Ageing in Place 2035: What Australia Must Build to Support More People Safely at Home

July 18, 2026

Ageing in place has become one of the defining ambitions of modern aged care. Many older Australians want to remain in their own homes, close to familiar people, routines, communities and places that carry personal meaning.

Yet ageing in place cannot be achieved simply by increasing the number of personal care or domestic assistance visits available. Remaining at home safely may also depend on accessible housing, reliable transport, timely clinical support, family sustainability, digital connectivity, local workforce capacity, emergency response and the ability to recognise deterioration before a crisis develops.

The Australia Social Care and Community Services Knowledge Hub provides a wider platform for examining how Australian aged care, home support and community systems can evolve together rather than through isolated reforms.

By 2035, ageing in place must mean more than helping people remain inside their existing properties. It must mean creating the conditions in which older Australians can continue living safely, meaningfully and with genuine control over how support enters their lives.

Ageing in Place Is a System Outcome

Ageing in place is often discussed as though it were primarily a service-delivery choice. A person either receives support at home or moves into residential aged care. In reality, the outcome is shaped by a much wider set of conditions.

An older person may have an appropriate home support package but still struggle because:

the property is inaccessible or difficult to maintain;
there are not enough workers available locally;
transport prevents access to health care and social activity;
family support is becoming unsustainable;
clinical deterioration is identified too late;
digital systems are inaccessible or unreliable;
specialist dementia, palliative or rehabilitation support is unavailable;
service coordination is fragmented; or
the person cannot increase support quickly when circumstances change.

Ageing in place should therefore be understood as a shared system outcome involving aged care providers, primary care, hospitals, allied health professionals, pharmacies, housing agencies, local government, transport services, community organisations and informal networks.

This requires the same kind of joined-up thinking found within effective homecare service models and care pathways, adapted to Australia’s geography, funding arrangements and diverse communities.

What Success Should Look Like by 2035

A mature ageing-in-place system should enable an older person to remain at home because the necessary conditions are in place, not because alternatives are unavailable or because relatives are absorbing unmet need.

By 2035, a strong Australian model would mean that:

home support can increase or reduce as needs change;
older people receive timely assessment and reassessment;
clinical and non-clinical services coordinate around one plan;
homes can be adapted before environmental risks become critical;
workforce capacity is understood at regional and neighbourhood level;
family carers receive support before exhaustion develops;
technology is accessible, optional and properly governed;
emerging deterioration triggers early intervention;
short-term step-up support is available during instability;
hospital discharge connects immediately with community support; and
moving to another setting remains an informed choice rather than a system failure.

The test is not whether everyone remains in the same home indefinitely. The test is whether each person has realistic, safe and informed options as their circumstances change.

Building Block One: Flexible Home Support Capacity

A system designed for ageing in place cannot rely solely on fixed care plans and scheduled annual reviews. Needs may change quickly following illness, bereavement, a fall, medication adjustment, carer breakdown or a decline in mobility.

Providers need the capacity to respond through:

rapid reassessment;
temporary increases in support;
short-term overnight or evening assistance;
responsive nursing and allied health input;
reablement following functional decline;
planned respite and carer relief;
urgent equipment or home modification pathways; and
clear step-up and step-down arrangements.

Without this flexibility, manageable changes can become hospital admissions or permanent transitions into more intensive care.

Flexible support must still be governed. Providers should define which changes frontline staff can make, what requires coordinator approval, when clinical review is needed and how the person’s consent will be obtained and recorded.

Operational Scenario One: A Temporary Increase That Prevents Permanent Dependency

Context: Ruth is 81 and lives alone in a regional centre. She normally receives assistance twice a week with household tasks and transport. After a chest infection, she becomes weaker and less confident walking around her home.

Step 1 — Recognising instability: A support worker notices that Ruth is moving more slowly, has stopped preparing hot meals and is sleeping in a chair because she is anxious about reaching the bedroom safely.

Step 2 — Arranging rapid review: The provider contacts Ruth the same day and, with her agreement, coordinates a nursing review and physiotherapy assessment rather than waiting for the next routine review.

