As Australia stands on the cusp of implementing its new Aged Care Act, many in the sector are questioning whether this long-awaited reform truly delivers the innovation older Australians deserve.
Despite promises of modernisation, accountability and improved quality of care, the Act lacks meaningful strategies to tackle one of the most pressing issues facing our ageing population: loneliness and social isolation.
What makes this shortfall especially frustrating is that the solutions already exist. Across the globe, governments are pioneering imaginative approaches that weave social inclusion into the fabric of care, from Japan’s community-based models and Denmark’s co-housing networks to Singapore’s housing incentives that keep families close.
These examples prove that loneliness can be addressed through thoughtful design and policy. Yet Australia’s new framework offers little to encourage similar innovation. Instead, the contentious Support at Home program, with its co-payment structure, risks creating additional barriers for those most in need, potentially deepening isolation rather than alleviating it.
Singapore’s proximity housing grant
One of the most pragmatic approaches comes from Singapore, where the Proximity Housing Grant (PHG) exemplifies how government incentives can strengthen intergenerational ties.
Introduced in 2015 and revised in 2024, the PHG provides financial subsidies of up to SGD 30,000 for families and SGD 20,000 for singles to encourage adult children to purchase resale flats within four kilometres of their parents’ or child’s home, or even to live together.
This isn’t a mere subsidy; it’s a deliberate policy to combat isolation by promoting proximity, enabling easier caregiving and emotional support.
The impact on seniors is profound. Studies show that closer family living reduces loneliness and improves health outcomes, with one analysis indicating that residential proximity correlates with lower modifiable dementia risks among older adults.
In Singapore’s high-density urban environment, where space is at a premium, the PHG has facilitated over 10,000 grants since its inception, helping seniors maintain active roles in family life.
Beyond the PHG, Singapore’s “state familism” includes schemes like the Multi-Generation Priority Scheme for housing allocation, prioritising three-generation families. These policies reflect a cultural emphasis on filial responsibility, adapted to modern realities where dual-income households predominate.
For Australia, where urban sprawl often separates generations, a similar grant could incentivise co-location in regional areas or suburbs. Imagine rebates for granny flats or priority housing access for families living near seniors, ideas that could alleviate the caregiving crunch without overburdening working adults.
Japan’s community-based integrated care
Japan, facing the world’s oldest population, has pioneered a comprehensive system to prevent senior isolation.
Since 2000, its long-term care insurance (LTCI) covers not just medical needs but social participation, funding community centres, volunteer befriending, and preventive programs like exercise classes and hobby groups. The “Community-Based Integrated Care System” emphasises “ageing in place”, with local governments coordinating services to keep seniors connected.
A standout initiative is the Iki-Iki Hyaku-Sai Taiso (Lively 100-Year-Old Exercise), a nationwide program combining physical activity with social gatherings, reducing isolation by fostering peer networks.
In rural areas, “Silver Human Resource Centres” employ seniors in part-time roles, providing income and purpose while integrating them into community life. These efforts have lowered loneliness rates, with one study showing improved mental health among participants.
Japan’s model highlights the power of public-private partnerships. For instance, tech integrations like robotic companions and AI monitoring devices supplement human interaction, addressing caregiver shortages.
Australia’s vast geography could adapt this through expanded community hubs in regional towns, funded via the new Act, to mirror Japan’s success in turning ageing into an opportunity for communal vitality.
Denmark’s senior co-housing
In Denmark, senior co-housing represents a grassroots revolution against isolation. These intentional communities, popular since the 1980s, house 20–50 residents in private units clustered around shared spaces like kitchens and gardens, promoting mutual support and socialising.
With over 250 such communities, Denmark boasts waiting lists in the thousands, as seniors seek autonomy with companionship.
The model reduces loneliness by design: residents share meals, organise events, and provide informal care, lowering healthcare costs by up to 20% through preventive social engagement. Philanthropic groups like Realdania fund developments, estimating 80,000 seniors interested in this lifestyle.
Intergenerational variants mix ages, enriching interactions; a concept echoed in Norway’s Vindmøllebakken project, where shared facilities foster cross-generational bonds.
Australia could pilot co-housing in suburbs like Melbourne’s outer rings, offering tax incentives for developers and integrating it with Support at Home to create supportive, cost-effective environments.
Netherlands’ dementia villages
The Netherlands’ Hogeweyk Dementia Village, opened in 2009, is a radical innovation: a gated community mimicking a normal town, with shops, restaurants, and theatres staffed by caregivers in plain clothes. Housing 152 residents with severe dementia, it prioritises normalcy over institutionalisation, reducing agitation and medication needs by encouraging social roles.
This “dementia village” model has inspired global replicas, proving that environment shapes wellbeing. Residents wander safely, shop with fake currency, and engage in community events, combating isolation through simulated independence. Evaluations show improved quality of life, though equity concerns arise for non-affluent groups.
For Australia, where dementia affects over 400,000 seniors, scaled-down villages in regional areas could integrate with the Aged Care Act, blending care with community to humanise support.
Sweden’s tech-driven solutions and China’s legal mandates
Sweden leverages technology to bridge gaps, with programs like digital intergenerational matching and AI companions reducing loneliness amid COVID-19. Initiatives such as Memory Lane use voice assistants for reminiscence therapy, fostering connections remotely.
Similarly, South Korea’s long-term care insurance provides home visits and meal services, supporting 10 million seniors with community-integrated policies.
In China, filial piety laws mandate adult children visit and support parents, enforceable by courts, reinforcing cultural norms amid rapid urbanisation. While controversial, they ensure emotional and financial aid, supplemented by community centres.
Italy’s Long Live the Elderly! program builds networks for at-risk seniors, offering home visits and social events to combat isolation. In the USA, DOROT’s friendly visiting pairs volunteers with seniors, while engAGED hubs curate innovative interventions.
These varied approaches — tech, legal, and communal — offer Australia a toolkit. Integrating apps for virtual befriending or mandating family support checks could enhance the Support at Home program.
Charting a connected future for Australian seniors
As the Aged Care Act dawns, Australia has a golden opportunity to innovate beyond co-payments and compliance. Around the world, we see powerful examples of how to keep older people connected, from Singapore’s family housing grants to Japan’s community-based care and Denmark’s co-housing revolution.
Yet rather than learning from these proven successes, our government has chosen to take the narrowest path forward. By rejecting Royal Commission recommendations for sustainable public funding, and embracing co-payments that shift the burden onto older Australians, we risk creating a system where connection becomes a privilege, not a right.
If Australia is to truly value its elders, it must look outward and be bold enough to adapt global best practice, rather than settling for policies that patch cracks while the foundations weaken beneath them.
