Let’s face it, we are all getting older.  There is no stopping time. But we do have a choice when it comes to how we will age and where.

Right now the government of Ontario appears to intend to institutionalize us if we need care (Government of Ontario, 2022), except that most of us have no intention of ending up in an institution, and the truth is that most are understaffed.  There is a mismatch between the policies and services that we want, and what is currently on offer.  That needs to change.

Enter Seniors for Social Action Ontario (SSAO) – an incorporated social advocacy organization comprised of elder volunteers from across the province who have had long careers that provided them with the knowledge, skills, and experience to make a different in Ontario’s outdated long-term care policies and programs.  We receive no government funding, and our organization runs on person power.

SSAO is advocating for real change.  We believe all of us can live in the community with the right supports irrespective of our care needs.  To do that a few things need to change.  Ontario needs:

  • A comprehensive, fully funded Home Care programthat is reliable and accessible to all elders. We do not have that right now because too much money (over $6 billion) has gone into funding institutions and much less for Home Care – which most of us have said we want (Financial Accountability Office, 2021).
  • Expansion of the Family Managed Home Care Program.  Ontario currently has a direct funding program called Family Managed Care (Home and Community Care Support Services, 2022).  The problem is that it is not designed to accommodate people with dementia and their caregivers.  This program needs to receive an infusion of funding and be redesigned to especially support people with dementia and their family members since they are at greatest risk of being institutionalized.
  • Individualized, direct funding.  The U.S. has something called a Money Follows the Person program (Medicaid, 2022) where funding is tied to the person needing care, not to the institution or service provider.  That empowers people to obtain their own services and supports when, where, and how they need them.  Tens of thousands of people have been able to leave institutions in the United States because of this program and nursing homes there are closing rather than new ones being built (Leading Age, 2015-2019).  Ontario needs a program like this funded under OHIP.
  • Paid family caregivers.  Those struggling to help elders to stay home are exhausted and often left isolated and without support.  They are trying to juggle work responsibilities, children, and care of loved ones.  They need help.  Newfoundland and Labrador have a Paid Family Caregiver program to support them (Seniors NL, 2017).   Ontario doesn’t, and it needs one.  This should be one of the options offered under Home Care that would help caregivers, and also help to ease the staffing shortage.
  • PACE (Program of All Inclusive Care of the Elderly).  PACE programs build support into the buildings where a high proportion of elders live – community housing, and other naturally occurring seniors’ communities.  A Burlington Councillor brought this program to that city where it is working very successfully in keeping people out of nursing homes (CBC The National, 2022).  This program needs to be expanded across the province.
  • Hub and Spoke model of care. Peel Senior Link ran a program that built supports into apartment buildings where a high proportion of older adults live.  Using a professional case manager, older adults were provided with the supports they needed to age in place.  The “spokes” were the care that was also provided from the “hub” to other older adults living in close proximity.  This was another successful program that could be replicated across the province (Peel Senior Link, n.d.).
  • Memory Care homes.  Institutions are the worst possible places for people with dementia.  They are loud, afford no privacy or security, and they feature long hallways that all look the same.  Small, neighborhood-based real homes operated by non-profits or municipalities are much better.  People with dementia need to be able to smell food cooking, and still go to their familiar parks and coffee shops, and have their social support system – neighbors and friends nearby.  Why uproot them when municipalities could rent or purchase homes in their own communities and staff them at the same cost as a nursing home, on a 1-6 staff to resident ratio (rather and 1-12 or more) and still afford homemaking support and special programs?  Ontario currently has no homes like this and we need them – in every community - so that no one needs to be uprooted, segregated, and excluded in a long-term care institution.

Seniors for Social Action Ontario is advocating for all of these things so that aging need not be something to dread.  After a lifetime of raising families, paying taxes, and being law abiding citizens, we believe that retirees deserve some security as they age.

We hope that you will join our e-mail list to receive regular updates and lend your voices to the call for systemic change in long-term care.  We think our lives may depend upon it.

Our website is:

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Dr. Patricia Spindel is a co-founder and Board member of Seniors for Social Action Ontario, a former President of Concerned Friends of Ontario Citizens in Care Facilities, a co-founder of the Advocacy Centre for the Elderly, and a former member of the O'Sullivan Commission on Advocacy for Vulnerable Adults.  She is a retired full-time faculty member of the University of Guelph-Humber Social and Community Services Program, and former Coordinator of the Social Services program at Humber College, as well as a former Associate Dean of Health Sciences at Humber.



CBC The National. (2022). Program aims to keep seniors out of nursing homes.

Financial Accountability Office. (2021). Ministry of Long-Term Care Spending Plan Review.

Government of Ontario. (2022). Ontario on track to build 30,000 new long-term care beds.

Home and Community Care Support Services. (2022). Family Managed Home Care.

Leading Age. (2015 – 2019). Nursing home closures and trends.

Medicaid. (2022). Money Follows the Person.

Peel Senior Link. (n.d.) Supporting Housing Journey – Peel/Halton regions.

Seniors NL. (2017). Provincial home support services program paid family caregiving option.

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