Step 3 — Increasing support temporarily: Daily meal assistance, personal care and mobility support are introduced for ten days. Equipment is moved to reduce unnecessary walking, and Ruth receives a simple strengthening programme.

Step 4 — Rebuilding confidence: Workers encourage Ruth to resume tasks gradually rather than taking over every activity. Her progress is reviewed through mobility, nutrition and confidence rather than only through visit completion.

Step 5 — Stepping support down safely: As Ruth recovers, daily visits reduce. Some practical changes remain, but the temporary increase has prevented avoidable hospitalisation and long-term dependence.

This scenario illustrates why ageing in place requires elastic capacity. A system that can only maintain or permanently increase support will struggle to respond proportionately to short-term instability.

Building Block Two: Housing as Essential Care Infrastructure

Housing is one of the strongest determinants of whether ageing in place is realistic. A person’s care needs can appear to increase when the underlying problem is an unsuitable environment.

Common barriers include:

steps and narrow doorways;
unsafe bathrooms;
poor lighting;
excessive heat or cold;
inadequate ventilation;
unreliable power or connectivity;
distance from services;
insecure tenancy;
maintenance costs; and
properties that cannot accommodate equipment or workers safely.

A future ageing-in-place strategy should therefore connect aged care with housing policy, accessible design, local planning and climate adaptation.

Assessment should identify environmental barriers early. Providers should be able to refer people into timely pathways for minor adaptations, larger modifications, assistive equipment, repairs, accessible housing or alternative accommodation.

The objective is not to keep people in unsuitable properties at any cost. It is to maximise choice by ensuring that housing options support changing needs.

Designing Homes for Change Rather Than Crisis

Many modifications occur only after a fall, hospital admission or serious loss of function. By 2035, Australia should move towards anticipatory adaptation.

This could include:

greater use of adaptable housing standards;
bathrooms designed for future accessibility;
step-free entrances;
wider circulation space;
reinforced walls for later installation of rails;
flexible lighting and environmental controls;
technology-ready infrastructure;
safe outdoor areas; and
neighbourhood design that supports mobility and connection.

These measures reduce the need for disruptive and expensive retrofitting later. They also support people with disability, families and carers across the wider population.

Building Block Three: Integrated Clinical Support at Home

As more people remain at home with complex and changing needs, home support services will increasingly interact with chronic disease management, medication, rehabilitation, wound care, frailty, dementia, palliative care and hospital avoidance.

This does not mean every support worker becomes a clinician. It means the system must provide reliable clinical oversight and clear boundaries.

A strong model would include:

timely access to nursing advice;
pharmacy and medication review pathways;
allied health assessment and rehabilitation;
shared escalation protocols;
virtual clinical consultation where appropriate;
delegated health tasks supported by competence and review;
rapid response following deterioration; and
clear arrangements for end-of-life support at home.

Workers need to know what to observe, what to record and when to escalate. A vague instruction to “monitor” a person is not sufficient. Monitoring should specify the relevant signs, expected response and accountable professional.

This connects with broader practice around medication and delegated health care in home support, where safe delivery depends on role clarity, competence and accessible clinical oversight.

Building Block Four: A Workforce Designed Around Place

Australia’s geography makes national workforce solutions difficult to apply uniformly. Metropolitan, regional, rural and remote communities face different recruitment, travel, housing and skill-mix challenges.

By 2035, workforce planning should move beyond aggregate vacancy figures. Systems need to understand:

which communities lack essential capacity;
where travel time makes standard visit models inefficient;
which specialist skills are unavailable locally;
how continuity is affected by turnover and casualisation;
where workers themselves cannot access affordable housing;
how clinical backup will be provided after hours;
which tasks can be supported remotely; and
what local training and career pathways are required.

Neighbourhood or micro-team models may offer part of the answer. Small, locally organised teams can build stronger knowledge of individuals and communities while reducing excessive travel and fragmented responsibility.

These teams still require governance, supervision and escalation. Local autonomy should not become professional isolation.

