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People leaving aged care

Information is collected on why people leave aged care and how long they generally stay using a care service.
 

Last updated: 28 July 2022.

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Contents

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For a downloadable summary of the information in this topic, view the People leaving aged care fact sheet

Related information can be found on other GEN topic pages:

The aged care system offers a continuum of care under three main types of service:

  • Home support (Commonwealth Home Support Programme), which provides entry-level services focused on supporting individuals to undertake tasks of daily living to enable them to be more independent at home and in the community.
  • Home care (Home Care Packages Program), which is a more structured, more comprehensive package of home-based support, provided over four levels.
  • Residential aged care, which provides support and accommodation for people who have been assessed as needing higher levels of care than can be provided in the home, and the option for 24-hour nursing care. Residential care is provided on either a permanent, or a temporary (respite) basis.

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

  • Transition care, which provides short-term care to restore independent living after a hospital stay
  • Short-term restorative care, which expands on transition care to include anyone whose capacity to live independently is at risk
  • Multi-purpose services, which offer aged care alongside health services in Regional and remote areas
  • Innovative Care Programme, which includes a range of programs to support flexible ways of providing care to target population groups
  • National Aboriginal and Torres Strait Islander Flexible Aged Care Program, which provides culturally-appropriate aged care at home and in the community.

For more information on aged care services in Australia see the Report on the Operation of the Aged Care Act, or visit the Department of Health website.

People leaving aged care in 2020–21

People leave aged care services for a number of reasons, including moving to another service for the same or a different program type. When a person leaves an aged care service it is referred to here as an ‘exit’ (excluding short periods of leave, such as for family visits or hospital stays). A person may exit aged care services more than once over a 12-month period.

The time that a person spends using an aged care service in a single episode is described as ‘length of stay’, regardless of whether they used community or residential care. Here we describe length of stay using the median value—the number found in the middle of a distribution of values (around half of people have a length of stay longer than the median, and around half of people have a length of stay shorter than the median). 

For exits that took place in 2020–21:

  • The median length of stay for permanent residential care was nearly 5 and a half months longer than for home care.
  • Respite residential care and transition care, which provide temporary aged care, had short median lengths of stay—0.7 months (21 days) and 1.8 months (56 days) respectively.
  • Over 67,000 exits were for permanent residential care, nearly 38,000 were for home care, and more than 23,000 were for transition care.
  • The most exits were for respite residential care (over 81,000 exits), reflecting that this care type is provided as a transient service and can be used multiple times by the one individual. 
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A horizontal bar graph shows the median length of stay (months) and number of exits from aged care services grouped by care type. In 2020–21, the median length of stay was longest in permanent residential care, followed by home care. The shortest median length of stay was for respite residential care, followed by transition care (care types that provide temporary accommodation).

Reasons for leaving aged care

People leave aged care services for a number of reasons. Death is a common reason for leaving aged care, particularly residential care. Other reasons include moving to another care service or returning to living in the community. 

For exits that took place in 2020–21:

  • People had a similar median length of stay in home care whether they exited due to death or due to entering permanent residential care (almost 17 months). For permanent residential care, the longest median length of stay was for those who died in care (almost 24 months).
  • Most exits from permanent residential care were due to death (83% of exits), while most for home care were due to entering residential care (54% of exits).
  • Most exits from respite residential care and transition care were due to returning to community-based living (51% and 55% of exits, respectively).
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A bar graph shows the median length of stay (months) and number of exits from aged care services grouped by care type and discharge reason. The median length of stay in home care was similar for people who exited due to death or due to entering permanent residential care. For permanent residential care, the longest median length of stay was for those who died in care (23.9 months).

People leaving aged care over time

There have been changes in the number of exits and typical length of stay for different care types over time. See also COVID-19 and people leaving aged care

Compared to 2019–20, in 2020–21:

  • The median length of stay increased by almost one month in permanent residential care and just over one month in home care.
  • The number of exits from home care increased by 15% (from almost 33,000 exits in 2019–20 to almost 38,000 exits in 2020–21). This may be explained, in part, by increasing numbers of people being admitted into and using home care services over this period (see Admissions into aged care and People using aged care).
  • The number of exits from transition care, respite residential care and permanent residential care all decreased (number of exits decreased by 5.8%, 2.0% and 1.4% respectively).
Trends over the decade from 2011–12 to 2020–21 indicate that:
  • The median length of stay increased by 4 months for home care and by more than 4 and a half months for permanent residential care, but remained stable for respite residential care and transition care.
  • The number of exits increased for most care types, with the largest increase in exits for home care (62% increase), followed by respite residential care (30% increase). This may be explained, in part, by increasing numbers of people using these services over time (see Admissions into aged care).
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A line graph shows the median length of stay (months) and number of exits from aged care services grouped by care type over time. Over the decade from 2011–12 to 2020–21 the median length of stay in care showed a steady increase for permanent residential care and an increasing trend overall for home care. The median length of stay for respite and transition care remained low and stable over time. Since 2019–20, the median length of stay has increased by almost 1 month in permanent residential care and just over 1 month in home care.

