Trends in Aged Care Services: some implications

Over the next 40 years, population ageing and growing diversity among older people — in terms of their care needs, preferences and affluence — are expected to pose a number of challenges to Australia's aged care system. These include:

• a significant increase in demand — those aged over 85 tend to be the main users of aged care services, and their numbers are expected to increase at least four-fold by 2047
• the changing pattern of disease among the aged is expected to increase the proportion of frail older people with more complex care needs
• an increased preference for independent living arrangements supported by community care, and a desire for greater autonomy and choice in aged care services generally
• many of the aged having higher levels of income and wealth with which to leverage services, although significant numbers — over three quarters of those of age pension age — will continue to be eligible for the age pension
• needing to secure a significant expansion in the aged care workforce at a time of 'aged induced' tightening of the labour market, accentuated by competing demands from the acute care sector.

The policy implications of these prospective challenges are broad ranging and complex. This study highlights several areas where further analysis seems called for to aid the development of an improved framework for aged care, including:

• assessing the potential for unbundling residential care (that is, accommodation, everyday living and personal care costs) to better reflect the underlying costs of these services and enable better targeting of public subsides to those most in need
• examining the current dual gate-keeping system and the scope to improve it by dispensing with the planning and allocation system (while retaining accreditation) and relying on the entitlement for aged care services established by aged care assessment teams
• considering the feasibility of introducing 'consumer-centred' care arrangements to enhance the potential for older people to influence the nature and scope of the services they receive
• looking at ways of improving responsiveness in aged care education and training arrangements and extending scopes of practice to overcome inefficiencies and inflexibilities in the workforce.