Australian Institute of Health and Welfare (2021) Older Australians, AIHW, Australian Government, accessed 27 November 2022.
Australian Institute of Health and Welfare. (2021). Older Australians. Retrieved from https://www.aihw.gov.au/reports/older-people/older-australians
Older Australians. Australian Institute of Health and Welfare, 30 November 2021, https://www.aihw.gov.au/reports/older-people/older-australians
Australian Institute of Health and Welfare. Older Australians [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2022 Nov. 27]. Available from: https://www.aihw.gov.au/reports/older-people/older-australians
Australian Institute of Health and Welfare (AIHW) 2021, Older Australians, viewed 27 November 2022, https://www.aihw.gov.au/reports/older-people/older-australians
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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.
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:
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:
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).
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.
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.
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).
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:
At 30 June 2020, including older people where sex is unknown:
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.
At 30 June 2020:
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.
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).
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:
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).
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.
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.
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.
For more information on older Australians’ use of aged care services, see:
AIHW (Australian Institute of Health and Welfare) 2020. Interfaces between the aged care and health systems in Australia—GP use by people living in permanent residential aged care 2012–13 to 2016–17. Cat. no. AGE 103. Canberra: AIHW. Viewed 2021.
AIHW 2021a. Australia’s welfare 2021: data insights. Chapter 8: People’s journey through aged care – the story in the data. Cat. no. AUS 236. Canberra: AIHW. Viewed 2021.
AIHW 2021b. GEN Aged Care Data: Admissions into aged care. Canberra: AIHW. Viewed 2021.
AIHW 2021c. GEN Aged Care Data: Care needs of people in aged care. Canberra: AIHW. Viewed 2021.
AIHW 2021d. GEN Aged Care Data: People using aged care. Canberra: AIHW. Viewed 2021.
AIHW 2021e. Interfaces between aged care and health systems in Australia—where do older Australians die? Cat. no. AGE 106. Canberra: AIHW. Viewed 2021.
Department of Health 2020. 2019–20 Report on the operation of the Aged Care Act 1997. Canberra: Department of Health. Viewed 2021.
Department of Health 2021. Coronavirus (COVID-19) case numbers and statistics. COVID-19 cases in aged care services – residential aged care. Canberra: Department of Health. Viewed 15 October 2021.
NACDC (National Aged Care Data Clearinghouse) 2020. AIHW analysis of unpublished aged care services data. Viewed 2021.
SCRGSP (Steering Committee Report on Government Service Provision) 2021. Report on Government Services 2021. Part F. Community Services Section 14. Canberra: Productivity Commission. Viewed 2021.
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