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The President is expected to give special emphasis in his proposals to expanding home- and community-based programs, as Canadian provinces are now doing. Keeping people in their own homes longer can improve the quality of life and save money.

Ontario, home to one of three Canadians, has just announced plans to spend $505 million over the next five years, mostly to expand and streamline home-care services for the elderly, like meal programs, home maintenance, transportation and nurses' visits.

The province's Health Minister, Ruth Grier, said in an interview that overall health spending is being drastically curtailed except in the home- and community-based sector, where the aim is to "help the elderly keep their independence as long as possible."

Olive Donaldson, a member of the nonprofit Victorian Order of Nurses, visits 12 patients a day, most of them elderly, in north Toronto. A "foot soldier," as she calls herself, "who is in the trenches every day," she provides home dialysis, intravenous medication, even "bowel routines" if necessary.

For her there is no question about the value of home care. "I feel it's cheaper in the long run," she said. "It takes longer to get well in a hospital. At home you're more relaxed. It's more supportive, and you're in charge."

Ontario government agencies provided some form of home medical care to 307,000 people last year, roughly 3 percent of the population of the province, but more than one-third of those over 65. The number is expected to grow to 340,000 in the current year. A Higher Priority

Many states in the United States already have well-developed home-care programs for the elderly, financed in part by Medicaid. The main differences are the higher priority given this approach in Canada and the degree of integration here between home and institutional care.

Dr. Duncan Robertson, head of geriatric medicine units at both the Sunnybrook Health Science Center in Toronto and the University of Toronto, points to an "artificial dichotomy" in the United States.

"In making choices, families must do a great deal more work and suffer more anxiety because the system is so complicated and disjointed, whereas in Canada, you literally have one or two contacts with placement specialists who can then access a full range of services," he said.

Basically, the Canadians run care for the aged as a social program, which means that the real risk of financial disaster for those facing long-term-care needs is incurred not by individuals but by society. Tests National Character

In their book "A Will and a Way: What the United States Can Learn from Canada about Caring for the Elderly," Rosalie A. Kane and Robert L. Kane, health economists at the University of Minnesota, call long-term care a test of national character.

Canadians, they wrote, "seem to show that persons and organizations of good will can grapple with long-term care and produce a program that both the country and individual users can afford."

Mrs. Kane added in an interview: "At the very minimum, the Canadian experience illustrates the art of the possible at a time when pessimism prevails in the United States regarding genuine, far-reaching long-term-care reform."

Photos: For Charlotte M. Cohan, life in a Canadian nursing home is better than she expected. (pg. A1); "This place is a godsend," says Charlotte M. Cohan, of the Rotary-Laughlin Center in Toronto. She watched a recent Blue Jays baseball game on televison with Nazmoon Baksh, a health care assistant. (pg. A2) (Carlo Allegri for The New York Times)