Why older Australians don’t speak up about problems in their care
New research from the Aged Care Quality and Safety Commission finds that fear of reprisal, not being taken seriously, and low confidence in the complaints process stop older Australians from raising concerns.
Most older Australians who have concerns about their aged care keep them to themselves. New research from the Aged Care Quality and Safety Commission explains why.
The study surveyed almost 2,300 older people and their supporters across Australia, and followed up with interviews and discussion groups involving aged care residents and home care recipients. Researchers also looked specifically at experiences in First Nations communities and among people from culturally and linguistically diverse backgrounds.
The findings are clear. Trust, safety, and confidence in the complaints process are the main factors in whether someone raises a concern. For many older Australians, those three things are in short supply.
What people are afraid of
The barriers the research identified are not abstract. They are the kind of fears that make sense when you think about the position many older Australians are in.
Fear of being ignored. Fear of being dismissed. Fear that raising a problem will change how staff treat them. For people in residential care especially, that last fear carries real weight. When you depend on the same people every day for your shower, your meals, and your medication, the prospect of upsetting them is not a small thing.
Aged Care Quality and Safety Commissioner Liz Hefren-Webb acknowledged the gap between what older people expect and what they feel able to do.
“Respect, safety and being listened to are key expectations, yet many older people do not feel safe or confident in raising concerns about their aged care,” she said.
The research also found that some people questioned whether speaking up would be worth it at all. If a complaint is unlikely to lead to real change, why go through the emotional effort and potential disruption?
That question is understandable. It is also a problem the system needs to solve, not something older people should have to accept.
The power imbalance in residential care
The research points to something advocates have long described: a real power imbalance in residential aged care.
Older people living in a facility are not customers in the usual sense. They can’t easily switch providers. They can’t go home at the end of the day. They are often physically dependent on the people they might need to complain about. That dependency shapes what feels safe to say.
One account shared by aged care advocate Ross Bell captures it clearly. A friend of his, living in residential care after years of independence, was roughly handled during a shower by a staff member. He told Bell what had happened. They raised a formal complaint together. The facility said there was no evidence to support the claim.
His friend, fearful of reprisal, did not persist.
This is not an unusual story. It describes the exact gap between having rights on paper and feeling able to use them in practice.
What the new laws say
Australia’s aged care system is now operating under the Aged Care Act 2024, which formally shifted the sector toward a rights-based approach. Complaints are at the centre of that framework.
A new independent Aged Care Complaints Commissioner has been appointed, with responsibility for overseeing how complaints are managed and improving accountability across providers.
Providers are required to have accessible, easy-to-understand complaint systems. Older people and their families have a legal right to raise concerns and have them addressed.
Commissioner Hefren-Webb was direct about what that means in practice.
“It is ok to speak up, sharing your concerns can help improve your care. No concern is too small,” she said.
The Commission is also running a public information campaign, “Choice, dignity, respect,” to build awareness of rights and complaint pathways across the country.
How to raise a concern
If you or someone you care about has a concern about aged care, here is where to start.
Talk to the provider first. Most people in the research said they would approach their provider directly, and that’s often the right first step. Raise the concern clearly, and ask what will be done about it.
Keep a record. Write down what happened, when, and what was said in response. A written record matters if the concern escalates.
Know who else you can contact. If the provider doesn’t resolve it, or if you don’t feel safe raising it with them directly, the Aged Care Quality and Safety Commission handles complaints about government-funded aged care services. You can contact them at agedcarequality.gov.au or call 1800 951 822.
Get an advocate. The Older Persons Advocacy Network (OPAN) offers free, independent advocacy support for older people in aged care across Australia. An advocate is there to support the older person, not to be neutral. Call the Aged Care Advocacy Line on 1800 700 600, available Monday to Friday 8am to 8pm and Saturday 10am to 4pm.
Don’t wait for it to be serious. Small concerns are worth raising. Patterns of poor care rarely start with one obvious incident.
Understand your rights in aged care
What families can do
If you have a parent or relative in aged care, you have a role to play here. Research consistently shows that older people are more likely to raise concerns when they have someone beside them.
That doesn’t mean taking over. It means being a consistent presence, asking questions during visits, and making clear to your relative that speaking up is worth doing and that you’ll support them through it.
If you notice something that doesn’t seem right, you can raise it too. Families have standing to contact the Commission.
The hardest part of this picture is that the people least able to speak up are often those most at risk. People who are isolated, cognitively impaired, or from communities where self-advocacy is culturally difficult face compounding barriers. If you’re visiting someone in this situation, staying engaged and asking questions is one of the most practical things you can do.
More on navigating aged care as a family
FAQ
Can I complain on behalf of someone else?
Yes. Family members, friends, and representatives can raise concerns with a provider or the Aged Care Quality and Safety Commission on behalf of an older person, with their knowledge and agreement where possible.
Will complaining affect the care my relative receives?
Legally, providers cannot treat a person differently because a complaint has been made. If you have concerns that this is happening, contact the Commission or OPAN directly.
What if the provider says there’s no evidence?
This is a common outcome, particularly for concerns about how care was delivered rather than what was documented. An independent advocate can help you decide whether to escalate, what to document, and how to approach the process.
What does the Aged Care Complaints Commissioner do?
The independent Aged Care Complaints Commissioner oversees how complaints are managed across the sector. They’re separate from the Commission’s compliance function, with a focus on improving accountability and accessibility in the complaints process.
Is there support for people from diverse backgrounds?
Yes. The Commission has looked specifically at complaint barriers for people from First Nations communities and culturally and linguistically diverse groups. OPAN’s advocacy network includes support for people whose first language is not English.