Workforce Continuity as a Safety Indicator

Continuity is often described as a preference, but it is also a source of intelligence and risk control. Workers who know a person well are more likely to notice changes in appetite, mood, mobility, cognition, appearance or home conditions.

High turnover can therefore weaken early warning systems even when every visit is technically covered.

Providers should track:

the number of different workers supporting each person;
unplanned changes in visit time;
agency or temporary workforce dependency;
missed or shortened visits;
travel-related lateness;
worker competence against individual needs; and
whether people feel known and understood.

A structured quality dashboard and governance assurance framework can help providers connect these workforce indicators with incidents, complaints, deterioration and outcomes rather than reviewing staffing data in isolation.

Operational Scenario Two: Supporting Ageing in Place in a Remote Community

Context: Thomas is 78 and lives in a remote community several hours from the nearest major hospital. He has diabetes, reduced vision and early frailty. His daughter lives nearby but also works and supports her own family.

Step 1 — Mapping the local reality: The provider identifies the limits of local workforce availability, pharmacy access, transport and after-hours clinical support rather than applying a metropolitan service model.

Step 2 — Building a mixed support arrangement: Thomas receives regular in-person care from a small local team, scheduled telehealth reviews and planned visits from a mobile allied health service.

Step 3 — Strengthening early warning practice: Workers are trained to identify relevant changes in Thomas’s feet, blood glucose management, nutrition, mobility and vision. Clear escalation routes are agreed with the clinical team.

Step 4 — Protecting family sustainability: Thomas’s daughter is involved with his consent, but the plan does not assume she will provide all evening and transport support. Planned respite and contingency arrangements are documented.

Step 5 — Reviewing the whole pathway: The provider tracks Thomas’s health, confidence, hospital use, continuity of workers and the reliability of remote consultations. Problems with connectivity and transport are escalated as system risks, not treated as personal failures.

This example shows that equitable ageing in place does not mean identical service delivery. It means designing a proportionate model around local conditions while maintaining comparable standards of safety, rights and accountability.

Building Block Five: Technology That Supports Independence

Technology will form part of ageing-in-place infrastructure, but it should not be treated as a substitute for workforce or relationships.

Potential applications include:

falls detection;
medication prompts;
remote clinical monitoring;
voice-controlled home systems;
accessible communication platforms;
digital care records;
virtual consultations;
route and scheduling optimisation;
environmental monitoring; and
automated prompts for unresolved actions.

The value of a technology depends on what happens after it generates information. A sensor alert without a reliable response pathway may create false reassurance. A remote consultation may improve access but fail if the person cannot hear, see or navigate the platform.

Providers should assess each technology against:

the person’s goals;
informed consent;
accessibility;
privacy;
response arrangements;
failure contingencies;
workforce training;
data quality; and
continuing proportionality.

Digital Inclusion Must Be Treated as Core Infrastructure

As aged care, health care, banking, transport and government services become more digital, exclusion from technology can directly undermine independence.

Some older people will confidently use digital systems. Others may face barriers related to cost, connectivity, language, literacy, vision, hearing, cognition, dexterity or trust.

A digital-first system should therefore never become digital-only. Providers and public systems should preserve accessible alternatives while supporting people who wish to develop digital confidence.

Practical inclusion may require:

affordable devices and connectivity;
accessible design;
support with setup and security;
trusted assistance rather than one-off training;
language and communication adaptations;
protection from scams and financial abuse;
clear consent for proxy access; and
non-digital routes for essential services.

This reflects wider principles of digital inclusion, access and the reduction of exclusion. Technology should expand participation rather than make essential support conditional on digital competence.

Building Block Six: Stronger Community Capacity

Ageing in place is supported not only by formal care but also by accessible communities. Local shops, libraries, faith groups, clubs, transport services, community centres and neighbours can all contribute to connection and resilience.

Community capacity should not be used as a way of replacing funded care. Volunteers cannot be expected to undertake regulated or clinical responsibilities without appropriate safeguards.

However, formal services can help people reconnect with local opportunities rather than becoming the centre of every aspect of their lives.

Providers can contribute by:

mapping local community assets;
building referral relationships;
supporting accessible transport;
connecting people with cultural and social organisations;
working with local businesses on age-friendly practice;
supporting community-led prevention initiatives; and
identifying neighbourhood gaps and exclusion.

