Aged care reform will be judged by the lives it makes better: Our thoughts on the way forward

Australia’s aged care sector is entering a defining period of reform implementation, with the challenge no longer simply to design a better system, but to deliver one that improves the lives of older people in practice. At CEDA’s Shaping the Future of Aged Care VIC event, which Nous attended in Melbourne in August, leaders from across the sector explored how aged care can navigate the most significant reform in decades along with rising demand, workforce pressures, regulatory change, funding constraints, and shifting community expectations while building the next era of care.

Here, five Nousers reflect on the key messages and lessons from the event, drawing together perspectives shared across the keynote and panel discussion. Their reflections synthesise the broader conversation and what it reveals about the choices now facing the sector as it seeks to deliver more dignified, rights-based and person-led care.

A consistent theme throughout the discussion was that the future of aged care should not be defined by reform milestones alone, but by the future we are trying to create for older Australians. The central question was whether the system now being designed is capable of delivering lives marked by connection, wellbeing, purpose, dignity, independence and continued contribution.

Commissioner Liz Hefren-Webb delivered the keynote and noted that the sector is undergoing its most significant reform in decades while also facing workforce shortages, rising demand, increasing costs, changing consumer expectations and intense public scrutiny. These pressures are real, but meaningful social change takes time. The choices made now will shape aged care for the next five to ten years. One of the most important underestimated opportunities is the mindset shift required to transition from person-centred care to genuinely rights-based care: moving beyond service delivery, funding requirements and input-based systems to focus on the outcomes that matter most to older people.

The panel extended this challenge by exploring what it will take to design a system capable of delivering that future. Speakers highlighted the need to address ageism, communicate more clearly with older people and families, and build a more positive narrative around ageing and aged care. They also argued that success must be redefined: not simply the implementation of Support at Home or the new Aged Care Act, but measurable improvements in independence, belonging, quality of life and consumer outcomes. Innovation that can enable this future is already happening across the sector; the next task is to share, scale and learn from what works.

Nikita Weickhardt, Principal

The shift to a rights-based approach under the new Aged Care Act was one of the most important themes of the event. Across both the keynote and panel discussion, speakers argued that legislation alone will not change the experience of older people. Rights-based care has to be translated into practical behaviours that staff, families, advocates and providers can understand and apply in everyday decisions. Several speakers suggested that without that translation, workers may default to caution, compliance or organisational convenience, rather than the older person's own definition of dignity and a good life.

That makes culture change a workforce challenge as much as a regulatory one. Staff need clarity about whose judgement matters in a care relationship, how risk should be balanced with choice, and what it means to support a person’s rights when family expectations, service constraints and professional instincts all pull in different directions. The event also highlighted a deeper tension: rights-based care is relational, but the system often pays for tasks. Funding models built around short time increments can work against the continuity, trust and attention that good care requires. Many providers are already working hard to build more relationship-based models of care, but doing so remains challenging within workforce, funding and accountability settings that continue to prioritise measurable service delivery. If reform is to succeed, the sector will need to find practical ways to value not only what is done for older people, but also the relationship through which care is delivered.

Jess Lees, Director

One of the more provocative themes from the discussion was that aged care reform is not simply about implementing a new Act, but about challenging long-held assumptions about ageing itself. Several speakers noted that the sector continues to operate within a system largely shaped by a medical model, where older people are often viewed through the lens of decline, risk and service need. As Ageing Australia CEO, Tom Symondson observed, we are effectively trying to overlay a rights-based framework onto a system that was designed for a very different era. The challenge is not recognising that older people have rights, but redesigning services, leadership and decision-making so those rights are consistently upheld in practice. That starts with pausing in every interaction to ask what matters most to the older person and ensuring both older people and frontline workers have a stronger voice in shaping how care is delivered.

The discussion also challenged the sector to confront the impact of ageism, including the less visible forms of internalised and benevolent ageism that can unintentionally limit choice and autonomy. Patricia Sparrow argued that the sector should move beyond the aspiration of "ageing in place" towards "ageing in community," recognising that connection, contribution and belonging are fundamental to quality of life. Rather than viewing older people primarily as recipients of care, the panel emphasised the importance of including older people and frontline workers more directly in leadership, service design and decision-making. Creating a genuinely rights-based aged care system will ultimately depend on who holds influence within the system and whose voice is heard when decisions are made.

Rodger Paul, Manager

Providers continue to explore a range of innovative approaches to improve participant outcomes and experiences. We heard examples ranging from technological applications, such as rotating beds that help prevent pressure injuries and the use of AI to deliver more culturally tailored experiences, through to alternative care approaches that advance positive ageing, such as social prescribing models. While these initiatives reflect a strong commitment to improving care, innovation often requires significant investment and experimentation. There is an opportunity for the sector to more systematically share lessons and evidence of what works, enabling successful approaches to be scaled and delivering greater impact across the broader aged care system.

Achieving the right balance between funding utilisation and delivering care that fosters meaningful connection also remains an ongoing challenge for providers. On the one hand, providers operate within funding models that often incentivise service delivery through time-based care blocks and utilisation targets. On the other, participants consistently value continuity of care and the opportunity to build trusted relationships with support workers. Navigating this tension is a key challenge as providers seek to deliver both financially sustainable and person-centred care.

Jyaes Tan, Director

Workforce development remains a significant challenge in the aged care sector. More broadly across health and care services, nursing and personal care workers often face unclear career pathways and limited opportunities for professional development. Responsibility for workforce development in aged care is fragmented across government, not-for-profit and for-profit providers. As a result, there is no single organisation providing the leadership, coordination and long-term investment needed to build a skilled and sustainable workforce.

The Aged Care Quality and Safety Commissioner, Liz Hefren-Webb, has played a critical role in advancing the vision of the Royal Commission and supporting the sector's transition to a more outcomes-focused regulatory approach. This approach goes beyond traditional compliance and risk-based regulation by using regulatory levers that are proportionate to risk and provider performance. Just as importantly, the Commissioner's engagement with providers is helping to foster a culture of continuous improvement, encouraging organisations to focus not only on meeting regulatory requirements but also on achieving the best possible outcomes for older Australians.

Ben Whitton, Director

Get in touch to discuss how aged care providers, policymakers and sector leaders can turn reform intent into practical changes that improve quality of life for older Australians.

Connect with Nikita Weickhardt, Jess Lees, Rodger Paul, Jyaes Tan and Ben Whitton on LinkedIn.