How it works.
PACE Canada is a community-based model for older adults that supports overall wellness by bringing healthcare, community services, and everyday supports together. Through a shared care plan and a coordinated team approach, it helps people stay healthier, more connected, and happy at home.
Our Program Pillars
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Interdisciplinary care teams providing wraparound wellness and social services
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Centralized coordination for service delivery, data collection, and evaluation
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Early, prevention supports that address social determinants of health
What makes PACE different?
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Team-based, connected care
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Prevention-focused, not crisis-driven
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Better support for caregivers
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Clear accountability for outcomes
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Designed to work with local providers and services, not replace them
What level of care does PACE support?
PACE supports older adults across a full continuum of needs, from staying well with prevention and community supports, to navigating frailty and more complex care. By bringing healthcare and community services together around one coordinated plan, PACE helps people stay safe, supported, and happy at home longer, while reducing avoidable hospital visits and the need for more traditional options, like long-term care, by strengthening support earlier.
Whole Person Care
PACE looks at the whole person, not just symptoms, because aging well is shaped by more than medical care alone. Whole-person support can include biological needs like mobility supports, falls prevention, nutrition resources, and chronic disease supports; psychological needs like brain health programs, coping tools, and caregiver support; social needs like peer groups, drop-in activities, transportation to outings, and volunteer engagement; and, when wanted, spiritual supports such as meaning-making opportunities and faith or community partnerships.
Technology helps coordinate care, not replace it. PACE uses simple tools to keep the care team connected, share updates, and respond quickly when needs change so people get the right support at the right time, with relationships and human care at the centre.
How the PACE model is delivered
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Intake: We learn needs, goals, and what matters most.
Assessment: A coordinated team of professionals review health, daily living and social factors.
Care Roadmap: A shared roadmap outlines goals, supports, roles and next steps in one place.
Delivery: Services are coordinated across providers and settings.
Ongoing Review: The team checks in, responds to changes, and updates the roadmap over time.
Costs and Coverage
PACE programs bring health and community supports together in a coordinated way to reduce duplication and strengthen prevention. In Canada, funding structures vary by province and the model is adapted locally based on what services are publicly funded and what partnerships are in place.
PACE Canada does not charge participants a membership fee. Depending on the service funding may vary by service provider and region.