People's care needs in aged care

Australia’s aged care system offers a variety of services to support the diverse care needs of older Australians.

Last updated: 27 June 2025

Domestic assistance and allied health and therapy services were the most commonly used home support services in 2023–24

The most common home care package was Level 2 (41%), followed by Level 3 (33%) and Level 4 (21%)

Almost 3 in 5 people (57%) in permanent residential care were in the assisted mobility category at 30 June 2024

Almost 2 in 5 people (39%) in permanent residential care were in the not mobile category at 30 June 2024

Types of aged care available in Australia

The aged care system offers a continuum of care under 3 main types of service:

Commonwealth Home Support Programme (home support) 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 Packages Program (home care) is a more structured, comprehensive package of home-based support, provided over 4 levels.
Residential aged care (residential care) 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, and services for specific population groups available that extend across the spectrum from home support to residential care, including:

Transition Care Programme (transition care) provides short-term care to restore independent living after a hospital stay.
Short-Term Restorative Care Programme (short-term restorative care) expands on transition care to include anyone whose capacity to live independently is at risk.
Multi-Purpose Services Program offers aged care alongside health services in Regional and remote areas.
Innovative Care Programme 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 provides culturally appropriate aged care at home and in the community for First Nations people.
Department of Veterans’ Affairs community nursing and Veterans’ Home Care services provide support to help eligible veterans stay independent and in their own home.

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, Disability and Ageing website.

Aged care assessment programs

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 largely 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 (except for home support) – rather, access is determined based on a person’s assessed care needs and the types of care and services a person may be eligible for.

My Aged Care website is a contact centre and serves as a 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. People undergo initial screening through the My Aged Care Platform.

Before December 2024, people were directed to one of two assessment organisations based on their assessed needs at screening:

Regional Assessment Service (RAS): carry out home support assessments to assess eligibility for entry-level home support services through the Commonwealth Home Support Programme (CHSP).
Aged Care Assessment Teams (ACATs): carry out comprehensive assessments – also known as the Aged Care Assessment Program (ACAP) – and approve eligibility for people entry into:
- a higher level of home care through the Home Care Packages (HCP) Program
- residential care, either a permanent or a temporary (respite) basis
- transition care
- short-term restorative care.

From December 2024, the Single Assessment System workforce replaced the RAS, ACATs and independent Australian National Aged Care Classification (AN-ACC) assessors, to deliver assessment services. This aged care reform aims to make it easier for older people to access aged care and adapt services as their needs change by enabling assessors to collect more complete information about the older person and ensure service recommendations and referrals are tailored to their current needs. Data from this new assessment approach will be incorporated into the relevant GEN Aged Care Data topic pages when available.

Further information on aged care assessments can be found in My Aged Care page and Single Assessment System for aged care page in the Department of Health and Aged Care website.

Care needs in home support

Home support mostly provides entry-level care services to people requiring extra assistance at home. For more information about people using home support and the services they access, visit the home support dashboard.

In 2023–24, of the 835,000 people who were assisted under the Commonwealth Home Support Programme (home support):

domestic assistance was the most commonly used home support service (40% of recipients), followed by allied health and therapy services (31%)
other commonly used home support services (used by more than 10% of recipients) included transport (20% of recipients), home maintenance (19%), individual social support (15%), nursing (13%), meals (13%) and group social support (11%).

Figure 1: Top 10 most commonly used home support services, 2023–24

Care needs in home care

Home care provides various levels of care to individuals based on their assessed care needs. Home care packages are available at 4 levels, from Level 1 (suitable for basic care needs) through to Level 4 (suitable for high-level care needs).

At 30 June 2024, of the 275,000 people who were using home care:

the most common home care package was Level 2 (41% of recipients), followed by Level 3 (33%) and Level 4 (21%); only 5.4% of recipients were using Level 1
across states and territories, Level 2 was the most common home care package in New South Wales (45% of recipients), Victoria (43%), Queensland (39%), Tasmania (42%) and Australian Capital Territory (34%), Level 3 was the most common package in South Australia and Northern Territory (38% each), and Level 4 was the most common package in Western Australia (38%).

Figure 2: People using home care by care level and states and territories, 30 June 2024

Care needs in permanent residential care

Care needs rating for permanent residential care (AN-ACC)

In 2022, the Australian National Aged Care Classification (AN-ACC) replaced the Aged Care Funding Instrument (ACFI) as the tool for assessing the care needs of people entering and living in permanent residential aged care.

