Australia’s ageing population is facing mounting challenges within the aged care sector, as highlighted in a recent report from the Older Persons Advocacy Network (OPAN).
The findings reveal a system under severe strain, where residential facilities are turning away potential residents based on lifestyle factors such as smoking or excess weight, while home care services resort to intimidating debt collection methods that leave elderly individuals fearful and isolated.
These trends, coupled with prolonged hospital stays and inadequate support, underscore a deepening crisis that demands urgent reform.
Selective admissions
One of the most disturbing patterns identified by OPAN involves residential aged care homes implementing informal screening processes to exclude those they consider “high-risk” or challenging to manage.
Facilities, already operating near full capacity in many regions, are reportedly declining entry to applicants who smoke or carry extra weight, alongside those with conditions like mental health concerns or dementia. This selective approach contravenes the principles of equitable access, leaving many older Australians in limbo.
In extreme instances, individuals have faced repeated knockbacks across multiple providers. OPAN’s data points to cases where people waited months for placement, exacerbating bed-blocking in public hospitals and forcing interim solutions like temporary hotel accommodations at taxpayer expense.
For example, in South Australia, some patients ready for discharge have been relocated to upscale venues such as the Pullman Hotel in Adelaide, highlighting the desperation of an overburdened system.
Carolanne Barkla, chief executive of Aged Rights Advocacy in South Australia, described the situation as a “wicked problem”, noting that homes retain significant discretion in choosing residents, which has not aligned with rising demand. This mismatch in supply and need is pushing vulnerable people further from the support they require.
Aggressive tactics
Equally concerning are reports of home care package (HCP) providers outsourcing debt recovery to agencies that employ bullying strategies, often without first verifying bills or engaging directly with clients. These “scare tactics”, including threats of legal action or service cut-offs, have left seniors anxious and withdrawn from essential services, particularly as new co-payment arrangements loom.
OPAN’s analysis showed that many older people accrued debts unknowingly due to billing mistakes, with providers failing to conduct thorough reviews before escalating matters. In one documented scenario, a client racked up $4,000 in arrears without prior notice, prompting an abrupt halt to all care upon discovery. A subsequent invoice audit revealed widespread errors, allowing the individual to resume services only after significant distress.
Craig Gear, OPAN’s chief executive, emphasised the human cost, stating that more than 52,000 people sought assistance from the network in the past financial year, a nearly 20 per cent rise. According to The Daily Mail, Mr Gear remarked, “This is a stark reminder of how much work remains to be done to ensure some of the most vulnerable in the community are afforded adequate rights and protections.”
Real life case studies
OPAN’s report draws on firsthand accounts to illustrate the everyday failures within aged care. These narratives paint a picture of neglect, inefficiency, and a lack of empathy that compounds isolation for those in need.
One individual, enduring long-term mental health struggles, incontinence, and limited mobility after a year-long hospital stay, was turned away by 21 local facilities. The rejections stemmed from concerns over past suicidal thoughts and intricate care requirements, trapping the person in prolonged institutional limbo.
Dietary oversights emerged as another recurrent issue. A vegetarian resident endured substandard meals, such as meat-contaminated “vegetable soup” or repetitive coleslaw, with special requests like mushrooms resulting in token portions (a solitary item on the plate).
Mobility support also fell short. A wheelchair-bound client requiring 15 to 30 minutes of assistance to transfer to bed each night was allocated a rushed 5pm slot, then charged for double the actual time by their provider.
Medical mishaps added to the toll. In one facility, a general practitioner altered a patient’s pain relief schedule from every four hours to every six while the person slept, only to later confuse them with another resident during follow-up rounds.
Accessibility barriers further alienated users. Residents were directed to lodge complaints via QR codes in their rooms, despite widespread unfamiliarity with the technology among the group.
Families, too, encountered callous responses. Relatives of a frail newcomer to residential care were billed for extras like pay TV and alcohol (services the individual could scarcely utilise) and curtly advised to seek alternatives elsewhere if dissatisfied.
These stories, drawn from OPAN’s advocacy caseload, reflect broader systemic flaws, including flawed assessments under the new Single Assessment Service. Complaints indicated that remote evaluations overlooked critical needs, while assessors often lacked specialised knowledge, delivering misleading guidance.
Calla for reform amid Government promises
The federal government has acknowledged these pressures, attributing them to entrenched complexities in patient discharges and service pathways. Officials from the Department of Health, Disability and Ageing stressed ongoing reforms, including a delayed Aged Care Act set for November 1, which will enshrine rights statements and behavioural guidelines for providers.
Emphasis has been placed on accurate invoicing to prevent debt build-up, with options for financial hardship aid via Services Australia. Yet, as OPAN’s evidence suggests, these measures must translate into tangible safeguards to restore trust and dignity in a sector costing over $36 billion annually.
