Living well in care – A conversation for older people

Redesigning Aged Care Homes

Australia's residential aged care sector is in the midst of transformation following the November 2025 commencement of the Aged Care Act 2024. This legislation, passed in late 2024, directly addresses the Royal Commission into Aged Care Quality and Safety's 2021 findings that the previous system was unfit for purpose—prioritising funding mechanisms over individual needs and rights, and failing to prevent neglect in many facilities.

The reforms place older people's rights at the core, including a legally enforceable Statement of Rights, strengthened quality standards, and greater transparency. Yet residential care remains a flashpoint: around one in four older Australians will need it at some stage, but reports of inadequate environments—cramped layouts, poor lighting, institutional aesthetics—have contributed to reduced independence, higher rates of falls, depression, and behavioural issues, particularly for those with dementia.

In early 2026, the government rolled out the National Aged Care Design Principles and Guidelines, accompanied by an eight-part webinar series starting with sessions for older people and families on recognising high-quality living environments. These principles emphasise home-like settings that support autonomy, social connection, and safety, moving away from hospital-style models. The timing is deliberate: with the Act now active, providers must align operations to meet enhanced expectations, while families entering the system post-reform confront choices with higher stakes for long-term wellbeing.

Concrete pressures abound. Workforce shortages persist despite prior mandates like 24/7 registered nurses, and funding sustainability is tested as demand surges—the first Baby Boomers turn 80 in 2026, accelerating need. Poor design risks higher costs through increased health interventions or premature hospitalisations, while inaction could entrench the 'neglect' label the Royal Commission applied. Trade-offs emerge: upgrading facilities demands capital many providers lack, potentially leading to closures or higher fees, even as price protections and transparency measures aim to shield residents.

Non-obvious angles include the mismatch between policy ambition and on-ground reality—reforms promise dignity but implementation lags in rural areas or smaller operators—and the tension between individual choice in home selection versus systemic capacity constraints that limit genuine options for many.