This working paper describes future needs in terms of support for the autonomy of the elderly in Quebec and attempts to estimate the related costs. The results of the simulations show that the needs will grow more and more rapidly over the next two decades. The costs will quickly become prohibitive, even if the current level of service is maintained. The projections of the status quo scenario show that we would need to increase the availability to accommodate more than 40,000 new residents in CHSLDs by 2040, a doubling of the current capacity. Finally, this report proposes a framework for considering different scenarios that can meet the needs of the population in a more financially sustainable way.