Younger people in residential aged care

Around 3,440 younger people

were in permanent residential aged care at 31 December 2021, compared with 4,860 at 30 June 2020

7 in 10

(73%) younger people in permanent residential aged care had a high level of need for help with behaviour (at 30 June 2020)

9 in 10

On entry to permanent residential aged care, 9 in 10 (88%) people aged under 65 had limitations in self-care (at 30 June 2020)

On this page:

Introduction

Government-subsidised aged care in Australia is provided based on need, not age. As such, sometimes even very young people take up permanent residential aged care to meet their care needs.

While for some people with disability, including some younger people, residential aged care is a setting of choice, generally younger people are considered to be better served by other services for their long-term care needs.

The Australian Government is working to reduce the number of younger people (under the age of 65) going into residential aged care, and to help younger people who are already in residential aged care to move into age-appropriate accommodation with the supports they need (DSS 2021a). The Younger People in Residential Aged Care Strategy 2020–25 sets out to achieve this goal through the following targets, apart from in exceptional circumstances:

  • no people under the age of 65 entering residential aged care by end of 2022
  • no people under the age of 45 living in residential aged care by end of 2022
  • no people under the age of 65 living in residential aged care by end of 2025 (DSS 2021a).

Younger people who are eligible for the National Disability Insurance Scheme (NDIS) can also use their NDIS funding to access alternative accommodation and support arrangements.

National Aged Care Data Clearinghouse

Data in this section are largely sourced from the National Aged Care Data Clearinghouse (NACDC). Any data not referenced on this page are sourced from Data tables for this report.

For the most up-to-date data, see the Younger people in residential aged care dashboard.

What is meant by ‘younger’ people in residential aged care?​

There is no minimum age requirement to access government-subsidised aged care. For policy and planning purposes, however, people under the age of 65 are considered ‘younger’ people in care.

At 30 June 2020, 4,860 people aged under 65 were living in permanent residential aged care in Australia. This decreased to 3,440 by 31 December 2021 (AIHW 2021b).

There is no direct way to identify disability using the available aged care data.

Recent analysis suggests that the younger people may choose to remain in residential aged care due to the closeness of the facility to family and informal supports, valued and trusted relationships with staff and co-residents, the younger person’s support needs and requirements being met, feeling secure and happy in their environment, or their preferred accommodation type or location not being available in an area in which they wish to live (DSS 2021b).

In mid-2020, more than 4,900 younger people were in permanent residential aged care (about 2.6% of all people in permanent residential aged care at 30 June 2020). This number was relatively stable between 2010 and 2018 (6,480 people at 30 June 2010 and 6,050 people at 30 June 2018) and has been decreasing since (to 5,610 at 30 June 2019) (Figure RESIDENTIAL.1).

Figure RESIDENTIAL.1: People aged under 65 in permanent residential aged care, by year, 30 June 2010 to 30 June 2020

Line graph showing the number of younger people in residential aged care at 30 June each year from 2010 to 2020. The chart shows a decrease in the number of people under 65 in care at 30 June 2020 (4,860) compared with 30 June 2017 (6,243).

Source data tables:​ Younger people in residential aged care (XLSX, 137KB)

This was accompanied by a decrease over the same period in the number of admissions of people aged under 65 to permanent residential aged care (noting that an individual person can have more than one admission in a year, or across years). During the 2009–10 to 2017–18 period, the number of admissions was relatively stable, fluctuating between 2,420 (in 2011–12) and 2,800 (in 2013–14), but has been decreasing since (to 2,110 in 2018–19 and 1,590 in 2019–20) (Figure RESIDENTIAL.2).

Figure RESIDENTIAL.2: Admissions and discharges from permanent residential aged care of people aged under 65, by year, 2009–10 to 2019–20

Line graph showing the number of younger people admitted to and discharged from permanent residential aged care each financial year from 2009–10 to 2019–20. The chart shows a decrease in the number of people under 65 admitted into care in 2019–20 (1,586) compared with 2017–18 (2,582).

