Saskatchewan faces a widening conversation about how best to care for an ageing population, with a veteran health policy analyst arguing the province should look beyond building more nursing-home beds and direct resources toward supports that help people remain at home.
Costly beds vs alternatives
Steven Lewis, who has spent decades studying health systems in Saskatchewan, told listeners on The Evan Bray Show that relying on long-term care homes as the primary solution would be expensive and potentially less responsive to what seniors want and need.
Lewis pointed to two broad concerns: the capital cost of adding nursing-home capacity and the heavy share of government finance already devoted to health. He said locking up large sums in bricks-and-mortar facilities reduces flexibility for other priorities within a system where health care accounts for about 40 per cent of the provincial budget.
"It’s crazy expensive for one thing, and when you have all that money locked into big capital expenditures, it reduces the amount of money that you have for other things," Lewis said.
What alternatives would look like
Lewis argued that investments in home care, supportive housing and community-based supports can help seniors stay independent longer, ease the burden on families who often become full-time caregivers and reduce pressure on public finances.
He said the current approach is often reactive: supports arrive after an older adult reaches crisis, rather than earlier when modest services could prevent institutionalization.
- Home care: practical care in a person’s own home to delay or avoid admission to long-term care.
- Supportive housing: housing with on-site or nearby services that help residents live independently.
- Community-based supports: networks and programs that provide social, health and practical assistance outside institutions.
Policy trade-offs and public preferences
Beyond cost and system planning, Lewis stressed that many people prefer to avoid moving into nursing homes when possible. He noted the importance of offering services early, before a health crisis forces the move, and contrasted Saskatchewan’s reliance on family caregiving with models in northern Europe where more comprehensive community services are provided.
Those trade-offs have practical implications for provincial planners. Construction of new long-term care beds carries substantial upfront capital costs — estimates discussed publicly in other forums put the figure at roughly $1 million per bed when building modern facilities — while community options typically require different, more distributed investments in staffing, program delivery and housing supports.
What this means for families and communities
For families in Saskatchewan, the debate affects both care availability and financial strain. Lewis highlighted how the current system often shifts costs and responsibilities onto unpaid family members who provide daily support.
Expanding home and community services could change that dynamic, but would require policymakers to reallocate funding and develop workforce plans to deliver more home-based care. Lewis warned that without those changes the system will remain reactive and expensive.
| Approach | Primary benefit |
|---|---|
| Long-term care homes | 24/7 clinical supervision and complex care |
| Home care | Supports independence, keeps people in their homes |
| Supportive housing | Combines housing with accessible on-site services |
| Community supports | Social and practical services to prevent crisis |
Where the conversation goes from here
The comments from Lewis come as Saskatchewan and other provinces consider how to meet growing demand for older-adult care without ballooning costs or diminishing quality. He emphasized the need to plan ahead and invest in a spectrum of options rather than expecting institutional beds alone to solve the problem.
Those decisions will affect not only how many beds are built, but how neighbourhoods, workplaces and families adapt as the population ages. For many Saskatchewan residents, the question is as much about dignity and choice as it is about balance sheets: how to provide care that keeps people rooted in their communities while managing public resources prudently.
Policymakers will face difficult choices about where to direct limited funds, how to recruit and retain staff for home- and community-based roles, and how to ensure supports reach people before crises force institutional transitions.
