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Explore people's care needs in aged care

This page has been updated with the latest data available at 30 June 2018. You can download data directly from the visualisations by clicking in the graph area and using the 'download' menu.

On this page you can explore more information, facts and figures about the care need ratings of people living in permanent residential aged care. You can filter the information in the graphs below to look at different data sub-sets.

High care need ratings are increasing over time

Since 2009, the proportion of people with a high care need has progressively increased on every ACFI care domain, except for a reduction in the number of people rated 'high' for complex health care since 2016. It is possible that the increase is due to a larger proportion of people entering residential aged care at a later age than in previous years (see Admissions into aged care).

In each year since 2009, cognition and behaviour had the largest proportion of people with needs rated as ‘high’, however the complex health care domain had the biggest increase in high care need ratings over this time—from 13% in 2009 to 61% in 2016, before dropping to 55% in 2017 and 53% in 2018. This drop reflects changes in the rating method for complex health care introduced in January 2017. You can learn more about these changes from the Department of Health.

A stacked bar graph shows a time series of care need ratings across the three care domains for people living in permanent residential care. The proportion of people with a high care need rating has increased for all domains between 2009 and 2018. Inversely, the proportion of people who reported nil or low care needs has decreased over time for each domain.

Care need ratings for cognition and behaviour decrease with age

Cognition and behaviour was the only care domain where ratings decreased with age. Among those aged 50–59 years, 73% had a high care need rating and this fell to 55% among those aged 100 years or older. In comparison, high care need ratings generally increased with age for activities of daily living and complex health care.

As people grow older they are more likely to require some level of care in activities of daily living. Less than 1% of people aged 90 or older were rated with a ‘nil’ care need for activities of daily living, whereas a higher proportion of people of the same age had a ‘nil’ care need rating on the cognition and behaviour and complex health care domains.
 

A stacked bar graph shows the relationship between age and the level of care need rating for people living in permanent residential care across each care domain. For both the activities of daily living and complex health care domains, the proportion of people who had a high care need rating increased with older age. Cognition and behaviour was the only domain for which the proportion of people with a high care need rating decreased with age.

Dementia increases high care need ratings

Cognition and behaviour had the highest proportion of people in permanent residential aged care rated with a 'high' care need (64%). This is likely to be because of the high proportion of people in permanent residential aged with dementia. While 81% of people with dementia were assessed with a high rating on the cognition and behaviour care domain, only 46% of people without dementia had a high care need rating for this domain. High care need ratings were also higher among people with dementia for activities of daily living (64% compared with 53%).  People with and without dementia had similar ratings for complex health care, 52% and 54%, respectively.

A stacked bar graph shows the care need ratings of people in permanent residential care by care domain and whether they have been diagnosed with dementia. People who had been diagnosed with dementia were more likely to have higher care needs for activities of daily living, and were twice as likely (81%) to have a high care need for cognition and behaviour compared to those without dementia (46%).

Cognition and behaviour is not always the area with largest high care need

Nationally, the cognition and behaviour domain has the largest proportion of people assessed with a high care need rating (64%), followed by activities of daily living (59%) and complex health care (53%). This trend was the same for both men and women. However, this pattern is not consistent across all states and territories, particularly in the smaller states as can be seen in the graph below:

  • Most of the larger populated states (New South Wales, Victoria, and Western Australia) follow the national pattern.
  • The Northern Territory had the most even split of high care ratings across the care domains, ranging from 54% for cognition and behaviour and activities of daily living to 51% for complex health care.
  • Complex health care had the largest high care need rating in South Australia (60%).

High care need ratings highest amongst women

Women have a slightly higher proportion of high care need ratings than men for activities of daily living (61% compared with 55%) and complex health care (55% compared with 50%), while cognition and behaviour was the same for men and women (64% each). Using the drop-down menu options in the graph below you can uncover some more interactions between state, sex, age and Indigenous status, such as:

  • Women had a larger proportion of high care need ratings than men on each care domain in every age group except cognition and behaviour, where men were slightly more likely to have a high care need rating in the 0–49 age group.
  • There were no clear patterns in ratings between Aboriginal and Torres Strait Islander people in care compared with non-Indigenous people.
     
A stacked bar graph shows the proportion of people in permanent residential care with a high, medium, low or nil care need rating across the three care domains. The graph allows this to be filtered by a number of characteristics, such as sex, age group, Indigenous status and state.

High care need ratings at first assessment have increased

People’s care need ratings for each ACFI domain are first assessed at entry into permanent residential aged care, and are reassessed throughout a person’s stay in residential care.

The proportion of people assessed as having a high care need on their first admission into permanent residential care has steadily increased for each domain since 2009.

  • Activities of daily living had the largest increase in high care need ratings over this time, from 29% of people with a high care need in 2009 to just over half (52%) of people entering permanent residential care in 2018.
  • Accordingly, the proportion of people with a ‘nil’ or ‘low’ care need rating has decreased over this period, with the largest decrease in nil ratings for complex health care (21% in 2009 to 0.6% in 2018) and the largest decrease in low ratings in activities of daily living (36% in 2009 to 14% in 2018).
A stacked bar graph shows a time series of care need ratings at first assessment for people entering permanent residential care. The proportion of people with a high care need rating at first assessment has increased for all domains between 2009 and 2018. Inversely, the proportion of people who had nil or low care needs at first assessment has decreased over time for each domain.

Care needs highest amongst people born in non-English speaking countries and people with a preferred language other than English

Some demographic factors, and combinations of factors, are more likely to be associated with a high care need rating than others. In particular:

  • High care needs were most prominent across all care domains amongst those who were born in non-English speaking countries and those who preferred speaking a language other than English. They were highest on the cognition and behaviour domain. Three quarters (74%) of people in permanent residential care who preferred to speak a language other than English had a high care need for cognition and behaviour, compared with 63% of English speakers. Those who were born in non-English speaking countries had higher care need ratings across all care domains than people born in other English-speaking countries and people born in Australia.
  • Women generally had a higher proportion of high care need ratings than men within language preference groups, country of birth groups, and age groups.

The graph below displays care need ratings against a number of demographic variables including state, sex, age, country of birth, and language.

A stacked bar graph shows the proportion of people in permanent residential care with a high, medium, low or nil care need rating across the three care domains. The graph allows this to be filtered by sex, age group, preferred language, country of birth and state.