The West Coast District Health Board says it is aware a proposal to close its two aged care facilities in Buller is causing anxiety for some residents.
The board plans to carry out public consultation next month on a proposal to close Kynnersley Home and the Dunsford Ward in Buller Hospital, which are currently home to 26 people.
The board's general manager of people and capability, Michael Frampton, said an increasing number of older people wanted to stay in their homes as long as they could, so the number using the facilities was dropping.
Mr Frampton said the homes were largely underutilised.
Kynnersley Home has 27 beds but just 11 are currently occupied, while Dunsford Ward has 18 beds, of which 15 are being used.
Mr Frampton said a private facility, O'Conor Home, was expanding its capacity and might offer beds to those affected by the potential closure.
However, he said he understood why some residents might be upset by the prospect of closure.
"I think what's really important to understand is that these facilities have become people's homes. We're not talking about hospital beds, we're taking about facilities that have become people's homes," he said.
"So yes, there is a level of anxiety and that is absolutely understandable."
Mr Frampton said public consultation would start in mid-July, with a decision expected by mid-August.
He said the board would work with residents and their families on their options if the facilities close.
But Age Concern has criticised the move.
Chief executive of Age Concern Canterbury Simon Templeton said if the proposal went ahead, people in Buller would have very limited options for residential care.
There would only be one DHB-owned aged care facility in the region, which was in Westport, he said.
Mr Templeton agreed older people were increasingly wanting in-home health services but that didn't suit everyone.
He said some people had raised concerns that they would now only have one choice if seeking residential care.
However, Mr Templeton said it would be a positive if the board would now put more money into community-based services.
DHB's chief executive David Meates said Kynnersley Home and the Dunsford Ward were in a poor state of repair and there was no further government funding to fix or replace them.
As the O'Conor Home also has plans to expand, he said it was not viable to continue to maintain Kynnersley Home and the Dunsford Ward.