Dementia Patients Warned Against Home Care Applications as Algorithm Cuts Funding
People living with dementia in Australia have been explicitly warned not to apply for home care support because of fears that the government’s automated assessment algorithm would result in a reduction of their funding packages. Documents released to Guardian Australia under freedom of information laws indicate that these warnings were issued by senior health officials and local assessment services within weeks of the algorithm’s rollout in November. The system, known as the Integrated Assessment Tool, is designed to determine funding levels and priority of need for older Australians requiring home support, which is critical for preventing hospital admissions and early entry into residential care.
Days before the implementation of the new system, the government barred aged care assessors from overriding the decisions made by the Integrated Assessment Tool, even when the allocated level of funding was deemed wrong or inadequate. This restriction has led to significant distress among advocacy groups and healthcare providers who argue that the rigid application of the algorithm fails to account for the complex and deteriorating needs of vulnerable individuals. Dementia Australia wrote to senior health department staff on December 8 to express ongoing concerns about the feedback they were receiving regarding the new assessment process.
The organization cited specific examples of individuals whose care needs had increased but who were discouraged from seeking reassessment. In one instance, a husband caring for his wife with dementia was advised by his local assessment service not to pursue a review, despite her condition worsening. He was told that many people with dementia had received less or no support following an assessment, even when their needs were clearly escalating. Similarly, the Older Persons Advocacy Network sent a paper to department officials in February warning of deaths occurring due to the failing assessment system. The document stated that the inability of clinicians to intervene and the over-reliance on automated decision-making were contributing to preventable deterioration and, in some cases, death.
Internal emails revealed that assessment organizations were telling potential applicants that there was no guarantee they would receive more funding, leading them to avoid the process altogether. Some assessors also reported that they had not been properly trained on the use of the Integrated Assessment Tool. Prof Tanya Buchanan, CEO of Dementia Australia, emphasized the need for clinical oversight to be restored to ensure the system can meet the needs of Australians living with dementia and their carers.
In response to these concerns, a spokesperson for the health department stated that the government would legislate a new assessment escalation pathway rather than returning human override powers. This pathway would allow assessors to raise cases to a system governor, specifically the secretary of the Department of Health, Disability and Ageing. However, advocates like Samantha Edmonds of the Older Persons Advocacy Network expressed skepticism about the effectiveness of this new process without further details. They argued that human oversight must remain part of the decision-making process to prevent catastrophic outcomes for older people.
Further evidence of systemic issues was provided by Ageing Australia, which outlined cases where individuals with Parkinson’s disease were assessed as requiring no additional support despite declining health. The Commonwealth Ombudsman is currently investigating these matters, while state and territory health department staff have logged hundreds of cases of systematic under-assessment. Dr Shirley Bowen, head of the Western Australian health department, warned of catastrophic outcomes resulting from the current system.
This report was produced in the Europe Brief News newsroom.
