The COVID-19 pandemic exposed the fragility of Canada’s eldercare system. While philanthropy is vital in supporting seniors and ensuring they receive the dignified care they deserve, it must complement – not replace – public services.
The COVID-19 pandemic exposed critical weaknesses in Quebec’s eldercare system, intensifying an already growing reliance on philanthropic funding by community organizations. This situation raises a crucial question: should philanthropy serve as a complement to – or, rather, a substitute for – the state’s obligations to the elderly? Grounded in PhiLab research that started before the pandemic and evolved in partnership with the Mirella and Lino Saputo Foundation, this article explores the distinct roles of the state and philanthropy in addressing the needs of seniors. While the research is based in Quebec, the questions it raises – about the shifting responsibilities between public institutions and philanthropy in supporting aging populations – are relevant across Canada. Many of the insights drawn from Quebec’s experience can, to some extent, be extrapolated to other provinces facing similar challenges in eldercare and non-profit funding.
A fragile eldercare system
The role of philanthropy in the eldercare system became salient when the COVID-19 pandemic exposed its fragility. Long before the pandemic, however, Quebec’s senior-care system was already facing a crisis, primarily due to underfunded home-care and long-term care services and overwhelmed community support structures. According to Statistics Canada, by 2012, 15% of the 2.2 million Canadians receiving home care services were not getting the care they required. Of these, 24% were 65 and older. By 2020, staffing shortages were a significant issue, with more than four out of five long-term care facilities, as well as half of nursing and seniors’ homes, reporting at least one staffing-related challenge that directly affected resident care and worker safety. Furthermore, workers in long-term care facilities have long been underpaid. Many researchers argue that these interconnected issues constitute a form of organizational mistreatment, ultimately affecting all beneficiaries. The lack of adequate support exacerbated existing inequalities and placed an increased burden on caregivers, further deepening the systemic crisis in the sector. The arrival of COVID-19 compounded these issues, exposing appalling conditions in long-term care facilities. More than 80% of all COVID-19 deaths in Canada during the first waves of the pandemic occurred in long-term care, mostly in Quebec and Ontario. These problems had long been known, but the crisis made them undeniable.
Philanthropy filling the gap
Philanthropy has attempted to fill the financial and programmatic gaps left by the public sector, yet it still struggles to compensate for the public sector’s ongoing reliance on charitable support, and them being possibly accustomed to this arrangement. In response to the crisis, several philanthropic initiatives emerged to address urgent needs in eldercare. For instance, the Mirella and Lino Saputo Foundation, in partnership with various community organizations, provided emergency funding to strengthen home-care services, ensuring that vulnerable seniors could receive support without having to move into overcrowded long-term care facilities. The foundation also contributed to the recruitment and training of caregivers, addressing some of the sector’s acute labour shortages. Additionally, United Way/Centraide and local community foundations increased funding to front-line organizations that assist seniors, such as food aid services, mental health support, and programs to combat social isolation. Our research interviews told us that some philanthropic actors also invested in innovative solutions, such as deploying technology to facilitate virtual healthcare consultations and creating new collaborative care models between community groups and healthcare institutions. Despite these efforts, the reliance on philanthropy to sustain critical services raises concerns. While these initiatives provided temporary relief, they underscored the long-standing structural deficiencies in the eldercare system, highlighting the urgent need for a more robust and sustainable public investment strategy.
Increasing pressure on philanthropy
Approximately one in four Canadians will be 65 or older by 2043. Quebec’s aging population is expanding rapidly, with seniors projected to comprise a quarter of the province’s population by 2030. Yet, of the 2,000 philanthropic foundations in Quebec, only 15 are explicitly dedicated to supporting the elderly. This scarcity of focused philanthropic initiatives only exacerbates the gaps in care services, which remain underfunded and overburdened. The existing philanthropic model, fragmented and under-resourced, cannot sufficiently fill the void left by public-sector retrenchment. While philanthropy attempts to provide relief, it cannot compensate for the chronic underfunding of long-term care homes in Quebec – known as Les centres d’hébergement et de soins de longue durée, or CHSLD for short – and home-care services. This creates a troubling paradox: while the Quebec government acknowledges the importance of home care and the failures within CHSLD, it nonetheless neglects to allocate the necessary resources for enhancing care quality and supporting services. This leaves philanthropy in the uncomfortable position of stepping in where the state falls short, putting it in a potential position of subsidiarity. (For more information on the delicate topic of subsidiarity in philanthropy for seniors, we recommend consulting PhiLab’s research report Étude de cas sur la cause des aînés-es au Québec: Regards croisés sur les dons des fondations subventionnaires et la subsidiarité de l’État en lien avec la cause aînée, Phase 1 and Phase 2.)
Of the 2,000 philanthropic foundations in Quebec, only 15 are explicitly dedicated to supporting the elderly.
After the COVID-19 pandemic, the pressure on foundations has only increased. Some are now receiving funding requests to cover unexpected costs, such as electricity bills for air conditioning in long-term care homes. This highlights the growing reliance on philanthropy to address public-sector deficiencies – raising critical questions: To what extent should philanthropy be expected to fill the gaps left by inadequate public action? And why do so few philanthropic organizations choose to invest in this growing sector, despite the clear urgency of needs?
