NIA Launching Policy Series on the Future of Home, Community and Long-Term Care

March 18, 2019

Each year, the National Institute on Ageing (NIA) identifies a key policy challenge to address through expert research, broad engagement, and actionable reports. In 2018 we focused on FrailtyWorking Caregivers and an ongoing series on Adult Immunization. This year, with support from and in collaboration with our series partners AdvantAge OntarioEssity, and Home Instead Senior Care - the NIA is launching a three-part policy series that examines the current system and future of long-term care for older Canadians covering the spectrum of home care and community care, to a variety of residential and nursing home services.

In the first report of the series, Dr. Bonnie-Jeanne Macdonald and Dr. Michael C. Wolfson will investigate the future costs of home, community, and long-term care across Canada. These services currently consist of a patchwork of publicly funded programs, privately paid services, and unpaid care being provided by close relatives and friends acting as caregivers.  Acknowledging that federal and provincial budgets are currently stretched, the purpose of this piece will be to project the actual costs of home and long-term care over the next three decades by building on current practices, existing research and using large scale, policy-oriented population microsimulation methods. The report will show projected future costs of home, community, and long-term care, and the personal tax impact to cover growing expenses.

In the second report, Dr. Samir Sinha, will explore how Canadians can be supported to age with greater quality of life, better health outcomes, and dignity in all settings through appropriate models of care and best practices. Dr. Sinha’s work will examine a range of care models to  determine the approaches to care that currently respond to need, evidence-based innovations in care delivery that can scale and be implemented across Canada, and the challenges that stand in the way of innovation in the home, community, and long-term care sector.

The final segment of the series brings together the NIA’s expertise in financial and health policy with the aim of presenting feasible and fiscally responsible policy scenarios that have the potential to improve quality of life for seniors in care and improve the value of services delivered. Equipped with qualitative as well as quantitative insights, the paper will outline a range of potentially feasible and fiscally responsible policy scenarios that, in turn, can motivate a more rigorous examination for home, community, and long-term care reform in Canada - reforms that provide quality of life for Canadians, and that are affordable and sustainable.

The goal of this policy series is to help government decision makers establish an evidence-informed road map to help them plan for meeting the needs of an ageing population, inform care providers and funders on best practices, and help older Canadians and their families better understand the long-term care options that should be available.

National Seniors Strategy

Through our National Seniors Strategy, the NIA has been a steadfast advocate for delivering care closer to home and for the principles of access, equity, choice, value, and quality in healthcare. With the proportion of older Canadians growing, it is time to think about empowering seniors to age on their terms and to re-examine the social contract for health and social care of the elderly in Canada. 

The context is a growing demand for home, community, and long-term care services to support seniors who are living far longer with more complex health, social and functional issues than previous generations. At the same time, governments are confronting growing healthcare budgets and historic demographic changes.

Only by understanding the evolving preferences and care needs of Canadians, now and into the future, and engaging in discussion about the scope of government, will we be able to equip people with the information they need to plan for and choose the course of their senior years.


NIA Experts

Dr. Samir Sinha, Director of Health Policy Research at the NIA, is a passionate and respected advocate for the needs of older adults. Dr. Sinha serves as the Director of Geriatrics at Mount Sinai and the University Health Network Hospitals in Toronto. In 2012 he was appointed by the Government of Ontario to serve as the expert lead of Ontario’s Seniors Strategy. Dr. Sinha’s is an in-demand consultant to hospitals and health authorities in Canada, Britain, the United States, and China.


Dr. Bonnie-Jeanne MacDonald, Director of Financial Security Research at the NIA, is a Fellow of the Society of Actuaries whose research focuses on the financial implications of the retirement and health programs available to Canada’s ageing population. She is a prolific international keynote speaker at industry and public policy engagements, and she recently appeared before parliament as a witness on how government can better support the well-being of Canadian seniors.


Dr. Michael C. Wolfson, has served as Assistant Chief Statistician, Analysis and Development, at Statistics Canada. He was awarded a Canada Research Chair in Population Health Modeling / Populomics in the Faculty of Medicine at the University of Ottawa in 2010. Dr. Wolfson’s areas of expertise include program review and evaluation, tax/transfer policy, pension policy, income distribution, design of health information systems, microsimulation modeling of socioeconomic policy and health dynamics, and analysis of the determinants of health.

Michael Wolfson.jpg

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The Future of Long-term Care Series is sponsored by:

AdvantAge Ontario has been the trusted voice for senior care for close to 100 years. We are community-based, not-for-profit organizations dedicated to supporting the best possible aging experience. It represents not-for profit, charitable, and municipal long-term care homes, seniors’ housing, and seniors’ community services.


Essity is a leading global hygiene & health company dedicated to improving well-being through products and solutions. 

Essentials for everyday life. Essity’s sustainable business model creates value for people and nature. Essity sells in approximately 150 countries under leading global brands TENA, Jobst, Leukoplast, Tork, and others.


Home Instead Senior Care was founded in 1994 to respond to a need for person-centred, relationship-based senior care. Today, with over 1100 operations in a dozen countries around the world, including Canada, Home Instead is relied upon to provide an estimated 75 million hours of service per year.

Allan McKee