Peak bodies back needs-based end-of-life care at home

Older people with life-limiting illness should be able to receive end-of-life care at home without fixed funding and time limits, according to a Senate Community Affairs References Committee recommendation backed by Ageing Australia and Palliative Care Australia.

The recommendation calls for the Support at Home End-of-Life Pathway to drop its funding and time restrictions and move to a flexible, clinically guided, needs-based model.

Ageing Australia and Palliative Care Australia argue that end-of-life care should follow a person’s needs, not arbitrary limits or uncertain predictions about how long they may live.

Belinda Allen, Ageing Australia’s chief member experience officer, said older people and their families need certainty, flexibility and practical support when someone is nearing the end of life.

“At the end of life, people and families need care that can respond to their circumstances, not a model that puts arbitrary limits around support,” Allen said.

She argued that a more flexible model would also reduce pressure on hospitals and aged care services. Without proper support at home, families can face a system that does not fit their needs, and avoidable hospital admissions can rise.

Support at Home End-of-Life Pathway

The current pathway links access to a prognosis of less than three months and an initial 12-week funding period.

Josh Fear, Palliative Care Australia’s national policy director, described that design as a major flaw because prognosis is often hard to predict for people with frailty, dementia, neurological conditions and other progressive illnesses.

“As long as access to the End-of-Life Pathway depends on whether someone is expected to live less than three months, older Australians with significant unmet palliative care needs will continue to miss out,” Fear said.

The Federal Government plans to introduce a second round of funding from early 2027 for people who live beyond the first 12 weeks. However, the change does not remove the pathway’s basic reliance on time limits and prognosis.

Fear welcomed the extra funding as a practical improvement, but he maintained that some people may still outlive the pathway while others may miss out because their life expectancy is unclear.

Palliative Care Australia is preparing submissions to the Senate inquiry into Support at Home before the 31 July deadline, including details of the sector’s proposed needs-based model for care at home.