Moving from Home Care to a Nursing Home (2026)

Note: Home Care Packages were replaced by the Support at Home program from November 2025. References to Home Care Packages below now apply to Support at Home.

Moving from home care to a nursing home is one of the most significant decisions a family can face. For many older Australians, the goal is to stay at home as long as possible. But there comes a point where home care services, even a Level 4 Support at Home package (formerly Home Care Package), may no longer meet the level of support someone needs.

This guide walks through the entire transition process. We cover the signs that residential care may be the right next step, how to have difficult conversations with family, what happens to your existing Support at Home package, how to prepare financially, and how to choose a facility that feels like home.

Signs It Might Be Time for Residential Care

Recognising that home care is no longer enough can be gradual. There is rarely a single moment of clarity. Instead, families notice a pattern of changes that, taken together, point toward a higher level of care.

Safety Concerns at Home

Safety is often the trigger that moves conversations forward. Watch for:

• Frequent falls or near-misses. One fall can be an accident. Repeated falls suggest the home environment is becoming hazardous, even with modifications like grab rails and non-slip mats.
• Wandering or confusion. For people living with dementia, wandering outside the home, leaving the stove on, or becoming disoriented in familiar surroundings creates serious risk.
• Medication mismanagement. Taking the wrong dose, skipping medications, or doubling up can have dangerous consequences, particularly with blood thinners, insulin, or heart medications.
• Inability to respond to emergencies. If someone cannot call for help during a fall, a medical episode, or a household emergency, living alone becomes high-risk.

Care Needs Exceeding Home Support

Support at Home packages provide substantial support, but they have limits:

• 24-hour care requirements. If someone needs supervision or assistance around the clock, home care becomes extremely expensive and logistically difficult to coordinate.
• Complex medical needs. Wound care, catheter management, oxygen therapy, and other clinical interventions may require nursing staff available on-site at all times.
• Two-person transfers. When it takes two carers to help someone move from bed to chair, the cost and scheduling demands can exceed what a Support at Home package covers.
• Rapid decline in function. A noticeable drop in the ability to eat, dress, bathe, or use the toilet independently over a short period often signals the need for more intensive support.

Carer Burnout

Family carers are often the last to acknowledge they are struggling. Signs of burnout include:

• Exhaustion, sleep disruption, and declining physical health in the carer
• Increasing frustration, impatience, or emotional withdrawal
• The carer neglecting their own medical appointments and social connections
• Relationship strain between the carer and the person receiving care

When a family carer reaches breaking point, the quality of care at home suffers. Recognising burnout early allows for a planned, considered transition rather than an emergency placement.

Having the Conversation

Talking about a move to residential care is difficult for everyone involved. The person receiving care may feel they are losing their independence. Family members may feel guilty. These conversations work best when they happen before a crisis, not during one.

Tips for a Productive Discussion

• Start early. Raise the topic while your loved one can still participate meaningfully in decisions. Waiting until a hospital admission forces the issue removes their voice from the process.
• Use “I” statements. Say “I worry about you being alone at night” rather than “You cannot look after yourself.” This reduces defensiveness and keeps the conversation collaborative.
• Acknowledge feelings. Fear of losing independence, leaving a family home, and being “put away” are real and valid emotions. Do not dismiss them.
• Focus on what residential care offers. Social connection, meals prepared daily, activities, on-site nursing, and relief from the burden of managing a household can genuinely improve quality of life.
• Involve a trusted third party. A GP, geriatrician, or aged care advisor can provide an objective perspective and help the family see the situation clearly.
• Revisit the conversation. One discussion is rarely enough. Give everyone time to process and return to the topic with new information.

When the Person Does Not Want to Move

Resistance is normal. Some strategies that help:

• Arrange respite stays at a residential facility so they can experience the environment without commitment
• Ask their doctor to explain the medical reasons a higher level of care is needed
• Involve them in visiting and choosing facilities so they feel in control
• Focus on trial periods rather than permanent decisions

If someone has cognitive impairment and lacks capacity to make safe decisions, the family may need to involve a guardian or work with an aged care assessment team to determine the safest path forward.