The most effective support may sometimes be helping a person resume an ordinary community role rather than creating a specialist aged care activity.

Social Connection as a Measurable Outcome

Loneliness and isolation should not be treated as soft or secondary concerns. They can affect nutrition, confidence, cognition, mental wellbeing, physical activity and willingness to seek help.

Providers should understand whether people:

have contact with those who matter to them;
can leave home when they choose;
continue participating in community life;
feel safe inviting others into their home;
have meaningful roles and routines; and
can access culturally relevant relationships and activities.

These outcomes should be interpreted personally. One person may value frequent community activity, while another may prefer a small number of close relationships. The objective is not maximum social contact but meaningful connection on the person’s own terms.

Building Block Seven: Sustainable Family and Carer Support

Many ageing-in-place arrangements depend heavily on spouses, adult children, relatives, friends and neighbours. Their contribution can make home life possible, but it must not be treated as unlimited capacity.

Carers may experience:

physical strain;
sleep disruption;
financial pressure;
reduced employment;
relationship stress;
social isolation;
anxiety about emergencies; and
difficulty navigating services.

A strong system should assess carer sustainability separately from the older person’s needs. It should understand what the carer is willing to do, what support they require and what would happen if they became unavailable.

Useful responses include:

planned respite;
training and information;
named coordination contacts;
peer support;
emergency contingency plans;
equipment and environmental changes;
flexible home support; and
early review when strain increases.

An ageing-in-place plan that works only because a family member is exhausted is not sustainable or safe.

Operational Scenario Three: Preventing Carer Breakdown

Context: Mei is 86 and lives with her husband, David, who supports her with dementia-related changes, medication and night-time reassurance. Formal support is limited because David has previously said that he can manage.

Step 1 — Identifying hidden strain: During a routine review, the coordinator speaks with David separately, with Mei’s agreement. He explains that he is sleeping poorly and has stopped attending his own medical appointments.

Step 2 — Understanding the household: The provider reviews Mei’s night-time needs, daily routines, risks, communication and sources of distress. David’s health and willingness to continue particular tasks are considered separately.

Step 3 — Introducing targeted support: Evening assistance is added several times a week, medication responsibilities are simplified and planned respite is arranged. Workers use familiar routines to reduce Mei’s distress.

Step 4 — Establishing a contingency plan: The family agrees who should be contacted if David becomes unwell. Relevant information, emergency arrangements and temporary support options are documented before a crisis occurs.

Step 5 — Monitoring sustainability: Reviews examine Mei’s wellbeing and David’s sleep, health, confidence and ability to continue his chosen role. Support is adjusted before either reaches breaking point.

This scenario demonstrates that carer support is not separate from ageing in place. It is one of the conditions that determines whether the arrangement remains viable.

Building Block Eight: Rapid Response and Crisis Prevention

Ageing at home becomes fragile when the only response to sudden change is emergency department attendance or permanent admission into care.

By 2035, communities should have access to more intermediate responses, including:

urgent community nursing;
rapid allied health assessment;
temporary night support;
short-term step-up care at home;
mobile diagnostic services;
medication review;
carer crisis support;
temporary respite;
virtual clinical assessment; and
short-stay community alternatives where home is temporarily unsafe.

These services require clear referral criteria and shared responsibility. A rapid-response pathway that exists on paper but cannot be accessed outside office hours will not prevent crisis.

Hospital Discharge Must Begin Before the Person Leaves

Transitions from hospital are a common point of failure. Older people may return home with changed medication, reduced function, new equipment needs and increased dependence, while community providers receive incomplete or delayed information.

Effective discharge should include:

early involvement of the person and those they trust;
assessment of the home environment;
confirmed medication arrangements;
equipment in place before return;
named clinical and service contacts;
support commencing on the day of discharge;
clear deterioration and escalation guidance; and
planned review within the early recovery period.

The system should also distinguish between temporary post-hospital needs and permanent changes. Without active reablement, short-term dependency can become embedded unnecessarily.

