Australian Institute of Health and Welfare (2021) Aged care for Indigenous Australians, AIHW, Australian Government, accessed 06 October 2022.
Australian Institute of Health and Welfare. (2021). Aged care for Indigenous Australians. Retrieved from https://www.aihw.gov.au/reports/australias-welfare/aged-care-for-indigenous-australians
Aged care for Indigenous Australians. Australian Institute of Health and Welfare, 16 September 2021, https://www.aihw.gov.au/reports/australias-welfare/aged-care-for-indigenous-australians
Australian Institute of Health and Welfare. Aged care for Indigenous Australians [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2022 Oct. 6]. Available from: https://www.aihw.gov.au/reports/australias-welfare/aged-care-for-indigenous-australians
Australian Institute of Health and Welfare (AIHW) 2021, Aged care for Indigenous Australians, viewed 6 October 2022, https://www.aihw.gov.au/reports/australias-welfare/aged-care-for-indigenous-australians
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The Aboriginal and Torres Strait Islander population has a much younger age structure (see Glossary) than the non-Indigenous population, due to higher rates of fertility and deaths occurring at younger ages (see Profile of Indigenous Australians). However, as with the general population, the Indigenous population is also ageing.
Access to aged care services (see Glossary) in Australia is determined by need, rather than age. However, planning for aged care services takes into account the specific needs of the Indigenous population aged 50 and over and the non-Indigenous population aged 65 and over (Department of Health 2020a). A broader age group is used for Indigenous Australians because of their greater need for care at a younger age compared with non-Indigenous Australians.
This page focuses on Indigenous Australians aged 50 and over and their use of aged care services. See also the Aged care and “Chapter 8, Understanding older people’s journey through aged care – the story in the data” in Australia’s welfare 2021: data insights.
Projections from the Australian Bureau of Statistics 2016 Census of Population and Housing (Series B) estimate around 155,000 Indigenous Australians were aged 50 and over in 2021. This includes about:
Indigenous Australians aged 50 and over comprised:
In Australia, the aged care system offers options to meet the different care needs of individuals. To help ensure aged care services are appropriate to the needs of all people, the Aged Care Act 1997 designates some groups of people as ‘people with special needs’. Indigenous Australians are one such group (Aged Care Act 1997: s11–3). For Indigenous Australians, challenges for the aged care system include ensuring access to culturally appropriate care, especially for those living in Remote and Very remote areas (ANAO 2017). In 2019, the Australian Government published Actions to support older Aboriginal and Torres Strait Islander people, developed under the Aged Care Diversity Framework. These outline actions to support more inclusive and culturally appropriate care for Indigenous Australians (Department of Health 2019b).
The Royal Commission into Aged Care Quality and Safety has also identified areas of importance in providing aged care to Indigenous Australians.
In its Final Report, the Royal Commission into Aged Care Quality and Safety identified that Aboriginal and Torres Strait Islander people have specific needs in accessing aged care. The report makes recommendations regarding:
In response to the Aged Care Royal Commission, the Australian Government will invest $572.5 million to ensure Aboriginal and Torres Strait Islander people receive quality and culturally safe aged care services, can access advice to make informed decisions about their care, and are treated with dignity and respect. This includes the funding of 250 Indigenous Australians to provide support and assistance in navigating the aged care system, upgrading services (including adding facilities to connect residential facilities with communities on Country), additional funding for National Aboriginal and Torres Strait Islander Flexible Care Services, and improved translation and interpreting services (Department of Health 2021a).
Data on the use of aged care by Indigenous Australians are available from the AIHW National Aged Care Data Clearinghouse. Considering the main types of government-subsidised aged care, among Indigenous Australians aged 50 and over, about:
Indigenous Australians using residential aged care tended to be older than those using home care or home support (Figure 1). For example, over half (51%) of Indigenous Australians in residential aged care were aged 75 and over, compared with 34% using home care, and 26% using home support.
It should be noted that Indigenous status was not stated for more than one-third (36%) of home care clients at June 2020, so home care data should be interpreted with caution.
