Ageing in Place or Nowhere to Go? Why Canada Must Embrace NORCs to Fix Its Home Care Crisis
Gabrielle, Gallant, Director of Policy, National Institute on Ageing
Catherine Donnelly PhD Reg OT, Director – Health Services and Policy Research Institute, Associate Professor, Queen’s University, Co-Lead - Oasis Communities for Aging Well
Vincent DePaul PT PhD, Associate Professor, Queen’s University, Co-Lead - Oasis Communities for Aging Well
A recent survey conducted by the National Institute on Ageing (NIA) sheds light on the challenges older Canadians face in accessing home care, as they struggle to age in their homes and communities – highlighting the critical need for innovation in health and homecare delivery. The NIA’s Perspectives on Growing Older survey highlights a significant gap between the desire of older adults to remain in their homes and the availability of adequate home care services to support them – with a startling 48% of older adults unable to access the home and community care services they need.
As Canada’s population ages, a significant proportion of older adults are encountering systemic barriers to remaining in their homes and communities. Without proper supports and services, many are left with no choice but to pay out of pocket, rely on family members or seek institutional care. It is clear, however, that long term care is not the place of choice for the vast majority of older adults want and further strains an already overburdened health care system.
In fact, the 2024 NIA survey data indicates that 80 percent (with earlier iterations of the survey returning even higher numbers) of older adults reported a desire to remain in their homes as they age, with hardly any respondents indicating a preference for long-term care homes. However, health concerns, limited support systems, and financial constraints often shape these preferences, with homeownership also impacting perspectives: more homeowners (89%) than renters (64%) prefer to age in place.
To support Canadians to age in their desired locations with the supports they need, governments of all levels must facilitate innovative solutions that align with the needs and preferences of older Canadians. As Ontario moves through a short election period, it is incumbent on political parties to bring new ideas to the forefront.
One such solution is to consider Naturally Occurring Retirement Communities (NORCs). NORCs are residential and geographic areas with a high concentration of older adults. These are not planned older adult communities and include a mix of ages. NORCs may develop in buildings or neighbourhoods over time, as people have aged in their homes. Alternatively older adults may move to certain apartments because they are close to amenities, thus becoming a NORC. These naturally occurring communities with a high number of older adults present an opportunity to be leveraged to more efficiently deliver social and health services and build social supports where people already live.
There is also a growing interest in developing NORCs with supportive service programming, or NORC programs. NORC programs having been running successfully in New York for over three decades and in Canada two examples, the Oasis and Ambassador program are gaining momentum. These NORC programs are being delivered within buildings or neighbourhoods, with the support of a coordinator or trained group of volunteers that bring supportive programs to the building. Early evidence supports that NORC programs can not only more efficiently bring in health and social care they may also delay or prevent costly long-term care admissions.
Supporting NORC-based program models would not only improve the well-being of older Canadians but may also alleviate pressure on hospitals and long-term care facilities. As the NIA has outlined in its research, enabling older adults to remain in their homes with the right supports is a cost-effective and humane alternative to institutional care. And it is what older adults in Ontario prefer. Now is the time for policymakers to recognize the potential of NORCs and commit to funding programs within as a sustainable solution to Canada’s home care crisis.