In this paper the changes in Australia’s aged care policies in the context
of demographic, economic, social and ideological factors are explored.
Through the 20th century the policies of federal and state governments
have resulted in a system of age pensions, residential and communitybased long-term care. This system is supported by a wide range of
services in both public and private sectors, which must respond to the
diverse needs of older people in a multicultural and geographically
dispersed society. Changes in government policies over the past 10
years have entailed responses both to international and local research
evidence and to economic values, resulting in the rhetoric of ‘self-help’,
privatisation and ‘user-pays’ principles. A three-tiered model of care,
adopted by the Australian Government in 2004, was designed to provide
consistent standards, equity of access, accountability, quality assurance
and planning. Current issues in Australia’s aged care policies for longterm care are discussed, specifically the funding and organisation of
services, the health-aged care interface, and the skills and payment of
the aged care workforce. It is concluded that community-based care will
remain the preferred policy direction, requiring refinement in resource
financing and allocation, training, service co-ordination and carer
involvement in policy development, all based on research evidence.
A broadening of the concept of ‘community-based care’ to include
‘community-based death’ is suggested, requiring a broadened scope for
palliative care to service the range of terminal conditions affecting older
people.

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