This chart show the proportion of Indigenous Australians using home care, home support and residential aged care, by age group. On June 30 2020, 51% of Indigenous Australians using residential age care and 34% of Indigenous home care clients were aged 75+. In 2019–20, 26% of Indigenous Australians using home support were aged 75+. In the same time periods, 2% of Indigenous Australians using home support and 2% of Indigenous Australians using residential aged care were aged 0–49.
Most Indigenous Australians using home support, home care, or residential aged care lived in non-remote areas. In 2019–20, among Indigenous Australians using home support (of all ages):
Similarly, for Indigenous Australians using home care and residential aged care, at 30 June 2020, over 4 in 5 lived in non-remote areas (90% for home care and 84% for residential aged care).
While most Indigenous Australians using aged care services lived in non-remote areas, the proportion of all Australians using aged care who were Indigenous was considerably higher in remote areas. For example, among people using home support in 2019–20, 30% in remote areas were Indigenous, compared with 2.3% in non-remote areas.
Another type of aged care is flexible aged care, which provides care for special groups or circumstances in a range of settings. An example is the National Aboriginal and Torres Strait Islander Flexible Aged Care Program, which provides culturally appropriate care for Indigenous Australians in locations close to their communities, with services mainly located in remote areas. On 30 June 2020, the program had 1,264 places, an increase of over one-third from 30 June 2016 (when there were 820 places) (Table 1).
Number of places
30 June 2016
30 June 2017
30 June 2018
30 June 2019
30 June 2020
Sources: Department of Health 2016, 2017, 2018, 2019a, 2020a.
Differences in aged care use exist between Indigenous and non-Indigenous Australians aged 50 and over. With the exception of those aged 65–69 and 75 and over using residential aged care, rates of aged care use were higher for Indigenous Australians than for non-Indigenous Australians (Figure 2).
Among people aged 65–74, compared with the rate among non-Indigenous Australians, Indigenous Australians were:
This chart shows that the rate of Indigenous Australians using home care was consistently above the non-Indigenous rate across all age groups. The highest rate is among those aged 75+ (95.0 per 1,000 for Indigenous Australians and 40.4 per 1,000 for non-Indigenous Australians).
Between 30 June 2016 and 30 June 2020, the rate of home care use for Indigenous Australians aged 50 and over increased from 16 to 23 per 1,000 (Figure 3), with numbers increasing from 1,982 to 3,411. This effect was particularly large between 30 June 2017 and 30 June 2018, likely reflecting the Increased Choice in Home Care reforms, which took effect in 2017 (Department of Health 2021b). These reforms have resulted in an increasing number of packages made available to support people in accessing home care.
Between 30 June 2016 and 30 June 2020, the number of Indigenous Australians in residential aged care rose from 1,539 to 1,916, with admissions also rising over this time period.
This chart shows that, among Indigenous Australians aged 50+, the rate of home care has risen from 16 per 1,000 on 30 June 2016 to 23 per 1,000 in 30 June 2020. The rate of Indigenous Australians aged 50+ in residential care remained relatively stable over the same time period—between 12 per 1,000 and 13 per 1,000.
Home support replaced the Commonwealth Home and Community Care programme from 2015, with a gradual rollout across the jurisdictions completing in July 2018. Between 2016–17 and 2019–20, the number of Indigenous Australians aged 50 and over using home support increased from 20,100 to 21,800. However, over the same time period, there was a relatively larger increase in the size of the Indigenous population aged 50 and over. As a result, the rate of home support among Indigenous Australians aged 50 and over decreased slightly from 158 per 1,000 people to 150 per 1,000 people.
Indigenous rate (per 1,000)
Non-Indigenous rate (per 1,000)
1. Table excludes people for whom Indigenous status was not stated. In 2016–17 9.0% of people had a not stated Indigenous status, improving to 6.7% in 2017–18, 6.6% in 2018–19 and 4.9% in 2019–20.