People leaving aged care by age

Although the majority of exits for aged care services are for people aged 65 and over, younger people also access and exit these services.

For exits that took place in 2020–21:

  • The longest median length of stay for people in permanent residential care was for those aged 100 and over (over 43 months; just over 3 and a half years), while for home care the longest median length of stay was for people aged 55–59 (almost 25 months; just over 2 years).
  • The median length of stay for transition care was shorter for older people than for younger people.
  • Older age groups represented a greater proportion of exits from permanent residential care compared to other types of care. The proportion of exits for people aged 85 and over was 64% for permanent residential care, 54% for home care and 52% for respite residential care. The proportion aged 85 and over exiting transition care was 38%, reflecting the younger age demographic of people using this type of care. 
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A bar graph shows the median length of stay (months) and number of exits from aged care services grouped by care type and age group. The longest median length of stay for people in permanent residential care was for people aged 100 and over, while for home care the longest median length of stay was for people aged 55–59.

People leaving aged care by sex

There are more exits from aged care for women than men across all program types.

For exits that took place in 2020–21:

  • The median length of stay for women was longer than for men for permanent residential care (over 10 months longer) and home care (2 and a half months longer) but somewhat similar for transition care (approximately 2 days difference). Length of stay in respite residential care was the same for males and females (approximately 21 days).
  • Around 59% of all exits were for women and around 41% were for men. This is likely due to the fact that more women than men use aged care services in general (see People using aged care). 
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A bar graph shows the median length of stay (months) and number of exits from aged care services grouped by care type and sex. The median length of stay in permanent residential care and home care was longer for women than men. Median length of stay was similar for men and women in respite and transition care.

People leaving aged care by age and sex

Women tend to leave residential aged care services at a later age than men.

For exits that took place in 2020–21:

  • For both men and women, the median length of stay in permanent residential care generally increased with age from age 70 onwards (length of stay for people aged 70–74 was approximately 12 months for men and 14 months for women, compared to people aged 100 and over whose length of stay was approximatley 29 months for men and 47 months for women).
  • In permanent residential care, almost half (47%) of exits were for those aged 90 and over among women, compared with just under one-third (32%) among men. The trends for leaving home care and transition care were similar by age and sex. 
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A line graph shows the median length of stay (months) and proportion of exits from aged care services grouped by care type, sex and age group. For both men and women, the median length of stay in permanent residential care generally increased with age from age 70 onwards.

Aboriginal and Torres Strait Islander Australians leaving aged care

Delivering culturally appropriate aged care can improve access to, and the quality of, aged care for Indigenous Australians. The National Aboriginal and Torres Strait Islander Flexible Aged Care Program provides culturally appropriate care for Indigenous Australians in certain locations, mostly in rural and remote areas, that are close to their communities.

In recognition of poorer health among Aboriginal and Torres Strait Islander communities, aged care services are offered to Aboriginal and Torres Strait Islander people from age 50. In practice, Indigenous Australians may face barriers to accessing and using aged care services for complex, inter-related reasons, including remoteness, language barriers, and the effects of racism and continued socioeconomic disadvantage.

You can learn more about Indigenous Australians in aged care by viewing the Aboriginal and Torres Strait Islander people dashboard, or learn about the health and welfare of Indigenous Australians on the AIHW website.

For exits that took place in 2020–21:

  • Median length of stay in permanent residential care and home care was shorter for younger Indigenous Australians compared to younger non-Indigenous Australians (Indigenous Australians aged under 50 years stayed approximately 19 months less in permanent residential care and almost 56 months less in home care).
  • Approximately 710 exits from permanent residential care, 1,100 exits from respite residential care, 860 exits from home care, and 185 exits from transition care were by Indigenous Australians. Exits by Indigenous Australians constituted 1.1% of exits from permanent residential care, 1.3% of exits from respite residential care, 2.3% of exits from home care, and 1.0% of exits from transition care.
  • ​Exits from all care types tended to take place at younger ages for Indigenous Australians compared to non-Indigenous Australians. The proportion of exits from permanent residential care by Indigenous Australians were highest in age groups 75–79 and 80–84 years, whereas exits by non-Indigenous Australians were highest in age groups 85–89 and 90–94 years.
Note that these data do not include exits from the National Aboriginal and Torres Strait Islander Flexible Aged Care Program. 