What Happens to Your Support at Home Package

When you enter permanent residential aged care, your Support at Home package (formerly Home Care Package) does not simply transfer across. The two programs are separate.

Key Steps

1. Notify your home care provider. Let them know you are transitioning to residential care. You typically need to give notice as outlined in your agreement.
2. Package cessation. Your Support at Home package formally ends on the date you enter permanent residential care. Services stop from that point.
3. Unspent funds. Unspent funds in your package are managed according to the program guidelines. Your provider will give you a final statement showing how funds were used and any remaining balance.
4. Equipment and modifications. Items purchased through your package (mobility aids, home modifications) are generally yours to keep. Items on loan may need to be returned.

Timing Considerations

If you are on a waiting list for a residential facility, you can continue using your Support at Home package until a bed becomes available. Do not cancel your package prematurely. The gap between ending home care and entering residential care can leave you without any support.

If you enter residential respite care (a temporary stay), your Support at Home package can be suspended rather than cancelled. This gives you the option to return home if the respite stay does not lead to permanent placement.

ACAT Reassessment for Residential Care

To enter a nursing home permanently, you need approval from an Aged Care Assessment Team (ACAT). If your current ACAT assessment only approves you for home care, you will need a reassessment.

How the Process Works

1. Request an assessment. You, a family member, your GP, or your home care provider can request an ACAT assessment through My Aged Care or by calling 1800 200 422.
2. Assessment visit. An ACAT assessor will evaluate care needs, usually at home or in hospital if the person has been admitted. The assessment covers physical health, cognitive function, emotional wellbeing, and social supports.
3. Approval categories. The ACAT will determine whether you are approved for permanent residential care, respite care, or both.
4. Validity period. ACAT approvals are generally valid for 12 months, though extensions can be requested.

Urgent Assessments

In emergency situations, such as a hospital discharge where returning home is unsafe, ACAT assessments can be fast-tracked. Hospital social workers can arrange urgent assessments, sometimes completing them within days.

If you already have ACAT approval for residential care, you do not need a new assessment. Check your current approval letter or call My Aged Care to confirm what you are approved for.

Financial Preparation: Understanding the Costs

Residential aged care costs are different from home care costs. Understanding them before you start looking at facilities prevents financial surprises.

The Fee Structure

Residential aged care fees fall into several categories:

Basic Daily Fee Everyone pays a basic daily fee. As of 2025, this is set at 85% of the single basic age pension (approximately $66.80 per day or around $22,000 per year). This covers daily living costs like meals, cleaning, laundry, and utilities.

Means-Tested Care Fee Based on your income and assets, you may be asked to pay an additional contribution toward your care costs. The government assesses this through Services Australia. There are annual and lifetime caps on how much you pay in means-tested fees.

Accommodation Costs This is often the largest cost and depends on your financial situation:

• Refundable Accommodation Deposit (RAD). A lump sum payment, similar to a bond. The RAD is fully refundable when you leave the facility (minus any agreed deductions). RADs typically range from $300,000 to $700,000 or more depending on the facility and room type.
• Daily Accommodation Payment (DAP). Instead of paying a lump sum, you can pay a daily amount calculated from the RAD using a government-set interest rate (the Maximum Permissible Interest Rate, or MPIR).
• Combination. You can pay part RAD and part DAP. For example, pay $200,000 as a lump sum and the remainder as a daily payment.

If your means-tested assessment shows you cannot afford the full accommodation cost, the government will subsidise it, and you will pay a reduced or zero accommodation contribution.

Extra and Additional Services Some facilities offer higher-standard rooms, premium meals, or additional services at extra cost. These are optional and negotiable.

Getting a Financial Assessment

Before choosing a facility, complete an income and assets assessment through Services Australia. This determines:

• Whether you need to pay a means-tested care fee
• Whether you are eligible for government help with accommodation costs
• Your fee caps and safety nets

Consider engaging a financial adviser who specialises in aged care. The RAD versus DAP decision has significant implications for your estate, pension eligibility, and overall financial position.

