Aged‑care homes failing on VAD access, report finds

A national report has found that most aged care providers are still failing to support older Australians’ access to voluntary assisted dying (VAD), despite the practice being legal in every state and the ACT and protected under federal aged care law.

Go Gentle Australia’s Voluntary Assisted Dying in Residential Aged Care Homes: A National Report Card reveals widespread gaps in transparency, policy and practical support. An astonishing 73 per cent of major providers are either not offering VAD access or failing to publish clear information about it. Two‑thirds are not providing public information at all, and only 10 per cent offer comprehensive guidance and full access.

These findings raise serious questions about whether providers are meeting their obligations under the Aged Care Act 2024 and guidance from the Aged Care Quality and Safety Commission, which states that older people in residential aged care retain the right to access VAD and must not be disadvantaged because of where they live.

“Sadly, this report shows the system is failing older Australians,” Go Gentle Australia chief Dr Linda Swan said.

“People entering aged care need to know which health services will be available for them and they need to know that their end‑of‑life choices will be respected and supported.”

The updated report, which for the first time names individual providers, assessed 70 organisations covering 130,000 aged care beds (around two‑thirds of national residential aged care capacity). It found that most providers have been slow to respond to the introduction of VAD, even though more than 14,000 Australians have applied to use the scheme since 2019, with demand continuing to rise.

The median age of VAD applicants is 74, and most are already receiving palliative care. Go Gentle Australia said this highlights the need for aged care homes to provide clear, accessible information before a resident chooses a facility.

“Throughout this research, we asked: ‘What does the experience of trying to access VAD look like from an older person’s point of view?’” Dr Swan said.

“For too many institutions, the experience is woefully inadequate.”

The Older Persons Advocacy Network (OPAN) contributed the report’s foreword, emphasising how the lack of transparency leaves residents entering aged care without knowing if their end‑of‑life decisions will be respected.

“This situation cannot continue,” OPAN CEO Craig Gear said.

“It should be self‑evident that all of us – no matter where we live – are entitled to choose the end‑of‑life care that is right for us. Where legal, this includes voluntary assisted dying.”

Mr Gear said aged care facilities can object to participating in VAD, but they cannot deny residents access to information or to the health professionals who can support them. He warned that unclear policies, limited access to VAD Care Navigator Services, and restrictions on telehealth create additional barriers for residents who might already be frail or distressed.

Research cited in the report, conducted by Professors Ben White and Lindy Willmott from QUT’s Australian Centre for Health Law Research, found that restrictive provider policies can cause significant harm to dying people and their families in these facilities.

Interviews with Victorian VAD patients and caregivers revealed three major issues arise when information isn’t clear:

• Delays in accessing VAD, including when providers block access to VAD clinicians or require residents to leave the facility to receive medication
• Reduced choice, with some residents transferred to unfamiliar hospitals or sent home to die in places that were not their preference
• Emotional distress, including fear of missing out on VAD, or feeling they were doing something wrong because of institutional stigma.

Staff were also affected, with some reporting frustration that they were prevented from supporting VAD despite having done so in previous workplaces.

Providers’ obligations under federal law

The Aged Care Act 2024 sets out a Statement of Rights guaranteeing older people’s ability to exercise choice, receive safe and equitable treatment, and access end‑of‑life care.

The Aged Care Quality and Safety Commission’s guidance makes clear that:

• Residents must not be disadvantaged if they seek VAD
• Providers must support access to medical services, including VAD
• Care must continue regardless of a resident’s VAD choice
• VAD cannot be used as a reason to ask a resident to leave.

Providers are also expected to have clear policies, staff training, and processes to protect privacy and dignity.

Five recommendations for reform

The report recommends improving VAD access and transparency by:

1. Enforcing provider obligations under the Aged Care Act as a condition of registration
2. Ensuring complaints about VAD access are addressed promptly, with investigations for repeated issues
3. Introducing state‑level obligations, including mandatory VAD policies, a duty to connect residents with VAD Care Navigator Services, and penalties for non‑compliance
4. Improving public awareness of VAD rights through health information providers and consumer groups
5. Requiring all providers to publish a VAD policy, with clear procedures, staff training and accessible online information

Go Gentle has also released a consumer guide and searchable online tool to help older people compare providers and understand their rights.

OPAN said the report marks a turning point for the sector as it undergoes major reform.

“Providers now have a clear opportunity – and responsibility – to embed older people’s rights into everyday practice and help drive meaningful change,” it said.

Dr Swan said the goal is not to shame providers but to ensure older Australians receive the dignity, clarity and support they are entitled to at the end of life.

“People at the end of life don’t have time for long back‑and‑forth with aged care homes,” she said.

“These tools give people the information they need, when they need it, in plain language.”