Aging In Place Works Until It Doesn't

For many Canadians, “aging in place” is the goal, and it is easy to understand why. Home can mean comfort, familiarity, and independence. But when health needs increase, the reality can shift quickly, and families often find themselves carrying more than they expected, coordinating services, juggling work, and making high-stakes decisions in the middle of a crisis. In long-term care and seniors' services, we see the strain this puts on caregivers every day, and we also see what helps when the right expertise and supports show up earlier.

A recent Globe and Mail article explored the growing desire among Canadians to age in place, alongside the often unseen financial, emotional, and caregiving costs that come with it. Journalist Meera Raman shares personal stories that will resonate with many families that want to do the right thing for aging parents but find themselves stretched thin by responsibilities they never fully anticipated.

Aging in place is a deeply held aspiration. For many people, remaining at home offers comfort, familiarity, socialization, and a sense of independence. It is often the right choice for people with complex needs when the right services are in place. But as Raman's article makes clear, aging in place becomes more difficult as health needs change, supports fragment, and the burden on family caregivers grows.

When aging in place starts to break down

What is often missing from the conversation is not compassion, but clarity. Long-term care is frequently referenced as the alternative when aging at home becomes too difficult, yet it is rarely presented in a way that reflects how care is evolving. This leaves families with the false impression that care options are binary: either stay at home with little help and a lot of expense or move into long-term care as a last resort.

In reality, aging well is not about choosing one place and staying there indefinitely. Aging in place works, until it does not. In fact, care should be a coordinated continuum where expertise follows people across settings. The real question is how we support people and families along that journey, and how we bring the right expertise to them before a crisis occurs.

According to the Ontario Caregiver Organization, 68 percent of caregivers have reached their breaking point. Long-term care organizations have a critical role to play in supporting them as part of aging in place, even when their loved one never sets foot in a long-term care facility.

How long-term care can support aging at home

The clinical knowledge, geriatric expertise, and understanding of health and social support systems that exist within long-term care should extend into the communities these organizations serve. This includes supporting seniors living independently, guiding families through changing care needs, and helping coordinate services before home living situations become unsafe or overwhelming. In fact, the Ontario Ministry of Long-Term Care is already testing this approach in a pilot program that engages long-term care organizations as community-based hubs that extend specialized expertise beyond their walls. This kind of approach reflects what integrated care is meant to achieve: specialized knowledge deployed earlier, across settings, and in ways that reduce crisis-driven transitions.

This approach also allows health systems to benefit from economies of scale and knowledge transfer, by extending long-term care expertise and workforce capacity into community and home-based settings. Their expertise in managing complex conditions, supporting frailty, and understanding how health and functional decline intersect with daily living can help seniors remain at home longer and more safely. When long-term care knowledge is leveraged earlier, families are better equipped to plan, adapt, and make informed decisions without waiting for a breaking point. For families, this means better guidance, earlier intervention, and clearer pathways through a complex system.

How applied research supports aging in place

Research also has a vital role to play. Specialized studies into aging and frailty help define best practices that apply across settings, not just within institutional walls. When evidence-informed approaches to frailty, mobility, cognitive health, and caregiver support are shared beyond long-term care, they directly strengthen the ability of seniors to age safely at home.

At the same time, we must be realistic about the scale of the challenge ahead. Our population is aging rapidly, and we do not, and are highly unlikely to, have the infrastructure or workforce to provide traditional long-term care to everyone who may eventually need support. That reality makes it even more important to rethink how we define aging in place and how we deploy expertise across the system. Recent plans to intensify home-based care also highlight a hard truth: without sufficient workforce capacity, funding and system coordination, even well-intentioned solutions risk continuing to fall short, or shifting pressure, rather than relieving it.

Supporting aging at home cannot rest primarily on unpaid caregivers or on families quietly absorbing financial and emotional strain. It requires better integration among home care, community services, and long-term care expertise, along with honest conversations about limits, transitions, and planning.

Aging well is not about a single location. It is about access to the right support, at the right time, in ways that respect dignity, independence, and the realities families face. We need to start planning for aging with that mindset.

By Akos Hoffer, CEO, Perley Health

"Supporting aging at home cannot rest primarily on unpaid caregivers or on families quietly absorbing financial and emotional strain. It requires better integration among home care, community services, and long-term care expertise, along with honest conversations about limits, transitions, and planning." Akos Hoffer, CEO, Perley Health