Australia’s aged care continues to operate on a one-size-fits-all model

Across the country, our culturally and linguistically diverse elderly population is growing faster than the systems designed to support it. Mainul Haque reports.

AUSTRALIA stands on the brink of an aging population tsunami and we are not ready for it.

Nationwide, our elderly population is growing faster than the systems designed to support it. These include culturally and linguistically diverse (CALD) Australians, where language, beliefs, food, family structures and cultural expectations are central to wellbeing. But aged care continues to operate on a “one size fits all” model that suits no one and fails far too many times.

As an elderly immigrant recently shared:

“We have worked hard for Australia all our lives. We just want Australia to understand us in our old age.”

Almost a third of Australians were born overseas. Many of those who arrived in the 1980s and 1990s are now entering their 60s, 70s and 80s. More than one million Australians aged over 65 speak a language other than English at home. Across cities and regional centres, multicultural populations are growing faster than the national average.

These older Australians are far from a fringe group. Many are highly educated former professionals, business owners and skilled workers. They are financially stable, socially connected, and willing to live with dignity in environments that allow them to practice their cultural, social, and spiritual traditions for as long as possible.

But aging changes everything. As mobility declines and dementia sets in, many people will no longer be able to stay at home. As dementia progresses, people often revert to their native language, making communicating in English increasingly difficult. Without culturally congruent support, confusion, anxiety, and distress intensify; It puts great emotional and financial strain on families, hospitals, and the public system.

The results are already visible. Older Australians from CALD backgrounds face higher rates of potentially preventable hospital admissions due to language barriers, low health literacy, social isolation and culturally inappropriate services. Each preventable hospital admission can cost nearly $6,000 and occupy approximately five bed days in the hospital. If we don’t act now, hospitals across the country that are already under pressure will shoulder an even heavier burden.

Aged care currently costs the Commonwealth approximately $36 billion annually. National capital investment needs are estimated to exceed $72 billion over the next seven years just to meet basic demand. Without innovation, these billions will continue to support an inefficient, reactive, crisis-focused model rather than a preventative, person-centered model.

Even a conservative 15 percent reduction in preventable hospitalizations through culturally appropriate, co-designed senior care services could save nearly $500 million nationwide over a decade and free up more than 430,000 hospital bed days over the same period.

Public-private partnerships: A game changer

Multicultural communities are willing to be part of the solution, but they cannot shoulder the millions of dollars of upfront costs alone. The cost of building a modern 200-bed aged care facility is estimated at approximately $90 million; this is far beyond the capacity of community groups alone.

This is where public multinational private partnerships (PPPs) become transformative. Combining government support, private investment and community participation, PPPs can deliver high-quality, purpose-built aged care facilities quickly, efficiently and sustainably.

A PPP-funded, jointly designed 200-bed facility will not only provide dignity, safety and culturally sensitive care to hundreds of older Australians, but will also serve as a replicable model for other states and territories and scale innovation across the country. Through careful planning and true co-design, PPPs enable facilities to meet increased demand without unduly burdening taxpayers or community groups, proving that economic prudence and social justice can go hand in hand.

Mainstream aged care homes often struggle to meet basic cultural needs: halal or kosher food, prayer spaces, bilingual staff, culturally informed dementia care, gender-sensitive services and faith-focused end-of-life support. These are not optional extras; they directly impact mental health, behavior, confidence and clinical outcomes.

That’s why co-design should be at the heart of every new model. Co-design is not a token consultation. It is a true partnership in which seniors, families, community organizations, faith leaders, healthcare professionals and policy makers collaborate from the beginning to shape building design, services, workforce, food, language support, governance and care practices. When people help design their own care environments, the result is safer, more dignified, more culturally intelligent, and more cost-effective.

Australia is uniquely positioned to lead this transformation. Pilot projects can be tested, evaluated and developed at manageable scales before being scaled up nationally. The diversity of Australia’s population reflects the future of the nation and the long tradition of collaboration between government, society and industry provides fertile ground for innovation.

A 200-bed, PPP-funded, collaboratively designed multicultural aged care facility will be an important first step in helping hundreds of older Australians live with dignity, belonging and security.

It will serve as a culturally sensitive model of care that can be replicated in other states and territories to meet the growing needs of our aging, multicultural population.

The economic benefits are significant: conservative estimates suggest savings of more than $24 million annually, or approximately $250 million over a decade, from reduced hospitalizations and improved long-term outcomes. At this rate, a $90 million capital investment could be effectively recouped in just four years.

But the real benefit cannot be measured in dollars alone.

This means less loneliness. Less confusion. Less distress for people living with dementia. Stronger family trust. Faith-centered end-of-life care. And a simple but profound reassurance that older Australians can grow old in environments where they are understood, respected and valued.

This isn’t about special treatment. It’s about fairness and foresight.

Aged care must evolve to reflect Australia: multilingual, multifaith, multicultural and aged. The tide of aging is no longer approaching. It’s already here. The only question that remains is whether we act with foresight or wait for a crisis to force our hand.

The solution is clear: co-design, co-finance and co-build aged care facilities with the communities they are intended to serve, now and into the future, and across Australia.

It is smart economy. This is good policy. And it’s the right thing to do.

Mainul Haque OAM is a retired Australian public servant with nearly three decades of experience in government, academia and community leadership.

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