Answering 12 main issues troubling families and people using aged care services
When change comes there is always concern about what happens - people tell you different things and advice can differ. The new Aged Care Act came into being last Saturday (1 November). In this article, we detail what has changed and what remains the same.
1. Accessing the aged care system
Firstly, to plan for future aged care and end-of-life care make an appointment with your GP and your solicitor, as has always been recommended. When the time comes for aged care, if unplanned it can be chaotic and a stressful time for everyone. It is highly advisable to plan ahead.
Things to discuss with your GP include making a referral to My Aged Care for an assessment for aged care services and making an advance care directive to guide medical practitioners about your medical treatment and end-of-life care wishes.
Things to discuss with your lawyer include appointing substitute decision makers for personal, medical and financial matters. These are variously termed Enduring Power of Attorney or Enduring Guardian, depending on which state or territory you live in.
Appoint someone you trust, who will involve you in decision making, make sure your will and preferences are up-to-date. If no family member or close friend fits the bill, you can appoint a private professional, or a public trustee.
You should also think about who you would like as a Registered Supporter.
It is always best to register with My Aged Care as soon as possible, as it can take some time before receiving an assessment or approval for aged care services. The Australian Government’s Senate Estimates were given figures last month that show at the end of September there were 121,909 older Australians on the waiting list for home care, and 116,000 waiting for an assessment.
For those who had a home care package, the ‘no worse off’ principle applies to older people who were registered with My Aged Care, already receiving a home care package, or assessed, approved and waiting for a package as of 12 September 2024 (when the Aged Care Bill was tabled in parliament). For residential aged care, the ‘no worse off principle’ applies to anyone who entered residential aged care before 1 November 2025.
2. Fees and charges
If people are unable to afford to pay contributions towards the cost of their aged care, financial hardship assistance is available. To be eligible, you must have assets valued at less than $44,811 and have not gifted more than $10,000 in the last 12 months or $30,000 over five years.
Services Australia will check to see how much income you have left after you have paid all your essential expenses. If you do not have more than 15% of the basic age pension amount (or $157.70 per fortnight) left after you have paid your essential expenses, you may be eligible for financial hardship assistance.
The service list for the Support at Home program has been developed to provide the types of services that evidence shows support older people to stay at home for longer and delay or avoid entry into residential aged care. It aims to provide clearer guidance on what aged care funding can be used for, compared to what is available under other government funded programs or what is considered a general expense the individual is responsible for. This was a recommendation of the Aged Care Taskforce to improve the targeting of public expenditure on aged care services and reduce uncertainty over what can and cannot be funded. There are also rules about what is and is not funded in residential aged care. For example, prescribed medicines and transport are paid for by the individual.
3. What will the RAD be under the new system?
The amount of refundable accommodation deposit (RAD) paid is by agreement between the older person and the provider and depends on things like the location of the aged care home, the size of the room and the quality of the fittings and fixtures.
Government regulates the maximum amount that a provider can charge for a RAD without getting special approval from Independent Health and Aged Care Pricing Authority (IHACPA). As of 1 July 2025, this is $758,627. The Weekly SOURCE reported in August, 36% of aged care homes have increased the RAD beyond $550K, the former limit.
Government also regulates the maximum amount that can be charged if you pay a Daily Accommodation Payment (DAP). If you enter residential aged care from 1 November 2025, the provider can deduct 2% of the RAD for each year you stay, up to a maximum of 10%. This is intended to help fund renovations and refurbishment to maintain and improve aged care accommodation.
The balance of the RAD is returned to you, or your estate when you leave. This must be explained to you and/or your family in detail before you enter the aged care home.
4. Will the new aged care reforms protect older people from financial hardship when accessing services?
As stated above, if people are unable to afford to pay contributions towards their care, financial hardship assistance is available. To be eligible, you must have assets valued at less than $44,811.00 and have not gifted more than $10,000 in the last 12 months or $30,000 over five years.
Services Australia will check to see how much income you have left after you have paid all your essential expenses. If you do not have more than 15% of the basic age pension amount (or $157.70 per fortnight) left after you have paid your essential expenses, you may be eligible for financial hardship assistance.
5. Rights-based act – what will the reality be?
There will be a legislated review of the new Act after the first three years of implementation.
