Getting old is never easy. For most aging adults, it’s a slow letting-go of the family home, life-long treasures, and one’s most valuable possession: independence.

For many, the period of life between complete independence and long-term care is ameliorated by transitional living options, like assisted and supportive housing. Homecare helps seniors live independently longer.

But there comes a time when it becomes necessary to move to a personal care home (PCH). And this is when Manitoba’s aging adults, oftentimes when they’re already at their most vulnerable, can fall into a healthcare abyss—a veritable no man’s land.

It’s called the PCH wait list—and in much of the province, and right across the country, the wait can take years.

Not just anyone can qualify for a PCH. It requires a homecare assessment to determine whether a person’s mental or physical state is such that it’s unsafe for them to continue living independently. For many seniors, this happens after a fall or a series of falls.

Since the fall often results in an emergency room visit, the hospital becomes the patient’s new home as they wait for a suite to open up at the care home of their choosing. Until then, they’re at the mercy of a system, and ward of a facility, that was never meant to provide long-term care in the first place.

Manitoba Health begins to charge a daily stipend for the costs the person incurs as they languish in a hospital room. That cost is shared with the province.

In Manitoba, you can expect to spend your days in a hospital within the health region in which your preferred PCH exists. So if your facility of choice were to be Niverville’s Heritage Life Personal Care Home (HLPCH), your wait could take place in any hospital within the Southern Health-Santé Sud (SHSS) region. That could see you land anywhere from Emerson to Vita to Carmen, Portage la Prairie, or Winkler. The region is vast and residents can find themselves far from loved ones, not to mention far from home.

Worse still, residents can be shuffled from hospital to hospital as these facilities feel pinched for valuable acute care beds.

Health authorities do their best to accommodate families by keeping aging parents as close to home as possible. But the shuffle is inevitable in a system where space is at a premium.

Sadie Friesen

Sadie Friesen of Niverville is currently panelled for the HLPHC. Two of her children and many of her grandkids and great-grandkids live in the community.

Sadie and her late husband John once bought into an aging-in-place ideal. They were quick to invest, perhaps before they were quite ready, in one of Niverville’s first seniors living facilities, Silver Courts. Like so many, they dreamed of living out their final years in their hometown.

When the dream of an actual full-circle seniors housing complex was proposed, in the form of the Heritage Centre, the Friesens championed the cause.

Sadie eventually lost her lifelong partner and, at 90, made the move to the Niverville Credit Union Manor, an assisted living facility.

In November 2024, following a series of falls, it was determined that she should be panelled for the HLPCH.

For the next five months, Sadie continued to live in her assisted living suite. In March 2025, however, Sadie suffered another fall that sent her to hospital for observation. She sat in the waiting room for nine hours before being seen. While she had no fractures or concussions, the doctors deemed it too risky to send her back home.

It’s not that Sadie couldn’t have managed in her home with a wheelchair and the continued help of homecare. According to her daughters, Sandra Martens and Phyllis Peters, the reason was that homecare didn’t provide nighttime services and there was a measured risk that Sadie might need to use the washroom at night.

“She lost [the last bit of] her independence,” says Martens.

This was a challenge for someone as fiercely self-reliant as Sadie. From this point on, decisions were no longer hers to make.

“You have to go to bed at a certain time,” Martens says of hospital and PCH life. “You have to do what [the staff] tells you. You can only have a bath once a week, even if you’re used to one more often.”

Within weeks, Sadie was scheduled to be transferred from the St. Boniface Hospital to her home health region. Her daughters say it took some firm advocacy on their part to get their mom into the De Salaberry Hospital in St. Pierre-Jolys, just a half-hour from Niverville.

The facility was adequate. She had a small private room with a large window, enough to see the world go by on the outside.

Unfortunately, Sadie was there for less than two months when a staff member woke her in the middle of the night to let her know that she would be transferred to another hospital. Her daughters weren’t informed until the next day.

Within days, Sadie found herself placed in a transport vehicle with just the clothes on her back, en route to Notre Dame de Lourdes, about 120 kilometres away, feeling confused and unsure what was going on. The family was told to collect her belongings from De Salaberry as quickly as possible and deliver them to Notre Dame.

“They called me at 10:00 at night, saying they’d had a meeting and that they would have to move my mom,” Martens says. “I said, ‘Really? She’s 97 years old. She’s sometimes confused. If you move her, it’s not going to be good.’”

They gave Martens only one alternative for reconsideration: pay the $3,000 per day hospital rate.

