A single shower. A $200 bill.
That is the reality one family says they are facing under Australia’s aged care system, as providers transition from Home Care Packages to the new Support at Home program.
The post, shared in the 17,000 member Facebook group Aged Care At Home Forum Australia, has struck a nerve with home care workers, care partners and older Australians across the country.
The woman’s mother is on a Level 4 Home Care Package, historically the highest level of support under the old system. She requires assistance with showering. The visit takes about an hour. But the provider charges a two hour minimum engagement, resulting in a $200 deduction from her package for each shower.
The family says the result is simple. Funds disappear faster. Other supports get squeezed. Dignity gets compromised.
And they are not alone.
Many commenters pointed to the SCHADS Award, the industrial agreement that sets minimum employment conditions for social and community services workers. Under that award, employees generally must be paid for a minimum two hour shift.
Providers argue that this is not optional. If a worker is rostered for a single short visit and there are no other clients immediately before or after, the employer must still pay them for two hours.
But here is where it gets murky.
Numerous frontline workers in the comments stated that they are rostered for full day shifts and visit multiple clients for 30, 45 or 60 minute services. Clients, they say, are billed only for the actual time delivered.
One worker wrote that she regularly completes eight or nine visits in a ten hour day, including 15 minute medication prompts and 30 minute showers. Another said their organisation charges in 15 minute increments. Others reported 30 minute minimums.
Which raises the uncomfortable question: when a client is billed two hours for a one hour service, where exactly is the extra money going?
Providers insist it covers award compliance, travel time, rostering gaps and business sustainability. Critics argue it is a blunt policy that shifts business risk onto frail older Australians.
Since November, the aged care landscape has been shifting to the new Support at Home model. Instead of four Home Care Package levels, there are now eight classifications. Level 8 is the highest under the new framework.
There is also a stronger move towards co contributions based on income and assets. Under Support at Home, many participants are required to pay a percentage of the service cost, meaning the higher the provider’s charge, the higher the out of pocket contribution.
Several commenters said they are already paying hundreds per month out of pocket. One woman said she paid $221 for her mother’s weekly services despite being on a Level 4 equivalent package. Another described paying $224 while personally showering her wheelchair bound husband five times a week because the maths no longer made sense.
The government argues the reforms are about sustainability and fairness, particularly ensuring wealthier retirees contribute more. But families on the ground say the transition has created confusion, reduced purchasing power and higher visible prices.
One commenter summed it up bluntly: “The new era of aged care is user pays.”
Beyond the two hour minimum debate, the thread exposed wider frustration about provider costs.
Claims included:
$1,500 charged for a five minute assessment about a tilt chair
Administration fees running into tens of thousands per year
Cleaning rates of $134 per hour through some council linked providers
Workers paid around $30 to $35 per hour while clients are charged $100 to $112 or more
Some of these figures vary by state and provider, and not all are independently verified. But the perception problem is undeniable.
When families see a support worker earning around $34 per hour and the provider charging $100 plus, trust erodes quickly.
The government caps care management and package management fees under aged care legislation, but under Support at Home the pricing structures are changing again. Greater transparency has been promised, including clearer unit pricing. Whether that delivers real downward pressure on costs remains to be seen.
A large portion of commenters advised self management. Platforms such as Mable and other brokerage models allow families to directly engage independent support workers, often at $50 to $80 per hour plus platform fees.
Supporters say it delivers better value, continuity and flexibility. Critics warn it can create inconsistency, administrative burden and workforce instability.
There is also the uncomfortable reality that not every 87 year old with arthritis has an adult child capable of navigating contracts, compliance and payroll.
As one worker noted, having industry knowledge makes the system “marginally less confusing”. That is hardly reassuring.
At the centre of this debate is a structural question.
If industrial law requires a two-hour minimum shift, should the financial risk of rostering inefficiencies sit with:
The provider
The worker
Or the older person receiving care
Many providers say they cannot operate at a loss. Advocates argue that billing two hours for one hour of delivered care effectively drains publicly funded packages and reduces frontline support.
In practical terms, families are being told to “use the other hour”. Get the worker to vacuum. Hang out washing. Make breakfast.
That may work in some cases. But it does not address the principle at stake.
A shower is not a luxury. It is basic personal care.
When a Level 4 package worth over $60,000 per year under the old system cannot comfortably absorb regular one hour showers without funding pressure, something is misaligned.
Australia’s aged care system has already been through a Royal Commission that exposed neglect, underfunding and structural failure. Billions have been injected since.
Yet here we are debating whether an elderly woman can afford a shower from her own package.
Some commenters urged families to complain to the Aged Care Quality and Safety Commission. Others recommended contacting MPs or contributing to the Senate inquiry into Support at Home. A few defended providers, warning that without viable business models there will be no services at all.
All of those perspectives can be true at once.
But this much is clear. When older Australians and their families look at a $200 charge for a one hour shower and feel ripped off, confidence in the system collapses.
Support at Home was meant to simplify, strengthen and future proof aged care. Instead, for many, it has amplified anxiety about value, transparency and fairness.
Aged care is not just another service industry. It is the final safety net for people who have paid taxes for decades.
If that net now comes with a $200 minimum for a shower, it is reasonable to ask whether we have lost sight of what the system is supposed to be for.
