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aging canada 2040 report: lack of services, housing and funds make aging in place challenging for canadians

a projected 22.7 per cent of us will be over 65 by 2040. are we ready for the demands of that demographic?

as the aging canada 2040 report notes, 92 per cent of canadians over age 45 want supports to age in place rather than moving to a long-term care home, and 95 per cent say that aging in place would allow them to “maintain their independence, comfort and dignity.” getty images
if your retirement plan includes staying in your home instead of moving to a long-term care home, there are significant hurdles that need to be addressed – especially when you look at canada’s rapidly aging population and the number of people who have a similar plan in mind. a new report from the canadian standards association public policy centre, an organization that helps policymakers develop standards around health and safety, highlights the demographic shift of our rapidly aging population and the urgent need to re-evaluate how and where we age.
increasing life expectancy and the fact that people are having fewer children are skewing canada’s overall population as older than ever before. a projected 22.7 per cent of us will be over 65 by 2040. are we ready for the demands of that demographic?
the researchers gained insight from a survey of 2,500 canadians conducted in february to march 2024 to better understand public opinion around the future of aging, and applied a foresight model to show how trends could play out for 2040. they also identified potential disparities in health outcomes, financial security and social inclusion among older adults without policy reform.
“what we found really interesting is that these trends and projections around population aging are very well documented. governments are aware and they have been for quite some time that the baby boom generation will enter retirement in quite large numbers and that will impact a lot of services and public policy,” says jordann thirgood, report co-author and manager of the centre.
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as the report notes, 92 per cent of canadians over age 45 want supports to age in place rather than moving to a long-term care home, and 95 per cent say that aging in place would allow them to “maintain their independence, comfort and dignity.” that said, only 12 per cent reported having funds available to receive home care services like personal support workers or nursing care.
“what i found really guiding in this research when it comes to aging in place is this idea of aging in the right place,” she explains, where someone’s home should be tailored to their preferences but also their care needs that typically increase with age.
“over the age of 85, you are more likely to require those more complex health interventions and care needs that might require you to enter a long-term care facility.” while the pandemic drew attention to the decline in long-term care, thirgood recognizes that it will still be a necessary component of senior housing and services that also requires improvement. “so we’re taking a look at all of the options to make sure that we can integrate someone along that journey based on their preferences and their care needs.”
the report notes a myriad of factors to consider in whether a home is suitable for independent living. beyond home care, there’s affordability and accessibility of the home itself where home modifications can be expensive and usually paid out of pocket. does the surrounding neighbourhood have nearby transit and other services and amenities?
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consider the following key facts, highlighted by the report:
  • an estimated 1.1 million people needed home care in 2019 (including those who were receiving informal care but wanted professional care). this number is expected to grow by 53 per cent, to over 1.7 million by 2031. homecare is expected to account for the majority (75 per cent) of overall care demand in 2031.
  • there is a shortage of personal support workers in home care specifically across provinces — about 13 per cent of positions in home care are currently unfilled in nova scotia. ontario reported a 331 per cent increase in vacant positions from 2020 to 2021 in the home and community care sector. manitoba saw a dramatic increase in vacancy rates to 33 per cent for home care attendants in 2024 up from 20.7 per cent in 2019.
  • in 2022, 42 per cent of canadians spent the past 12 months providing unpaid care to others, with 20 per cent providing care to dependent adults, 28 per cent providing care to children, and six per cent reporting “sandwich caregiving,” where they provided unpaid care to both dependent children and adults. these caregivers are more likely to be women than men.
  • in 2021, the proportion of singles and couples that live in homes with three or more bedrooms increased to 29 per cent in canada, suggesting that many seniors are choosing to remain in their home rather than downsize.
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how do we ramp up services and provide appropriate housing to meet the coming demand? thirgood also points out the compounding problem of a diminished tax base with this demographic well out of the workforce.
funding is an issue, but another big piece of the puzzle is social isolation and loneliness among seniors aging in place. growing evidence links these challenges with serious risk for mental and physical illness like depression and heart disease — these are on par or even exceeding the risks that come with obesity, physical inactivity and smoking, she notes. solutions need to address better use and access to technology and tech literacy for seniors, and community involvement where outreach to seniors can bring them to social groups like exercise class and art workshops, for example.
“there may not be enough support, socially or otherwise, for somebody to remain within their home and feel connected to their community. i think there’s a significant gap there,” thirgood adds. “there’s also a lot of small pockets of innovation happening at the grassroots level and more needs to be done to bring that to people’s attention and share those ideas,” she says of the need for a collaborative approach of all levels of government and stakeholders.
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melissa chang, director of operations and sustainability at norc innovation centre at the university health network in toronto, is helping lead that kind of critical grassroots innovation. she says there are a lot of similarities to the recommendations in the csa report to what her team is suggesting for aging in place.
norc stands for naturally occurring retirement community where residential high-rise buildings with a high proportion of older adults have downsized and naturally gravitated to high-rise living with mixed age groups. “there is a need for institutions and some people really enjoy a retirement home where there is a ready-made community and all of that. but we have found that the vast majority, though, prefer not to be an institution,” chang says. “people want to stay where they are. they’ve built up their community, they know where the grocery store is and the pharmacy. and many of these older adults want to be in a multi-generational environment.”
