National policy response to dementia

Australia was one of the first countries to design comprehensive dementia-specific policy initiatives at a national level, in response to the rising challenges of an expanding and ageing population and advocacy from groups, such as the then Alzheimer’s Association of Australia (Hunter and Doyle 2014).

The first federal dementia policy initiative was launched in 1992 (the National Plan for Dementia Care 1992–1997) and succeeding policy initiatives have cemented dementia as a key priority in the national aged care agenda. Dementia has also been increasingly recognised as a national health priority requiring a focus on preventive strategies, high-quality health and social care, and investments in medical research (Hunter and Doyle 2014; Department of Health 2015). In 2017, the World Health Organization developed The Global action plan on the public health response to dementia 2017-2025 to encourage a concerted international effort to address the global impacts of dementia. The global action plan was adopted by Australia and other Member States (WHO 2017).

This webpage focuses on:

While this page focuses on the national policy response to dementia by the federal government, it is acknowledged that governments at all levels develop and deliver dementia-specific policies and services. State and territory governments also fund (in full or part) essential services such as: memory clinics; geriatric evaluations and aged care visiting services; older adult mental health services; hospital to residential aged care transition services; and support for people experiencing behaviours and psychological symptoms of dementia (Mond 2019). Some of these essential services also receive federal government funding, for example through the Medicare Benefits Scheme or through specific programs and initiatives (for example, Dementia Behaviour Management Advisory Service, Severe Behaviour Response Teams and the Specialist Dementia Care Program).

Box 16.1: The Royal Commission into Aged Care Quality and Safety

The Royal Commission into Aged Care Quality and Safety (Royal Commission) was set up in 2018 to look into issues related to the quality of residential and in-home aged care. The Royal Commission’s final report, Care, Dignity and Respect, was tabled in the Australian Parliament on 1 March 2021. This report included 148 wide-ranging recommendations for fundamental reform of the aged care system.

The Royal Commission identified four areas in need of immediate attention: food and nutrition; care and support for people living with dementia; elimination and reduction of restrictive practices; and palliative care (Royal Commission 2021).

Other recommendations specific to dementia from the final report, are:

  • Recommendation 15: establishing a comprehensive, clear and accessible post-diagnosis support pathway for people living with dementia, their carers and families.
  • Recommendation 16: reviewing and publicly reporting on whether the number of Specialist Dementia Care Units established or planned to be established is sufficient to address need within the areas and populations they are designed to cover. 
  • Recommendation 19: reviewing of the Aged Care Quality Standards, including dementia care standards.
  • Recommendation 45: improving the design of aged care accommodation, including dementia-friendly design.
  • Recommendation 80: implementing mandatory dementia care training for workers engaged in residential aged care and in care at home (Royal Commission 2021). 

The Australian Government’s response to the Royal Commission into Aged Care Quality and Safety

A range of changes are being made to aged care in response to the final report of the Royal Commission into Aged Care Quality and Safety. These changes are expected to deliver significant reform in aged care, providing care, dignity and respect to senior Australians.

Dementia-specific changes will support people living with dementia and their carers at every stage from diagnosis through to residential aged care. Together this will ensure people living with dementia are connected with the support they need post-diagnosis, are enabled to remain in their home for longer, and able to access high quality, dementia informed aged care services.

Key initiatives include: 

  • improved early intervention assistance
  • more help to navigate the aged care system
  • more staff trained in dementia care
  • improved respite experience for people living with dementia
  • improvements in capacity and quality of dementia care
  • more support for carers to maintain their caring role.

For more information on any of the above points see Our work related to dementia | Australian Government Department of Health and Aged Care.

The reforms also include funding to improve dementia data collection and understanding, and to develop new National Design Standards for residential aged care, incorporating dementia-friendly design. A more detailed description on the Australian Government’s response to the final report can be found on the Australian Government Department of Health website.

The National Dementia Action Plan  

The Australian Government commenced development of the new National Dementia Action Plan (‘the Plan’) in 2021 with state and territory governments, informed by the 2019 review of the National Framework for Action on Dementia 2015-19. The Plan will span 10 years and include specific actions that promote a collaborative national approach to drive improvements for people living with dementia, their carers and families throughout Australia.

This Plan is a collaborative effort between the Commonwealth, States and Territories, and is occurring in consultation with key stakeholders, including people living with dementia and their carers and families, Dementia Australia, health professionals, aged care providers and researchers. The Plan forms part of the Commonwealth Government’s response to the Royal Commission and contributes to Australia’s international obligations as a member state to the World Health Organization’s Global action plan on the public health response to dementia 2017–2025.

Governments are working to release the plan in 2024.