What About the Family Home?

A common concern is whether you need to sell the family home to fund aged care. The short answer: no, you are not required to sell your home.

However, your home may be counted in the means test for accommodation costs. Key rules:

• If your spouse or dependent continues living in the home, it is exempt from the means test.
• If the home is vacant, it may be included in your assessable assets after a certain period.
• There are caps on the assessed value of your home for means-testing purposes.
• Renting out the home generates income that is included in the means test, but the rental income can help fund ongoing fees.

For detailed strategies on protecting the family home, see our guide on how to avoid selling your home for aged care.

For a full breakdown of nursing home costs, read How Much Does a Nursing Home Cost in Australia?.

Choosing the Right Facility

Not all nursing homes are the same. The right facility for one person may be completely wrong for another. Spending time on this decision pays off in comfort and quality of life.

What to Look For

Location

• Proximity to family and friends who will visit regularly
• Access to familiar community, shops, and services
• Distance from the person’s GP or specialist if they wish to keep the same doctors

Care Quality

• Staff-to-resident ratios, particularly overnight
• Availability of registered nurses on-site 24/7
• Specialist dementia care if needed
• Allied health services (physiotherapy, occupational therapy, speech pathology)
• Star ratings and compliance history on the My Aged Care website

Lifestyle and Culture

• Daily activities program and social engagement opportunities
• Meal quality, menu variety, and accommodation of dietary needs
• Private versus shared rooms
• Outdoor spaces, gardens, and communal areas
• Pet-friendly policies
• Cultural and language considerations
• Religious or spiritual support

Financial Transparency

• Clear fee schedule with no hidden costs
• Willingness to explain RAD, DAP, and extra service fees in writing
• Flexibility in payment arrangements

Visiting Facilities

Visit at least three to five facilities before making a decision. When you visit:

• Go at different times of day, including mealtimes
• Talk to current residents and their families if possible
• Observe how staff interact with residents
• Ask about staff turnover and training
• Check the cleanliness and maintenance of common areas and rooms
• Ask what happens if care needs change over time

For a detailed checklist on evaluating nursing homes, see our guide on how to choose a nursing home in Australia.

Managing Waiting Lists

Popular facilities often have waiting lists. Planning ahead gives you more options.

How Waiting Lists Work

• Most facilities maintain their own waiting lists. There is no centralised national list.
• You can be on multiple waiting lists at the same time.
• Some facilities prioritise people already using their respite services or those in the local community.
• Emergency placements (such as from hospital) may bypass standard waiting lists.

What to Do While Waiting

• Continue using your Support at Home package at its current level.
• Request a package level increase through My Aged Care if your needs have grown.
• Use residential respite care to trial preferred facilities (respite stays are usually up to 63 days per financial year).
• Keep your ACAT approval current and request an extension before it expires.
• Stay in contact with your preferred facilities. Call regularly to check your position on the list.

If You Need Placement Urgently

In urgent cases, such as after a hospital stay or a sudden decline, options include:

• Ask the hospital social worker to help find available beds in the area
• Contact My Aged Care on 1800 200 422 for assistance
• Consider interim placement at a facility with availability, then transfer to your preferred facility when a bed opens
• Call Carevo on 1800 953 253 for guidance on navigating urgent placements

Preparing for Moving Day

Once a bed is confirmed, the practical preparations begin.

Administrative Tasks

• Sign the Resident Agreement carefully. Understand what you are agreeing to pay and what services are included.
• Complete the accommodation payment paperwork (RAD, DAP, or combination).
• Notify Services Australia of the change in living arrangements.
• Update your address with banks, insurers, Centrelink, Medicare, and other agencies.
• Arrange power of attorney and advance care directives if not already in place.
• Cancel or redirect mail.

