursing Homes Support Scheme - commonly known as Fair Deal.
Long-stay bed requirements are projected to grow from 29,579 beds in 2022, to between 47,590 to 53,270 beds by 2040, which is a rise of between 61% and 80%.
Almost 29 million home support hours were provided to older people in 2022, with three-quarters of these hours provided through the HSE's home support service and a quarter of hours privately purchased.
Home support hours required are projected to grow to between 44.9 million and 54.9 million annually by 2040, which reflects a growth of between 57% and 91%.
The ESRI has explored the policy implications of its findings.
Even at the lower end of the projections, the report highlights that substantial increases in long-term residential care beds and home support hours for older people will be required by 2040.
The analysis shows how healthy ageing effects may reduce future requirements and different policy choices, such as expanding home support services could reduce requirements on long-term bed capacity.
However, it has warned that the substantial impact of increases in the older population will offset much of the potential moderations in long-term care requirements that may arise out of healthy ageing effects or model of care changes.
Senior Research Officer at the ESRI and lead author of the report Dr Brendan Walsh said Ireland had experienced "tremendous improvements in life expectancy" in recent decades, driven mainly by reductions in mortality at older ages.
"This means there is and will be a much larger population at older ages who require long-term care services to support them at home, or within residential facilities," he said.
"Therefore, plans and policies are needed for long-term care to ensure the health system is in a position to meet the increasing care needs of the older population," he added.
Mr Walsh said the findings "provide policymakers with an important evidence base to help develop these plans and policies".
Minister of State for Older People and Housing Kieran O’Donnell said the analysis would be "invaluable" in advancing evidence-based capacity planning for residential care and home support.
Nursing Homes Ireland (NHI) has renewed its call for a dedicated national nursing home care policy, in response to the latest ESRI report.
NHI has written to Department of Health, the Minister for Older People, and the HSE for "an urgent meeting" on the matter.
In a statement it said it was ready to work collaboratively to ensure additional capacity is delivered in the right locations and supported by the right policy framework.
CEO Tadhg Daly warned that if a "fragmented approach" continued, the system would place "unfair pressure" on families, residents, staff, care providers, and the wider health service.
Due to the increasing privatisation of nursing home services, the Irish Nurses and Midwives Organisation said any mass expansion of beds in the nursing home sector must be provided by the public health service.
INMO General Secretary Phil Ní Sheaghdha pointed out that 74% of all long-term residential care beds in Ireland are currently in private facilities, while 14 large private operators now control about 40% of all long term residential beds nationally beds nationally.
"The INMO firmly rejects the privatisation of care for older people. The care of older people is not a commodity to be bought and sold. It is a public good and it must be treated as such through sustained public investment in the provision of high quality, publicly delivered, residential and care services for older persons," she said.