The Aged Care Diversity Framework

In 2017 the Australian Government launched the Aged Care Diversity Framework and associated action plans to address the needs of older Australians from diverse backgrounds, including those with cognitive impairment and dementia. The Diversity Framework provides a mechanism for government, aged care providers, peak bodies and representative groups, service users, and their families and carers, to ensure diversity is embedded in the design and delivery of aged care services.

The delivery of safe and inclusive services to people with diverse needs and life experiences is built into the Aged Care Quality Standards (Quality Standards). Diversity is embedded throughout the standards and underpinned by Standard 1 to value the identity, culture and diversity of each aged care recipient and to deliver culturally safe care and services.

While the Quality Standards are a powerful tool to maintain and improve quality of care, in response to Royal Commission recommendations a review of the Quality Standards was conducted and has now been completed. This was to make the Quality Standards more comprehensive, measurable and easy to understand to better support quality care. The review included a focus on key areas including dementia, diversity, governance, clinical care and food and nutrition. Following significant consultations since December 2021 and a pilot by the Aged Care Quality and Safety Commission in 2023, the final draft of the strengthened Quality Standards has been published to support sector readiness.

The draft of the strengthened Quality Standards embeds dementia and diversity and significantly enhances expectations for the delivery of safe and quality care. The final draft of the strengthened Quality Standards will be written into legislation under the new Aged Care Act (Act) and will be implemented at the same time as the Act. 

In February 2019, four Action Plans designed to address the specific needs and challenges faced by diverse groups in the community were launched under the Aged Care Diversity Framework for:

  • First Nations people
  • older people from Culturally and Linguistically Diverse Communities
  • people who identify as Lesbian, Gay, Bisexual, Trans and Gender Diverse, Intersex, Queer or other (LGBTIQ+)
  • actions common to all diverse older people, in recognition of the many commonalities within and between diverse groups.

These plans assist aged care providers to identify actions they could take to deliver more inclusive and culturally appropriate services for their residents and clients. They acknowledge that there is no ‘one-size-fits-all’ approach to diversity, and that each aged care provider will be starting from a different place and operating in a different context.

Dementia research

Australian dementia researchers funded by the Australian Government through the National Health and Medical Research Council (NHMRC) have a renowned reputation for producing international-leading work. Australian research has high potential to positively impact Australians with dementia, particularly when research is collaborative and conducted on a large-scale (Moira Clay Consulting 2021).

Starting in 2014, the government funded a 5-year $200 million dementia research expansion coordinated by the then NHMRC National Institute for Dementia Research (NNIDR) (Mond 2019). While allocation of the funding for the NNIDR concluded in 2019, the NHMRC still offers dedicated dementia-specific research funding opportunities (NHMRC 2021).

The NHMRC awarded funding to establish the Australian Dementia Network (ADNeT) in 2018 – a network of scientists, clinicians, and researchers across multiple institutions. ADNeT has established Australia’s first dementia clinical quality registry to monitor, report and improve clinical care for people with dementia; establish a collaborative network of memory clinics and develop best practice guidelines for dementia diagnosis treatment and management; and progressed screening sites for people with dementia who are suitable for participation in clinical trials. The government also funds a broad range of research and innovation projects on emerging priorities in dementia:

  • The Medical Research Future Fund (MRFF) is a $20 billion long-term investment by the government that aims to support health and medical research and innovation. The Dementia, Ageing and Aged Care Mission will invest $185 million over 10 years under the MRFF to improve outcomes for people living with dementia and older Australians. The Mission will support older people to maintain their health and quality of life as they age, live independently for longer, and access quality care when they need it. 
  • Aged Care Research and Industry Innovation Australia is designed to address long-standing barriers to the development, evaluation and uptake of aged care workforce research. They focus on the development of innovation to improve workforce capability and the development of assistive technologies to enable care recipients to maintain independence for longer. Funding of $34m was announced over 4 years, starting in 2021–22.

There are still persistent gaps in national data that limit monitoring and reporting on dementia in Australia and planning for dementia programs and services. The National Centre for Monitoring Dementia (NCMD), located at the Australian Institute for Health and Welfare (AIHW) was established in 2021 and is undertaking routine monitoring of dementia in Australia, addressing existing data gaps and informing specific Government policy on the needs for Australians living with dementia. The NCMD currently undertakes activities in two main streams:

  • Analysis and reporting: including routine monitoring of dementia via the Dementia in Australia report (this report) and special interest or thematic projects that utilise currently available data to address specific policy and research information priorities and dementia data gaps.
  • Improving dementia data: including projects to address dementia data gaps or data quality issues.

For more information on current dementia data gaps, and ways in which these gaps can be systematically and strategically addressed, see the 2023 AIHW report: National Dementia Data Improvement Plan 2023–2033.