This is Not an Imminent Health Crisis. It's Here and BC Is Not Ready.

By 2036, nearly one in four British Columbians will be over 65 years old. The number of seniors aged 75 and older requiring the intensity of care provided in a long-term care home is projected to grow from approximately 35,000 today to 55,000 within the next decade. The waitlist for publicly subsidized long-term care has tripled since 2016. Average wait time: 290 days.

This is not a coming crisis. It is a current one that is accelerating.

The demographic trajectory was entirely predictable. The baby boomers born between 1946 and 1964 are now between 62 and 80 years old. Their healthcare needs, multimorbidity, cognitive decline, mobility limitations, palliative care, were always going to arrive at scale in the 2020s and 2030s. Health systems that invested in preparation, in community care infrastructure, in home-based support, in prevention that compresses morbidity into fewer years, in workforce pipelines, are in a fundamentally different position than those that deferred those investments.

BC deferred.

The Budget 2026 Signal

Budget 2026 delayed construction of seven long-term care facilities representing 1,223 beds in communities including Squamish, Abbotsford, Campbell River, Chilliwack, Delta, Kelowna, and Fort St. John, with no new timelines. Finance Minister Bailey's stated reason, $1.8 million per bed construction costs, is a legitimate fiscal concern. But the delay was not accompanied by an alternative strategy for meeting the care needs of the seniors who will not have access to those beds.

The private cost is borne by families. BC Seniors Advocate Dan Levitt has documented how the publicly funded care shortage shifts responsibility to families who are not professionals, not trained for long-term care, and who absorb the burden without compensation or adequate support. The healthcare cost shows up downstream: in emergency departments, in avoidable hospitalizations, in premature mortality among seniors who waited nearly a year for appropriate care. Neither cost appears in the budget line for long-term care construction.

What Population Aging Actually Demands

The global evidence on aging population management points consistently toward the same set of investments. Systematic reviews find that complex, multifactorial care models that are person-centred, address health and social needs together, and are delivered by multidisciplinary teams have the most consistent evidence for supporting older people to remain in community settings. Specialist geriatric and home-based palliative care have robust evidence for helping seniors stay and die at home, which is where the overwhelming majority of them want to be.

These are not cheap investments. They require home support workers, community nurses, occupational therapists, social workers, geriatricians, and the coordination infrastructure to connect them across a fragmented service landscape. But they are cheaper, and far more humane, than the alternative of an institutional system that cannot build beds fast enough to meet demand it could have partially prevented.

The compression of morbidity matters here too. Chronic disease self-management programs, preventive health interventions, and integrated primary care for multimorbidity all reduce the pace at which aging adults accumulate care dependencies. Every year a senior remains well, mobile, cognitively intact, and living independently in the community is a year of long-term care cost avoided. This is the investment logic that BC's health system has yet to apply at sufficient scale.

A Generation That Deserves Better Planning

The generation currently entering the most care-intensive years of their lives built this province. They paid taxes that funded a healthcare system premised on the promise of universal access. They are now waiting nearly ten months for a publicly funded care bed, if they are among the 7,212 who have made it onto the waitlist, and not among the many more who are managing without adequate support because they have not yet reached the threshold for formal eligibility.

Budget 2026 offers no spending plan to address the 2,000 long-term care bed shortage identified by the Seniors Advocate today, let alone the 16,000 bed deficit projected over the next decade. The $447 million in Aging with Dignity federal funding winds down after 2027–28. What replaces it, and whether it is directed at genuine system redesign or at maintaining an inadequate status quo, will determine the quality of aging for a significant proportion of BC's population.

This is not a distant policy problem. The people it affects are alive now, waiting now, and running out of time for the system to catch up with them.

IHSTS works with provincial partners on integrated care solutions for BC's aging population, including community-based models that support dignity, independence, and quality of life. Learn more at ihsts.org.