For many older Australians, the promise of government-funded home care is the ability to age safely, comfortably, and independently in their own homes. However, new research reveals a disconnect between the design of these support systems and the reality of the people relying on them.
A study published in The Australasian Journal on Ageing highlights that while programs are built on the ideal of consumer-directed care, many recipients feel overlooked, unheard, and burdened by a complex system that prioritises processes and administration over personalised support.
Researchers from Flinders University interviewed older adults across Australia to understand their experiences navigating home care funding, specifically how they prioritised essential services and managed their daily needs.
Feeling Like a Number
The findings point to a system where recipients often have to fight for basic services. Participants reported feeling dismissed when explaining their needs and expressed deep frustration over administration fees and unclear spending rules.
Lead author Caitlin Wyman, an Accredited Practising Dietitian and researcher at the Flinders Caring Futures Institute, noted the emotional toll this takes on older adults.
“Several participants described feeling like a number within the aged care system, and others spoke about the emotional toll of repeatedly having to advocate for their care needs,” Wyman said.
Dr Alison Yaxley, co-author and Flinders University researcher, reinforced this sentiment, noting that older people generally know exactly what support they need but face significant bureaucratic barriers to securing it.
“Participants wanted care that respected their preferences and allowed them to make decisions about their own wellbeing,” Dr Yaxley said.
The Impossible Trade-Offs
The strict limitations of home care budgets force many recipients into making difficult, and sometimes dangerous, trade-offs.
The study found that some older adults went without basic cleaning or personal care just to afford physiotherapy or transport to medical appointments. Others, fearing their requests would be rejected or delayed, avoided asking for help altogether, instead using their own limited funds to pay for essential items.
One of the most concerning areas of compromise was food and nutrition. Despite understanding the importance of eating well, many participants deprioritised their nutritional needs to stretch their budgets for more urgent medical care. Some reported relying on toast rather than preparing balanced meals due to mobility issues, fatigue, or the prohibitive cost of paying a support worker for meal preparation.
When pre-prepared meal services were utilised, recipients often found they did not meet dietary requirements, cultural preferences, or personal tastes—a problem compounded for those living in regional areas.
“Nutrition plays a crucial role in healthy ageing and should not be treated as optional,” Wyman said. “Our findings highlight a significant gap in the program’s capacity to support older people’s nutrition, a fundamental need that no one should be left to go without.”
The Path Forward
The research clearly indicates that when care is genuinely personalised and attentive, older adults feel significantly more secure and respected.
Participants who self-managed their packages often reported better outcomes, as they could select support workers who understood their specific routines. However, self-management requires time, confidence, and capability that not every older person possesses. The system, researchers argue, must work for everyone—not just those equipped to navigate its complexities.
While the Australian Government continues to reform aged care and transition toward new models of support, the core issues identified in this study remain highly relevant. True reform requires listening to the people the system is designed to serve.
“The voices of older Australians must guide improvements to our home care system, so it genuinely delivers person-centred care,” Wyman said. “Every older person deserves support that helps them to stay healthy, connected, and independent in their own home.”
Ritchelle is Content Team Manager at Akolade, producing stories for Australia's not-for-profit sector at Third Sector.
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