2. Indigenous rates calculated using ABS 2016 Census-based population projections (Series B) (ABS 2018). Non-Indigenous rates calculated using ABS ERP calculations (ABS 2020), subtracted by Indigenous projections for that time period.
3. Dates that home support providers input can reflect dates of data submission rather than dates of service use.
4. For home support, the jurisdictions in scope changed as states transitioned from the Home and Community Care Program to the Commonwealth Home Support Programme from 2015, with Victoria and Western Australia transitioning later than other states. Thus, any interpretation of changes in patterns of use over time should be done with caution.
Source: AIHW National Aged Care Data Clearinghouse.
In March 2020, measures to reduce the risk of community transmission of the coronavirus disease 2019 (COVID-19), including limiting public gatherings and reducing non-essential travel, were put in place across Australia (Department of Health 2020b). Provisions for aged care providers were included in jurisdictional public health orders – with changes including the restriction of visits to and from residential aged care facilities – however the details differed across states and territories, and across individual facilities. COVID-19 and the subsequent changes to aged care services may have influenced Indigenous Australians’ patterns of accessing aged care. This was particularly evident in admissions to residential aged care among Indigenous Australians, which saw a lower than expected number in April and May of 2020, based on monthly trends from previous years (Figure 4). This could be due to fewer new admissions as well as fewer movements between facilities (which are also counted as admissions).
Restrictions put in place in 2021 as a result of outbreaks of the delta variant of COVID-19 in Australia are likely to have similar impacts to aged care admissions that were seen in 2020.
This chart shows that admissions to residential care among Indigenous Australians, which saw a lower than expected number in April and May of 2020, based on trends from previous years. The impact is slightly higher in respite residential aged care. However, the fluctuation in admissions may or may not be due to the COVID-19 pandemic.
See Aged care for information on the impacts of COVID-19 on aged care use.
For more information on older Indigenous Australians and aged care use among the Indigenous population, see:
ABS (Australian Bureau of Statistics) 2016. Estimated resident population – as at 30 June 1996 to 2016, Census years. ABS.Stat. Canberra: ABS. Viewed 10 February 2021.
ABS 2019. Projected population, Aboriginal and Torres Strait Islander Australians, Remoteness Area, 2016–2031. ABS.Stat. Canberra: ABS. Viewed 2 February 2021.
ABS 2020. National, state and territory population. Canberra: ABS. Viewed 5 July 2021.
ANAO (Australian National Audit Office) 2017. Indigenous aged care. Department of Health. Australian Aged Care Quality Agency. Canberra: Australian National Audit Office. Viewed 12 March 2019.
Department of Health 2016. 2015–16 Report on the operation of the Aged Care Act 1997. Canberra: Department of Health. Viewed 4 March 2021.
Department of Health 2017. 2016–17 Report on the operation of the Aged Care Act 1997. Canberra: Department of Health. Viewed 4 March 2021.
Department of Health 2018. 2017–18 Report on the operation of the Aged Care Act 1997. Canberra: Department of Health. Viewed 4 March 2021.
Department of Health 2019a. 2018–19 Report on the operation of the Aged Care Act 1997. Canberra: Department of Health. Viewed 4 March 2021.
Department of Health 2019b. Actions to support older Aboriginal and Torres Strait Islander people. Canberra: Department of Health. Viewed 27 February 2019.
Department of Health 2020a. 2019–20 Report on the operation of the Aged Care Act 1997. Canberra: Department of Health. Viewed 18 January 2021.
Department of Health 2020b. Australian Health Protection Principal Committee (AHPPC) coronavirus (COVID-19) statement on 18 March 2020. Canberra: Department of Health. Viewed 15 October 2020.
Department of Health 2021a. Aged care – Reforms to support Aboriginal and Torres Strait Islander people. Canberra: Department of Health. Viewed 25 May 2021.
Department of Health 2021b. Home Care Packages Program Reforms. Canberra: Department of Health. Viewed 16 April 2021.
RCACQS (Royal Commission into Aged Care Quality and Safety) 2021. Final Report -Volume 1: Summary and recommendations. Viewed 4 March 2021.
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