Why Are Older Australians Waiting Longer Than Ever for the Care They've Been Approved For?
In early 2026, Margaret received the news she'd been desperately awaiting: she was approved for a home care package. At 82, with declining mobility and memory challenges, she needed help with showering, meal preparation, and medication management. But approval didn't mean help arrived. Eight months later, Margaret is still waiting one of more than 100,000 Australians trapped in a system that says "yes" on paper but "not yet" in reality. The median wait time between approval and actually receiving home care services has doubled from four months to eight months, with many elderly Australians waiting over a year. This isn't just bureaucratic delay; it's a fundamental breakdown in the social contract we've made with our elderly population.
The Royal Commission into Aged Care explicitly stated that nobody should wait more than one month for care. Yet in 2026, we're eight times beyond that standard, pushing vulnerable older people into hospitals and residential aged care prematurely, precisely the outcomes the reforms were designed to prevent. This crisis reveals something deeper than logistics: it exposes the tension between our policy aspirations for person-centered, dignified care and a system still fundamentally structured around scarcity, rationing, and institutional convenience rather than human need. When we approve someone for care but don't deliver it, we're not just failing administratively we're abandoning the reciprocal responsibility that should define how communities care for their elders.
The Support at Home Program is essentially a new name, but Same Capacity Crisis
Australia's aged care system entered what was supposed to be a "new era" on November 1, 2025, with the launch of the Support at Home Program. Replacing the Home Care Packages system, this reform promised simpler access, greater flexibility, and person-centered care aligned with recommendations from the Royal Commission. The program introduced innovative pathways including restorative care (up to $12,000 for allied health services), assistive technology funding, and dedicated end-of-life support up to $25,000. On paper, it represents everything modern aged care should be: responsive, individualized, and dignity-preserving.
The problem isn't the program's design—it's the mathematics of undersupply. While the government announced 83,000 new packages for 2025-26, demand has far outstripped this increase. Peak body Ageing Australia reports over 100,000 people currently waiting for packages, with another 100,000 awaiting assessment. By 2044, the number of Australians aged 70 or over is expected to reach 2.3 million, intensifying pressure on a system already buckling. Productivity Commission data confirms the crisis is worsening: the median wait ballooned from 118 days in 2023-24 to 245 days in 2024-25.
What does this mean for real people? Delays push older Australians who want to age at home into hospitals for conditions that could be managed with appropriate home support. Emergency departments become de facto aged care waiting rooms. Families exhaust themselves providing unpaid care while navigating complex bureaucracy. The program's innovative pathways—restorative care, assistive technology, end-of-life support—remain theoretical for those stuck in limbo. Patricia Sparrow from COTA Australia captured the disconnect: "It's good to see clear evidence that increased care minutes and better nursing coverage are making a difference inside aged care services, but for older people who are still waiting months—or even years—to get the care they've been assessed as needing, those improvements don't mean very much".
The capacity crisis also reveals deeper structural issues. Australia needs an estimated 10,000 new residential aged care beds built annually for the next two decades, yet only around 800 beds were added last year. This shortage creates a bottleneck effect: when residential care capacity is insufficient, people who might prefer that option remain in the community without adequate support, while those who want home care wait even longer as the system struggles to serve everyone.
Moving Beyond Transactional Care
The waiting list crisis isn't just about funding more packages, it's a symptom of how we've structured care itself. Australia's aged care system, despite reforms, remains fundamentally transactional: assess need, assign package level, allocate funding, deliver services. This marketplace model assumes care is a commodity that can be efficiently distributed if we just get the logistics right. But eight-month wait times suggest the model itself may be part of the problem.
Communities worldwide are experimenting with alternatives that emphasize reciprocity and relationship over transaction. Intergenerational programs, where early learning centers co-locate with aged care facilities, demonstrate how mutual benefit can replace one-way service delivery. Research shows older adults in these programs experience improved mental and physical health, feeling valued and less isolated, while children develop empathy, social skills, and respect for older generations. These aren't feel-good extras, they're evidence that care works better when it's embedded in authentic relationships rather than professionalized service contracts.
Age-friendly cities across Australia—from Ballarat to Fremantle to the Surf Coast—are redesigning communities to support older people participating actively rather than receiving passively. This approach recognizes what CareNeighbour's philosophy articulates: today's caregiver is tomorrow's cared-for, and sustainable systems must be reciprocal, not extractive. When Margaret waits eight months for approved care, she's caught in a system that sees her as a service recipient rather than a community member whose lifetime of contribution should be reciprocated.
Technology also offers pathways beyond transactional models. AI-powered health monitoring and predictive analytics can identify deterioration early, potentially preventing the crises that push people onto waiting lists. But technology alone won't solve a crisis rooted in how we conceptualize care. The most sophisticated monitoring system still requires human response, community connection, and the kind of relational care that can't be packaged or rationed. Until we address care as fundamentally about relationship—not just service delivery—we'll continue creating elegant programs that real people wait months to access while their needs become urgent.
