Caring for older Australians

• Over one million older Australians receive aged care services. The range and quality of these services have improved over past decades, but more needs to be done.
• Future challenges include the increasing numbers and expectations of older people, a relative fall in the number of informal carers, and the need for more workers. By 2050, over 3.5 million Australians are expected to use aged care services each year.
• The aged care system suffers key weaknesses. It is difficult to navigate. Services are limited, as is consumer choice. Quality is variable. Coverage of needs, pricing, subsidies and user co-contributions are inconsistent or inequitable. Workforce shortages are exacerbated by low wages and some workers have insufficient skills.
• The Commission’s proposals address these weaknesses and challenges and aim to deliver higher quality care. The focus is on the wellbeing of older Australians - promoting their independence, giving them choice and retaining their community engagement. Under this integrated package of reforms, older Australians would:
  • be able to contact a simplified ‘gateway’ for: easily understood information; an assessment of their care needs and their financial capacity to contribute to the cost of their care; an entitlement to approved aged care services; and for care coordination - all in their region receive aged care services that address their individual needs, with an emphasis on reablement where feasible
  • choose whether to receive care at home, and choose their approved provider
  • contribute, in part, to their costs of care (with a maximum lifetime limit) and meet their accommodation and living expenses (with safety nets for those of limited means)
  • have access to a government-sponsored line of credit (the Australian Aged Care Home Credit scheme), to help meet their care and accommodation expenses without having to sell their home. A person’s spouse, or other ‘protected person’ would be able to continue living in that home when an older person moved into residential care
  • choose to pay either a periodic charge or a bond for residential care accommodation
  • if they wish to sell their home, retain their Age Pension by investing the sale proceeds in an Australian Age Pensioners Savings Account
  • have direct access to low intensity community support services
  • be able to choose whether to purchase additional services and higher quality accommodation.
• Limits on the number of residential places and care packages would be phased out, while distinctions between residential low and high care and between ordinary and extra service status would be removed.
• Safety and quality standards would be retained. An Australian Aged Care Commission would be responsible for quality and accreditation; and would transparently recommend efficient prices to the Government.

• Preliminaries
  • Cover, Copyright, Letter, Terms of reference, Contents and Abbreviations
• Overview - including key points
• Recommendations
• Summary of proposals
• Chapter 1 About the inquiry
  • 1.1 The Commission's brief
  • 1.2 What is aged care?
  • 1.3 Who are older Australians?
  • 1.4 The Commission's approach
  • 1.5 A road map to the rest of the report
• Chapter 2 The current aged care system
  • 2.1 Foundations of Australia's aged care system
  • 2.2 Care and support services
  • 2.3 The financing of aged care
  • 2.4 Regulation of aged care
  • 2.5 Aged care and other social policy areas
• Chapter 3 Drivers of future demand
  • 3.1 Population ageing and demand for aged care
  • 3.2 A growing diversity of aged care needs
  • 3.3 Trends in the availability of informal carers
  • 3.4 The influence of price and wealth on demand
  • 3.5 Calculating the trends in demand
• Chapter 4 A framework for assessing aged care
  • 4.1 A new vision for care and support
  • 4.2 Caring for older Australians - what role for government?
  • 4.3 'Wellbeing' of the community - the key objective
  • 4.4 Criteria for assessment
• Chapter 5 Assessment of the current aged care system
  • 5.1 Access, continuity and choice is limited
  • 5.2 Pricing, subsidies and co-contributions are inequitable and distort investment
  • 5.3 Regulatory burdens are excessive
  • 5.4 How much reform is required?
• Chapter 6 Who should pay?
  • 6.1 Are existing funding arrangements sustainable?
  • 6.2 Who should pay and what should they pay for?
• Chapter 7 Paying in practice
  • 7.1 Accommodation costs - applying the principles
  • 7.2 Everyday living expenses - applying the principles
  • 7.3 Care costs - putting the principles into practice
• Chapter 8 Options for broadening the funding base
  • 8.1 Saving accounts and superannuation
  • 8.2 Drawing on housing equity to pay for care costs
  • 8.3 Insurance for aged care
• Chapter 9 Care: Access, coverage and delivery
  • 9.1 An aged care gateway: information, needs assessment and care coordination
  • 9.2 Improving care continuity and enhancing consumer choice
  • 9.3 Associated reforms
• Chapter 10 Quality of care and support
  • 10.1 Defining and measuring quality of care and support
  • 10.2 Current measures to ensure quality of care
  • 10.3 How effective is the current quality framework?
  • 10.4 Building the evidence on quality of care
  • 10.5 Access to health care and what it means for quality care
• Chapter 11 Catering for diversity
  • 11.1 Diversity in demand for aged care services
  • 11.2 Socially disadvantaged people
  • 11.3 Older Australians from culturally and linguistically diverse backgrounds
  • 11.4 Gay, lesbian, bi-sexual, transgender and intersex people
  • 11.5 Veterans
  • 11.6 Aboriginal and Torres Strait Islander people
  • 11.7 Older Australians living in rural and remote locations
• Chapter 12 Age-friendly housing and retirement villages
  • 12.1 Improving choice of age-friendly housing
  • 12.2 Improving the age friendliness of communities
  • 12.3 Improving rental choices for older Australians
  • 12.4 Regulation of retirement living options
  • 12.5 Residential care building regulations
• Chapter 13 Informal carers and volunteers
  • 13.1 Some facts about informal carers
  • 13.2 Reasons for supporting carers
  • 13.3 Current system of support available for informal carers
  • 13.4 Ways to better support informal carers
  • 13.5 Volunteers
• Chapter 14 The formal aged care workforce
  • 14.1 Who delivers care services to the aged?
  • 14.2 Future aged care workforce requirements
  • 14.3 Addressing direct care workforce challenges
• Chapter 15 Regulation - the future direction
  • 15.1 What are the current regulations?
  • 15.2 Improving Australian Government governance arrangements for aged care
  • 15.3 Implementing 'responsive regulation' with appropriate standards and streamlined reporting
  • 15.4 Reducing the extent and burden of regulation
  • 15.5 Clarifying and simplifying jurisdictional responsibilities and harmonising regulation
• Chapter 16 Aged care policy research and evaluation
  • 16.1 Improving data collection and access
  • 16.2 Building a better evidence base
  • 16.3 Research capacity
• Chapter 17 Reform implementation
  • 17.1 An implementation framework
  • 17.2 Grandfathering arrangements
  • 17.3 Mitigating the risks from the reform implementation
  • 17.4 Sequencing of reform
  • 17.5 What do the reforms mean for older Australians, their carers and service providers?
• Appendix A Conduct of the inquiry
• References

Please note: Appendix C is only available in PDF.

• Appendix B Cameos (PDF - 320 Kb)
• Appendix C New aged care model options (PDF - 1420 Kb)
• Appendix D International experience (PDF - 151 Kb)
• Appendix E Cost and workforce implications (PDF - 248 Kb)
• Appendix F Aged care regulation (PDF - 217 Kb)
• Appendix G Past recommendations (PDF - 68 Kb)
• Appendix H The survey of disability, ageing and carers (PDF - 193 Kb)

• Appendices B to H (ZIP/Word - 1583 Kb)

The following errata have been issued for the 'Caring for Older Australians' inquiry report. The chapters and appendices on the website have been amended to reflect these errata.

Download the errata

• Errata - Caring for Older Australians (PDF - 129 Kb)
• Errata - Caring for Older Australians (Word - 93 Kb)