In this guest post, former optometrist turned aged care provider Christina Harlamb warns new Support at Home rules risk undermining affordability and care quality. She argues that higher out-of-pocket costs and capped care management funding threaten seniors’ independence, increase hospitalisations, and erode the system’s purpose of supporting ageing at home. Christina Harlamb founded Focus Care 10 years ago with a vision to provide innovative, quality aged care, dementia care and disability support services to people living in their home and community.
After 25 years working as an optometrist, I never imagined I’d end up as an aged care provider. But when I began caring for my in-laws, I saw firsthand the barriers and frustrations that older Australians face just to stay healthy and independent at home.
That personal experience changed the course of my career, and it’s why I am speaking out today. The government’s new rules around the new Support at Home Program, while aiming to improve aged care services, risks doing the opposite. Under the new rules, seniors will be asked to pay more out of their own pockets for essential non-clinical support. For many, it will mean abandoning a home care package altogether.
Home care was designed to keep people safe, supported and out of the hospital. If affordability becomes the deciding factor, the entire system risks collapsing in on itself. Older Australians deserve more than a choice between food, medicine, and the basic services that allow them to live with dignity.
The lesson I learned caring for my in-laws is that aged care isn’t abstract policy – it’s lived reality. Unless we rethink how the Support at Home Program is structured, thousands of families will pay the price.
Many older Australians will turn down home care packages, not because they don’t need help, but because they won’t be able to afford the out-of-pocket costs for non-clinical support.
Without support for day-to-day needs like meals, cleaning, transport and personal care, we’ll see more preventable hospitalisations and premature entry into residential care – both far more costly than home support
“This is not the kind of aged care system Australians were promised.”
And the problem doesn’t stop there. The proposed cap on care management funding at 10% threatens to strip away the very coordination and support that allow older Australians to stay at home.
Care management is the backbone of safe, person-centred aged care; it’s not enough to provide pieces of support, someone has to connect the dots.
As part of my Master’s degree, my thesis was on the quality of life for people living with dementia – and it’s research that continues to shape my work. What I learned only reinforced what I witness every day as a provider – continuity and coordination of care for seniors – and especially those living with dementia, are critical.
When care is fragmented, the impact is immediate and painful. Each new face a person must adjust to, each time their story has to be retold, each disruption to a routine chips away at their dignity and independence. It places stress on families and undermines the purpose of home care – to support older Australians to age well in the place they love most.
When care is consistent and well-coordinated, the difference is extraordinary. People eat better, sleep better, and stay connected to their communities longer. Families feel supported rather than abandoned. Staff are able to do their jobs with confidence and compassion.
Receiving ad hoc help in the form of meal delivery or house cleaning is useful, but without professional coordination to link the gaps in care, the growing confusion, missed medical appointments, and weight loss, that’s where the decline can go unnoticed.
The reduction in funding from an average of 17-20% to 10% is significant when applied across the whole sector. That gap translates into millions of dollars unavailable for care management and leaves families and older people to carry the risk.
When you underfund care management, you don’t save money; you lose good people and potentially put the well-being of older people at risk.
Care management is what ties all of the moving parts together, so the small things get picked up before they become bigger health problems.
Care management is specialist work, not admin, and these cuts send the message to skilled staff that their expertise doesn’t matter.
