They built the system to help older Australians stay in their own homes. But according to damning new research, many of the people it was designed to serve feel like they are fighting it every single day.
A study from Flinders University, published in the Australasian Journal of Ageing, has lifted the lid on the daily reality of Australia’s Home Care Package program — and the picture it paints is not a flattering one. Older Australians on government-funded packages described feeling dismissed, confused, financially squeezed and, in the words of the researchers themselves, treated as “a number within the aged care system” rather than a person with needs, preferences and dignity.
Researchers from Flinders University’s Caring Futures Institute interviewed older adults aged 65 and over from across Australia about their experiences accessing a Home Care Package – the government-funded program designed to help them stay independent in their own homes.
What they heard should alarm anyone with an ageing parent, or anyone who expects to grow old in this country.
Participants described a system that was administratively complex, financially opaque and often unresponsive to individual need. Many said administration fees and unclear rules about how they could spend their package funds left them confused and distressed. Others described having to repeatedly advocate for their own care – a process that took an emotional toll – only to feel dismissed or ignored when they explained what would actually help them.
Some went without cleaning or personal care in order to afford physiotherapy. Others couldn’t justify the cost of meal preparation services, knowing that every hour spent on cooking was an hour taken from another area of their care. Several older Australians – people who were supposed to be receiving government-funded support – ended up paying out of their own pockets for essential items rather than waiting for approvals that felt too uncertain and too slow.
“Several participants described feeling like a number within the aged care system,” said lead author Caitlin Wyman, an Accredited Practising Dietitian and PhD candidate at Flinders. “Others spoke about the emotional toll of repeatedly having to advocate for their care needs.”
Perhaps the most confronting finding is what the research revealed about nutrition – an issue that sits at the very foundation of healthy ageing, and one that is supposed to be covered under home care.
Many participants understood the importance of eating well. They valued fresh food, variety and the pleasure of a proper meal. But in practice, nutrition was frequently the first thing sacrificed when budgets were stretched thin. Some described eating toast instead of preparing balanced meals – not out of preference, but because mobility issues, fatigue and limited funds made anything more feel impossible.
Pre-prepared meal services, where they were available, often failed to meet participants’ dietary needs, cultural preferences or personal tastes. For older Australians in regional areas, the options were even more limited.
“Nutrition plays a crucial role in healthy ageing and should not be treated as optional,” said Ms Wyman. “Our findings highlight a significant gap in the program’s current capacity to support older people’s nutrition – a fundamental need that no one should be left to go without.”
The research did find bright spots. When care was personalised and attentive, older adults felt more secure and respected. Participants who self-managed their packages – choosing their own workers and directing their own care – generally reported better experiences. Having workers who understood their routines and respected their preferences made a meaningful difference to their sense of independence and wellbeing.
But self-management requires time, confidence and often the support of family or advocates. Not everyone has those things. And the researchers were blunt: a system that only works well for the people who can navigate it independently has failed the people who need it most.
Co-author Dr Alison Yaxley was direct about what the research showed. “Participants wanted care that respected their preferences and allowed them to make decisions about their own wellbeing,” she said. “Many older people know exactly what support they need but face barriers when trying to secure it.”
The Home Care Package program has since been replaced by the new Support at Home program, which the Australian Government introduced on 1 November 2025. The researchers note that their study was conducted under the previous model.
But they were careful to flag that the issues their participants described – the complexity, the trade-offs, the sense of being unheard – are not automatically resolved by a new name and a restructured program. The voices of those who lived through the old system, they argue, carry lessons that the new one cannot afford to ignore.
“The voices of older Australians must guide improvements to our home care system, so it genuinely delivers person-centred care,” said Ms Wyman. “Every older person deserves support that helps them to stay healthy, connected and independent in their own home.”
That is not a radical demand. It is the minimum that a wealthy, modern country owes the people who built it.
The paper, ‘Care by Name, Not by Nature: Experiences of Older Adults Accessing a Home Care Package Including Food and Nutrition Services,’ is published in The Australasian Journal on Ageing.