A senior health official says the government is still committed to the Transforming Your Care policy, despite the u-turn by Health Minister Edwin Poots on the closure of care homes.
Director of Social Care and Children with the Health and Social Care Board Fionnuala McAndrew is leading the new consultation process on the policy.
In a written statement to the Belfast Telegraph, she first apologised to older people for any anxiety caused over the past few weeks, but added there had to be changes in the way care is delivered. Ms McAndrew said: "The reality is we simply can't leave the current system the way it is.
"Over the next 18 years the number of people over 65 will increase by 42% and those over aged 85 years will have doubled.
"With this in mind, it is important that we prepare our services for the future, and this will mean making choices about how we want our health and social care services to be delivered, based on the best evidence and making best use of available resources. It is about significant change, but change that will improve the health of the population."
Ms McAndrew said care homes were just part of the story.
"The public debate has focussed on residential care. It is a small but significant service, but the area where there is likely to be most change.
"However, residential care will remain part of service provision – care for older people is based on assessed need, so if there is a need to provide residential care; more care at home; or in a nursing home, it will be provided."