Quebec is preparing to face a gray tsunami. By 2040, the number of elderly people with independent living support needs will increase by almost 70%, to reach 547,900. To maintain the current level of services, the government will need to recruit 13,700 nurses and 45,600 workers. providing personal care and assistance with daily living. This is without counting the places in CHSLDs or seniors’ homes: 42,500 will have to be added.
These are the findings of a projection carried out by a team of researchers from the Jacques-Parizeau Research Chair in Economic Policies at HEC Montréal. Their report, commissioned by the Health and Welfare Commissioner, has just been published. Its conclusions are dizzying.
Pierre-Carl Michaud, professor of economics at HEC Montréal and researcher at the Interuniversity Center for Research in Organizational Analysis (CIRANO), led the project. “What strikes me about this report is realizing how much more expensive it is going to be,” he said. We will have to build at an astonishing pace, we will have enormous labor needs, and despite all that, we will end up with a very low rate of response to needs, particularly in home care, which will remain about 10% [proportion d’heures de services fournis par rapport aux heures de soins requis]. »
The researchers made their projection assuming that the current system would be maintained as is in the years to come, that is to say that there would be no change to the organization or financing of home care. and long lasting. According to their modeling, this status quo would result in an increase in the total cost of autonomy support of 120%. From $7.6 billion in 2023, this cost would increase to $16.5 billion (constant for 2023) in 2040.
“In accommodation, the result is that we need to continually build around 2,500 new places per year in CHSLDs or seniors’ homes,” says Pierre-Carl Michaud. Capacity needs to be doubled [d’ici 2040]. »
The government will have to decide whether it focuses on seniors’ homes, which cost more than CHSLDs. “In terms of cost per place, seniors’ homes, we are more around a million dollars – in the report, we used $750,000, which was the last official figure –, while in CHSLDs, it is $450,000,” he explains.
Status quo: “not a viable option”
In its report, the team of researchers — which includes former minister and professor at the University of Montreal Réjean Hébert — concludes that “the status quo is not a viable option and that it would lead to a deterioration of supporting the needs of an aging population, with costs that will quickly become a heavy burden on taxpayers.”
She emphasizes that the future users she surveyed (3,000 Quebecers aged 55 to 69) want to stay at home “when their needs are low or moderate”. “We believe that alternative avenues must be seriously studied in order to chart a path towards a real shift towards home in the short, medium and long term,” she writes.
To explore possible solutions, the team developed a tool to measure the effects of new measures on the care of seniors at home, their well-being and the cost associated with them for the government. Put online on Wednesday, this tool is intended for authorities and specialists in the field. It opens the way to reflection on various scenarios, according to Pierre-Carl Michaud. For example, he said, the government could decide to maintain services for seniors such as nursing care, but ask citizens to pay in part for their domestic assistance, such as meal preparation or housekeeping.
In its calculations, the modeling tool takes into account demographic aging by region. In 2040, more than 20% of the population will be aged 75 and over in Gaspésie and the Magdalen Islands as well as Bas-Saint-Laurent.