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A line graph and butterfly chart show the median length of stay (months) and proportion of exits from aged care services by care type, Indigenous status and age group. Median length of stay in permanent residential care and home care was longer for younger non-Indigenous Australians compared to younger Indigenous Australians. From age 60, median length of stay in home care was longer for Indigenous Australians.

People from culturally and linguistically diverse backgrounds leaving aged care

Many older Australians, including those living in residential aged care, were born overseas, speak a variety of languages, may not speak English fluently or have differing religious or cultural practices. These groups of people can be referred to as culturally and linguistically diverse (CALD), although these Australians are by nature heterogenous, and situations and needs vary greatly. CALD Australians can face barriers in engaging with aged care and the support they require. Due to data availability, this section focuses on country of birth and preferred language as measures of people's cultural and linguistic diversity.

For exits that took place in 2020–21:

  • The median length of stay for all care types was slightly longer for people who preferred to speak languages other than English, however differences in median length of stay were small (less than 1 month).
  • Approximately 20% of exits were for people born in non-English-speaking countries, and 9.4% were for people who preferred to speak a language other than English. Home care was the service with the greatest proportion of exits by people born in non-English-speaking countries (almost 23%) and people who preferred to speak a language other than English (almost 12%).
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Two horizontal bar graphs show the median length of stay (months) and number of exits from aged care services grouped by care type, country of birth and preferred language. The median length of stay for all care types was slightly longer for people who preferred to speak languages other than English, although differences were small (less than 1 month).

States and territories

Both the number of exits and the typical length of stay for aged care programs vary across Australia's states and territories.

For exits that took place in 2020–21:

  • South Australia had the longest median length of stay for permanent residential care—4 and a half months longer than Tasmania, which had the shortest median length of stay for permanent residential care. The median length of stay for home care was longest in the Northern Territory, while the Australian Capital Territory and Northern Territory had the longest median length of stay for transition care. 
  • Trends in exits mirrored trends in admissions (see Admissions into aged care). For example, the number of admissions to respite residential care per 1,000 target population in 2020–21 was highest in South Australia and lowest in Western Australia and the Australian Capital Territory, and so were exits. 
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A bar graph shows the median length of stay (months) and number of exits per 1,000 target population from aged care services grouped by care type and state and territory. Median length of stay in home care and respite residential care was longest in the Northern Territory (almost 20 months for home care and just under 0.9 months for respite care). South Australia had the longest median length of stay in permanent residential care (approximately 23 months).

Remoteness

The number of exits from aged care services per person in the target population differs between remoteness areas. Additional care types, such as Multi-purpose services (MPS) and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program, also provide aged care to members of the target population, often in remote areas, however these data are not represented here.

For more information on flexible care programs, see the MPS fact sheet and Indigenous Australians fact sheet and dashboard.

For exits that took place in 2020–21:

  • The median length of stay was similar across remoteness areas for permanent residential care and home care.
  • Trends in exits mirrored trends in admissions (see Admissions into aged care). For example, the number of admissions to permanent and respite residential care per 1,000 people in the target population in 2020–21 was highest in medium rural towns (MM 4) and lowest in very remote areas (MM 7), as were exits from these care types. 
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The Modified Monash Model (MMM) is one of several classifications for defining whether a location is a city, rural, remote or very remote. The model measures remoteness and population size on a scale of Modified Monash (MM) category MM 1 to MM 7. MM 1 is a metropolitan area, including Australia’s major cities, and MM 7 is a very remote community, such as Longreach.

From January 2020, Department of Health programs began transitioning to use the MMM classification. You can learn more about MMM on the Department of Health website.

A bar graph shows the median length of stay (months) and number of exits per 1,000 target population from aged care services grouped by care type and remoteness. Median length of stay in transition care was highest in medium rural towns (MM 4), while median length of stay was similar across remoteness areas for permanent residential care and home care.

People leaving permanent residential care by dementia status

People with dementia tend to have longer lengths of stay in permanent residential care than people without dementia. People’s health conditions are captured through Aged Care Funding Instrument (ACFI) assessments.