Building Block Nine: Intelligent Data and Early Warning

Future ageing-in-place systems will generate information through care records, workforce platforms, health systems, medication tools, monitoring technology and personal feedback.

The objective should not be to collect the greatest possible volume of data. It should be to identify the information that supports timely decisions.

Potential early warning indicators include:

reduced food or fluid intake;
increased falls or near misses;
changes in sleep or movement;
missed medication;
declined visits;
increasing worker concerns;
repeated service cancellations;
carer fatigue;
rising emergency contacts;
loss of community participation; and
deteriorating home conditions.

Each indicator needs an owner, threshold and response. Information without action can create an illusion of assurance.

Data should also be used to identify wider inequalities. Leaders should be able to see whether rural communities, culturally diverse groups, renters, people with low income or those without digital access experience longer waits or poorer continuity.

Governance for Ageing in Place

Ageing in place carries complex responsibilities because support is delivered across private homes, multiple organisations and informal networks.

Boards and senior leaders should understand:

where home support arrangements are becoming fragile;
which communities lack workforce capacity;
how many people are waiting for reassessment or increased support;
where family care is masking unmet need;
how frequently hospital discharge fails;
where housing conditions are increasing risk;
whether digital solutions are accessible and proportionate;
how emergency and after-hours pathways perform; and
whether improvement actions have changed outcomes.

The Governance Maturity Assessment can support organisations to test whether leadership, accountability, risk oversight and board assurance are sufficiently developed for complex, distributed home-based care.

Measuring Whether Ageing in Place Is Working

The number of people remaining at home is not, by itself, a sufficient measure of success. A person may remain at home because they lack alternatives, fear change or rely on an exhausted family member.

A balanced outcomes framework should examine:

whether the person remains in control of decisions;
safety and confidence within the home;
maintenance of daily living abilities;
access to health and clinical support;
social connection and community participation;
workforce continuity;
carer sustainability;
avoidable hospital attendance;
timeliness of changing support;
equity across regions and communities; and
the person’s own view of their quality of life.

These measures should not create pressure to keep people at home when another setting would better reflect their needs and wishes. A planned, informed move can be a positive outcome.

What Australia Must Begin Building Now

The infrastructure required for 2035 cannot be created in the final years before it is needed. Providers and system leaders can begin laying the foundations now.

Map local ageing-in-place pathways. Identify where people encounter delays, repetition, unclear ownership or lack of urgent support.
Build flexible capacity. Develop arrangements for temporary increases, evening support, rapid review and step-down.
Connect housing and care assessment. Treat environmental barriers as potential drivers of need.
Plan workforce by locality. Understand travel, housing, skill and continuity risks at community level.
Strengthen clinical interfaces. Define escalation routes, delegated tasks and access to professional advice.
Measure carer sustainability. Do not rely on informal care without informed agreement and contingency planning.
Invest in digital inclusion. Ensure technology does not exclude people from essential services.
Create early warning frameworks. Connect frontline observations with rapid intervention.
Develop community partnerships. Link formal care with transport, housing, cultural and social infrastructure.
Align governance with outcomes. Track whether people are safe, connected, independent and genuinely choosing to remain at home.

Ageing in Place Must Become a Real Choice

Australia’s ageing-in-place ambition will succeed only if home becomes a supported environment rather than the location where increasingly complex needs are expected to be managed through fragmented visits and unpaid family labour.

By 2035, older Australians should be able to access a connected system that brings together flexible support, clinical expertise, suitable housing, community connection, technology, transport and responsive workforce capacity.

The home should not become an isolated care setting. It should remain part of a wider network of relationships, services and community life.

This requires investment, but it also requires a different way of thinking. Ageing in place is not one programme, one package or one provider responsibility. It is the outcome produced when multiple systems organise themselves around the older person’s life.

Australia now has the opportunity to build that infrastructure deliberately. The goal should be neither to keep every person at home indefinitely nor to reduce access to residential care. It should be to ensure that remaining at home is safe, sustainable and genuinely chosen for as long as it continues to support the person’s rights, wellbeing and preferred way of living.