For Sadie’s kids and grandkids in Niverville, the move meant a 90-minute one-way trip for visits. For her Winnipeg son and his family, the drive was closer to two hours.

The daughters wasted no time and started advocating for their mom. Their hard work paid off and, within weeks, Sadie was moved again, this time landing in Morris, just 35 minutes from Niverville.

To meet Sadie, you’d say she’s strong, feisty, and clear of mind for someone who’s about to turn 98. In conversation, she skillfully injects humour and wit, followed by her signature mischievous grin.

But deep down she admits to feeling forgotten by her community. She doesn’t understand why they aren’t advocating harder on her behalf so she can finish off her race on home turf.

“They’re not thinking of us older people that have built the town,” she says. “How we worked to get it this far.”

Indeed, Sadie has been a resident of Niverville since her family emigrated to Canada when she was just two years old. Niverville is where she eventually married and raised a family of her own. It’s where she supported John as he started his own business.

Sadie and John were heavily invested in the community all their lives. They dedicated themselves to community and church and countless hours of volunteering.

John was among the early founders of a funeral aid society that allowed every resident of Niverville, regardless of means, to access a plot and decent burial in the local graveyard.

In 1974, Sadie and four other women were instrumental in the opening of Niverville’s first MCC Thrift Store. Sadie volunteered there through all its stages of growth until she was 90 years old.

Now she spends her days in a crowded shared room at the Morris General. Her roommate is another Niverville resident awaiting placement at the HLPCH. Their space is about 10 by 15 feet, including a bathroom that’s too small to fit a mobility device. Every bathroom stop requires aid.

The small window, their only source of natural light, is too high up for them to look through.

The hospital itself is about 75 years old and in need of renovation. The paint is drab and the lights either brightly on or entirely off, without any dimming to accommodate sensitive eyes.

Suffice it to say, the hospital staff do their very best under the circumstances. Sadie recognizes and appreciates their daily effort and tries hard to be a bright spot in their day whenever she can.

According to her daughters, there are at least five Niverville residents and one New Bothwell resident currently living in this state of limbo until a spot opens up at the HLPCH. Ten months into her wait, Sadie is still only thirteenth on the list, so it’s conceivable she’ll remain in limbo for at least another year.

At this point, her greatest desire is to be settled back in Niverville in time for her one hundredth birthday.

Southern Health and the Niverville PCH

The Citizen reached out to Southern Health-Santé Sud for some insight into the wait times in Manitoba for placement in a PCH.

“Wait times vary significantly by community within Southern Health,” replied a media spokesperson. “Over the past four to five years, wait times in Southern Health-Santé Sud have consistently been around six months.”

The situation, however, looks different from the perspective of administration at the Heritage Life Personal Care Home.

Shelly Mall, the facility’s director of care, works alongside executive director Ron Parent to advocate to the health authority on behalf of patients on their wait list. She says their wait list has held steady between 35 and 50 people for many years. For the average senior, that translates to a two-year wait, give or take, from the time of their first assessment.

According to Mall, this isn’t unique to Niverville. It’s a province-wide concern.

Parent himself goes one step further by suggesting that some places in Manitoba, like the Interlake, have even longer wait times. Equally true, he points out, there are some care homes with lower wait lists, which affects the overall average.

Only the province has the authority to invest in and build new personal care homes in Manitoba. So the crumbling bridge between independent living and long-term care falls directly in their lap.

The problem is multi-layered. Firstly, the tail end of the baby boomer generation is now entering their senior years, creating greater demand for space. At the same time, many of the early PCHs built in the1960s are crumbling and in desperate need of restoration. This is all happening during a period of austerity which has left precious little funding for healthcare in general.

The province may be stuck between a rock and a hard place, since the baby boomers will eventually die off. The risk is that further investment now could lead to Manitoba having too many PCHs in the future, when demand falls.

But according to Statistics Canada, millennials now outnumber baby boomers in this country, largely due to the number of immigrants who have arrived on Canadian soil in recent years.

“On July 1, 2023, for the first time, the millennial generation comprised a greater number of people in the population than the baby boomer generation,” states a report by Statistics Canada.1

It could be argued that the current gap in seniors housing needs won’t be resolved naturally.

Parent can understand, though, why this issue has become such a behemoth for the provincial government. He says that the cost to build a new personal care home today, thanks to inflationary pricing and increasing regulation, comes with a price tag of between $400,000 and $500,000 per bed.

