Long term care without a long term plan: aging population’s demand going unmet

Most Canadian provincial governments lack multi-year capital plans to build long term care and no province with a plan is sufficient to meet the expected demands for long term care caused by an aging population, according to our analysis of provincial documents.

Many provincial ministries of health or long term care have developed strategic plans that acknowledge the coming bulge in Canada’s senior population. Many are orienting themselves to a goal of “age in place.” However, no provincial strategy document shows how much such a re-orientation can reduce the demand for long term care beds. “Age in place” appears as more of a hope than a plan. 

With care needs already unmet, seniors’ population to rise dramatically

According to data from the Canadian Institute for Health Information and the Canadian Medical Association, provinces are already far behind the demand for long term care residences. In March 2021, CIHI reported there are spaces for 198,220 long-term care residents in Canada. The CMA, also in 2021, reported an unmet need of 77,000 care residences. To meet demand in 2021, an additional 275,200 long term care beds were required.

Without significant expansion of long term care facilities or other actions to reduce expected demand on them, the current shortage can be expected to grow as Canada’s population increases. 

Statistics Canada measured the population of people aged 75 years or older at 2,994,300 in 2021. Based on their medium growth assumption, Statistics Canada projects the population of those 75 years old and more to increase by 25 per cent by 2026, rising to 3,740,700. It will increase by 53 per cent by 2031, when the population is projected to reach 4,592,900. 

An analysis of Census data by Environics found the percentage of people living in a health-related facility to be 2.4 per cent of people aged 70 to 79, 10.3 per cent among those aged 80 and 84, and 26.9 per cent among those aged 85 or more. If the same percent of Canadians in these age ranges require a long term care bed, the demand for long-term care residence will rise to 344,025 by 2026 and 421,087 by 2031.

Distributing these findings of current unmet demands and anticipated future demands across provincial jurisdictions, we can readily see an aggressive investment plan is required to accommodate Canada’s quickly growing population of seniors.

To complete this report, health or long term care ministries’ websites, annual reports and provincial budget documents were reviewed. Where no comprehensive view of investment plans was found, provincial ministry and government communications or public engagement departments were contacted with requests for further information. Some departments responded. Most did not.

For a few provinces there is evidence of a multi-year report for long term care expansion. However, in most, there is no evidence of comprehensive plans. In some of these there is fragmentary information in government news releases, annual reports, and budget documents. 

This report analyses the known data from provincial ministries and compares them to our estimates of need by 2026 and 2031.

No clear plan despite a clear problem getting closer 

No Canadian province is constructing enough new long term care capacity to match the projected demand caused by the increase in Canada’s senior population. Few provinces appear to even have multi-year plans for construction and some show no plans for expansion and little or no recent increase to the number of beds in their jurisdiction. 

Many provinces acknowledge the coming surge in senior population and are proposing alternate strategies to allow residents to “age in place.” While many ministry strategic plans discuss this orientation, none provide a view on how effective their strategies will be in reducing demand for long term care facilities. “Age in place” appears to be more of a hope than a plan.

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