ABSTRACT
There is a widespread, although not universal perception that the elderly are a problem group in society. Certainly there are figures from many countries, including both the United States and Canada that could be interpreted to support this pessimistic view. Ideally, a system of community care for the elderly shall embrace private homes, residential, extended care, nursing facilities, acute care hospital beds, geriatric assessments, day hospitals, day care centers, rest beds, palliative care units, palliative care teams, and palliative care programs. There should be free movement between all types of this system. Public expectations are reflected in public policy: there is little evidence of political will to alter the pattern of funding to allocate increased resources to the community, to long-term care, or to palliative care. In fact, community-based palliative care in Canada has been inhibited by the limited, fragmented, and poorly funded home health and social services in all of the provinces.