“So if you wanted to build a 100-suite personal care home, it could cost [the province] from $35 million to $50 million,” Parent says. “Provinces across Canada are facing a double-edged sword. They have a lot of old care homes that need to be replaced, plus they need to build new spaces.”

Determining Priority

Seniors on a wait list aren’t necessarily prioritized based on where they fall in the queue. Neither do residents naturally get priority over non-residents. For administrators of a health authority, greatest consideration goes to those deemed in greatest need.

Generally speaking, those living with dementia or physical impairments get highest priority.

“For me and Shelly, we’ve advocated for individuals who have a connection to Niverville, or they have a spouse in the care home or some other circumstances,” Parent says. “We will ask the question, ‘Could you consider this admission sooner versus later?’ We’re mindful that the healthcare system is meant to treat everybody equally, as much as reasonably possible, and I believe in that.”

Of course, those taking up space in a valuable acute care bed, like Sadie, are also prioritized over others. Priority may also be given to someone requiring personal care whose spouse is already in personal care.

“Keeping spouses together is shown to have tremendous therapeutic benefit,” says Parent. “So if they know that there’s a man in the hospital and his wife is in a personal care home, even though the man hasn’t been panelled as long as others, they will sometimes allow for him to move to the personal care home to get them back together.”

In the meantime, people like Sadie wait. Many will die in the hospital before ever getting to their care home of choice.

According to Parent, about 20 percent of hospital beds across the province are occupied by those awaiting PCH placement. They are considered “alternative levels of care.”

“Hospitals are not set up to support our elderly population,” says Parent. “Plus, you don’t thrive in a hospital setting.”

He’s not convinced, either, that working to keep aging residents at home longer is the ideal answer, especially if they live alone. The social component of living in a care home facility plays an important role in a resident’s mental health.

“We have a bit of a hybrid [system at HLPCH],” Parent says. “We have additional resources, such as resident companions to address helplessness, loneliness, and boredom. We can do a much better job when we focus on those three plagues versus just the clinical part.”

Advocating for Long-Term Care

Sue Vovchuk is the executive director of the Long Term and Continuing Care Association of Manitoba (LTCAM). This non-profit represents about 10,000 aging adults across the province. Most of the work that they do is in advocacy to enhance the quality of care for older adults.

“What we’re trying to do is ensure that we are providing our older adults in Manitoba with the right resources and the right housing to live a dignified life,” Vovchuk says.

Vovchuk worked in healthcare for more than 30 years. For some of that time, she managed the wait list in Winnipeg.

Nothing much has changed, she says. Thirty-three years ago, when Vovchuk attended one of her first healthcare conferences, there were already warnings about the necessity of getting ready for aging baby boomers.

It takes a lot of lobbying and advocacy, she says, to get new personal care homes built.

“It’s not just [about new care homes],” Vovchuk says. “It’s, ‘How do we keep the 124 PCHs already in Manitoba open?’ The cost of operating these facilities, with the funding model that we have right now, is astronomical. There hasn’t been a funding increase in more than 15 years. We’re on the precipice of a crisis here.”

That’s not to say that nothing has improved in the past few decades. Early PCHs were built with parking spots for residents, suggesting few stopgaps between complete independence and round-the-clock care. Now, with assisted living and supportive living options, as well as homecare services, independence can be maintained much longer.

In Manitoba, PCHs are the only long-term care facilities that are governmentally controlled, regulated, and funded. Assisted and supportive living facilities are entirely private.

But Vovchuk says there might be lessons to learn from provinces in Atlantic Canada, where governments subsidize a broader scope of housing.

“There, if an individual can no longer live in their own home but they’re not eligible for a personal care home, the government will subsidize them to move into assisted living or a different model of care.”

More can be done, as well, in terms of supporting the resources and services that help people stay in their homes longer.

If 24-hour homecare was available, residents like Sadie might never need a PCH bed. Indeed, the 20 percent of hospital beds occupied by adults on a PCH wait list might be freed up for the use they were intended to meet.

“I think what we’re continually saying is that long-term care is a huge part of healthcare,” says Vovchuk. “Right now, acute care seems to be the focus. But if we don’t do our work with long-term care, we’re never going to fix the problem in the hospitals. It’s all a part of the same system.”

Vovchuk encourages everyone to make some noise, since we are all at risk of one day finding ourselves in the same position Sadie is in today, spending her twilight years in no man’s land. She recommends writing letters and emails to MLAs and MPs, as well as the federal minister of health, demanding that more be done for our aging population.