What the government’s changes to home care mean for ageing Australians

The Albanian government announced this week that it will introduce one of the biggest reforms so far in the Australian aged care sector.

The package includes an investment of A$4.3 billion in home care, currently calledSupport at home”, which will come into effect from July 2025. This reflects both the desire of many people to remain at home as they age and the Government’s desire to reduce the cost of residential care for older people.

What changes are the government making to home care packages? And what will these changes mean for ageing Australians?

Reducing waiting times

One of the main complaints about the current home care system is the long waiting times. Estimates suggest that there are Waiting time 6–12 months for higher home care packages 3 and 4. For people with the greatest needs this is definitely too long.

In March this year, approximately 45,000 people were waiting for any level of home care. An additional 14,000 people were already receiving the package, but at a lower level of home care than they were entitled to.

Thanks to the additional funds, the novel system will be support more participantsThe aim is to shorten the waiting time an average of three months from July 2027

Changes in services

The novel system will replace the current four levels of home care packages eight classifications Funding for services. During the assessment of participants, they will be assigned the most appropriate category. There is currently very little information about these classifications, but the idea is that they will provide more targeted services.

There will also be a range of short-term supports available. These include assistive technology (such as mobility aids) and home modifications. Some people will be able to access 12 weeks of restorative care – a more intensive programme designed to build function after injury or illness – as well as palliative care support.

The way in which different types of services are subsidized is also changing. Previously, the same means-tested co-contribution applied regardless of the type of service.

Under the novel system, services are classed as clinical care (such as physiotherapy or wound care), independence (such as aid with bathing or cooking) and daily living (such as gardening or home maintenance). The novel reforms will fully fund clinical services regardless of income, while independence and daily living services will attract co-contributions based on a means test.

For example, self-financed retiree would pay nothing out of pocket for physiotherapy, but would pay 50% for shower assistance and 80% for gardening costs. Someone on a full pension would also pay nothing for physiotherapy, but would pay 5% for shower assistance and 17.5% for gardening costs.

This is a positive change. Our research has previously shown a tendency for people using home care packages to choose daily living services such as gardening and cleaning and refusing clinical care services such as health care and nursing because these types of services are more steep.

These changes should raise the likelihood that older people will choose clinical and related care services, which will aid them remain fit and functional for longer.

Some challenges

For government reforms to deliver faster and better support in the country, a number of issues need to be addressed.

As people stay at home longer, we also see that people are weaker and have more health problems than in the past. This requires a different and more qualified home care staff.

Current home care staff consists mainly of personal care and home care workers, with a much smaller number of qualified nurses and healthcare workers.

However, as the profile of people receiving home care changes, there will need to be a greater focus on maintaining functional ability. This may mean that greater input from allied health services such as physiotherapists and occupational therapists will be required.

It is tough to find a suitably skilled workforce throughout the sector and almost impossible in other sectors. rural and remote areasAlternative models, such as training personal care workers to act as healthcare assistants and effectively using technologies such as telehealth, will be necessary to meet demand without compromising the quality of care.

One example of the need for upskilling in specific areas is dementia care. The majority of people living with dementia at home receive care from family carers, supported by home care workers. It is significant that these carers have the appropriate knowledge and skills specific to dementia.

However, research has shown that home care staff can lack of knowledge and skills provide the best care for people with dementia. Specialist dementia training for home care workers is effective in improving knowledge, attitudes and sense of competence in providing care. It should be implemented across the sector.

What about unpaid home care?

Unpaid caregivers, such as family members, provide significant amounts of care for the elderly. The value of this unpaid care is estimated to be in the billions. As older people stay at home longer, this amount is expected to raise even more.

However, caregivers with a high caregiving burden are particularly vulnerable to poor physical and mental healthWithout appropriate support, we may find that additional caregiving pressures can lead to the breakdown of caregiving relationships and increased other healthcare costs for both the caregiver and the care recipient.

We must therefore ensure that carers are adequately supported financially, psychologically and practically. However, the details of the reforms currently available do not suggest that this has been adequately addressed.

With careful implementation and ongoing evaluation, these reforms have the potential to significantly improve the home care system. However, their success will depend on addressing staffing issues, providing adequate support for unpaid carers and maintaining a focus on the holistic needs of older Australians.

More information about Support at Home can be found here available online.