Systemic discrimination exposed by OPAN aged care report

A new report into the state of Australian aged care has revealed systemic abandonment of older people with complex care needs.

The Older Persons Advocacy Network (OPAN) annual National Aged Care Advocacy Program Presenting Issues Report highlights the most common complaints made by older people receiving or seeking access to aged care services in Australia.

Limited access to care services exacerbated by poor communication, ageism and targeted screening processes, and unreasonable wait times and financial exploitation, were among the top complaints received by OPAN in 2024-25.

The report warns that older people with complex needs are “falling through the cracks, having a poor quality of life and dying with pain that could have been managed, indignity and struggle at home, and/or in inappropriate long-stay hospital settings.”

“Poor communication and a lack of clear information in a format the older person can understand [...] is an abuse of older people’s right to be supported to make informed decisions about their aged care.”

OPAN CEO Craig Gear said the report serves as a “stark reminder” of the work left to be done within the sector.

“It is deeply concerning that the same issues keep surfacing year after year. Older people tell us they are still waiting too long for care, not getting clear information, and being excluded from decisions that affect their lives,” Mr Gear said.

The report also indicates that older people with disabilities, including psychosocial, dementia, and cognitive decline, are the most common diverse group seeking advocacy, yet they are often further disadvantaged by the very system meant to assist them.

Residential aged care providers are reportedly using respite care as a ‘screening’ mechanism, denying permanent places to individuals with high disability support needs. The report says some facilities now even require a short respite stay before considering an application, specifically targeting those with high behavioural support needs or complex interacting disabilities.

OPAN says this approach is a misinterpretation of the purpose of residential aged care, which should be to support those with the highest needs. Instead, these vulnerable individuals are falling through the cracks, experiencing poor quality of life, and often ending up in inappropriate long-stay hospital settings or dying at home without adequate support.

Providers have also been observed accepting multiple applications for a single room, ultimately selecting the person with the lowest care requirements.

In one instance revealed by the report, an older person living with long-term mental health issues, poor mobility, and incontinence needed residential aged care support, having spent 12 months in hospital with only 15 days at home.

A team of hospital social workers contacted a total of 21 residential aged care providers in the region, and all 21 declined the older person’s application. It was implied that the person's past suicidal ideation and complex care needs were deciding factors.

This issue also extends to Home Care Package providers, who are reportedly refusing individuals with specific disability needs, claiming they only have staff equipped for ‘low’ needs services such as domestic assistance.

“Home Care Packages continue to be a major area of concern for older Australians. The proportion of advocacy cases relating to them is two times higher than expected given that Home Care Package recipients comprise only 21 per cent of the total aged care population,” Mr Gear said.

What now?

The report concludes that recent key investments into aged care reform, including the Single Assessment System services and Support at Home, are “unlikely to address the systemic issues in aged care which lead to persistent human rights breaches,” and outlines 59 policy recommendations to “improve the aged care journey for older people”, of which over half (34) have been carried over from 2023 and 2024.

Key among these is the release of all 83,000 promised home care packages by June 2026, alongside provision for additional Support at Home places to meet the needs of over 200,000 waiting older Australians.

It recommends ending the rationing of care packages and publishing real-time information on waiting periods for assessment and service receipt. The Inspector-General of Aged Care is urged to review the Single Assessment System, and the Senate asked to inquire into the Support at Home Program's impact, particularly on older Australians with disability.

Finally, the report recommends the government urgently finalise its ICT systems to ensure providers are ready for the new Aged Care Act.

“Breaches of older people’s human rights across their aged care journey continued to be a dominant theme. Day-to-day breaches show that ageist and ableist attitudes persist throughout the system, which is unfair and unjust,” Mr Gear said.

“The new Aged Care Act on 1 November is an important new chapter and an opportune time to reflect on how the government and sector can work collaboratively to improve the quality of life for older Australians.”