The terms of reference will include:
• the operation of the Statement of Rights and the Statement of Principles;
• the effectiveness of the Act in delivering the objects, including enabling individuals to exercise choice and control;
• the effectiveness of the Act in embedding the role of supporters in the aged care system;
• the extent of unmet demand for funded aged care services in a home or community setting;
• the duration of waiting periods from application to service commencement for funded aged care services in a home or community setting;
• the expansion of regular reporting on the duration of waiting periods for funded aged care services to cover specialist aged care programs.
6. What is the ‘grandfathering’ provision for existing care recipients?
The no worse off principle applies to older people who were approved for, waiting for or receiving a home care package on 12 September 2024 and for all older people in residential aged care before 1 November 2025.
7. Who is going to regulate the new Act?
The new Aged Care Act is governed by the Department of Health, Disability and Ageing and regulated by the Aged Care Quality and Safety Commission. They will each have new powers to improve provider accountability for how government funding and older people’s money is spent on delivering safe, quality care in accordance with the Statement of Rights.
8. Families have to accept that people living with dementia still have the right to make decisions about their care
A diagnosis of dementia does not automatically mean that someone has lost all decision-making ability. Most families do recognise that although a person living with dementia may need support to make major life decisions such as where to live, they are still able to make day-to-day decisions about their life and care.
It is important that people who are registered as an aged care supporter for a person living with dementia also have access to support, such as information on why people have the right to supported decision-making and the best ways to support someone with decision-making. It should also be recognised that providing support for decision-making can be time consuming and emotionally draining and supporters should have access to counselling and other supports to be able to continue to provide effective decision-making support to a person living with dementia. Contact the National Dementia Helpline on 1800 100 500 for assistance.
9. Will aged care services improve?
Having the rights of older people respected is at the centre of the new Act and fundamental to improving the system. These reforms seek to empower older people, improve their quality of life, and ensure they receive the care they need in the setting of their choice.
Replacing representatives with registered supporters means older people are presumed to be able to make their own aged care decisions and have access to support if they want and need it. Independent aged care advocates are authorised and empowered under the Act to help protect older people’s rights.
The Act aims to improve provider accountability and strengthen the regulatory framework to ensure quality and safety standards are met. Information about the finances and operations of aged care providers is being published to enhance transparency and accountability.
The Support at Home program provides enhanced access to services, equipment, home modifications, restorative care and end-of-life care, enabling older people to remain in their homes longer.
In residential aged care, mandatory care minutes and 24/7 registered nurse availability, aim to ensure residents receive adequate clinical and personal care. Improved food and dining regulations are trying to address food-related concerns. Aged care workers have received pay rises and improved access to training to attract and retain a skilled workforce.
10. Support at Home, Home Care Packages and Commonwealth Home Support Programme
What does “no worse off” mean for packages carried forward from My Aged Care?
The no worse off principle ensures that older people receiving aged care services before the Act was tabled in parliament or commences will not be financially disadvantaged by the changes. Older people already in residential aged care will continue to have their fees assessed under the existing rules. Older people transitioning from Home Care Packages to the new Support at Home program will maintain their existing funding levels and any unspent funds.
The no worse off principle will continue to apply even if re-assessed and allocated a higher funding classification under the Support at Home program, or entering residential aged care.
From 1 November 2025, all Commonwealth Home Support Program (CHSP) clients need to be registered with My Aged Care and have an assessment to access CHSP services. There will also be changes to eligibility for the CHSP from this date.
11. Continence pads – who pays for them?
When Home Care Package recipients transition to the Support at Home program, disposable continence products can be funded as ‘nursing care consumables’ under the clinical care service category and reusable continence products can be funded as independence supports under the assistive technology and home modifications scheme.
People who get government funded home care whose support plan includes continence products are not eligible for the separate Continence Aids Payment Scheme (CAPS) of $717.10 per year. Call the National Continence Helpline on 1800 33 00 66 for advice.
12. How will the changes affect family, friends and carers? What support is available?
The new Act says aged care needs assessments should include family and friend carers with the consent of the older person. This can help to ensure that the need for respite care and other supports that assist carers are identified and included in the support plan.
Home and community-based respite care and overnight cottage respite care is available through the Commonwealth Home Support Program (CHSP) and the Support at Home program. Residential respite care is also available, but not at all aged care homes. Carers can also access emergency respite care and carer support independently of the aged care system through Carer Gateway. Contact Carer Gateway on 1800 422 737