Source data tables: Younger people in residential aged care (XLSX, 137 kB)

In addition to those people living in permanent residential aged care, younger people can be admitted for respite residential aged care. The number of admissions to respite care was relatively stable between 2009–10 (2,500 people) and 2017–18 (2,660 people) and has been decreasing since (to 2,210 in 2018–19 and 1,750 in 2019–20) (Figure RESIDENTIAL.3).

In general, the number of discharges has remained consistent with the number of admissions (Figure RESIDENTIAL.3).

Figure RESIDENTIAL.3: Admissions and discharges from respite residential aged care of people aged 65, by year, 2009–10 to 2019–20

Line graph showing the number of younger people admitted to and discharged from respite residential aged care each financial year from 2009–10 to 2019–20. The chart shows a decrease in the number of people under 65 admitted into respite care in 2019–20 (1,750) compared with 2017–18 (2,659).

Source data tables: Younger people in residential aged care (XLSX, 137 kB)

Each stay in respite residential aged care by younger people is generally short, but the proportion of younger people in respite care for more than 5 weeks has been increasing:

  • 19% (or 470 of 2,440) in 2009–10
  • 26% (or 670 of 2,520) in 2014–15
  • 36% (or 630 of 1,770) in 2019–20.

Need for help

Seven in 10 (73% or 3,535) of the 4,860 younger people in permanent residential aged care had a high level of need for help with behaviour, for example cognitive skills, at 30 June 2020. More than half (58% or 2,807) had a high level of need for help with activities of daily living, for example mobility. Half (51% or 2,489) had a high level of need for help with complex health care. Some variation can be observed by age group, depending on the Aged Care Funding Instrument (ACFI) category:

  • 59% (or 1,275 of 2,150) of those aged 0–59 have a high level of need for help with activities of daily living compared with 57% (or 1,532 of 2,710) of those aged 60–64
  • 55% (or 1,174) of those aged 0–59 have a high level of need for help with complex health care compared with 49% (or 1,315) of those aged 60–64 (Figure RESIDENTIAL.4).

Figure RESIDENTIAL.4: People aged under 65 in permanent residential aged care, by Aged Care Funding Instrument (ACFI) level, broad age group and ACFI category, at 30 June 2020

Bar chart showing the proportion of people who have a high, medium, low or nil need for help in the age groups 0–59, 60–64 and everyone aged 0–64 in permanent residential aged care. The reader can select to display the chart by 3 ACFI categories including activities of daily living, behaviour and complex health care. The chart shows 59% people aged 0–59 in permanent residential aged care have a high level of need for help with activities of daily living and only 2.1% have no need for help.

Source data tables: Younger people in residential aged care (XLSX, 137 kB)

How is the level of need for help determined?

In this section, the Aged Care Funding Instrument (ACFI) level is used to categorise the level of help needed by each person in residential aged care. This information is used to calculate the funding received by the residential aged care provider. The ACFI is used to assess a person’s need for support with activities of daily living, behaviour, and complex health care (Department of Health 2016). In each of the 3 domains, the person is assigned an ACFI level of need of high, medium, low or nil.

The Activities of Daily Living Domain includes need for help with nutrition, mobility, personal hygiene, toileting, and continence. The Behaviour Domain includes cognitive skills, wandering, verbal behaviour, physical behaviour, and depression. The Complex Health Care Domain includes the administration of medicines and health care procedures.

Demographics

Sex and age

Just over half (54% or 2,620 at 30 June 2020) of younger people in permanent residential aged care are males; this proportion is similar for people aged 49 and under (55% or 200 of 360), 50–59 (52% or 940 of 1,790), and 60–64 (55% or 1,490 of 2,710). The pattern is very different for people aged 65 and over, where the majority (67% or 120,000 of 179,000) of people in permanent residential aged care are females (Figure RESIDENTIAL.5).

Figure RESIDENTIAL.5: People in permanent residential aged care, by age group and sex, at 30 June 2020

Stacked bar chart showing the proportion of people in residential aged care who are males and females for age groups 0–49, 50–59, and in 5-year groups from 60–64 to 80–84, and 85 and over. The chart shows 55% of people aged 60–64 in permanent residential aged care are males and only 27% aged 85 and over.

