Aging at home: integrating community-based care for older persons

Integrating community-based health and social care has grabbed international attention as a way of addressing the needs of aging populations while contributing to health systems' sustainability. However, integrating initiatives in different jurisdictions work (or do not work) within very various institutional and structural dynamics. The question is, what transferable lessons can we learn to guide policy makers and policy innovators at the local level? In this paper, we consider "aging at home" as a policy option in Ontario, and beyond. In the first section, we focus on the problem, in effect, what not to do. Here, we briefly review findings from national and international research literature and from our own research in Ontario that identify the costs and consequences of non-systems of care for older persons. In the second part, we turn to solutions, in effect, what to do. Drawing on our recent scoping review of the international literature, we identify three guiding principles, as well as a number of recommendations, for integrating care for older persons, knowing that important details of how to put such initiatives "on the ground" will be provided by other contributors to this journal edition.