Aged care needs assessments
The use of aged care services by a person with dementia will depend on numerous factors, including their health status and presence of other health conditions, the types of activities for which assistance is required and level of assistance needed, current carer status and availability, financial resources, accessibility, cultural influences and personal preferences.
Since 1 July 2024, significant changes have been made to Australia’s aged care needs assessment system through the Single Assessment System for aged care reform.
The introduction of the Integrated Assessment Tool (IAT) on 1 July 2024 marked the first phase of this reform, which has been designed to streamline access and improve consistency across aged care needs assessments. The IAT replaced the National Screening and Assessment Form as the standard tool for determining eligibility for government-subsidised aged care services.
All aged care needs assessments – whether for home support, comprehensive in-home care, or residential aged care – are now conducted using the IAT. The tool enables assessors to collect more complete and tailored information, reducing the need for older people to repeat their stories. It also supports both clinical and non-clinical assessments (comprehensive and home support assessments), allowing organisations to assess a person’s needs holistically.
On 9 December 2024, the Single Assessment System workforce officially replaced the previous Regional Assessment Service (RAS), Aged Care Assessment Teams (ACATs), and independent AN-ACC assessors. This unified workforce ensures that older Australians can remain with the same assessment provider as their needs evolve, improving continuity of care and reducing wait times.
First Nations assessment organisations are being introduced progressively in response to Royal Commission Recommendation 28 and 48.2(b) to ‘ensure, wherever possible, that aged care assessments of Aboriginal and Torres Strait Islander people are conducted by assessors who are Aboriginal or Torres Strait Islander people, or others who have undertaken training in cultural safety and trauma-informed approaches’ (Department of Health, Disability and Ageing 2025).
From August 2025, a small number of Aboriginal and Torres Strait Islander aged care assessment organisations started delivering culturally safe, trauma aware and healing informed aged care assessments. This pilot is part of a phased rollout and over time, future phases will cover more areas across Australia.
For more information, see About the Single Assessment System for aged care, the IAT User Guide and the My Aged Care Assessment Manual.
Support for people living with dementia or suspected dementia
All aged care needs assessments conducted using the IAT will require the assessor to record whether the client has a confirmed dementia diagnosis from a geriatrician or neurologist (Department of Health, Disability and Ageing 2024).
Aged care needs assessors using the Integrated Assessment Tool will also determine suitability to complete validated assessment tools used to screen for dementia (the GP or KICA COG tools). Assessors will consider providing referrals to the National Dementia Helpline or a GP where concerns about cognitive impairment are raised or where there is a diagnosis of dementia but the person or their registered supporters are not receiving the dementia-specific support they need. Assessors are also encouraged to foster links with dementia specific services, including Dementia Australia and Dementia Support Australia to improve linkages, integrated care, and access.
The data presented in this section come from the National Screening and Assessment Form (NSAF), which was used for aged care needs assessments from 1 July 2015 until 30 June 2024. From 1 July 2024 this has been replaced by the Integrated Assessment Tool (IAT). This section reports on aged care needs assessments using the NSAF that were completed between 1 July 2023 and 30 June 2024.
There were two main types of assessment services using the National Screening and Assessment Form depending on the level of care needed:
- Home Support Assessments –for people seeking community-based entry-level support that is provided under the Commonwealth Home Support Program.
- Comprehensive Assessments –for people with complex and multiple care needs to determine the most suitable type of care (home care, residential or transition care).
As part of a home support assessment or a comprehensive assessment, an assessor could record up to 40 health conditions (including mental health conditions or disabilities) which impact the person’s care needs – allowing people who report having dementia to be identified (AIHW 2025).
Assessors approved people to use multiple aged care services, based on their immediate needs and long-term care needs. Information on the aged care service approvals for people living with dementia who completed comprehensive aged care assessments are available in the NSAF data.
The National Screening and Assessment Form records one or more health conditions that impact a person’s need for assistance but does not specifically report on whether the person has dementia. The National Screening Assessment Form is therefore likely to underestimate the number of people with dementia who had an aged care needs assessment.
All aged care needs assessments conducted using the Integrated Assessment Tool (from 1 July 2024) will require the assessor to record whether the client has a confirmed dementia diagnosis from a geriatrician or neurologist (Department of Health, Disability and Ageing 2024). This may improve reporting on dementia prevalence compared with the National Screening and Assessment Form.
Aged care needs assessments completed by people living with dementia
Of the 473,000 Australians who completed an aged care needs assessment in 2023–24, 8.6% (or just under 40,600) had dementia recorded as a health condition (Tables S10.1 and S10.2). A higher proportion of men with a completed aged care needs assessment reported having dementia (10%) compared with women (7.6%). This was observed across all age group categories except the 95+ age group (Table 10.1).
Among people living with dementia who completed an aged care needs assessment, just over half were women (53% or 21,400 women, and 19,200 men) and most (83%) were aged 75 and over.
