Community-based aged care
Home based aged care services are a vital resource for supporting older Australians to remain living in their own home for as long as possible. Many older people express a desire to continue to live in a familiar setting in the community, with the Royal Commission into Aged Care Quality and Safety reporting that 80% of older Australians want to remain living in their current home and 62% want to receive community-based aged care services (Royal Commission 2020).
The Home Care Package Program was replaced by the Support at Home program on 1 November 2025. The Commonwealth Home Support Program will continue to operate until 1 July 2027, at which time it will also be phased into the new Support at Home program. The Support at Home program aims to streamline aged care services and provide more tailored support across a broader range of care needs.
The National Screening and Assessment Form for aged care assessments was replaced by the Integrated Assessment Tool from 1 July 2024. The Integrated Assessment Tool collects data on functional capacity, cognitive status, social and environmental factors and preferences and goals to enable assessments to provide tailored service recommendations and referrals based on individual needs. All aged care needs assessments conducted using the Integrated Assessment Tool 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).
The Dementia and Cognition supplement will not be a feature of the Support at Home program, as the Support at Home classification framework considers each participant’s cognitive ability, alongside other factors, when assigning them to a level of funding. Existing recipients receiving the supplement as of 31 October 2025 will continue to receive the additional funding while they remain on their grandfathered level of funding in the Support at Home program.
Support at Home program supports for older people with dementia include:
- Access to ‘clinical support’ services such as nursing and allied health that are fully funded by the Australian Government.
- Continuing the Dementia and Cognition Supplement for grandfathered HCP recipients who were receiving the supplement on 31 October 2025, while they remain on their grandfathered level of funding.
- For non-grandfathered participants, the Support at Home classification framework will consider each participant’s cognitive ability, alongside other factors, when recommending them to a level of funding.
For more information on these services, see My Aged Care and for more information on the use of these services, see GEN Aged Care data.
Dementia and cognition supplement for home care
Between 1 July 2016 and 30 June 2024 the Home Care Packages Program provided community-based care and services to people with greater or more complex care needs to support them to live safely and independently at home. Four levels of support were provided, ranging from Level 1 (for people with basic care needs), to Level 4 (for people with high care needs).
The dementia and cognition supplement for home care can be used as a proxy for the number of people with dementia who accessed the Home Care Packages Program, as dementia status was not recorded by this program and aged care assessments conducted using the National Screening and Assessment Form did not record whether people accessed services they were approved for.
The dementia and cognition supplement for home care provided additional funding for people with moderate or severe cognitive impairment to acknowledge the additional costs associated with caring for this group. To receive the supplement a person had to meet specified criteria as part of a psychogeriatric assessment performed by a medical professional trained in the cognitive assessment tool (Department of Health, Disability and Ageing 2025).
The dementia and cognition supplement does not identify all people with dementia who accessed the Home Care Packages Program as:
- A dementia diagnosis alone did not mean that a home care recipient was eligible to receive the supplement. People with lower levels of cognitive impairment did not attract the supplement so people with less severe dementia may not be eligible for the supplement.
- Home Care recipients who were eligible for the Veterans’ Supplement could not also receive the dementia and cognition supplement.
- People with cognitive impairment associated with conditions other than dementia could also be eligible for the supplement.
Respite care
Respite care is especially important for people caring for someone with dementia, where the demands of the caring role may involve providing substantial amounts of physical, psychological, cognitive and social support, while behaviour changes may add to the complexity of caring.
The Australian Government subsidises community-based and residential respite with the aim of providing a person and their carer with a break from their usual care arrangements, or during emergencies.
Aged care assessments conducted using the National Screening and Assessment Form record whether the person being assessed has received any respite services (informal, community or residential respite) in the past 12 months, and whether the person has been approved to access residential respite care.
While the dementia and cognition supplement provides some insights into the number of people with dementia who accessed the Home Care Packages Program, people with mild dementia and veterans with dementia are not captured, and people with cognitive impairment due to conditions other than dementia are included. The number of people using Home Care Packages who receive the dementia and cognition supplement will therefore not accurately describe the provision and need for community-based aged care services for people living with dementia.
Aged care assessments conducted using the National Screening and Assessment Form record whether people have been approved to access residential respite care, but not whether they accessed this service, and results should be interpreted with caution.
There is no information on the number of people with dementia accessing other community-based aged care services, such as:
- the Commonwealth Home Support Program – provides entry-level services focused on supporting individuals to undertake tasks of daily living to enable them to be more independent at home and in the community
- the Transition Care Programme – provides short-term care to restore independent living after a hospital stay
- the Multi-Purpose Services Program – offers aged care alongside health services in Regional and remote areas
- the Innovative Care Programme – a range of programs to support flexible ways of providing care to target population groups
- the National Aboriginal and Torres Strait Islander Flexible Aged Care Program – provides culturally appropriate aged care at home and in the community for First Nations people.
- the Department of Veterans’ Affairs community nursing and Veterans’ Home Care services provide support to help eligible veterans stay independent and in their own home.
There are ongoing efforts to improve the reporting of dementia in aged care data in Australia. See 8: Collection and reporting of dementia and other health conditions in aged care data of the National Dementia Data Improvement Plan 2023–2034 for information on current developments and future activities.
Dementia and cognition supplement for home care
As of 30 June 2024, over 24,000 people were receiving the dementia and cognition supplement as part of their Home Care Package (14,900 women and 9,100 men). Around 81% of both men and women who were receiving the dementia and cognition supplement were receiving high levels of care (Home Care Package Level 3 designed for those with intermediate care needs and Home Care Package Level 4 for those with high care needs) (Table S10.23).
Respite care
For those living with dementia who completed a comprehensive aged care assessment in 2023–24, about 22,100 people were approved for residential respite care (72% of people with dementia approved for care – see Table S10.10).
Previous studies have shown that people living with dementia often use residential respite care as part of a transition to permanent residential aged care (AIHW 2023b, AIHW 2023c). Analysis of linked data showed that in 2019, 70% of people living with dementia used residential respite care in the 12 months before entry to permanent residential aged care, compared with 5.4% of people who did not enter permanent care, suggesting that early uptake is low (AIHW 2023a).
For information on expenditure on respite care for people with dementia in 2022–23, see Spending on aged care and support services. Due to the lack of data on the use of respite care by people living with dementia, expenditure was estimated using the proportion of approvals for respite care for people not currently living in residential care and were associated with a dementia diagnosis from the National Screening and Assessment Form (NSAF) data (accessed through the National Aged Care Data Clearinghouse).
1 in 4 (25%) primary carers of people with dementia from AIHW analyses of the Australian Bureau of Statistics (ABS) 2022 Survey of Disability, Ageing and Carers (SDAC) reported they needed more respite care. This was higher than what was reported by primary carers of people without dementia (7%). Refer to Carers’ unmet needs (Table S6.19) for more information.
ABS (2024) Survey of Disability, Ageing and Carers, Australia: 2022, ABS Website, accessed 15 September 2025.
AIHW (Australian Institute of Health and Welfare) (2023a) Geographical variation in health service use by people living with dementia, AIHW, Australian Government, accessed 26 June 2024.
AIHW (2023b) Respite use on the way to permanent residential aged care, AIHW, Australian Government, accessed 12 September 2025.
AIHW (2023c) Transitions to residential aged care after hospital for people living with dementia, AIHW, Australian Government, accessed 26 June 2024.
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)(2025) Dementia and cognition supplement for home care, Department of Health, Disability and Ageing , Australian Government, accessed 15 September 2025.
Royal Commission (2020) What Australians Think of Ageing and Aged Care, Research paper 4, Australian Government.