As aged care reform gains momentum in Australia, the introduction of the Support at Home Program brings renewed focus on restoring independence and preventing functional decline for older Australians living in the community. However, there’s a growing concern that those in residential aged care are being systematically overlooked when it comes to restorative care.

Despite the intent of reforms to promote wellbeing, independence, and person-centred care, the current model continues to operate under deeply embedded assumptions — namely, that once a person enters residential aged care, their capacity to improve has ended.

This is not only inaccurate; it’s harmful.

Ageism and the Disability Model in Aged Care

Australia’s aged care system has long been entrenched in a disability model of care — one that focuses on deficits, dependence, and decline. This outdated framework often assumes that older people, particularly those in residential settings, are incapable of regaining function or living a life of purpose and autonomy.

Such thinking is underpinned by ageist ideals that reduce older individuals to their limitations rather than their potential. The reality is that older people — regardless of where they live — can continue to gain strength, improve function, and enhance quality of life when given the right opportunities.

The Missed Opportunity in Residential Aged Care

Under the current aged care framework, restorative and reablement services are widely funded and encouraged for those living at home through the upcoming Support at Home Program and the Short-Term Restorative Care (STRC) Program.

In contrast, residents in aged care facilities are largely excluded from these same targeted interventions, despite evidence that they, too, can benefit immensely from strength-based, goal-oriented care.

This is a false divide. Living in a residential care setting does not equate to an absence of potential. A sedentary lifestyle — often the result of system limitations, not personal choice — contributes to sarcopenia, falls, frailty, cognitive decline, and increased hospitalisation. These are not inevitable consequences of ageing; they are consequences of inactivity and low expectations.

Strengths-Based Care in Action: What’s Possible

Adopting a strengths-based approach within residential aged care settings has the potential to:

• Reduce falls through targeted mobility and balance programs.
• Prevent or reverse sarcopenia by introducing resistance-based exercise and nutrition support.
• Improve mood and cognitive function by promoting engagement in meaningful, purposeful activities.
• Decrease polypharmacy and reduce the burden of chronic disease through improved function and physical activity.
• Enhance dignity, self-esteem, and connection, all of which are vital indicators of quality of life.

This isn’t theory — it’s evidence-based practice, already being implemented in small pockets of progressive aged care homes across Australia and internationally.

The Case for Policy Reform

The Aged Care Quality Standards (Standard 1: Dignity and Choice; Standard 3: Personal and Clinical Care) mandate that aged care providers support individual goals and optimise health and wellbeing. But without equitable access to restorative care in residential settings, these standards fall short of their promise.

If we are truly committed to person-centred care, the system must:

• Embed funded restorative care services within residential aged care, not just for those at home.
• Train staff and leadership to adopt a strengths-based mindset, rather than a custodial one.
• Challenge ageist assumptions that suggest function cannot be regained in later life.
• Measure success not just in safety and compliance, but in meaningful functional outcomes.

It’s Time to Expect More

The idea that people in residential care “can’t improve” is not just outdated — it’s a self-fulfilling prophecy. When we expect decline, we create environments that encourage it. But when we see potential, we foster change.

Let’s stop assuming that function ends at the door of a residential aged care home.

Let’s build a system that expects and supports growth, recovery, and capability — wherever someone calls home.