Support at Home’s biggest test: Can government turn reform promises into real-world care access? 

A national survey of retirement village residents has provided fresh evidence that many of the implementation challenges surrounding Support at Home are being experienced by older Australians themselves, reinforcing concerns repeatedly raised by aged care providers, advocates and peak bodies.

The preliminary findings from the Retirement Village Residents Association’s (RVRA) Support at Home Survey reveal that while older Australians broadly support the goal of the program, many are struggling to navigate the system, access timely services and understand what support is available to them.

The survey, which received responses from 2,451 retirement village residents and included more than 8,800 written comments, highlights concerns around lengthy assessment processes, confusing information, provider availability and rising out-of-pocket costs.

For many in the aged care sector, the findings confirm concerns that have been raised since the introduction of Support at Home: that a reform designed to empower older Australians risks creating new barriers if the system is too difficult to understand or access.

Consumer evidence reinforces sector warnings

The aged care sector has consistently called for Support at Home to be judged by its outcomes for older Australians, rather than the intentions behind the reform.

Providers and advocates have warned that moving towards a more consumer-directed model would require strong communication, efficient assessment pathways and sufficient workforce capacity to ensure older people could actually access the care they were approved for.

The RVRA survey suggests those concerns are now being reflected in the experiences of older Australians attempting to use the system.

Thirty per cent of respondents reported waiting seven months or more for their My Aged Care assessment, while 24 per cent waited seven months or more after assessment for approval.

A further 28 per cent waited three months or more to receive services from a provider.

RVRA President Roger Pallant said the findings showed a significant gap between the intention of Support at Home and the experience of many residents.

“Residents want Support at Home to succeed. They want to remain independent, and they value the support that helps them do that. But too many are telling us they are waiting months, struggling to understand the system, and going without help when they need it,” he said.

A system designed around choice must first be understandable

One of the strongest themes emerging from the survey was the difficulty many older Australians are having understanding and navigating the new system.

Thirty-seven per cent of respondents rated their overall understanding of Support at Home as poor or very poor.

The application process was also a source of significant stress, with 46 per cent of residents describing it as moderately to extremely stressful and 44 per cent describing it as moderately to extremely confusing.

Almost one-third of respondents required help from family or friends to apply.

One resident wrote: “Extremely frustrating and confusing. I needed my daughter and son-in-law to navigate the system on my behalf.”

Another said: “The system is very frustrating. You can be assessed and told that you are eligible for services and then you have to try and find providers to provide the services you are eligible for.”

For a reform built around greater choice and control, the findings raise questions about whether all older Australians have an equal opportunity to participate in the system.

The concern is particularly significant for older people who live alone, have limited digital literacy, experience cognitive decline, or do not have family members available to advocate on their behalf.

While assessment delays have been a major concern, the survey also highlights that receiving approval does not necessarily mean receiving care.

Twenty-four per cent of respondents said they could not obtain all the services they required, while 26 per cent said there were services they needed that were not available through their provider.

More than one-quarter of residents reported paying privately for some services.

Residents reported difficulties accessing a range of supports, including allied health, transport, meals and other services needed to remain independent.

One respondent said they had stopped receiving some services because there was not enough funding available, including speech pathology and physiotherapy that supported their health and mobility.

The findings raise broader questions about whether Support at Home is currently matching funding allocation with the availability of services on the ground.

A consumer-directed model relies on older Australians being able to find providers who can deliver the support they need. However, workforce shortages, provider capacity and service availability remain ongoing challenges across the aged care sector.

Government faces pressure to respond to lived experience

The RVRA survey does not suggest older Australians oppose Support at Home. In fact, many respondents expressed support for the program’s underlying purpose of helping people remain independent in their own homes.

However, the findings add weight to calls for the Federal Government to address the practical barriers preventing the reform from achieving its intended outcomes.

The sector has previously warned that a successful transition would require clear communication, simple processes and adequate support for older Australians navigating the new arrangements.

The survey provides further evidence that these concerns are not simply industry objections to change, but issues being experienced by the people the system is designed to support.

Mr Pallant said Support at Home needed to be judged by how it operated in everyday life.

“If older people cannot understand the system, cannot get timely assessments, cannot find available providers, or have to pay privately for essential services, then the system is not yet meeting its promise,” he said.

The survey also highlighted the role retirement villages play in helping older Australians maintain independence.

Ninety-one per cent of respondents said village living helped them remain independent for longer, with residents identifying community connection, nearby neighbours, safer housing and reduced maintenance as key benefits.

However, the RVRA emphasised that retirement villages should not be considered a substitute for properly funded aged care services.

“Retirement villages can help people stay connected, safe and independent,” Mr Pallant said. “But informal neighbour support and village community life cannot replace timely, affordable and appropriate aged care services.”

As the government continues to refine Support at Home, the survey presents a clear message: older Australians are not rejecting reform, but they expect a system that is easier to understand, quicker to access and capable of delivering the support they have been promised.

For the aged care sector, the findings reinforce a message it has been making since the reform began: good policy outcomes depend not only on design, but on whether the system works in practice for the people relying on it.