The AN-ACC Assessment Tool focuses on the characteristics of residents that drive care costs in residential 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 rather than the care planned or provided by the service to the assessed individual.

Independent assessors use the AN-ACC Assessment Tool to assess a resident’s care needs and assign each resident with an AN-ACC classification. This classification corresponds to the amount of government funding the approved service provider will receive per resident.

The Assessment Tool considers a residents’:

physical ability (including pain)
cognitive ability (including ability to communicate, socially interact, problem solve, and memory)
behaviour (including ability to cooperate, physical aggression, problem wandering, passive resistance, and being verbally disruptive)
mental health (including depression and anxiety).

Under the AN-ACC model, independent assessors are trained and qualified aged care clinicians with a minimum of 5 years’ experience delivering clinical services in aged care settings as registered nurses, physiotherapists or occupational therapists.

The AN-ACC model separates care planning done by providers from funding assessments done by independent assessors. The separation of assessors and providers ensures the integrity of the system and that residents’ care needs come before funding decisions. Furthermore, the AN-ACC model is designed to contribute to better planning and quality care for aged care residents.

There are 13 classes of care funding under the AN-ACC model, with each class based on the cost of care, including:

Class 1: reserved for people near end-of-life. This class allows frail residents with a life expectancy of less than 3 months, with an approved palliative care plan, to enter a facility without an AN-ACC assessment.
Class 2 and 3: identified for residents considered ‘Independently mobile’.
Class 4–8: identified for residents considered as having ‘Assisted mobility’.
Class 9–13: identified for residents considered as being ‘Not mobile’.

Each class includes residents with similar needs, clinical risks and safety indicators whose daily care costs are similar. Each class aligns with the cost of staff time to deliver consistent and appropriate care.

For more information about AN-ACC, see the AN-ACC Reference Manual and AN-ACC Assessment Tool and the AN-ACC Funding Guide on the Department of Health, Disability and Ageing website.

Permanent residential care provides up to 24-hour care for people who need ongoing assistance with everyday tasks and health care, and who can no longer live independently in the community.

At 30 June 2024, over 189,800 people had a current Australian National Aged Care Classification (AN-ACC) assessment, representing 99.5% of all people living in permanent residential care (189,900). Among these 189,800 people:

around 200 people (0.1%) in the palliative care category (Class 1)
most people (96%) were assessed as having some mobility needs – either in the assisted mobility category (Class 4–8; 57%) or the not mobile category (Class 9–13; 39%) – and 3.0% were in the independent mobility category (Class 2–3):
- the most common AN-ACC classification was Class 5, assisted mobility, higher cognitive ability with compounding factors (19%)
- the least common AN-ACC classification was Class 3, independent mobility, with compounding factors (0.8%).

Figure 3: People living in permanent residential care with a current AN-ACC assessment by mobility category/classification, 30 June 2024

Permanent residential care needs by sex

Men and women have different life experiences that contribute to their different care needs when living in permanent residential care.

At 30 June 2024:

a slightly higher proportion of men were in the independent mobility category compared with women (4.2% and 2.4%, respectively)
the proportions of men and women in the assisted mobility category were similar (around 58% both for men and women)
a slightly higher proportion of women were in the not mobile category compared with men (40% and 38%, respectively).

Figure 4: People living in permanent residential care by mobility category and sex, 30 June 2024

Permanent residential care needs by age

In permanent residential care, people in different age groups have different care needs.

Although the majority of people using aged care services are aged 65 and over, younger people also access these services, largely due to challenges associated with accessing age-appropriate accommodation and supports in the community. The Australian Government has committed to no people under the age of 65 living in residential aged care by 2025, except in exceptional circumstances. For more information on younger people in residential care, see the Younger people in residential aged care dashboard.

At 30 June 2024:

the proportion of people in the independent mobility category decreased from age group 55–59, from 11% of people aged 55–59 to 0.6% of people aged 100 and over
people aged 85–89 and 90–94 had the highest proportion in the assisted mobility category (both 60%), and people aged 0–49 had the lowest (21%)
the proportion of people in the not mobile category was highest among people aged 0–49 (72%), followed by those aged 50–54 (54%), 55–59 (52%) and 100 and over (50%).

Figure 5: People living in permanent residential care by mobility category and age group, 30 June 2024

Permanent residential care needs by sex and age

Women were more likely than men to have some mobility needs at every age group. Generally, from age 65 mobility decreases with each age group and care needs increase.

