Residential aged care explained: how it works and how to get in

If you're reading this, chances are someone you love is struggling to manage at home, or you are. That's a hard place to be. Residential aged care, what most of us still call a "nursing home", is one of the options on the table. This guide walks you through what it actually is, who it's for, and the steps to get a place. No jargon left undefined, we promise.

What is residential aged care?

Residential aged care is supported accommodation for older people who can no longer live safely or comfortably at home, even with help coming in. You move in permanently. The home provides your room, meals, laundry, cleaning, personal care (help with showering, dressing, getting around), and nursing care around the clock.

It's different from a few things people often confuse it with:

• Home care is support delivered to you in your own home. If you'd rather stay put, that's worth exploring first. See our guide on home care.
• Retirement living is independent units or apartments for older people who don't need daily care. You manage your own life; there's no nursing on tap.
• Respite care is a short stay, planned or emergency, to give a carer a break or help you recover after a hospital stay. More on respite care.

Residential aged care is the option when the level of care needed is high and ongoing.

Who is it for?

Broadly, people who need a lot of support every day. That might be because of:

• Frailty that makes everyday tasks unsafe (falls are a big one)
• Dementia or other cognitive decline
• A chronic health condition that needs regular nursing
• A carer who can no longer cope, or who has died or become unwell themselves

There's no fixed age. Most residents are over 65, but younger people with high care needs can sometimes access it too. The deciding factor is need, not a birthday.

How the system is funded (the short version)

The Australian Government subsidises most of the cost of your care. You contribute too, based on what you can afford. There's no single "fee", there are a few separate ones, and the rules changed for new residents from 1 November 2025 under the new Aged Care Act.

We've written a full breakdown in aged care home costs: RAD, DAP, the basic daily fee and the means test, but here's the gist:

• Basic daily fee covers day-to-day living (meals, laundry, power). Everyone pays this.
• A means-tested contribution towards your care, based on your income and assets. Some people pay nothing.
• Accommodation costs, which you can pay as a big refundable lump sum, a daily rent-style payment, or a mix. Government may pay this for you if your means are low.

The key thing to know now: get the figures from a financial adviser before you sign anything. The numbers are real money and the rules are fiddly.

How to get in: the steps

Here's the path, start to finish.

Step 1: Register with My Aged Care

Everything government-funded runs through My Aged Care. Call 1800 200 422 or go to myagedcare.gov.au. The first call is free and takes about 15-20 minutes. They'll ask about the person's health, daily challenges, and what help they already get.

You can call on behalf of someone else, but it's smoother if they're with you or you have their consent on file.

Step 2: Get assessed

To access any government-funded aged care, you need an assessment. Since December 2024 this runs through the Single Assessment System, which replaced the old ACAT (Aged Care Assessment Team) and RAS arrangements. You might still hear staff say "ACAT", old habits die hard.

For residential care you'll get a comprehensive assessment: an accredited assessor visits, usually at home, and spends roughly 45-75 minutes going through physical health, memory and thinking, mood, daily living, social situation, and what carers need. It's free.

After triage, an assessor is meant to be assigned and make contact, then visit. Start early. Waiting lists are long, and an approval doesn't expire quickly, so there's no harm being assessed before you're desperate.

Step 3: Get your approval letter

If the assessor agrees residential care is appropriate, you'll get a letter (the assessment outcome) approving you for permanent residential aged care. Keep it. Homes will ask to see it.

Step 4: Sort out the money side

Before or alongside choosing a home, arrange an income and assets assessment through Services Australia so you know what you'll be asked to contribute. You do this via Services Australia using the relevant aged care calculation of cost form. This is also the right time to talk to a financial adviser. We cover finding one in financial advice.

Step 5: Find and choose a home

Now the real work begins: finding a home that suits, has a place, and that you feel good about. Use the "Find a provider" tool on My Aged Care, and read our guides on how to choose a residential aged care home and understanding aged care star ratings. You can also search Our Mate for homes in your area.

Step 6: Apply, accept a place, move in

You apply directly to the homes you like. Many have waiting lists, so apply to more than one. When a place is offered, you'll sign a Resident Agreement and an accommodation agreement. Read them, or have someone read them with you, before signing.

A quick reality check on timing

Stage	Rough timeframe
First My Aged Care call	Same day
Assessment booked and done	Weeks, sometimes longer
Choosing and applying to homes	A few weeks if you're organised
Waiting for a place	Days to many months, varies hugely by area

The honest truth: in some regions, demand outstrips supply badly. Apply broadly, keep your assessment current, and consider respite as a stop-gap if a crisis hits before a permanent place opens up.

Frequently asked questions

Do we have to sell the family home?
Not necessarily. The home can be paid for in several ways, and the value of the family house is sometimes capped in the means test, especially if a protected person still lives there. Get advice before selling anything.

Can Mum change her mind or move homes later?
Yes. You're not locked in for life. People do move, usually to be closer to family or because a better-suited place opens up.

What if it's an emergency and there's no approval yet?
Call My Aged Care and explain. Emergency and hospital-discharge situations can be fast-tracked, and respite care can bridge the gap.

Is it only for people over 65?
Mostly, but not strictly. Younger people with high care needs can sometimes access residential aged care. If disability is the main driver, also look at the NDIS.

The bottom line

Residential aged care is a big step, practically and emotionally. The system is navigable if you take it one stage at a time: register, get assessed, sort the money, choose well, apply broadly. Start before you're in crisis if you possibly can. And lean on the people around you, this isn't a decision anyone should make alone.

If the emotional side is weighing on you, our guide on moving a parent into aged care was written for exactly that.