Across Australia, thousands of older people are living in hospital beds they no longer need. They are medically fit for discharge, yet stuck in limbo because there is simply nowhere else for them to go. A nationwide shortage of aged care beds, combined with delays in disability accommodation and home care reforms, has created one of the most pressing health and social challenges facing the country.
While the problem is visible in every state and territory, its human cost is perhaps best captured in the story of George and Petronella Davis in Queensland. George spends each day driving 100 kilometres to sit beside his wife, who is in hospital, not because she is medically unwell, but because no aged care home can take her. Petronella has rapidly progressing dementia and can no longer be cared for safely at home. Even so, she has now spent months waiting for a residential placement that may still be weeks or months away.
Their case is not unique. Queensland has more than 1,000 people occupying hospital beds while waiting for aged care or disability placements. Some patients have remained in hospital for 250 to 400 days. The state government estimates that long stay patients are costing its hospital system 2.5 million dollars a day, funding that could be redirected to emergency departments, surgery backlogs and chronic disease services if those beds were freed up.
In the Northern Territory, the scale of the problem is even more stark. Around 80 older Territorians are stranded in public hospitals at any given time, representing almost 10 per cent of the Territory’s entire bed stock. Many of these patients stay for more than six months, and some considerably longer. The Territory has the lowest ratio of residential aged care beds in the country and an acute shortage of culturally safe care for Aboriginal people, who often require residential care from age 50 onward due to higher rates of chronic illness. The result is a system under significant pressure, with bed block contributing to emergency department overcrowding and repeated Code Yellow events.
Similarly in Tasmania, more than 90 people have been medically cleared to leave hospital but cannot because aged care places or NDIS supports are unavailable. Some have remained in hospital for nearly half a year, costing the state more than 70 million dollars in twelve months and leaving already stretched hospitals with no capacity to manage surges in demand.
Nurses, social workers and hospital teams are describing unprecedented challenges in trying to place older people into residential care. One Brisbane nurse with three decades of experience said the system had deteriorated rapidly, forcing her to contact up to 176 facilities for a single patient. Many providers have closed their waiting lists entirely because they cannot safely take more residents under the current funding and staffing constraints. Others are prioritising people who can pay higher accommodation deposits, which leaves concessional and government supported residents at the back of the queue.
Families are worn down by the uncertainty. Some are being told that their loved one may remain in hospital for months or even years. Others are forced to accept placements hours away from home, making regular visits almost impossible and leaving older people isolated from their communities.
The causes of the crisis are complex but well recognised. Australia has an ageing population with rising rates of dementia and complex health needs. However, the supply of residential aged care beds has barely grown. Nationally, only 578 new beds were added in the last year despite annual demand requiring more than 10,000. Many aged care providers warn they cannot expand due to the financial strain of new regulatory requirements, increasing staffing costs and the need to improve safety and quality after the royal commission.
Under the new funding system, some providers are also prioritising residents who attract higher payments, which can unintentionally disadvantage people with dementia, behavioural needs or limited means. At the same time, NDIS delays are preventing many younger patients with disability from accessing community supports, leaving them stuck in inappropriate hospital settings for extended periods.
State and territory leaders have repeatedly called on the federal government to take greater responsibility for aged care capacity. Governments in Queensland, Tasmania and the Northern Territory have been vocal about the need for increased Commonwealth investment, stronger incentives to build new facilities and faster pathways for high needs residents. They argue that the hospital funding currently spent on long stay patients could be redirected to frontline care if the aged care sector had the capacity to accept those who no longer require acute treatment.
The federal government says negotiations on hospital and NDIS reforms are ongoing and has pointed to recent investments through aged care capital grants. However, health leaders warn that these measures are not keeping pace with demand. Some stakeholders argue that even the planned increase to 45 per cent federal hospital funding would still fall short of what state health systems require.
For families like the Davises, the debate about funding percentages and reform agreements does little to ease the immediate burden. George simply wants his wife to have somewhere safe and dignified to live. Others want assurance that their parents will not spend their final years in a hospital ward because no aged care home has a bed available.
What is unfolding across the country is not only a health system failure but a moral one. Older Australians who worked, raised families and contributed to their communities deserve more than a hospital bed and a waitlist. They deserve care that is timely, compassionate and suited to their needs.
Until aged care capacity expands, until funding and staffing stabilise, and until discharge pathways are rebuilt, thousands of seniors will remain stranded in hospitals. Their families will continue to carry the emotional and financial load, and state health systems will remain locked in crisis.
Australia can do better for its elders. The question is how long older people must wait before meaningful action is taken.