People living with dementia were more likely to be seeking (or were more likely to be directed to seek) a higher level of aged care. About 75% of aged care needs assessments undertaken by people living with dementia in 2023–24 were comprehensive assessments (for people with more complex care needs) compared with 40% of people without dementia.
People with and without dementia who completed comprehensive aged care assessments tended to be older than those who completed home support assessments, with a higher proportion aged 85 or older. Nearly 40% of those who completed a comprehensive aged care assessment and about 20% of those who completed a home support assessment were aged 85 or older.
Table 10.1: Number and percentage of people living with dementia who completed an aged care needs assessment: by assessment type, age and sex, in 2023–24
The table shows people living with dementia who completed an aged care needs assessment, by age, sex and assessment type. A radio button allows the option of looking at number or percentage.
People with cognitive impairment (but no record of dementia)
An additional 22,200 people with cognitive impairment (but no record of dementia) completed an aged care needs assessment. This equates to 4.7% of people who completed an aged care needs assessment in 2023–24 (Table S10.2).
This group includes people with mild cognitive impairment – where they have significant memory loss but no other changes in cognitive function. Mild cognitive impairment increases the risk of dementia, particularly Alzheimer’s disease, but it does not mean that the development of dementia is certain (Dementia Australia 2025). However, it is recognised that some people with cognitive impairment who complete an aged care needs assessment may be in the early stages of dementia and are yet to receive a formal diagnosis. Therefore, the number of people living with dementia in this report may be an underestimate of the true number of Australians with dementia seeking entry into aged care services.
Living arrangements at time of assessment
The majority (96%) of the 40,600 people living with dementia who completed an aged care needs assessment in 2023–24 (both for comprehensive and home support assessments) were living in the community at the time of their assessment (Table S10.3).
The living arrangements of people living with dementia who completed home support assessments and comprehensive assessments differed substantially by sex (Figure 10.1, Table S10.3). Men with dementia were more likely to be living with their partner (66%) compared with women with dementia (39%). Men and women who completed a home support assessment were more likely to be living with their partner (72% of men and 48% of women) compared with those who completed a comprehensive aged care needs assessment (64% of men and 36% of women).
Over one third (36%) of all women with dementia who completed an aged care needs assessment in 2023–24 lived alone, compared to 17% of all men with dementia. Women and men who completed comprehensive aged care needs assessments were more likely to live alone (39% for women and 20% for men) compared with those who completed home support assessments (27% of women and 11% of men). These patterns were also seen in people without dementia (Figure 10.1, Table S10.3).
Figure 10.1: Living arrangements of people who completed an aged care needs assessment: percentage by dementia status, sex and assessment type, in 2023–24
The bar chart shows marked sex differences. Men with dementia were much more likely to live with their partner compared with women. Women with dementia were more likely to live alone or with family compared with men.
Assessment setting and carer status
Nearly all home support assessments (96% for people with and without dementia) and about and 2 in 3 comprehensive aged care assessments (64% for people with dementia and 68% for people without dementia) were completed in the person’s home.
Comprehensive assessments can also take place in a hospital, and 25% of people living with dementia and 24% of people without dementia had their comprehensive assessment performed in a hospital setting (Table S10.4).
A higher proportion of people with dementia were living in their carer’s home at the time of their home support assessment (2.1%) or comprehensive aged care assessment (4.5%) compared with people without dementia (1.2% and 3.0%, respectively).
The majority of people living with dementia (89%) and less than half of people without dementia (48%) received assistance from an informal carer (such as family members, friends or neighbours) (Table S10.5). Refer to Carers of people with dementia for detailed information on informal carers of people living with dementia.
Triggers for doing an assessment
There are several triggers that indicate a potential need for aged care services and may prompt an aged care needs assessment. These may be closely related to the individual’s health and care needs or related to other circumstances such as a change in care arrangements.
When looking at individual triggers, aged care comprehensive assessments for people living with dementia were most triggered by change in cognitive status. Aged care needs assessments for people living with dementia were much more likely to be triggered by a change in cognitive status (86%) than for those without dementia (where a change in cognitive status triggered 21% of comprehensive assessments and 2.7% of home support assessments). Medical conditions were the most common trigger for home support assessment for both people living with and without dementia, and comprehensive assessment in people without dementia (Figure 10.2, Table S10.6).
Figure 10.2: Triggers for aged care needs assessments among people who completed an aged care needs assessment: percentage by dementia status and assessment type, in 2023–24
The bar chart shows that most people with dementia were triggered to complete a home support and comprehensive assessment because of a change in cognitive status.
Co-existing health conditions
Older people who require support and assistance provided by aged care services often have several co-existing health conditions. On average, people living with dementia had 6.1 health conditions (including dementia) listed on their aged care needs assessment, while people without dementia had 5.6 health conditions listed. However, people living with dementia who had a comprehensive assessment had more health conditions recorded on average (6.5) than those who had a home support assessment (4.9) (Table S10.7). This reflects the fact that comprehensive assessments are generally undertaken for people with more complex care needs, who also tend to be older.
