Impact of COVID-19 on older people in aged care
The COVID-19 pandemic impacted the health and wellbeing of people using aged care, particularly those in residential aged care. Compared to the general community, people in residential aged care were disproportionately affected by COVID-19 infection in terms of risk of serious illness and related mortality (Department of Health and Aged Care 2023a). Three-quarters (75%) of all COVID-19 related deaths in the first year of the COVID-19 pandemic (to 5March 2021) were among people living in residential aged care (Department of Health and Aged Care 2023b).
The 2021–22 financial year saw an increased COVID-19 case load on the aged care sector. Most of Australia’s residential aged care homes experienced a COVID-19 outbreak during 2021–22 (2,570 facilities experienced one or more outbreaks in 2021–22). During the 12-month period, there were over 56,000 resident cases and almost 2,200 resident deaths in aged care (Department of Health and Aged Care 2022). As at 30June 2022, 29% of all COVID-19 related deaths in Australia were among people living in residential aged care (Department of Health and Aged Care 2023b).
Across all types of aged care, the lockdowns and social restrictions may have affected access to formal and informal support. For example, older people living in the community were encouraged to seek health services remotely through telehealth, and a number of temporary Medicare items were added. Additionally, measures introduced in the aged care sector meant that people in residential aged care could temporarily return to community-living through ‘emergency leave’ that provided up to eight weeks of home support.
The restrictions imposed may also have affected people’s physical, mental and emotional wellbeing. The isolation and social disconnection experienced by permanent residential aged care residents as a result of visitor restrictions and lockdowns at many facilities, placed older people at greater risk of health problems including anxiety and neurocognitive conditions.
Assessment of care needs
Until recently, the Aged Care Funding Instrument (ACFI) has been used to assess the care needs of people living in permanent residential aged care to determine the government funding provided to care providers. Residents may be reappraised in the same year if their needs change. The ACFI measures care needs across 3 different areas of care:
- activities of daily living
- cognition and behaviour
- complex health care.
On 30 June 2022, among people aged 65 and over living in permanent residential aged care, almost 2 in 5 (37%) had high care ratings across all 3 ACFI assessment areas (AIHW 2023b).
Australian National Aged Care Classification
On 1 October 2022, the Australian National Aged Care Classification (AN-ACC) residential care funding model replaced the ACFI. The AN-ACC Assessment Tool focuses on the characteristics of residents that drive care costs in residential care. AN-ACC data are not currently reported on this page.
For more information about AN-ACC, see the AN-ACC Reference Manual and AN-ACC Assessment Tool on the Department of Health and Aged Care website.
Health of people in aged care
People using aged care continue to interact with the health system through General Practitioners (GPs), specialists and the hospital system. For example, GPs are an important part of the health care of people living in residential aged care. Among people living in permanent residential aged care in 2016–17, some 92% had at least one Medicare Benefits Scheme claim for a GP visit, and almost all of the remaining would have seen a doctor through some other interface with the health or aged care system, such as hospitals or through Department of Veterans’ Affairs arrangements (AIHW 2020).
For more information on use of health services, see the Health – service use chapter.
Leaving aged care
Many people use aged care in their final years of life. For deaths among people aged 50 and over in 2016–17, over two thirds (67%) had used at least one aged care service in the last 2years of life. For people over the age of 85 in 2016–17, 50% of deaths were in residential care, compared with 40% in hospital (AIHW 2021).
People may also leave care to move back home, to enter other aged care, or to be admitted to hospital. The following information covers exits from aged care services in 2021–22. A person may be counted twice if they exited aged care services more than once over the 12-month period.
In 2021–22, for people aged 65years and over:
- there were almost 201,000 exits from residential aged care and home care
- the majority of exits were by people leaving respite residential care (82,000, 41%), followed by permanent residential care (71,200, 35%) and home care (47,700, 24%)
- most (86%) exits from permanent residential care were due to death, compared with 38% from home care. The majority of exits from home care were to residential care (51%).
Of all people who exited permanent residential aged care, those who died in care had the longest median length of stay (approximately 25months) (AIHW 2023c).
Among people aged 65 and over exiting aged care, those in permanent residential care had the longest median length of stay (22months), followed by home care (17months) and respite residential care (21days). Women stayed longer in permanent residential care than men, while this difference was less pronounced in respite care.
Where do I go for more information?
For more information on Australians’ use of aged care services, see the AIHW's aged care data website,GEN aged care data.