At 30 June 2024:

the age group with the largest proportion of people in the independent mobility category was 55–59 for both men and women (14% and 6.6%, respectively)
the age groups with the largest proportion of people in the assisted mobility category was 95–99 for men (62%) and 85–89 for women (60%)
the age group with the largest proportion of people in the not mobile category was 0–49 for both men and women (75% and 67%, respectively). This may include younger people with disability living in residential aged care.

Figure 6: People living in permanent residential care by mobility category, sex and age group, 30 June 2024

Permanent residential care needs for Aboriginal and Torres Strait Islander people

Aboriginal and Torres Strait Islander (First Nations) people face multiple health and social disadvantages. Consequently, they are more likely to develop serious medical conditions earlier in life and have a lower life expectancy than their non-Indigenous counterparts. In recognition of poorer health among First Nations communities, aged care services are offered to First Nations people from age 50. According to Australian Bureau of Statistics 2021 Census, of the 812,000 people who identified as being of Aboriginal and/or Torres Strait Islander origin, 18% were aged 50 and over (ABS 2021). First Nations people accounted for 1.7% of the 9.0 million Australians aged 50 and over (ABS 2021).

In practice, First Nations people 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. Delivering culturally appropriate aged care can improve access to, and the quality of, aged care for First Nations people. The National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) Program provides culturally appropriate care for First Nations people close to their communities, primarily in rural and remote areas.

For more information on First Nations people using aged care, see the Aboriginal and Torres Strait Islander people using aged care dashboard, or visit the First Nations people topic page on the AIHW website.

At 30 June 2024:

the proportion of First Nations people in the independent mobility category was higher than for non-Indigenous Australians (4.2% compared with 2.9%)
the proportion of First Nations people in the assisted mobility category was slightly lower than for non-Indigenous Australians (56% compared with 58%).

Figure 7: People living in permanent residential care by mobility category and Indigenous status, 30 June 2024

Permanent residential care needs for people from culturally and linguistically diverse backgrounds

Many older Australians were born overseas, speak a variety of languages, may not speak English fluently or have diverse cultural and religious practices. These groups of people are referred to as being culturally and linguistically diverse (CALD). Older CALD Australians may face additional barriers when engaging with aged care services and the supports they may require.

Cultural and linguistic factors may influence how people access and engage with aged care services, as well as how their needs are assessed while using aged care. Due to data availability, this section focuses on country of birth and preferred language as measures of cultural and linguistic diversity. According to Australian Bureau of Statistics 2021 Census, of the 4.4 million older Australians (people aged 65 and over), 35% were born overseas and 16% spoke languages other than English at home (ABS 2021).

At 30 June 2024:

the proportion of people born in non-English-speaking countries in the not mobile category was higher than for people born in Australia and people born in other mainly English-speaking counties (43% compared with 39% and 37%)
the proportion of people who preferred to speak language other than English in the not mobile category was higher than for people who preferred to speak English (46% compared with 39%).

Figure 8: People living in permanent residential care by mobility category and country of birth/preferred language, 30 June 2024

Permanent residential care needs by states and territories

The care needs of people living in permanent residential care vary across states and territories.

At 30 June 2024:

Victoria had the highest proportion of people in the independent mobility category (3.5%) while Tasmania had the lowest (2.1%)
Australian Capital Territory had the highest proportion of people in the assisted mobility category (61%) while Northern Territory had the lowest (51%)
Northern Territory had the highest proportion of people in the not mobile category (51%), while Western Australia had the lowest (36%).

Figure 9: People living in permanent residential care by mobility category and states and territories, 30 June 2024

Permanent residential care needs by remoteness areas

People’s care needs and access to aged care services are also impacted by how regional or remote the location where they live is and the types of aged care services available.

Most older people live in metropolitan areas. At 30 June 2024, 66% of the older Australians (aged 65 and over) lived in Metropolitan areas (MM 1), 9.5% lived in Regional centres (MM 2), 23% lived in Rural towns (MM 3–5) and only 1.5% lived in Remote or Very remote communities (MM 6–7). For more information on people using aged care by remoteness area, see People using aged care.

Most aged care services are located in metropolitan areas. It means that people living in remote areas may need to move to less remote areas to access higher-level aged care services. For more information on the distribution of aged care services, see Providers, services and places in aged care.

In this section, remoteness areas are based on the location of the residential care facility (service) from which care is delivered.