For exits that took place in 2020–21:

  • The median length of stay for permanent residential care was over 8 months longer for people with a record of dementia than for people without a record of dementia. 
  • The difference in length of stay between people with dementia and without dementia was 10 months for women and over 6 months for men. 
  • Over half (56%) of people exiting permanent residential care had a record of dementia, with the proportion remaining the same for men and women. 
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A bar graph shows the median length of stay (months) and number of exits from aged care services grouped by dementia status and sex. The median length of stay for permanent residential care was over 8 months longer for people with a record of dementia than for people without a record of dementia. Both men and women with a record of dementia had a longer median length of stay than men and women without a record of dementia.

The Aged Care Funding Instrument (ACFI) is a tool for assessing the care needs of people entering and living in permanent residential aged care. The tool is used to allocate government funding to residential aged care service providers based on the needs of the people in their care, regardless of the actual care planning or care provided by the service to the assessed individual.

The ACFI contains 12 questions and two diagnostic sections used to assess how much assistance a person needs in a range of areas. The ACFI is not a comprehensive assessment; it is focused on factors that affect the cost of care. Needs are classified under the 3 funding domains

  • activities of daily living (ADL), including questions relating to nutrition, mobility, personal hygiene, toileting and continence,
  • cognition and behaviour (BEH), including questions relating to cognitive skills, wandering, verbal behaviour, physical behaviour and depression, and
  • complex health care (CHC), including questions relating to the need for assistance with administering medications, and need for management of complex health care procedures,

with four ratings for each domain

  • nil
  • low
  • medium
  • high

The rating on each of the ACFI domains is based on the scores on the 12 underlying questions. The ratings across the ACFI domains determine the amount of funding the residential aged care provider receives per day per person in their care. If a person is assessed as having nil or minimum care needs in a particular domain the provider receives no funding for that domain for that person. Reappraisals can be undertaken as a person’s needs change.

To find out more about the ACFI and subsidy amounts, see the Department of Health website.

People leaving permanent residential care by care needs

Some people have high care needs recorded in each care domain of the ACFI, meaning that they were assessed as requiring considerable assistance in managing activities of daily living, cognition and behaviour, as well as medications or other complex health care procedures. People whose care needs are rated ‘high’ in all three domains in their last assessment before leaving permanent residential care typically have the longest median length of stay. 

For exits that took place in 2020–21:

  • The median length of stay for permanent residential care was nearly 12 months longer for people whose care needs were recorded as 'high' in all three ACFI domains than for people with other ratings. 
  • The difference in length of stay for people with high ACFI ratings compared with people who had other care ratings was over 14 months for women and nearly 8 months for men. 
  • Just over half (52%) of exits from permanent residential care were for people who did not have 'high' ratings in all three ACFI domains.
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A bar graph shows the median length of stay (months) and number of exits from aged care services grouped by care need ratings assessed via the Aged Care Funding Instrument (ACFI). The median length of stay in permanent residential care was nearly 12 months longer for people whose care needs were recorded as ‘high’ in all three ACFI domains (activities of daily living; cognition and behaviour; and complex health care) compared to people with other ratings.

Explore people leaving aged care

Use the interactive table below to explore the number of people exiting aged care services by care type, age group, sex, Indigenous status, preferred language, country of birth and geography (Aged Care Planning Regions).

If you are interested in accessing a confidentialised data set that includes selected information about exits from residential care, home care, and transition care in Australia by state and territory and Aged Care Planning Regions, please see the relevant Confidentialised Unit Record File available on GEN.

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A table shows the number of exits from aged care services in Australia by care type, age group, sex, Indigenous status, preferred language, country of birth and geography (Aged Care Planning Region).

COVID-19 and people leaving aged care

Australia has faced significant challenges during the COVID-19 pandemic. COVID-19 illness can be more serious for people who have pre-existing health conditions, including older Australians.

The number of people leaving aged care services is likely to have been impacted by COVID-19. In some cases, people temporarily leaving permanent residential aged care for community living with extra supports provided may have been recorded as exits. In addition, approximately one-third of COVID-19-related deaths in Australia have occurred in people living in residential aged care facilities. The extent of pandemic-related impacts will be clearer in future data releases.

For further information related to older Australians and COVID-19, including access to advice and support resources, see the Australian Government’s My Aged Care website. For more information regarding COVID-19 outbreaks in Australian residential aged care facilities, see the latest weekly snapshot.

 

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