She helped design the aged care reforms. Now she is living their failures

Lynda Henderson, an experienced aged care consultant and advocate, helped shape key elements of Australia’s recent aged care reforms, yet now, as a recipient of in-home care herself, she is facing the harsh realities of the very system she worked to improve.

Henderson, who served as the Older Persons Advocacy Network (OPAN) representative on the assessment working group that developed the Integrated Assessment Tool (IAT), expresses profound disappointment and fury at how the reforms, particularly the Support at Home program that commenced on 1 November 2025, have unfolded.

Henderson’s involvement dates back to the early 2020s, when she contributed to designing what was intended to be a practical, flexible and needs-based assessment tool.

Drawing on her background in psychology, psychometrics and statistics, she and the working group created an integrated tool meant to assess needs across programs, allow for reassessments when circumstances change such as worsening health or loss of informal support, and incorporate assessor comments and adjustments.

The goal aligned with Royal Commission recommendations: a single, person-centred tool that could be completed efficiently, around 45 minutes, and provide accurate funding classifications without unnecessary repetition.

“I think we came up with a tool that was practical, flexible and really extensive and fitted the purpose,” Henderson said in a recent interview.

The design deliberately included text fields for assessor notes and the ability to revisit sections for more accurate responses, ensuring human judgement could refine outcomes.

However, the implemented version diverged sharply from those intentions. Henderson highlights a critical change: assessors are no longer permitted to override the scoring algorithm that determines funding levels under the new system. While the IAT itself is not an AI tool, it is a structured assessment populated by assessor inputs, the algorithm applied to those inputs now dictates classifications, with limited exceptions for overrides.

This shift has led to widespread concerns about underfunding, particularly for those with complex or high needs.

Minister for Aged Care and Seniors Sam Rae has addressed these issues in public forums, including Senate estimates and parliamentary question time, emphasising that the IAT “does not replace assessor input” and relies on clinicians documenting advice first. He has rejected characterisations of the system as “robo aged care”, stressing assessor involvement for accuracy and consistency, with ongoing monitoring and refinements planned.

Yet Henderson describes Rae’s responses as deliberately evasive on the core issue: the algorithm’s rigidity and the prohibition on overrides for classification decisions.

“He talked around it. He intentionally went around it,” she said, noting that while assessors enter data, the scoring mechanism, the true determinant of funding, remains inflexible.

The personal toll on Henderson underscores the frustration. 

Since the reforms and transition to Support at Home, she says costs have increased by around 10 per cent on some services, forcing her to reduce the level of support she receives despite ongoing needs.

Case management pressures have also intensified. She says some case managers are carrying as many as 150 clients while working 12 to 15 hour days, six days a week, creating delays and limited capacity for meaningful oversight.

Henderson’s disillusionment runs deeper. She invested years contributing to OPAN’s National Reference Group and the assessment working group, which produced detailed recommendations, including a 350-plus page analysis from genuine consultations, to avoid unintended consequences. This advice, she says, was ignored.

“I’m unbelievably furious,” Henderson said. “The government cheated, and tricked us.”

Earlier efforts on the new Aged Care Act went nowhere, and decisions like co-contributions and service caps penalised frailty. She points to systemic rationing, failure to measure true demand accurately, and a push towards algorithmic profiling.

“What the government has done all along has been to refuse to actually measure demand accurately,” Henderson said. “This allows them to deflect scrutiny of funding and the scale of the issue.”

As someone who volunteers in dementia and disability spaces, guides others through systems, and lives with a permanent spinal disability, she feels a sense of betrayal.

The reforms, meant to support seniors amid an ageing population, instead appear to cut services and let needs go unmet, potentially contributing to worse outcomes, including hospital blockages and delayed care.

Henderson’s story highlights a painful irony: an insider who poured effort into positive change now endures its shortcomings firsthand.

With appeals against IAT outcomes surging, hundreds lodged shortly after rollout, and calls from advocates for assessor override rights, her experience serves as a stark reminder of the gap between reform intentions and real-world implementation.

For many older Australians, the promise of a fairer, needs-based system remains unfulfilled.