What to Bring

Nursing home rooms are smaller than a family home. Most facilities provide furniture, but you should bring:

• Personal clothing (labelled with the resident’s name)
• Favourite photos, artwork, or small decorative items
• A familiar blanket, pillow, or bedding
• Personal toiletries and grooming items
• Books, puzzles, or hobby supplies
• A small television or radio if the room allows
• Important documents (in a secure location or with family)

What Not to Bring

• Valuable jewellery or large amounts of cash
• Bulky furniture (check with the facility first)
• Items that pose a safety risk (electric blankets, candles, certain appliances)

Settling In: The First Few Weeks

The adjustment period is real, and it affects both the person moving in and their family. Understanding what to expect helps everyone cope.

For the Person Moving In

• Expect a settling-in period. It typically takes four to six weeks to adjust to a new routine, new people, and a new environment.
• Participate in activities. Joining group activities, even reluctantly at first, builds social connections faster than staying in the room.
• Communicate preferences. Let staff know about preferred routines, food likes and dislikes, and how you like things done.
• Keep familiar routines. If you always read the newspaper at breakfast or watched the evening news, maintain those habits.
• Accept that some days will be harder than others. Grief for the old home and the old life is normal.

For Family Members

• Visit regularly but do not hover. Frequent short visits are often better than long, exhausting ones. Consistent visiting patterns help the resident feel secure.
• Build relationships with staff. Get to know the carers by name. They are your allies in ensuring your loved one receives good care.
• Raise concerns early. If something is not right, speak with the care manager promptly. Small issues are easier to fix than entrenched problems.
• Look after yourself. The transition is emotional for families too. Guilt, relief, sadness, and worry are all normal responses. Seek support from friends, a counsellor, or carer support groups.
• Give it time. Do not make hasty judgments about whether the facility is right in the first week. Allow time for everyone to adjust.

Warning Signs to Watch For

While adjustment takes time, some things should not be ignored:

• Unexplained bruises, injuries, or weight loss
• Significant decline in mood, hygiene, or engagement
• Staff who seem dismissive of concerns
• Repeated requests for help that go unanswered
• The resident expressing fear of specific staff members

If you have serious concerns about care quality, contact the Aged Care Quality and Safety Commission on 1800 951 822.

Emotional Adjustment: Grief and Acceptance

Moving to a nursing home involves grief. The person leaving their home grieves for their independence, their garden, their neighbourhood, and the life they built. Family members grieve too, often carrying guilt about whether they did enough.

Healthy Ways to Process the Transition

• Acknowledge the loss. Moving to residential care is a significant life change. Pretending everything is fine does not help anyone.
• Focus on what is gained. Safety, social connection, regular meals, on-site medical care, and relief from the daily struggle of managing at home are genuine benefits.
• Maintain identity. Encourage the person to continue hobbies, interests, and relationships. A move to residential care does not mean giving up who they are.
• Create new traditions. Regular family visits, outings to familiar places, or sharing meals at the facility help maintain connection.
• Seek professional support. Counselling services are available for both residents and family members adjusting to the change.

Over time, many residents and families find that the move, while difficult, was the right decision. Knowing that a loved one is safe, cared for, and socially engaged brings a peace of mind that struggling at home could not provide.

Planning Ahead Makes the Difference

The families who navigate this transition best are the ones who plan ahead. Waiting until a crisis forces a decision limits your options and increases stress for everyone.

Start by:

1. Talking to your GP about current and future care needs
2. Requesting an ACAT assessment if you do not already have residential care approval
3. Understanding the finances through a Services Australia assessment and, ideally, an aged care financial adviser
4. Visiting facilities in your preferred area before you need one
5. Getting support from organisations that help families navigate the aged care system

How Carevo Can Help

Carevo connects older Australians and their families with trusted providers through every stage of the aged care journey, including the transition from home care to residential care.

As a connection platform, we help you:

• Find and compare residential aged care facilities in your area
• Understand your options and navigate the assessment process
• Connect with aged care financial advisers
• Access respite care while you explore your choices
• Get answers to your questions from people who understand the system

Ready to explore your options? Call us on 1800 953 253 or visit carevo.com.au to get started.

You can also explore our aged care resources for more guides on navigating the system with confidence.