The Dual Perspective: Valuing Older People vs. Fearing the Process
Australians tend to hold a nuanced, often contradictory, view of ageing. On one hand, a 2020 Royal Commission survey found that over 90% of Australians hold a positive perspective towards people aged 70 or older, believing they have value to society. This respect for seniors stands in contrast to a deep-seated fear of the physical and cognitive decline associated with the ageing process. Research indicates that Australians' greatest fears surrounding ageing are cognitive decline, followed by physical decline and the loss of independence. For many, the concept of 'old age' is a shifting horizon, one that older Australians feel is often misrepresented by younger generations.
This division in perspective highlights a societal challenge: while people respect the wisdom and experience that older people offer, there is a pervasive fear and negative portrayal of the physical and mental changes that come with age. Ageism is also a significant concern, with the Australian Human Rights Commission reporting that 90% of adults agree it exists in Australia. This is reflected in feelings of invisibility, discrimination, and negative stereotypes experienced by older Australians in various aspects of life, from the workplace to healthcare.
The Strong Preference for 'Ageing in Place'
Perhaps the most resounding opinion Australians hold is the desire to 'age in place,' or to remain in their own homes for as long as possible. A Royal Commission survey revealed that 80% of older Australians want to remain in their current home, and 62% want to receive care services there. The preference for home care has been steadily increasing, with government data showing a significant rise in the number of Home Care Packages utilised in recent years. This trend is a direct result of several factors:
- Fear of Residential Care: The community's perception of life in residential aged care is largely negative, driven by concerns over quality, safety, and well-being. High-profile issues exposed by the Royal Commission have solidified these anxieties.
- Independence and Familiarity: Staying at home allows older adults to maintain their independence, privacy, and connection to their communities, which is highly valued. In contrast, residential care is often seen as a last resort, associated with loss of control and forced relocation.
- Personalised Care: Many believe that personalised home care, with services tailored to individual needs, is a superior alternative to institutionalised care with its stricter routines and schedules.
- Financial Factors: For some, home care is a more cost-effective solution than expensive residential care, which also adds to its appeal.
Concerns with the Aged Care System: Knowledge and Cost
While most Australians want older people to be properly looked after, there is a widespread lack of awareness about how the aged care system works. The Royal Commission's findings highlighted that most people have very little knowledge of key government portals like My Aged Care or regulatory bodies like the Aged Care Quality and Safety Commission. This low level of awareness is a major obstacle to navigating the system effectively and may explain why governments have historically failed to address glaring problems.
Beyond knowledge gaps, financial anxiety is a dominant theme. Many Australians, particularly those under 55, express high levels of concern about the cost of aged care. The recent Aged Care Taskforce reviewed funding options, and while aiming for greater fairness, it indicated that consumers, especially those with higher assets, will likely pay more for their care and accommodation costs. For many, the financial burden of aged care is a significant source of worry, with concerns about whether they can afford quality care and how long their savings will last.
The Evolving Landscape of Aged Care Reforms
In response to the damning findings of the Royal Commission, the Australian government is implementing significant reforms to overhaul the aged care system. These changes, set to roll out in the coming years, aim to address many of the public's concerns and realign services with consumer expectations. Key reforms include:
- Strengthened Quality Standards: A new Aged Care Act (effective Nov 2025) introduces new standards focusing on person-centred care, dignity, safety, and respect, with robust governance and accountability frameworks.
- Enhanced Home Care: The new Support at Home program (from Nov 2025) will replace the Home Care Packages program to improve access to home modifications, equipment, and services.
- Improved Transparency: Measures are being introduced to enhance transparency regarding provider finances and quality ratings, with the goal of increasing choice for consumers.
- Workforce Improvement: Reforms address the need for a larger, better-trained workforce, including requirements for 24/7 onsite registered nurses in residential facilities.
Despite these efforts, some critics argue that the new funding models may disproportionately affect average Australians, shifting more financial responsibility to consumers. There are also lingering concerns about whether the reforms will sufficiently address the systemic workforce shortages and funding gaps that plague the sector.
Comparison of Aged Care Options
| Feature | Home Care | Residential Care |
|---|---|---|
| Public Preference | Strongly preferred | Viewed negatively |
| Autonomy & Independence | Maximised; people maintain control over their lives | Limited; schedules and routines are often strict |
| Familiarity & Community | People remain in their own homes and local networks | Requires moving and rebuilding social connections |
| Quality & Safety Perception | Perceived as safer and more comfortable | Significant concerns over quality, safety, and abuse |
| Cost Concerns | Worries about funding and financial planning exist | Often perceived as expensive, with concerns over affordability |
| Personalised Support | Tailored services for individual needs | Can be less personalised due to standardised care |
| Funding & Waiting Lists | Demand exceeds supply, leading to waiting lists | Entry sometimes occurs prematurely due to package shortages |
Conclusion: Looking Towards a Sustainable Future
What Australians think of ageing and aged care is a complex narrative. While there is respect for older individuals, there is also widespread fear of the age-related declines and anxiety regarding the care system. The clear preference for ageing in place, coupled with negative perceptions of residential facilities, highlights the disconnect between community desires and system realities. The ongoing reforms, driven by the Royal Commission's findings, represent a significant effort to improve standards, transparency, and consumer choice. However, systemic challenges related to funding, workforce shortages, and public awareness remain. A truly sustainable and equitable aged care system will require continued effort to align funding and workforce capacity with the high expectations and preferences of the Australian public.
For more information on the aged care reforms, you can visit the official My Aged Care website for updates.
