When Maria Zappala’s best friend began navigating the aged care system for her mother, Zappala started asking questions.
Her friend’s mother is receiving palliative care. Zappala says her funded care hours fell from 10 to eight a week after a reassessment, despite her increasing needs. The family is selling assets to help pay for care, while her friend has stepped back from her business to help provide it. Residential aged care options are hours from home.
Zappala wanted to understand how someone could need more care but receive less of it.
She has spent her executive career leading complex operations in mining, aluminium smelting, rail and heavy industry. Aged care is not her professional background, but she says her experience in regulated industries has taught her the importance of reliable reporting.
“Metrics matter. They tell you how you’re going. They must be comparable over time.”
In a recent LinkedIn post, Zappala questioned whether Australia’s measures and responses to unmet care needs reflect systemic ageism.
“Ageism in practice is quiet. It doesn’t shout,” she says.
For Zappala, it’s in long waits after someone is assessed as needing support, and in figures that don’t clearly show how much approved care remains outstanding.
The Aged care waitlist in Australia: What do the figures show?
Australia’s official home care waitlist stood at 100,191 in March 2026. However, 53,718 people receiving interim funding are no longer included after changes were made to the reporting method. Including them would bring the total to 153,909.
Under Support at Home, interim funding provides 60 per cent of a person’s approved allocation while they wait for the remainder.
“If someone has been assessed as needing 100% of a package and receives only 60%, they should not be removed from the waitlist,” Zappala says.
“They are waiting for 40% of the care package they were assessed as needing.”
“From a methodology perspective, if you change the metric, you disclose the change, and you show the old number alongside the new.”
Support at Home algorithm: Who can challenge a decision?
Zappala also questions the role of the Integrated Assessment Tool (IAT) when someone’s circumstances are complex or changing.
She’s not opposed to automated decision-making, but says human oversight is essential.
“Used well, with proper design, human oversight and accountability, they deliver consistency and efficiency. Used badly, they cause serious harm.”
“Human judgement in these decisions is not a nice-to-have.”
Zappala points to the Robodebt Royal Commission as a reminder of the risks when automated decisions lack adequate oversight.
The government has proposed an escalation pathway for cases where the assessment tool has not adequately captured a person’s needs. Under the proposal, a departmental decision maker could review the original outcome. A separate bill to restore human override passed the Senate in July 2026.
For providers, the question is how to document changing care needs and raise concerns when an assessment or funding decision doesn’t reflect the support a person requires.
Home care package wait times and unmet demand
In 2024–25, 4,812 older Australians died while waiting for approved home care funding. The figure doesn’t establish that delays caused each death, but Zappala says it adds to her concerns about the time between assessment and receiving care.
Her friend’s experience shows why she wants reporting to capture more than whether someone has received funding. A person may receive some support while still waiting for the full amount they have been approved.
What does accountability look like for aged care leaders?
Zappala is cautious about prescribing sector-specific reforms. Her priority is for people to receive the care they have already been approved for. She also wants meaningful human review when an assessment is disputed and clearer reporting of outstanding care.
Asked what she would want published, she lists: “Numbers waiting for assessment, packages outstanding, deaths by month, investigations completed.” And she believes providers have a role in raising concerns about gaps in care.
“Providers have a platform and a voice,” she says.“Silence is understandable given commercial and regulatory pressures. It is also complicity.”
For aged care leaders, her questions come back to what their organisations can see and act on. When a client’s needs change, is that recorded? If approved care is still outstanding, does the reporting show it? And when an assessment is disputed, who helps the person and their family seek a review?
Zappala wants the figures to show not only who has received funding, but who is still waiting for the care they have been assessed as needing.