Figure 10.3 shows the 10 most common health conditions for people living with dementia who completed an aged care needs assessment in 2023–24, and how this compared to people without dementia.
The most common conditions among people living with dementia who completed an aged care needs assessment were:
- high blood pressure (51% of all people living with dementia)
- high cholesterol (31%)
- osteoarthritis (29%) (Table S10.8).
Several cardiovascular conditions, such as heart disease and atrial fibrillation were among the 10 most common conditions recorded for men living with dementia but not for women living with dementia. In contrast, osteoporosis, pain, and thyroid-related disorders were reported among the leading 10 conditions for women but not men living with dementia.
The 10 most common conditions for those living with dementia were also frequently reported by people without dementia. Similar differences by sex were also observed among people without dementia. Conditions with the biggest difference in reporting percentages among people living with dementia and without dementia were pain, osteoarthritis and depression and mood affective disorders.
Figure 10.3: Leading 10 health conditions impacting care needs of people who completed an aged care needs assessment: percentage by dementia status and sex, in 2023–24
The bar chart shows the leading health conditions of those who completed aged care needs assessments with or without dementia. A radio button allows the option to look at the trend by sex.
Notes:
- 'Other diseases of the digestive system' includes diseases of oral cavity, salivary glands and jaws, oesophagitis, gastritis and duodenitis, cholecystitis, other diseases of gallbladder, pancreatitis, coeliac disease and reflux.
- 'Disorders of the thyroid gland' include iodine-deficiency syndrome, hypothyroidism, hyperthyroidism and thyroiditis.
- 'Acute and chronic ischaemic heart disease' includes coronary artery bypass grafting (CABG).
The most common conditions shown in Figure 10.3 are similar to those reported by people living with dementia in the Australian Bureau of Statistic’s Survey of Disability, Ageing and Carers (SDAC) 2022, noting aged care needs assessment data and the SDAC capture different populations. The SDAC provides data on both people living with dementia living in the community and those in cared accommodation (such as residential aged care), including those without an aged care needs assessment. See Care needs of people living with dementia for more information on findings from the SDAC.
Geographic variations
To assess variation in aged care needs assessments completed for people living with dementia by state and territory, rates were calculated for people aged 65 and over by the type of assessment they received. Age-standardised rates for states and territories are available in Table S10.9.
The rate of older Australians (those aged 65 and over) who had dementia and completed an aged care needs assessment in 2023–24 varied by state and territory (Figure 10.4). The crude rate of people with dementia who completed a home support assessment was lowest in the Northern Territory, Victoria and Tasmania and highest in Queensland, while the rate of people with dementia who have completed a comprehensive assessment was lowest in the Northern Territory and highest in Western Australia. When age-standardised, the comprehensive assessment rate for the Northern Territory was close (6.4) to the rate for the whole of Australia, suggesting that the lower crude rate is likely due to the younger age composition in Northern Territory. These variations may reflect differences in both the demand for and use of aged assessment care services, as well as availability of other care and support for people living with dementia across states and territories.
Figure 10.4: People living with dementia who completed an aged care needs assessment: crude rate by assessment type and state/territory, in 2023–24
The bar chart shows the crude rate by assessment type and state and territory with a radio button to change between crude and age-standardised rates.
Notes:
- State and territory is based on the place of residence of the person with dementia at the time of their assessment. Those with unknown state or territory are included in the figures for Australia.
- The crude and age-standardised rates are based on people aged 65 and over. Age-standardised rates were standardised to the Australian population as at 30 June 2001 and are expressed per 1,000 population.
Approvals for use of aged care services
In 2023–24, most people living with dementia who completed a comprehensive assessment were approved for:
- residential respite care (72% of people living with dementia who completed a comprehensive assessment, or 22,100 people)
- permanent residential aged care (72% or 22,000 people)
- community-based care under the Home Care Packages Program (66% or 20,300 people).
This highlights the current and anticipated need for a range of aged care services, particularly as a person’s dementia progresses.
Information on the aged care service approvals for people living with dementia who completed a home support assessment was not available in the NSAF data.
AIHW (Australian Institute of Health and Welfare) (2025) National Aged Care Data Clearinghouse: User guide, AIHW, Australian Government, accessed 15 September 2025.
Dementia Australia (2025) Mild cognitive impairment (MCI), Dementia Australia website, accessed 18 September 2025.
Department of Health, Disability and Ageing (2024) My Aged Care – Integrated Assessment Tool (IAT) User Guide, Department of Health, Disability and Aged Care, Australian Government, accessed 15 September 2025.
Department of Health, Disability and Ageing (2025a) Aboriginal and Torres Strait Islander Aged Care Framework, Department of Health, Disability and Ageing, Australian Government, accessed 11 November 2025.