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People's care needs in aged care

This page has been updated with the latest data available at 30 June 2017. You can download data directly from the visualisations by clicking in the graph area and using the 'download' menu.

As people age, their need for care changes. Each person’s needs are different and in Australia services are tailored so that each person receives the assistance they need. Care is generally provided through residential and community-based approaches—lower levels of care are delivered in a person’s home, and higher levels of care are provided in residential facilities.

31% of people in permanent residential care on 30 June 2017 had high care needs in all three care domains.
85% of people in permanent residential aged care on 30 June 2017 had at least one diagnosed mental health or behavioural condition.
47% of people in permanent residential aged care on 30 June 2017 had a diagnosis of depression.
52% of people in permanent residential aged care on 30 June 2017 had a diagnosis of dementia.

Home support provides care aimed at helping people manage independently at home for as long as possible. Around 1 in 5 people using home support reported having a disability and the most common type of service provided in 2016–17 was domestic assistance (37% of people received at least some help around the house), followed by allied health services (29% ). 

Home care provides similar services to help people remain at home, and also provides support for more complex care needs, including nursing and other clinical services. A coordinated package of care is provided at 4 different levels to suit the assessed care needs of the person. At 30 June 2017, around 1 in 10 people using home care were eligible for the dementia and cognition supplement, indicating they had moderate to severe levels of cognitive impairment associated with dementia or other conditions.

People in permanent residential care require assistance with most activities. Their needs are assessed through the Aged Care Funding Instrument (ACFI), an assessment tool which looks at three different areas of care—activities of daily living, cognition and behaviour, and complex health care.

A snapshot of the people who were in permanent residential aged care on 30 June 2017 shows that:

  • Almost all had a current ACFI assessment on their record—this was 177,589 people or 99.4% of all people in permanent residential aged care.  Around one-third (31%) of people had a high care need rating in all three of the ACFI assessment areas.

  • The majority (85%) of residents were diagnosed with at least one mental health or behavioural condition.
  • Depression was the most commonly diagnosed mental health condition (47%).
  • Dementia had been diagnosed in just over half of the residents (52%).
  • Women, people born in non-English speaking countries and people who prefer speaking a language other than English were more likely to have a ‘high’ rating across all three assessment areas.
  • The largest proportion of care needs rated as ‘high’ (63%) was in the cognition and behaviour assessment area. This can be seen in the graph below.
A stacked bar graph shows the proportion of people living in permanent residential care who have high, medium, low or nil care needs across the three care domains. The largest proportion of people with high care need ratings was in the cognition and behaviour domain (63%), followed by activities of daily living (57%) and then complex health care (55%). Cognition and behaviour also had the highest proportion of nil care need ratings, whereas activities of daily living had the lowest proportion of people with nil care need ratings.

What is the Aged Care Funding Instrument (ACFI)?

The ACFI is a tool used to assess and provide basic information on the care needs of a person in permanent residential aged care. The ratings—high, medium, low or nil—are used to allocate government funds to these facilities.  

The ACFI contains 12 questions used to assess how much help a person needs in nutrition, mobility, personal hygiene, toileting, continence, cognitive skills, wandering, verbal and physical behaviour, medication, depression and complex health care. These questions all relate to the three ACFI assessment areas (also called care domains). Responses to ACFI questions are rated on a scale of A to D and are used to determine the level of care a person needs. Mental health or behavioural diagnoses, along with other medical diagnoses, can be recorded but the ACFI is not designed to be a comprehensive assessment tool.

The ACFI is administered by the Department of Health and performed by a trained employee of the residential aged care provider. Funding on each of the ACFI domains is provided based on an individual’s rating. The sum of needs across the ACFI domains determines the amount of funding the residential provider receives per day per person in their care. ACFI reappraisal is undertaken as a person’s needs change. To find out more about the ACFI and subsidy amounts, please go to the Department of Health website.

In the next section you can explore more about how care needs have changed over time, the care need ratings for people with dementia, and care needs based on demographic factors such as age, sex, Indigenous status, language and country of birth.