On the one anniversary of her husband’s death in residential aged care, Jane (name changed for privacy) continues to fight for accountability in a system she believes has failed her and many others.
In early June 2024, a COVID-19 outbreak emerged in the residential care unit in Queensland where Jane’s husband – who was living with both dementia and Parkinson’s – resided, alongside seven other residents.
The outbreak resulted in a two-week lockdown, despite only one resident initially testing positive. This meant Jane’s husband was confined indoors and denied access to vital physiotherapy for his Parkinson’s. He even expressed feeling suicidal.
While staff maintained full use of personal protective equipment, a delay in COVID-19 boosters meant many residents were at higher risk of succumbing to the virus. Unfortunately, this included Jane’s husband. He passed away in late June 2024.
“The last few weeks of my husband’s life were less than they should have been,” Jane shared with HelloCare. His sudden and preventable loss left her wondering why it had to happen and who was responsible.
As a result, she filed an official complaint with the Aged Care Quality and Safety Commission about the facility’s use of environmental restraint in August 2024. The complaint also noted that facility management had denied using environmental restraint during a meeting with family members in June.
Overall, the use of physical restraint has decreased by almost four percentage points since the start of 2021, with it reportedly being used for 19.3% of residents at the end of 2024. Meanwhile, environmental restraint (classified as physical restraint exclusively through the use of a secure area) increased by two percentage points, impacting 15.1% of care recipients.
Worryingly, both restrictive practice statistics were at their lowest points at the start of 2023 and have increased over the last two years.
A spokesperson from Aged Care Justice, who chairs the organisation, said this is a cause for concern, particularly as the new Aged Care Act does not drastically change the governing rules. “The use of restrictive practices is a complex care practice that involves balancing the freedom and safety of aged care residents,” they said.
“We need to understand why inappropriate practices are being used to ensure the industry has the support to deliver care in accordance with the rights of residents. Ensuring residents’ rights and wellbeing are protected is crucial to protect trust in the aged care system.
A well-supported system means aged care providers are less likely to use inappropriate practices because they have the training, staff, and resources to care for residents appropriately,” they added.
The cost of inaction
Despite filing her complaint in August 2024 with the help of an advocacy organisation, Jane has seen little progress. The complaint was initially closed after six months.
Jane argued that the response didn’t address the use of environmental restraint, and in early 2025, she requested a review. Several months later, the provider asked for more time to provide evidence. As of July 2025, Jane is still waiting. The Commission has suggested she could contact the Commonwealth Ombudsman to make a further complaint.
“In the closure letter, the facility and the Commission confirmed that the doors were locked. Why hasn’t there been any consequence for the actions?” Jane asked. “Why can this have dragged on for so long? There has been no apology, no acceptable explanation to me for my loss. There is still no outcome of consequence regarding the circumstances in the weeks leading up to my husband’s death
I’m not hopeful that the system will provide that outcome. I followed the formal channels, but it won’t bring my husband back.”
Jane is aware of at least two other families who have filed similar complaints.
Rights-based care, or bureaucratic jargon?
One of Jane’s greatest concerns is the diluted nature of the new Aged Care Act, which may prevent providers from being held accountable if restraint is used inappropriately.
She has advocated for stronger measures, including the reinstatement of criminal penalties for providers who neglect or abuse residents and the introduction of an independent regulator with enforceable powers.
Under the new Aged Care Act, it remains unclear whether restrictive practices will be considered a serious breach or whether the retained civil penalties – such as fines of over $1 million – would actually reduce the use of inappropriate restrictive practices.
Anna Willis, Aged Care Justice Chief Executive Officer, acknowledged that managing restrictive practices in aged care settings can be extremely difficult where instances of aggression or high risk are found. However, because the misuse of restrictive practices is a human rights issue that may result in physical and mental harm, she warned providers that it may also be a breach of the law.
“The legislation supports the use of a restrictive practice only if it is used as a last resort to prevent harm and if consent is acquired from the resident themselves or from their substitute decision-maker, with exceptions for emergencies,” Ms Willis reinforced.
“The requirement of consent is complicated, as capacity to make decisions can fluctuate. The question becomes: Is the resident able to make decisions for themselves at this point in time? Would they consent to being restrained? Or, if they lack capacity, does their substitute decision-maker have authority to make decisions about restrictive practices? Are they making an informed decision?”
Questions like these need answers, but, as Jane’s experience shows, they are lacking. So where does the ownership lie?
The former Aged Care Minister, Anika Wells, has been replaced by Sam Rae and a new Assistant Minister, Rebecca White. Mark Butler will likely play a larger role in aged care reform moving forward, too. All three ministers will drive the rights-based, person-centred Aged Care Act. Arguably, their biggest task will be ensuring providers adhere to what those words mean.
“I don’t believe there are any more rights for older people. Buyer beware when you put your loved one into aged care, because they’re private enterprises, they’re businesses,” Jane expressed.
She, like many grassroots activists, is calling on the government to do more. This includes clamping down on providers causing harm and strengthening public systems like star ratings so they accurately represent instances of harm, resident risk, and provider wrongdoing.
For instance, despite being under an enforceable undertaking since December 2024, the facility where Jane’s husband died is still listed as a four-star provider on My Aged Care.
Jane believes any enforceable undertaking or similar penalty should result in the facility’s star rating dropping, with the provider then re-earning a higher rating by meeting a series of requirements.
Meanwhile, for leaders themselves, Jane’s message is unequivocal. “If you are the manager or CEO of a residential aged care facility, you need to know your industry and ensure you are doing the right thing. These are people, not pieces of equipment,” she said.