Need for relief: A complementary view
Philanthropy is vital in supporting seniors but must complement – not replace – public services. The state guarantees essential care, while philanthropy drives social innovation and amplifies seniors’ voices in policy debates. Together, they ensure that seniors receive the dignity and care they deserve.
The state guarantees essential care, while philanthropy drives social innovation and amplifies seniors’ voices in policy debates.
Remaining a complement (not a substitute) to the state: The key challenge is preventing philanthropy from becoming the fallback solution to the many pressing challenges faced by seniors, while also encouraging a more holistic approach to the issues seniors face around aging well. To address this, we must:
- Strengthen public funding for home-care services and long-term care homes.
- Foster balanced partnerships between the state and philanthropy.
- Involve seniors in the discussions that pertain to their well-being.
- Identify ambassadors and public figures who can bring more attention to the cause.
- Develop more inclusive, intergenerational public policies that address the complexities of aging well for all.
By rethinking philanthropic engagement with seniors, we can build a sustainable, inclusive approach that complements public services without replacing them. The state has a distinctive role in ensuring access to essential services – such as home care and long-term care facilities – and in developing comprehensive public policies tailored to seniors’ needs. On the other hand, philanthropy brings its own unique contributions by supporting social innovation, taking risks on pilot projects, and fostering community partnerships to address emerging challenges. For instance, as highlighted in the Canadian government’s report on social isolation, targeted social innovations can create meaningful solutions for issues affecting seniors. By integrating these distinct yet complementary approaches, we can ensure that seniors receive the care, respect, and opportunities they deserve.
Advocating for the sector. The seniors’ community is often overlooked, its concerns quietly simmering beneath the surface. With a broad and diverse demographic, seniors are considered anyone 65 and older by the state or 50 and older by organizations like FADOQ (Fédération de l’âge d’or du Québec, which claims to be the largest seniors’ network in Canada). Some seniors are healthy, others not so much, and growing isolation is a pressing concern. In any case, they are largely removed from the social life, and their sense of utility and purpose in the public’s perception is often stripped away. Despite the significant challenges they face, seniors rarely capture the spotlight. It’s easy for their causes to get lost in the noise of more visible and more supported social causes.
Foundations often shy away from investing in senior causes, not seeing a direct return on investment in terms of visibility and public engagement.
Foundations often shy away from investing in senior causes, not seeing a direct return on investment in terms of visibility and public engagement. Why? The answer lies in a lack of representation, especially from public figures. Celebrities and media influencers wield substantial power in shaping public discourse. When they rally behind a cause, it garners attention, attracts donations, and influences policymakers. But seniors’ issues rarely have such high-profile champions. Without endorsements from well-known figures or media coverage, these causes remain in the shadows, leaving the elderly to face mounting challenges in near silence. Interestingly, according to a recent study, seniors are one of the top three causes deemed “most touching” to Quebec donors. Individual donors may support the cause, but it is difficult to say if their monetary donations reflect their sensitivities. The absence of advocacy contributes to the persistent invisibility of seniors’ struggles – a reality that is mirrored in the philanthropic sector.
Redefining our approach toward aging. In recent years, some philanthropic efforts have opted to engage seniors through intergenerational projects, often bypassing direct support for their specific needs. These initiatives tend to celebrate seniors in their roles as grandparents or as contributors to the well-being of younger generations, positioning them as valuable links between the past and the future. While the intent behind such projects is admirable, they often overlook the pressing material issues that seniors face – such as access to healthcare or financial security. While intergenerational initiatives can indeed hold social value, they do not directly address the immediate needs of seniors themselves. This trend, however, presents a valuable opportunity to redefine how philanthropy engages with aging. By integrating intergenerational initiatives, philanthropy is starting to break free from traditional boundaries, opening up a wider discussion on the interconnectedness of generations and the causes that affect them.
Philanthropy should take more risks to support another cross-cutting theme: aging well.
In parallel with intergenerational projects, philanthropy should take more risks to support another cross-cutting theme: aging well. Aging well, in this context, is about emphasizing the dignity, independence, and right to a fulfilling life of each individual. This theme goes beyond traditional initiatives, breaking down existing silos and placing the individuals involved at the centre of the conversation. It is an approach that recognizes the diversity of aging experiences and aims to directly address the specific needs of older adults without confining them to predefined roles.
Conclusion
While philanthropy holds significant potential in fostering social innovation, it must not replace the core responsibilities of the state. As community organizations increasingly depend on foundations, better coordination between state and philanthropic efforts becomes crucial. These actors must collaborate strategically to address the specific needs of seniors, focusing on targeted responses rather than solely on indirect benefits. The future of eldercare should rest on a model in which philanthropy complements public action rather than replacing it. As the demand for services for older adults increases, it is crucial to ensure that essential services are not slowly privatized, leaving vulnerable populations without adequate support. Philanthropic organizations have a crucial role to play, but this role must be part of a broader, coordinated strategy that includes robust public funding and policies. By rethinking the position of foundations in the sector, we can better support dignified aging for all, ensuring that seniors are provided the care, respect, and autonomy they deserve. This collaboration between the state and philanthropy can create a sustainable, inclusive system where the well-being of older adults is a shared priority across society.
Further listening
PhiLab podcasts:
• “Are We Failing Seniors?” with Adam Saifer (2023)
• “Subventionner ou subsidiarité?” with Lise Roche (in French; 2024)
