There's no way New Zealand - or the Whanganui District Health Board - can afford to pay for aged care for everyone, New Zealand Council of Elders chairwoman Sharon Duff says.
The average cost for a week's care in a rest home is $800 to $1200. Hospital-level care costs even more.
Whanganui District Health Board (WDHB) gets a pool of government funding to pay for all health care in the region. The board's region has a small population with high health needs and low socio-economic status.
"In a low decile population with high health needs you are going to have heavy demands on the hospital, and less ability to spend on health care in the community," Duff said.
Whanganui has enough rest home beds for now, but New Zealand Aged Care Association CEO Simon Wallace says it will need 60 to 100 more during the next 10 years.
To get a bed in a rest home, people are assessed in their own homes by DHB staff or contractors. It's "a very prescribed process" that is used across New Zealand.
Despite that, getting assessed as needing rest home care is easier in some places than others.
Wallace said more than half of DHBs denied rest home care to people who needed it. He wants more consistent assessment.
Whanganui wasn't the hardest place to get rest home care, which surprised Duff.
"I would have thought we would be close to the bottom."
She doesn't blame WDHB for that.
"We only have this amount of money and it only goes a certain distance. Probably the DHB is doing a pretty good job with the money they've got."
People should give up expecting they will get rest home care at the end of their lives, and instead take responsibility for themselves. At age 55 she said they should be thinking about where they want to live, who with and what they still want to do.
Most people prefer to stay independent, in their own houses.
Now is the ideal time for Whanganui people in their late 50s to sell the large family house and find a warm, safe, one or two-bedroom home with the right technology for their later years.
Duff feels sorry for people who have high health needs, no savings and no house. It's hard to rent and live on the pension.
And with New Zealand's rental squeeze spreading to Whanganui, she's heard all the city's pensioner flats are full.
She's in full support of Housing New Zealand's move to build more one and two-bedroom houses. They are ideal for older people, she said, and for people with mental health conditions that make it hard for them to live with others.