In addition to those people living in permanent residential aged care, on average, more than 2,000 younger people are admitted for respite residential aged care each year (2,200 people aged under 65 in 2018–19). Each stay in respite residential aged care is generally short, and younger people (aged under 65) also typically stay less than 4 weeks (64% in 2018–19).
To further understand the needs and characteristics of younger people living in residential aged care, the rest of this page uses administrative data from the AIHW’s Pathways in Aged Care linked dataset and the National Aged Care Data Clearinghouse to describe:
- the activity limitations of people aged under 65 who first entered residential aged care
- the extent to which their main medical condition limits their daily activities
- their need for help with activities of daily living, behaviour and complex health care, of younger people in residential aged care
- their age and sex
- their Indigenous status
- their remoteness area.
Pathways in Aged Care link map
The best available measure of a person’s functional limitations comes from the assessment undertaken by an Aged Care Assessment Team (ACAT, or Aged Care Assessment Services in Victoria). These teams assess and approve access to subsidised aged care programs, such as residential aged care. The result is an Aged Care Assessment Program (ACAP) assessment which aims to comprehensively assess people’s needs and direct them to appropriate services (AIHW 2016).
To understand the assessment’s association to take-up of care, it is necessary to link assessment data with residential aged care data. The AIHW’s Pathways in Aged Care (PIAC) link map joins an aged care residents’ ACAP assessment record with their residential aged care record. This enables analysis of their activity limitations and medical conditions as identified at the time of their latest ACAP assessment, before moving into permanent residential aged care.
The linkage of ACAP data to residential aged care data has only been completed up to June 2014. During 2013–14, around 8,700 people aged under 65 were in permanent residential aged care. This included around 2,300 people aged under 65 admitted to permanent residential aged care for the first time in this financial year. Of these, around:
- 230 (10%) were under 50 years
- 900 (40%) were 50–64 years
- 1,100 (50%) were 60–64 years (AIHW 2019a).
Aged Care Funding Instrument
Another view of people’s care needs in permanent residential aged care is through the Aged Care Funding Instrument, which assesses the cost of care through a person’s need for support with activities of daily living, behaviour and cognition, and complex health care. This assessment tool does not take a ‘functional’ approach like other disability measures do.
Activity limitations
Activity limitations reflect the difficulty a person has in executing a task or action.
Activity limitations in the Aged Care Assessment Program
In an ACAP assessment, a person is limited in an activity if they have difficulty carrying out the activity and require another person to assist or supervise.
The 10 recorded activity limitations can be divided into ‘core’ and ‘other’:
Core activities
- self–care—daily tasks to do with, for example, eating, dressing and toileting
- communication
- movement—for example, changing position or moving from chair or bed
- moving around—walking or otherwise moving between places at or away from home.
Other activities
- health care tasks—for example, taking medications or managing chronic health issues
- transport—driving or use of public transport
- social and community participation—including shopping, financial management and recreational activities
- assistance in domestic activities—managing household chores
- meal preparation
- home maintenance—such as basic house repairs and gardening.
This assessment differs from the definition used in the Australian Bureau of Statistics’ (ABS) 2018 Survey of Disability, Ageing and Carers (SDAC), which uses 3 core activities—self-care, mobility, and communication—to determine severity of disability.
Core activities
Most younger people who enter permanent residential aged care have a limitation in 1 or more core activities (Figure RESIDENTIAL.3). The most common are related to self–care (88%) and moving around (77%). Fewer younger people (49%) have a limitation in movement, and fewer still have a limitation in communication (39%). About 1 in 4 (22%) have limitations in all 4 core activities defined by the Aged Care Assessment Program.
This varies by age. For example, those aged under 50 are more likely to have a core activity limitation than those aged 50–59 and 60–64. Almost 36% of those aged under 50 have an activity limitation in all 4 core activities, compared with 24% and 18% for those aged 50–59 and 60–64 respectively.