At 30 June 2024:

Rural towns (MM 3–5) and Remote and Very remote communities (MM 6–7) had higher proportions of people in the independent mobility category compared with Metropolitan areas (MM 1) and Regional centres (MM 2)
Very remote communities (MM 7) had the highest proportion of people in the assisted mobility category (67%) and Remote communities (MM 6) had the lowest (56%)
Metropolitan areas (MM 1) had the highest proportion of people in the not mobile category (40%), and the proportion of people in the not mobile category generally gradually decreased with increasing remoteness from Metropolitan areas (MM 1; 40%) to Small rural towns (MM 5; 35%).

Figure 10: People living in permanent residential care by mobility category and remoteness areas, 30 June 2024

Modified Monash Model

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. You can learn more about MMM on the Department of Health, Disability and Ageing website.

Care needs rating for permanent residential care (ACFI)

On 1 October 2022, the Australian National Aged Care Classification (AN-ACC) residential care funding model replaced the Aged Care Funding Instrument (ACFI).

The ACFI was a tool for assessing the care needs of people entering and living in permanent residential aged care between 2008 and 2022. The tool was 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 2 diagnostic sections used to assess how much assistance a person needs in a range of areas. The ACFI was not a comprehensive assessment but instead focused on factors that affect the cost of care. Needs were 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
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 and high.

The scores of the 12 questions determine the rating in each of the ACFI domains. The ratings across the ACFI domains then determines 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 Aged Care Funding Instrument (ACFI) User Guide on the Department of Health, Disability and Ageing website.

Permanent residential care needs over time (ACFI)

This section is based on ACFI to 30 June 2022 as there is insufficient new data to report on trends based on the AN-ACC. For more information on the ACFI, see the 'Care need ratings in permanent residential care (ACFI)' section.

The proportion of people assessed as having high care needs when they first enter permanent residential care has increased over time.

Trends over time for the 10 years from 2012–13 to 2021–22 indicate that:

high care need ratings when first entering permanent residential care have become more common for activities of daily living (from 36% to 58%) and cognition and behaviour (from 35% to 55%)
ratings for complex health care have fluctuated, reflecting changes to the rating method for complex health care that were introduced in January 2017
being assessed as having nil or low care need ratings became less common in all 3 domains:
- the largest decrease in nil care need ratings were for complex health care (from 11% to less than 1%)
- the largest decrease in low care need ratings were for activities of daily living (from 32% to 8.9%).

Figure 11: People living in permanent residential care by care domain and care need ratings, 2012–13 to 2021–22

Permanent residential care needs by dementia status (ACFI)

Dementia status of people in permanent residential care

The Aged Care Funding Instrument (ACFI) was a funding tool for assessing the care needs of people in permanent residential care. It included 2 diagnostic sections for health conditions that most affect the person’s care needs. The ACFI was used to report on the dementia status of people in permanent residential care.

In October 2022, the ACFI was replaced by the Australian National Aged Care Classification (AN-ACC) residential care funding model. The AN-ACC Assessment Tool focuses on the characteristics of people in residential care that drive care costs, including physical ability, cognitive ability, behaviour and mental health. However, the AN-ACC Assessment Tool does not collect diagnostic information on health conditions, including dementia.

As a result, the dementia status of people in permanent residential care is no longer reportable.

For information about the AN-ACC, view the AN-ACC funding model page on the Department of Health, Disability and Ageing website.

For information about dementia in Australia, view the dementia topic on the AIHW website.

This section is based on ACFI data to 30 June 2022 as the AN-ACC does not collect information about health conditions (including dementia). For more information on the ACFI, see the 'Care need ratings in permanent residential care (ACFI)' section.

People with dementia tend to have higher care needs than people without dementia. These differences are also reflected in care need ratings of people in permanent residential care, as assessed by the ACFI. To learn more about how dementia affects people in Australia, see the dementia topic on the AIHW website.

At 30 June 2022:

The majority of people with dementia (83%) and over half (51%) of people without dementia were assessed as having high care needs for cognition and behaviour.
The proportion of high care need ratings for activities of daily living was also greater among people with dementia (71% compared with 65%).
High care need ratings for complex health care were more common for people without dementia (60%) than with dementia (56%).

Figure 12: People living in permanent residential care by care domain, care need ratings and dementia status, 30 June 2022

Reference

ABS (Australian Bureau of Statistics) (2021) Snapshot of Australia, ABS, Australian Government, accessed 4 March 2025.

Where can I find out more?

Related information can be found on other GEN topic pages:

For a confidentialised unit record file (CURF) on this topic, view GEN data: People’s care needs in aged care.

Publications and data

View all publications

View all data