This article examines the changes in policy focus and service provision that have occurred over
the last 30 years to help people remain at home for as long as possible. The major changes in aged
care policy over the last few years mean that it is timely to review the past and set the scene for
examination of aged care services in the future. Changes that will particularly affect program provision
include the merging in 2013 of the Commonwealth low- and high-care package programs into
Home Care Packages—incorporating Consumer Directed Care for the first time in aged care—and
the establishment in 2015 of the Commonwealth Home Support Programme, which combines the
large Commonwealth Home and Community Care Program with a number of smaller programs. These
policy innovations will take effect as existing users exit and new users enter the system.
In this context, longitudinal analyses can answer important questions such as: have the changes
in program provision kept pace with population change; have there been changes in patterns of
service use over time; are people staying in their homes longer; and for those who do use services,
what services are they using and in what combination?
Overall, at any one time the vast majority of older Australians are not using aged care services. In
2010–11, over two-thirds of people aged 65 and over (71%) did not use an aged care service over
the year, other than perhaps assessment services. Of those who did, more than two-thirds only
accessed community care. However, program use is more likely as a person gets closer to the end
of life, with 67% of people aged 85 and over using an aged care service in 2010–11. Around 80% of
people who live to at least age 65 will use community and/or residential care over their lifetime.