Specialist palliative care use for older people receiving aged care

People approaching the end of life may receive support from a range of health care providers, including specialist palliative care teams for those with complex or advanced needs, as well as from other health professionals, such as General Practitioners (GPs), non-palliative care specialists, nurses and allied health practitioners.

This section focuses on palliative-care related hospitalisations, palliative care medical consultations in outpatient clinics and Medicare-subsidised services provided by palliative medicine physicians/specialists.

2 in 5 older people received specialist palliative care in the last year of life

Almost 2 in 5 (38% or 50,500) people in the study population (aged 65 and over) received specialist palliative care in the last year of life. Of these:

• 31% (40,600) were admitted to hospital for palliative care–related hospitalisations
• 9.3% (12,300) attended outpatient clinics for palliative care medical consultations
• 7.6% (10,000) received Medicare–subsidised services provided by palliative medicine physicians/specialists.

Residential aged care users less likely to receive specialist palliative care

People living in residential aged care were less likely to receive specialist palliative care compared with people using home care and residential respite care and people not receiving any of the selected aged care services (21%, 49% and 50%, respectively).

Compared with people living in residential aged care, people using home care and residential respite care were:

• 2.7 times as likely to have palliative care–related hospitalisations
• 1.9 times as likely to attend outpatient clinics for palliative care consultations
• 3.4 times as likely to receive Medicare–subsidised palliative care services.

Older people living in residential aged care and approaching end of life may receive palliative care in other ways. For example, palliative care and support provided by aged care workers or through palliative care nurse visits to residential aged care facilities. This may, in part, explain the lower rates of specialist palliative care receipt among people living in residential aged care.

Palliative care services provided in residential aged care are not captured in national administrative data collections or linked data, and therefore not reflected in this report.

Specialist palliative care receipt higher among younger aged care users

Receipt of specialist palliative care among the study population was higher for people aged 65–74 compared with people aged 85 and over (50% and 30% respectively).

The difference between age groups was most pronounced for people living in residential aged care. People aged 65–74 living in residential aged care were almost twice as likely to receive specialist palliative care compared with those aged 85 and over (34% and 18%, respectively).

Among people using home care and residential respite care, people aged 65–74 were 1.3 times as likely to receive specialist palliative care compared with those aged 85 and over (57% and 46%, respectively).

Cancer patients most likely to receive specialist palliative care

People in the study population who died from cancer were the most likely to receive specialist palliative care (60%), followed by people who followed the organ failure trajectory (28%) and people who followed the dementia and frailty trajectory (22%).

For all disease trajectories, people using home care and residential respite care were at least twice as likely to receive specialist palliative care compared with people living in residential aged care:

• 2.0 times as likely for people who died from cancer
• 2.1 times as likely for people who followed the organ failure trajectory
• 3.0 times as likely for people who followed the dementia and frailty trajectory.

The higher rates of specialist palliative care among cancer patients reflect the traditionally strong association between palliative care and cancer diagnoses. Cancer patients often experience a more predictable illness trajectory, with a rapid progression to a shorter terminal phase, during which they are typically at home, in hospital, or receiving care in specialist palliative units.

In contrast, individuals with dementia and other chronic conditions follow a slow, prolonged, and unpredictable decline. People living in residential aged care are less likely to have cancer, and more likely to have conditions such as frailty or dementia (AIHW 2025). As a result, the need for palliative care may be less readily recognised in residential aged care settings, contributing to lower access to specialist palliative care (Quinn et al. 2021, Murray et al, 2005).