As Australia’s ageing population grows, demand for end-of-life care is rising, but experts say a lack of community conversation means families are unprepared to support dying loved ones outside hospital settings.

Data from the Australian Bureau of Statistics shows Australia’s median age is projected to increase from 38.5 in 2022 to between 43.8 and 47.6 by 2071.

University of Western Australia Associate Professor Samar Aoun OA was named WA Australian of the Year in 2023. She says Australia’s ageing population will place increasing pressure on the healthcare system.

“More people are going to live with chronic disease or experience disability, and therefore need medical care,” she says.

“We won’t have the workforce to look after us, and as it is now, we don’t have enough palliative care centres.”

She says community-based care will be critical moving forward.

“We need the community to be central in delivering end-of-life care, and for that to happen, we need investment in community education so people can understand their options and feel confident having these conversations.”

University of Nottingham School of Health Sciences Associate Professor Eleanor Wilson says people often avoid talking about death.

“People’s willingness to discuss end-of-life often sits on a continuum, with some keen to get plans in place, others willing to make some plans, and those who do not wish to talk about dying at all,” she says.

“People often wait for health professionals to initiate these conversations, but conversations within families. Talking in the hypothetical is much easier than when actually facing impending death.”

Registered nurse and death doula Gemma Tomlinson says she created the A Loving End event to fill a gap in people’s knowledge about death options. She says she’s seen people go against their own end-of-life wishes to appease family members.

“People think that death is a scary word to say, but it’s not, it’s going to happen to all of us, so we may as well be open and honest about what we want,” she says.

“It’s never too early to start planning. Things like thinking about what your ideal death would look like, if you want to be buried or cremated, donate your body to medical science, or at what point you would want medical interventions to stop are important conversations to have.”

Gemma Tomlinson

Event attendee Aileen White has experienced the sudden loss of two family members, her sister at 53 and her niece’s husband at 43. She says events like this support those left behind and also encourage people to plan ahead.

“It’s a big thing to leave for someone else to deal with, and events like this help remind people to get their shit together,” she says.

“It also makes talking about death easier and more normal.”

In 2020, researchers at Western Sydney University created the Death Literacy Index, Australia’s first tool to measure people’s knowledge of death systems. Australia’s Death Literacy Index rose from 4.70 in 2020 to 4.81 in 2024.

La Trobe University Associate Professor Kerrie Noonan, who co-created the Death Literacy Index, says Australia’s Death Literacy Index increase is likely linked to the COVID-19 pandemic and the introduction of voluntary assisted dying that same year, which prompted more open conversations about death.

“The Index’s purpose is twofold: to track Australians’ knowledge of death systems and to help people reflect on what parts of death and dying they haven’t looked into,” she says.

“We often run workshops where we print out the questions from the Death Literacy Index and ask people to discuss each component of death literacy and identify where their knowledge gaps lie.”

Dr Aoun founded Compassionate Communities, an organisation focused on upskilling community members to better support end-of-life care. She says community-based models can reduce pressure on the healthcare system and improve support for people at the end-of-life.

“People generally leave their end-of-life planning up to themselves, but that’s too much responsibility. One person can’t be responsible for their own death; you need a network. People don’t have this network, and that’s why they go to a hospital or a nursing home,” she says.

“The healthcare system isn’t equipped to keep going the way it is. We need all levels of government to get their act together and understand the problem. Despite the calamity they are going to face, they are not doing enough to prepare for the tsunami of death and ageing that is coming.”