she also says that many older adults are much more comfortable and want to downsize versus other generations, and the trend is toward urban and high-rise living.
her team is presenting another option that speaks to aging in place challenges and works with existing high-rise density. they’ve mapped out 500 norcs in toronto and a total of almost 2,000 across ontario where high-rise living already exists to show how health services can be organized differently. these natural living pockets far outnumber province’s long-term care homes and retirement homes combined.
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“when you talk about the challenges, it’s like we already don’t have enough health system resources for the existing demand. but we can actually organize our services better.”
the centre has developed a model for a dedicated home care team who can visit multiple clients within the same complex to share the cost for affordability and streamlining services.
instead of care providers like personal support workers travelling from client to client doing piecemeal work, they’d be able to work full-time or part-time shifts with minimal travel and provide care for duration and frequency based on client needs, whether that’s light housekeeping, meal prep or more complex nursing care.
“the other piece that we’ve seen is the rising cost of living. so we have very creative ways around expenses, like can we all chip in for housekeeping service? maybe someone can’t afford a half-hour or an hour, but they can afford 15 minutes. but these older adults are like, ‘i just need 15 minutes. i have one toilet. i’d love if you just clean that.’”
chang explains that shared services is happening with meals as well, where it’s a lot of work to cook for one. neighbours are chipping in for prepared meal delivery that becomes less expensive with a group service.
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she also talks about efforts to build capacity into the healthcare system by involving seniors themselves for mutual care and support. the centre runs training groups for 2022年世界杯名单猜测 habits and fall prevention, which is a huge issue for older adults that can lead to hospitalization and the end of independent living.
some people, for example, wear a fall pendant device that detects when a person falls and alerts emergency contacts. in a group setting, a person sees that another senior is wearing a similar pendant in a nicer colour or wearing it on their shoe so it’s out of the way of activities. “they talk about it and they’re normalizing it and reinforcing it for each other, so we’re all in this together and there’s nothing to be ashamed of. but they’re also just reinforcing how to stay healthy together,” she says. these are significant positives that add up to healthier communities.
“what we’re finding is that when we go in and we work with the communities and kind of train them up together, they actually see it as a social opportunity of getting together and then they’re having fun with it and they’re helping each other.”
as chang emphasizes, “we don’t necessarily need more funding to provide more care or more people trained to provide care.”
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alternatives to the status quo are also the focus for the national institute on ageing, canada’s leading public policy think tank on issues that surround aging. dr. samir sinha, geriatrician and clinician scientist at sinai health system and university health network heads up healthy policy research for the institute and is well-versed in the preference for aging in place. he commends the csa report for bringing the issues to the forefront because canada is lagging behind with unmet needs of seniors right now.
“the key point here is where this report has been helpful is that it outlines a number of different things we need to think about to better meet the needs of our aging population. and these are not things that we can avoid,” he says. “this new paradigm is not just for a couple years. we’ll be living with it for decades.”
the situation already shows that services are not robust enough. sinha points to the institute’s latest survey that reveals that almost 430,000 canadians report having unmet home care needs. “so if we talk about half a million canadians having unmet home care needs, then you can imagine that it’s no coincidence why we have over 50,000 canadians who are on wait lists for nursing homes. if you can’t get the care you need to stay in your own home, then you’ve got to live somewhere else. and at that point, your only choices are a shelter, living in a hospital or living in a care home.”
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he says the counter argument to the growing numbers of seniors who need care is burdening families, expecting them to step up to fill in the gaps. spouses, siblings and adult children “will have to put more effort into being unpaid caregivers.” however, sinha’s research has found that between now and 2050, we’re going to see 30 per cent fewer family caregivers available compared to what we have now.
“and that’s just on the basis that we as a society are increasingly having smaller families and people are more likely to be living at greater distances from each other. so we know that there’s a greater number of people who are going to be aging on their own.”
the reality is bleak when you don’t have a family member or friend close at hand who can help with basic tasks like getting a prescription filled, he continues, noting the increasing risk of isolation and its associated health problems.
sinha’s team has reviewed the literature on aging in place and decided to coin the phrase more appropriately as “aging in the right place” which thirgood refers to as a preference of experts in the geriatrics space.
the re-engineering of health services needs to shift to support people to age in their own homes for as long as possible. there’s a long list of needs to facilitate that mission: initiatives to promote 2022年世界杯名单猜测 and prevent the development of chronic diseases, along with support for chronic diseases. these efforts have to be supported by adequate home and community care, appropriate supports for caregivers, accessible and affordable housing and transportation services in age-friendly communities, and having a framework that focuses on combating social isolation. investing in home care programs can stretch dollars so much further than nursing home care and hospital beds occupied by people who are waiting for a spot to become available in a nursing home.
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“it’s a bit perplexing to be honest because some people use the term, an ‘aging tsunami’ or a ‘silver tsunami’ that’s going to hit us. but tsunamis happen all of a sudden without any warning,” he says, adding he developed a report on ontario’s senior strategy in 2012 and everything he said in that report is what he’s saying today.
“but we know what our demographics look like and we know what they’ll look like in 2050. we have to get a handle on our aging population and what its needs are.”
karen hawthorne
karen hawthorne

karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

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