Many older Australians receiving government-funded home care struggle to get the support they need to live well at home, according to new research that reveals the daily challenges faced by a growing part of the community.
The study , published in The Australasian Journal on Ageing (AJA), reveals that while the Home Care Package program was designed to help older people stay independent, many felt overlooked, unheard and left to navigate a complex system without the personalised care that was supposed to underpin the program.
Researchers from Flinders University interviewed older adults aged 65 years and above from across Australia to understand their experiences of accessing a Home Care Package, including how they used their funds and prioritised essential services, such as food and nutrition support.
The findings show that participants valued the idea of consumer-directed care but said the reality often fell short of that promise.
Lead author Caitlin Wyman , an Accredited Practising Dietitian and PhD candidate in Flinders’ Caring Futures Institute, says many older adults felt as though the program was more focused on system processes and fees rather than meeting their individual care needs to support them to stay well at home.
“Several participants described feeling like a number within the aged care system and others spoke about the emotional toll of repeatedly having to advocate for their care needs,” says Ms Wyman, from Flinders’ College of Nursing and Health Sciences.
Many recipients reported administration fees and unclear rules around package spending, which left them confused and distressed about how they could use their funds. Participants also described having to fight for basic services and feeling dismissed or ignored when they tried to explain what would help them most.
Co-author and Flinders University researcher and Accredited Practising Dietitian Dr Alison Yaxley , says the research shows that many older people know exactly what support they need but face barriers when trying to secure it.
“Participants wanted care that respected their preferences and allowed them to make decisions about their own wellbeing,” says Dr Yaxley, from Flinders’ Caring Futures Institute .
Concerningly, the study also found that limited budgets forced many recipients to make difficult trade-offs which could compromise their ability to live safely, independently and comfortably at home. Some went without cleaning or personal care to afford physiotherapy or transport to medical appointments.
Others said they avoided asking for help because they feared their requests would be rejected or would take too long to process. Several older adults used their own money to pay for essential items because waiting for approval felt too uncertain.
Food and nutrition emerged as an area of concern. While participants understood the importance of eating well, many said nutrition was often pushed aside as they tried to stretch their budgets to cover more urgent health needs. Some described eating toast instead of preparing balanced meals because of mobility issues, fatigue or lack of motivation.
Although meal preparation can be funded through home care, most participants could not justify the staff hours and associated costs, as this would lessen funds available for other aspects of their care.
Others said pre-prepared meal services did not meet their dietary needs, personal tastes or cultural preferences. For older people living in regional areas, their options were even more limited.
“Nutrition plays a crucial role in healthy ageing and should not be treated as optional. Our findings highlight a significant gap in the program’s current capacity to support older people’s nutrition, a fundamental need that no one should be left to go without,” says Ms Wyman.
“Participants valued fresh food, variety and enjoyment when eating but found it hard to maintain these habits within the constraints of their package.”
The researchers found that when care was personalised and attentive, older adults felt more secure and respected. Participants with self-managed packages often reported better experiences because they could choose workers who understood their routines and preferences.
However, not everyone has the time, confidence or support to self-manage, and the researchers say the system needs to work well for all recipients, not just those able to navigate it independently.
“The voices of older Australians must guide improvements to our home care system, so it genuinely delivers person‑centred care. Every older person deserves support that helps them to stay healthy, connected and independent in their own home,” says Ms Wyman.
The researchers hope their findings place a spotlight on the need for older Australians to be at the centre of their care, with a significant gap identified in how home care supports their nutritional health.
The authors note that the research was conducted prior to aged care reforms in which the Australian Government replaced the Home Care Package program with Support at Home on 1 November 2025. However, they note that the findings provide important insight into the experiences of older adults under the previous model and highlight issues that remain relevant as Australia shifts to a new approach to home care.
The paper, ‘ Care by Name, Not by Nature: Experiences of Older Adults Accessing a Home Care Package Including Food and Nutrition Services: An Exploratory Qualitative Study ,’ by Caitlin Wyman, Victoria Hoekman, Michael Lawless, Jolene Thomas, Alison Yaxley is published in The Australasian Journal on Ageing (AJA) . DOI:10.1111/ajag.70156
Australasian Journal on Ageing
Survey
People
Care by Name, Not by Nature: Experiences of Older Adults Accessing a Home Care Package Including Food and Nutrition Services—An Exploratory Qualitative Study
8-Apr-2026
The authors declare no conflicts of interest.