Can home care keep Ontario seniors out of hospitals?
The economics of aging in place might be better than anyone expected
April 13, 2026
Remember when your grandmother insisted she'd never move out of her house, no matter what? Turns out she was onto something.
More than 50% of long-term care (LTC) admissions are now people coming from a hospital, a 67% jump from pre-pandemic levels, as nursing home closures have meant many LTC facilities are taking in new residents exclusively from hospitals. It's a shift that's forcing healthcare planners to reconsider what "caring for seniors" actually means, and where it should happen.
The math of staying home
Here's where the numbers get interesting. In Ontario, LTC homes create over $100,000 in savings in the health system per day for every 100 patients who leave hospital and move there. But what if we could prevent seniors from ending up in the hospital, or long-term care, in the first place?
For proponents, the argument is straightforward: many people just need a bit of extra care and support to continue living independently in their own homes.
The demand is certainly there. A 2024 National Institute on Aging study revealed that 91% of older adults in Canada would prefer to age at home rather than move to an institution. For many retirees, staying home isn't just about comfort; it's about maintaining the independence to head across town to see the family, tend to the garden that's been growing for 40 years, or simply wake up in the bedroom where they've started every day for decades.
“The challenge is the race against the natural physical and cognitive decline with aging,” says Dr. James Aw, OMERS Chief Medical Officer. “Physical challenges that negatively impact independence may include muscle weakness, frailty and risk of falls in an unsafe home. Elderly patients often have multiple medical conditions and medications that require coordinated care and supervision. Home programs are effective if they include comprehensive geriatric health and social screening assessments, access to a multi-disciplinary medical team, coordinated care plan and regular follow-ups. Caregiver responsibilities and coordination often fall on family members where the focus should be on keeping homes safe, maintaining strong interpersonal relationships and coordinating care across the medical teams.”
What stronger support actually means
So what would stronger home care support actually provide? Think of it as the difference between a safety net and a slippery slope.
Currently, private home care services in Ontario range from $28 to $45 per hour for personal support workers, and nursing services can cost $45 to $80 per hour. For a senior who needs help with bathing, meal preparation and medication management a few times a week, those costs add up quickly; often faster than savings can cover them.
Without adequate support, what starts as difficulty managing stairs can cascade into a fall, a hospital visit and ultimately an admission to long-term care that might have been delayed by years with the right home support. Over 50,000 people are currently waiting for long-term care in Ontario, a waitlist that has doubled in the past decade.
Ontario has been testing innovative approaches. The Community Paramedicine for Long-Term Care Program provides individuals on the waitlist with 24/7 access to non-emergency support through home visits and remote monitoring. It's an example of how creative solutions can fill gaps in traditional care models.
The hospital capacity question
Here's why this matters beyond individual seniors: hospital capacity. When hospitals fill up with people who don't actually need acute care but have nowhere else to go, the entire healthcare system starts to buckle. Emergency departments get crowded. Surgeries get delayed. And the costs mount.
Recent investments, including $35 million annually through the Local Priorities Fund, aim to help those with complex medical needs connect to specialized care and supports in long-term care homes without requiring emergency room visits or hospital admissions.
Looking ahead
With one in four Canadians expected to be over age 65 by 2030, and Ontario's 80+ population projected to nearly double by 2040, the pressure on our healthcare system will only intensify.
“An aging population will be leaning on a generation with socioeconomic challenges and a declining fertility rate,” adds Dr. Aw. “Eldercare is complex and can put financial and emotional strain on caregivers and families. There is also limited access to geriatric expertise and resources to deal with individuals with multiple medical conditions, which can lead to fragmented care. Dementia is increasing as people live longer. The future should focus on prevention, personalized care teams, as well as home and hospital-based comprehensive geriatric assessments and programs. Technology will help with home safety solutions and care coordination, but eldercare will need humans in the loop for social wellbeing.”
Innovative ideas like The Community Paramedicine for Long-Term Care Program and funding through The Local Priorities Fund aren’t just about respecting seniors' preferences to age in place, though that matters. They’re about creating a healthcare system that actually works, where the right care happens in the right place at the right time. Sometimes the most cost-effective hospital bed is the one that never gets filled in the first place.
For the retiree planning that weekend trip to see relatives, staying independent at home means a continued sense of freedom and independence. As healthcare costs continue to climb, the challenge is increasingly clear: can fresh solutions in home care deliver better outcomes for both seniors and the system that serves them?
The Relatable Economist is an ongoing written series focused on how the economy, geopolitics, markets and more are impacting our day-to-day lives, discussing topics that matter to you, even if just to share with your friends at your next get-together or in the stands at your child’s or grandchild’s soccer game. Have a topic you want to learn more about? Write to us at therelatableeconomist@omers.com.