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People's care needs in aged care

This page has been updated with the latest data available at 30 June 2019. You can download data directly from the visualisations by clicking in the graph area and using the 'download' menu.

Every person has different care needs, and as people age their care needs change. In Australia, a range of programs are available to support a person’s care needs, and for many of these programs, the services are tailored to the individual’s needs.

Care is generally provided through residential and community-based approaches—lower levels of care are delivered in a person’s home, and higher levels of care are provided in residential facilities.

31% of people in permanent residential care on 30 June 2019 had high care needs in all three care domains.
9% of people using home care on 30 June 2019 were receiving the Dementia and Cognition Supplement.
87% of people in permanent residential aged care on 30 June 2019 had at least one diagnosed mental health or behavioural condition.
49% of people in permanent residential aged care on 30 June 2019 had a diagnosis of depression.
53% of people in permanent residential aged care on 30 June 2019 had a diagnosis of dementia.

The Commonwealth Home Support Program (home support) provides services to help people manage independently at home for as long as possible. There were over 840,900 people using home support in 2018–19. Almost 1 in 4 people using home support reported having a disability (23%). The most common type of service people used in 2018–19 was domestic assistance (39%), followed by allied health services (29%). For more information about home support, visit the home support dashboard.

The Home Care Packages Program (home care) provides higher levels of care to people living at home, supporting more complex care needs, including clinical care. A coordinated package of care is available at 4 levels to suit the assessed care needs of the person. There were over 106,700 people using home care at 30 June 2019. At 31 March 2019, around 1 in 5 (19%) people using home care had intermediate care needs (level 3) and 27% had high-level care needs (level 4).

A stacked bar graph shows the proportion of people using home care who have a level 1, 2, 3, or 4 home care package, across all states.

At 30 June 2019, around 1 in 10 (9%) people using home care were receiving the Dementia and Cognition Supplement, indicating they had moderate to severe levels of cognitive impairment associated with dementia or other conditions.

When living at home is no longer an option, permanent residential aged care in a facility is available. People in permanent residential care may have complex care needs and can require assistance with a range of activities. Their needs are assessed through the Aged Care Funding Instrument (ACFI), an assessment tool which looks at three care domains—activities of daily living, cognition and behaviour, and complex health care.

 

A snapshot of the people who were in permanent residential aged care on 30 June 2019 shows that:

  • Almost all (99.7%) had a current ACFI assessment on their record.
  • Around one-third (31%) had a high care need rating in all three ACFI assessment areas.
  • Nearly two-thirds (64%) had a high care need rating in the cognition and behaviour assessment area—the highest proportion across the three assessment areas
  • The majority (87%) were diagnosed with at least one mental health or behavioural condition.
  • Almost half (49%) of people in permanent residential aged care had a diagnosis of depression .
  • Just over half (53%) of people in permanent residential aged care had a diagnosis of dementia.
  • Individually, women, people born in non-English speaking countries, and people who prefer speaking a language other than English, were overall more likely than other people to have a ‘high’ rating across all three assessment areas.
A stacked bar graph shows the proportion of people living in permanent residential care who have high, medium, low or nil care needs across the three care domains. The largest proportion of people with high care need ratings was in the cognition and behaviour domain (64%), followed by activities of daily living (60%) and then complex health care (52%). Cognition and behaviour also had the highest proportion of nil care need ratings, whereas activities of daily living had the lowest proportion of people with nil care need ratings.

What is the Aged Care Funding Instrument (ACFI)?

The ACFI is a tool used to assess and provide basic information on the care needs of a person in permanent residential aged care. The ratings—high, medium, low or nil—are used to allocate government funds to residential aged care service providers.

The ACFI contains 12 questions used to assess how much help a person needs in nutrition, mobility, personal hygiene, toileting, continence, cognitive skills, wandering, verbal and physical behaviour, medication, depression and complex health care. These questions relate to the three ACFI assessment areas (also called care domains)—activities of daily living, cognition and behaviour, and complex health care. Responses to ACFI questions are rated on a scale of A to D and are used to determine the level of care a person needs. Mental health or behavioural diagnoses, along with other medical diagnoses, can be recorded but the ACFI is not designed to be a comprehensive assessment tool.

The ACFI is administered by the Department of Health and performed by a trained employee of the residential aged care provider. Funding on each of the ACFI domains is provided based on an individual’s rating. The sum of needs across the ACFI domains determines the amount of funding the residential provider receives per day per person in their care. ACFI reappraisal is undertaken as a person’s needs change. To find out more about the ACFI and subsidy amounts, please go to the Department of Health website.

Explore more about how care needs have changed over time, the care need ratings for people with dementia, and care needs based on demographic factors such as age, sex, Indigenous status, language and country of birth.