Imagine an 82-year-old woman living with dementia who has not spoken in weeks. One morning, her usual carer gently brushes her hair, hums her favourite 1960s song, and notices a subtle change in her breathing. That small observation leads to early medical intervention and ultimately saves her from a serious infection.
This kind of quiet expertise happens every day in Australia’s aged care homes. It is delivered primarily by personal care workers (also known as Aged Care Employees – Direct Care, or PCWs), who provide the vast majority of hands-on, person-centred care.
Yet these essential workers are too often treated as interchangeable, low-skilled labour rather than the skilled professionals they are.
Jacinta Coulston, a former nurse and clinical case manager who is currently the Care Concierge at Care & Co Match, has seen the reality up close.
“They spend the majority of time with the residents,” she says. “The bulk of Australian seniors are cared for by these people, and they are treated like an afterthought.”
Caring for older residents is physically demanding and emotionally taxing. Workers assist with showers, transfers, continence care, meals, and mobility while managing complex needs such as dementia and behavioural issues. Shifts involve constant bending, lifting, and emotional labour.
Many personal care workers come from overseas backgrounds where English is a second language. They often support family members back home while paying Australian rent. Most work casually across multiple facilities to secure enough hours, meaning they miss out on paid sick leave, annual leave, and job security. This forces them to work even when unwell, putting vulnerable residents at increased risk of infection or other harm.
“They are underpaid for what they do,” Coulston notes.
When system problems arise, such as during COVID-19 when casual staff moved between sites, carers are often scapegoated. The consequences include chronic shortages, high turnover, inconsistent care, and lost institutional knowledge.
Governments talk about building more beds, but without a stable, skilled carer workforce, those beds cannot deliver quality care.
Recent Fair Work Commission decisions have delivered welcome wage increases and a new six-level classification structure for direct care workers under the Aged Care Award, effective from 1 January 2025, with further adjustments to follow.
The new levels are:
These changes provide a strong foundation with higher minimum rates. However, Coulston stresses that true professionalisation requires more than minimum award progression. Entry-level classifications should not define the career. Qualified personal care workers need meaningful grading, ongoing education, and clear opportunities for advancement.
“We have got to give them the ability for a carer to be a career,” she argues.
“There has to be proper support and recognition. The longer they stay and develop skills, the more their wage and role should reflect that. It is an incentive to do what is a really hard job.”
Coulston advocates for:
“Why aren’t we saying we are going to support you and support the University of Tasmania, which has wonderful online services? Actually give them continued, meaningful education and career progression.”
In one retirement village, Coulston and management identified an exceptional male carer in his 30s. Supporting a wife, three children, and family overseas, he brought remarkable skill, gentleness, and initiative while informally coordinating and mentoring colleagues.
“We were like, well, how can we keep someone like this? How do we give him an incentive to mentor others?”
They created a higher-paid position to formally recognise his abilities. The role boosted retention and improved team capability until a company takeover led to its removal.
Stories like this show the potential of intentional workforce strategies and the loss when exceptional workers burn out or leave for better opportunities.
Professionalising the role delivers system-wide benefits. Experienced carers are often the first to notice subtle changes in residents, build trust with families, and share critical insights with nurses. They improve safety, consistency, and quality of life.
Economically, lower turnover reduces recruitment and training costs while preserving valuable organisational knowledge.
Most importantly, it affirms dignity.
“By not making carers or personal care workers a career, we are saying that looking after vulnerable people is a job that anyone can do,” Coulston says.
“And that is not the case.”
Australia must move beyond simply building beds and instead build a carer workforce with genuine career structures. Governments, providers, and industry bodies should collaborate on a national framework that includes:
As the population ages and the prevalence of dementia increases, the need for skilled, committed personal care workers will only grow. Supporting high-quality training and creating genuine careers is both practical and compassionate.
The alternative is ongoing workforce shortages, declining standards of care, and a system that fails both residents and the dedicated workers who are the human face of aged care every day.
Carers are not “just staff”. They change lives through consistent expertise, kindness, and vigilance. It is time we treated them as the professionals they are, with real career structures, respect, and investment.
Discontinuity of staff in shifts across health and aged care must impact adversely on observation of the patient/resident. A structured career path might give more stability and continuity in staffing in shifts for direct carers, improve the overall quality of care, and give the cared for the benefits of the continuity.
They are not professionals. They are vocationally trained if they have a Cert III and not a ‘professional’ with regard to ANZSCO or labour market expectations. Don’t confuse an AQF Level 3 qualification with a degree qualification.