Aged care

Key findings Most older people (aged 65 and over) using aged care services receive it in their homes. At 30 June 2020, 821,000 were using home support and 140,000 were using home care.
Key findings At 30 June 2020, 185,000 older people were using residential aged care (permanent and/or respite).
Key findings A large proportion of older people using aged care services are aged 85 and over (60% in residential care, 42% in home care, and 30% in home support).
Key findings There were more women than men in each aged care service type.

Australia’s aged care system delivers services through a range of care types to cater for the diverse needs of the ageing population. Services range from supports to remain living independently at home, through to full-time care in a residential setting. Access to government-subsidised aged care services does not involve a minimum age of eligibility (with the exception of home support); rather, access is determined based on assessed need. Although the majority of people using aged care services are aged 65 and over, younger people also access these services (AIHW 2021d).

Throughout this page, people aged 65 and over who are using aged care services are referred to as ‘older people’. Where ‘older people’ is not specified, this page is referring to all people using aged care services. The ‘Older Aboriginal and Torres Strait Islander people’ feature article defines older people as aged 50 and over. This definition does not apply to this page, with Indigenous Australians aged 50–64 not included in the information presented.

Types of aged care

The three mainstream types of care are:

Residential aged care provides accommodation and care at a facility on a permanent or respite (temporary) basis. Permanent care is intended for those who can no longer live at home due to increased care needs, while respite provides a break from normal living arrangements.

Home support (Commonwealth Home Support Programme) provides entry-level support at home for people as well as their carers. Services available through home support include domestic assistance, personal care, social support, allied health and respite services.

Home care (Home Care Packages Program) provides different levels of aged care services for people in their own homes. It is targeted towards people with needs that go beyond what home support can provide. Ongoing services are available to keep people well and independent (such as nursing care), stay in their home (through help with cleaning, cooking and home maintenance) and remain connected to their community through transport and social support.

There are also several types of flexible care available that extend across the spectrum from home support to residential aged care, including:

  • Transition care provides short-term care to restore independent living after a hospital stay.
  • Short-term restorative care provides early intervention services to reduce difficulty with everyday tasks and maintain or restore independence.
  • Multi-Purpose Services Program provides integrated health and aged care services in small regional and remote communities that cannot support both a separate aged care facility and a hospital.
  • National Aboriginal and Torres Strait Islander Flexible Aged Care Program delivers a mix of care types in a culturally appropriate way for older Aboriginal and Torres Strait Islander people.

Aged care assessments

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:

  • Aged Care Assessment Teams (ACATs) conduct comprehensive assessments and approve people for entry into residential aged care (permanent or respite), home care and transition care programs.

  • Regional Assessment Services assess eligibility for entry-level home support services, known as the Commonwealth Home Support Programme. 

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).

Entering aged care

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.

In 2019–20:

  • 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 using aged care

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.

Home support

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.

Figure 4.1: Older Australians using home support by age group and sex, 2019–20

The butterfly chart shows that the highest percentage of people using home support were aged 80–84 years (approximately 23% of men and women using home support were aged 80–84). The age distribution of home support use by older Australians was similar among men and women.

Home care

At 30 June 2020, 140,000 older people were using home care. The number of older people accessing home care services has more than doubled from approximately 62,000 older people at 30 June 2016 (NACDC 2020).

Levels of home care

Home care provides varying levels of care to individuals based on their assessed care needs. A coordinated package of care is available at 4 levels, from Level 1 (basic care; for example, shopping assistance, transportation, and meal preparation), through to Level 4 (high-level care; for example, assistance with bathing, dressing, and getting out of bed, including support for additional care needs such as dementia, or vision and hearing impairment).

At 30 June 2020, of all home care recipients:

  • 12% were receiving care at Level 1
  • 41% were receiving care at Level 2
  • 21% were receiving care at Level 3
  • 27% were receiving care at Level 4 (SCRGSP 2021)

At 30 June 2020, including older people where sex is unknown:

  • 2 in 3 older people using home care were women (66%, 91,600 people). 
  • 2 in 5 older people using home care were aged 85 and over (42%, 58,600 people) (Figure 4.2).

Figure 4.2: Older Australians using home care by age group and sex, 30 June 2020

The butterfly chart shows that the highest percentage of people using home care were aged 80–84 and 85–89 years (46% of men and 48% of women using home care were aged 80–89 years). The age distribution of home care use by older Australians was similar among men and women.