Source data tables: Younger people in residential aged care (XLSX, 137 kB)

Of the 2,620 younger males in permanent residential aged care, at 30 June 2020:

  • 7.4% were aged 49 and under
  • 36% were aged 50–59
  • 57% were aged 60–64 (Figure RESIDENTIAL.6).

The pattern is similar for the 2,240 younger females in permanent residential aged care, at 30 June 2020:

  • 7.2% were aged 49 and under
  • 38% were aged 50–59
  • 55% were aged 60–64 (Figure RESIDENTIAL.6).

Figure RESIDENTIAL.6: People aged under 65 in permanent residential aged care, by age group, sex and Indigenous status, at 30 June 2020

Column chart showing the proportion of people aged 0–64 in permanent residential aged care for age groups 0–49, 50–59 and 60–64. The reader can select to view the chart by sex and Indigenous status. The chart shows 46% of people in permanent residential aged care who identify as Aboriginal and/or Torres Strait Islander are aged 50–59 compared with 36% of those who are non-Indigenous.

Source data tables: Younger people in residential aged care (XLSX, 137 kB)

Aboriginal and Torres Strait Islander people

Of all younger people in permanent residential aged care, 8.6% (or 414) identify as Aboriginal and/or Torres Strait Islander (excluding those whose Indigenous status is ‘not stated’). This is higher than the proportion of the total Australian population aged 0–64 who are Indigenous (3.8%) (ABS 2019).

At 30 June 2020 (excluding Indigenous status ‘not stated’):

  • 11% (or 38) of people aged 49 and under in permanent residential aged care identified as Indigenous
  • 11% (or 192) of people aged 50–59
  • 6.8% (or 184) of people aged 60–64.

Indigenous status

People in residential aged care are asked if they identify as Aboriginal and/or Torres Strait Islander. The question is not compulsory and may not be asked consistently, so the numbers reported in this section may be an underestimation of the true number of Indigenous people using these programs. Indigenous people may also access aged care services under the dedicated National Aboriginal and Torres Strait Islander Flexible Aged Care Program, and this can also affect the number of Indigenous people using mainstream residential aged care.

What is meant by ‘younger’ Aboriginal and/or Torres Strait Islander people in aged care?

Access to aged care services 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 (AIHW 2021a).

By comparison, 1.0% of all people in permanent residential aged care (including those aged 65 and over) identify as Aboriginal and/or Torres Strait Islander (excluding Indigenous status ‘not stated’).

The Aboriginal and Torres Strait Islander population has a much younger age structure than the non-Indigenous population, due to higher rates of fertility and deaths occurring at younger ages. However, as with the general population, the Indigenous population is also ageing (AIHW 2021a).

Remoteness

Of the 4,860 younger people in permanent residential aged care at 30 June 2020:

  • 66% were in Major cities
  • 23% were in Inner regional areas
  • 9.3% were in Outer regional areas
  • 1.4% were in Remote areas
  • 0.5% were in Very remote areas.

These proportions are similar to the proportions of people who live in each of these remoteness areas (ABS 2021).

How is remoteness defined?

The remoteness categories used in this section are based on the ABS Australian Statistical Geography Standard (ABS 2016). Records are distributed by Remoteness Area based on the location of the aged care service through which care was provided.

The proportions for people aged 59 and under and those aged 60–64 in permanent residential aged care are similar for each remoteness area (Figure RESIDENTIAL.7).

Figure RESIDENTIAL.7: People aged under 65 in permanent residential aged care, by broad age group and remoteness, at 30 June 2020

Bar chart showing the proportion of people in residential aged care in the age groups 0–59, 60–64 and all people aged 0–64 by whether they live in Major cities, Inner and outer regional areas, or Remote and very remote areas. The chart shows 66% of people in permanent residential aged care live in Major cities and 1.9% live in Remote and very remote areas.

Source data tables: Younger people in residential aged care (XLSX, 137 kB)

Where can I find out more?

Data tables for this report.

ABS Disability, Ageing and Carers, Australia: Summary of Findings, 2018.

Use of aged care services – GEN.

Services the NDIS funds – NDIS.

Younger People in Residential Aged Care – GEN

Younger People in Residential Aged Care – DSS annual report