To access government-funded aged care services, people undergo an assessment of need. These processes assess people’s circumstances and care needs and, where relevant, approve them for particular aged care services. They also refer people to service providers.
My Aged Care is a contact centre and website which serves as the starting point for access to government-subsidised aged care services. Access to My Aged Care can be gained by self-referral, or requests from carers or health and aged care professionals.
Following an initial screening through the My Aged Care platform, people are directed to 1 of 2 types of assessment:
In 2019–20, there were more than 252,000 home support assessments and around 184,000 comprehensive assessments completed. Generally, people receiving comprehensive assessments were somewhat older (39% were over the age of 85, compared with 21% for home support assessments), and had a greater proportion of complex health issues than those receiving an assessment for home support (such as higher instances of dementia, cancer, memory issues or confusion, nervous system disorders, arthritis and heart disease) (AIHW 2021a).
The number of aged care assessments of older people (aged 65 or over and Aboriginal and Torres Strait Islander people aged 50–64) has increased by 4.4% between 2018–19 and 2019–20, but tends to fluctuate generally from year to year (SCRGSP 2021).
The time between an individual’s ACAT approval and access to an aged care service can be influenced by a range of factors, including availability of places and packages of care, and an older person’s individual preferences about entering care.
42% of the aged care target population (all people aged 65 years or over and Aboriginal and Torres Strait Islander Australians aged 50–64 years) assessed by an ACAT entered residential aged care within 3 months of their ACAT approval.
The median time elapsed for access to a Home Care Package ranged from 6 months for a Level 1 package to 28 months for a Level 4 package (SCRGSP 2021).
In 2019–20, just under 242,000 older people entered residential care, home care and transition care services. Around 3 in 5 admissions were for residential aged care, including just over 67,900 for permanent and just over 80,900 for respite care (AIHW 2021b).
Characteristics of older people entering aged care in 2019–20 include:
The majority (88%) of older people entering permanent residential aged care were aged 75 years and over.
Overall, nearly 3 in 5 (59%) older people entering permanent residential care for the first time were women. This proportion increased with age.
The majority (81%) of older people entering home care were aged 75 years and over (AIHW 2021b).
Of all people entering aged care in 2019–20, 2.3% were people aged under 65 years (AIHW 2021b).
People tend to use different aged care programs at different stages of their life. As people get older, it is likely they will experience escalating care needs that require different care types. The journey through aged care is rarely straightforward. Some older Australians may progress linearly through the aged care continuum; starting with lower level care services, then increasing levels of care as their needs change. For others, their first experience with the aged care system may require higher level care after a sudden event, such as the loss of a carer or a health crisis.
In 2019–20, around 821,000 older people used home support services. Almost 2 in 3 (65%) older people accessing home support were female. Across the age groups, the highest proportion of people were aged 80–84 (23%) (NACDC 2020) (Figure 4.1). Compared with home care (42%) and residential aged care (60%), the population of older people using home support had the lowest proportion of people aged 85 and over (30%). Note this includes older people where sex is unknown.