Residential aged care

At 30 June 2020:

  • 185,000 older people were accessing residential aged care with:
    • 179,000 living in permanent residential care
    • 5,800 using respite care.
  • The number of older people living in permanent residential aged care has increased by 15% over the last 10 years (from 156,000 at 30 June 2010 to 179,000 at 30 June 2020).
  • The number of older women in permanent residential care was more than double the number of older men.
  • Older people living in permanent residential aged care were most commonly aged 85–89 (Figure 4.3) (AIHW 2021d).

Compared with other aged care programs, people generally use residential age care at older ages. The average age on admission to permanent residential aged care was 83 for men and 85 for women (Department of Health 2020).

Figure 4.3: Older Australians using residential aged care by age group and sex, 30 June 2020

The butterfly chart shows that the highest percentage of men using residential care were aged 85–89 years (23%), while among women, the age group with the highest percentage using residential care was slightly older (26% of women using residential care were aged 90–94 years). The age distribution of residential care use among older Australians differed, with greater percentages of older men in relatively younger age groups (65–84) using residential aged care compared to older women.

Impact of COVID-19 on older people in aged care

The coronavirus disease 2019 (COVID-19) pandemic, starting in Australia in March 2020, highlighted the health and wellbeing of older people, particularly those in residential aged care. COVID-19 illness can result in more serious health outcomes for this cohort, including death.

To 14 October 2021, for people living in government-subsidised residential aged care facilities, there were:

Across all types of aged care, the lockdowns and social restrictions may have affected access to formal and informal support. Some older people in the community were encouraged to seek health services remotely through telehealth, for example.

The restrictions imposed may also have impacted people’s physical, mental and emotional wellbeing. The isolation and social disconnection experienced by permanent aged care residents as a result of visitor restrictions and lockdowns at many facilities placed older people at greater risk of health problems including anxiety and neurocognitive conditions.

For more information on the impact of COVID-19 on people using aged care, see Aged care snapshot and People's journey through aged care – the story in the data (PDF 153kB).

Assessment of care needs

The Aged Care Funding Instrument (ACFI) is used to assess the care needs of people living in permanent residential aged care to determine the funding needed by care providers. Residents may be reappraised in the same year if their needs change. The ACFI measures care needs across 3 different areas of care:

  • activities of daily living
  • cognition and behaviour
  • complex health care.

On 30 June 2020, among people living in permanent residential aged care, 1 in 3 (33%) had high care ratings across all three ACFI assessment areas (AIHW 2021c).

Health of people in aged care

People using aged care continue to interact with the health system through General Practitioners (GP), specialists and the hospital system. For example, GPs are an important part of the health care of older people living in residential aged care. Among older people living in permanent residential aged care in 2016–17, some 91% had at least 1 Medicare Benefits Scheme claim for a GP visit, and almost all of the remaining would have seen a doctor through some other mechanism (AIHW 2020).

For more information on older people’s use of health services, see the Health – health service use chapter.

Leaving aged care

Many people use aged care in their final years of life. Research indicates that people who lived in residential aged care near the end of their life commonly died in that setting. For older people over the age of 85 in 2016–17, 50% of deaths were in residential care, compared with 40% in hospital (AIHW 2021e). People may also leave care to move back home, to enter other aged care, or to be admitted to hospital. The following information covers exits from aged care services in 2019-20. A person may exit aged care services more than once over a 12-month period. 

In 2019–20:

  • There were 204,000 exits from residential aged care, home care and transition care by older people.
  • The majority of exits were older people leaving respite residential aged care (81,000), followed by permanent residential aged care (66,700), home care (32,600) and transition care (23,700).
  • Most (84%) exits from permanent residential care were due to death, compared with 34% from home care. The majority of discharges from home care were to residential care (55%).
  • People who died in permanent residential care had the longest median length of stay at approximately 23 months.

Older people in permanent residential care had the longest median length of stay, at around 21 months, followed by home care (around 15 months), transition care (52 days) and respite care (21 days). Older women stayed longer in permanent residential care than men, while this difference was less pronounced in respite care.

Where do I go for more information?

For more information on older Australians’ use of aged care services, see: