Growing older is a journey everyone experiences, but for the 5.5 million Australians living with disability — 21.4% of our population — this transition brings unique considerations. When you’ve spent years building independence and accessing tailored NDIS support, the approach of your 65th birthday can feel overwhelming. What happens to the supports you’ve come to rely on? How do you maintain the quality of life you’ve worked so hard to create? For families in Cairns and Brisbane, understanding these transitions isn’t just about navigating policies — it’s about preserving dignity, choice, and connection to community during a significant life stage.
The reality is that disability prevalence increases substantially with age. By 65-69 years, 40.3% of Australians have disability, climbing to 77.1% by ages 85-89. This means many NDIS participants will experience changing support needs as they age, whether through their original disability or developing age-related conditions. The intersection of disability support and aged care systems creates both opportunities and challenges that require careful planning, early conversations, and informed decision-making.
What Happens to Your NDIS Support When You Turn 65?
The age of 65 represents a crucial threshold in Australia’s disability support landscape. Under the National Disability Insurance Scheme Act 2013, new applicants must be under 65 to enter the NDIS. However, if you’re already an NDIS participant before turning 65, you have options that deserve thoughtful consideration.
Existing NDIS participants can continue receiving support after their 65th birthday. This continuation isn’t automatic, though — you must maintain eligibility criteria and cannot move into residential aged care or commence regular home care services. The access fee no longer applies after age 65, which represents a small administrative change, but the more significant consideration is whether NDIS or aged care better suits your evolving needs.
Alternatively, participants can choose to transition into the aged care system through My Aged Care, which provides government-funded services specifically designed for older Australians. This system operates quite differently from NDIS, offering Home Care Packages at four levels based on assessed need: Level 1 at $9,026 per annum for basic support, Level 2 at $15,887 for low-level care needs, Level 3 at $34,550 for intermediate needs, and Level 4 at $52,337 annually for high-level support requirements.
The choice between continuing with NDIS or transitioning to aged care isn’t merely administrative — it fundamentally affects your support structure, funding levels, and the degree of personalisation in your care. NDIS funding typically provides more generous, individualised support tailored to disability-specific goals and isn’t means-tested. Aged care, conversely, is means-tested and may require co-payments based on your income and assets, with funding often less flexible than NDIS arrangements.
How Do Support Needs Change as NDIS Participants Age?
Aging with disability creates a complex interplay between your original disability and age-related changes that affect everyone. Secondary conditions and comorbidities become increasingly common, making it difficult to distinguish between disability-related needs and general aging processes.
NDIS participants often experience additional health challenges as they age. Arthritis, hearing loss, vision impairment, and cognitive changes can compound existing disabilities. Musculoskeletal, nervous system, circulatory, and respiratory conditions become more prevalent. These changes aren’t separate from your disability experience — they interact with and often intensify your support requirements.
For participants living in Supported Independent Living (SIL) arrangements, these changes might mean increased assistance with personal care, more complex medication management, or additional mobility support. SIL provides 24/7 assistance to help people with higher support needs live as independently as possible, covering personal care, meal preparation, household tasks, and community participation. As aging brings new challenges, your SIL support may need reassessment to ensure it continues meeting your evolving needs.
The support ratios and intensity required often increase substantially as participants age. What worked well in your 40s or 50s may need significant adjustment in your 60s and beyond. Mobility assistance becomes more complex, health appointments multiply, and the coordination between disability support and healthcare services becomes increasingly important. For those in regional areas like Cairns and Brisbane, accessing specialists and coordinating multiple services can present additional logistical challenges that require careful planning.
| Support System | NDIS | Aged Care (My Aged Care) |
|---|---|---|
| Eligibility | Under 65 at application; existing participants can continue after 65 | Available from 65 years (50+ for Aboriginal and Torres Strait Islander peoples) |
| Means Testing | No means testing | Income and asset tested; co-payments required |
| Funding Focus | Disability-specific needs and goals | General age-related support needs |
| Service Flexibility | Highly individualised, responsive to changing needs | Set funding levels with less flexibility |
| Support Coverage | Assistive technology, home modifications, employment support, capacity building | Home help, personal care, transport, limited modifications |
| Residential Care | Does not typically fund residential/nursing homes | Funds residential aged care facilities |
| Annual Funding Range | Varies significantly based on individual needs | $9,026-$52,337 depending on Home Care Package level |
When Should You Start Planning for the Transition at 65?
The single most important factor in successfully navigating aging with disability is early planning. Waiting until your 65th birthday approaches creates unnecessary stress and limits your options. Ideally, conversations about your transition should begin 12-18 months before your 65th birthday.
During this initial period, engage with your NDIS planner or support coordinator to discuss whether continuing with NDIS or transitioning to aged care best suits your circumstances. This isn’t a decision to make hastily. Gather relevant medical reports and functional assessments that document your current support needs and any changes you’ve noticed. Understanding the aged care assessment process early helps you prepare for what lies ahead if you’re considering that pathway.
Between six to twelve months before turning 65, obtain an Aged Care Assessment (ACAT or ACAS in different states) if you’re considering aged care transition. This free assessment determines your eligibility and appropriate service level. Simultaneously, request a final NDIS plan review before your 65th birthday to ensure your current plan accounts for any aging-related support needs. Collect financial and asset documentation, as aged care means-testing requires comprehensive information about your financial situation.
In the three to six months leading up to your 65th birthday, finalise your decision. If continuing with NDIS, ensure your plan is current and reflects your goals. If transitioning to aged care, identify providers in Cairns or Brisbane, complete applications, and understand your rights under aged care quality standards. Notify the NDIS in writing if you choose to leave the scheme.
The 3.0 million Australians who provide unpaid care — 11.9% of households — also need consideration during this planning process. If family members support you, their wellbeing and capacity should factor into transition decisions. Primary carers themselves have disability in 43.8% of cases, making sustainable support arrangements crucial for everyone’s wellbeing.
What Support Options Maintain Independence After 65?
Maintaining independence, community connection, and quality of life remains possible regardless of which support system you choose after 65. The key is understanding what each pathway offers and aligning it with your personal goals and circumstances.
If you continue with NDIS after 65, your existing support structure remains largely intact. You can continue living in your current arrangements, whether that’s independently with support, in shared accommodation, with family, or in Supported Independent Living. Home modifications can be updated as your needs evolve, and assistive technology remains available. Your support must relate to your disability and align with your goals, but the flexibility and individualisation that attracted you to NDIS initially continues.
Supported Independent Living remains a valuable option for NDIS participants over 65 who require regular or 24/7 support. SIL focuses on building daily living skills while providing comprehensive assistance with personal care, medication management, meal preparation, and community participation. Whether you need lower-level regular daytime support or complex 24-hour intensive assistance, SIL can be tailored to your specific requirements. Participants pay for their accommodation separately while NDIS funds the support component, maintaining a clear distinction between housing costs and care needs.
For those transitioning to aged care, Home Care Packages enable aging in place with support scaled to your assessed needs. Entry-level services might include cleaning, shopping assistance, and occasional personal care. Higher-level packages provide more intensive support, approaching the comprehensiveness of NDIS funding in some cases, though typically with less flexibility and individualisation.
The Disability Support for Older Australians (DSOA) Program serves people 65 and older (or First Nations people aged 50-64) who weren’t eligible for NDIS but received state or territory disability services. This programme provides Individual Support Packages, offering choice and control over services while maintaining independence. It includes crucial respite care for carers, recognising that sustainable support requires attention to the entire support network, not just the person with disability.
In Cairns and Brisbane, local providers understand the unique considerations of aging with disability in Queensland. While rural and remote areas face challenges with thin markets for disability services and limited provider choices, major regional centres like Cairns and metropolitan areas like Brisbane offer more comprehensive options. However, planning timelines may need to be longer in areas with fewer providers to ensure appropriate supports are secured before transitions occur.
How Do You Navigate the Practical Realities of Changing Support Systems?
Theory and policy frameworks matter, but the practical reality of transitioning support systems involves numerous daily considerations that affect your wellbeing and quality of life. Understanding the mechanics of each system helps you make informed decisions and advocate effectively for your needs.
Financial implications represent one of the most significant practical considerations. NDIS provides support based on disability need without means-testing, while aged care requires detailed financial assessment and potentially substantial co-payments based on your income and assets. If you own your home, have savings, or receive income beyond the Age Pension, aged care costs could significantly exceed what you’re accustomed to under NDIS. Seeking financial planning advice before making transition decisions helps you understand the long-term implications for your finances and lifestyle.
The administrative processes differ substantially between systems. NDIS participants familiar with plan management, support coordination, and regular plan reviews will find aged care operates quite differently. My Aged Care has its own assessment processes, provider arrangements, and administrative requirements. If you’ve self-managed or used a plan manager under NDIS, aged care’s structure may feel more restrictive. Conversely, some participants find aged care less administratively demanding, though typically with less flexibility in how support is delivered.
Service delivery models vary significantly. NDIS emphasises participant choice and control, allowing you to select providers, change arrangements, and direct your support. Aged care, while incorporating consumer-directed care principles in Home Care Packages, operates within more structured frameworks. Understanding these differences helps set realistic expectations and identify where advocacy might be necessary to maintain the lifestyle and community connections you’ve established.
Quality and safeguarding standards apply across both systems, but different regulators oversee compliance. The NDIS Quality and Safeguards Commission regulates NDIS providers, while the Aged Care Quality and Safety Commission oversees aged care services. Providers supporting NDIS participants who also deliver aged care services must register with both commissions, ensuring consistent quality regardless of which funding source supports you.
For younger NDIS participants entering residential aged care — a situation the government aims to reduce through the Younger People in Residential Aged Care Strategy 2020-2025 — specific protections exist. Organisations like the Summer Foundation and specialised programmes support people in inappropriate aged care settings to move into age-appropriate accommodation. This remains particularly relevant for those in their 50s or early 60s who may be considering residential options due to high support needs.
What Rights and Choices Do You Have During This Transition?
Understanding your rights throughout the transition process empowers you to make decisions aligned with your values and goals. Whether continuing with NDIS or transitioning to aged care, you retain fundamental rights to dignity, respect, choice, and control over your life.
Under NDIS, you have the right to:
- Continue receiving support after 65 if you were a participant before that age and maintain eligibility criteria
- Regular plan reviews that reflect changing needs, including age-related changes
- Safe, quality support from registered providers meeting NDIS Practice Standards
- Lodge complaints through the NDIS Quality and Safeguards Commission if issues arise
- Access advocacy support if you need assistance navigating the system
If transitioning to aged care, your rights include:
- Respectful treatment and dignity regardless of your age or disability
- Active participation in decisions about your care
- Safe, quality services meeting Aged Care Quality Standards
- Transparent information about costs and service arrangements
- Access to complaints mechanisms through the Aged Care Quality and Safety Commission
The decision about whether to continue with NDIS or transition to aged care is ultimately yours. While healthcare professionals, planners, and coordinators can provide information and recommendations, you maintain the right to choose the pathway that best aligns with your goals, values, and circumstances. For those with decision-making support needs, trusted supporters or formal advocates can assist in ensuring your voice remains central to planning.
Regional considerations matter particularly in areas like Cairns and Brisbane. While metropolitan areas typically offer more provider choices, Far North Queensland presents unique accessibility considerations. Travel distances to specialist appointments, provider availability, and the coordination of services across larger geographic areas all factor into practical decision-making. Starting conversations early allows time to identify appropriate local providers and establish relationships before transitions occur.
Moving Forward with Confidence and Support
Aging with disability doesn’t mean losing the independence, community connections, and quality of life you’ve built. The transition at 65 represents a significant decision point, but with early planning, comprehensive information, and appropriate support, it’s entirely manageable.
The 2.3 million Australians aged 65 and older living with disability — representing 52.3% of older Australians — demonstrate that disability in later life is common, expected, and supported through multiple pathways. Whether you continue with NDIS or transition to aged care, systems exist to provide the support you need. The key is understanding your options, starting conversations early, and making decisions based on your unique circumstances rather than defaulting to one pathway or another.
For families in Cairns and Brisbane, local expertise in navigating these transitions makes a substantial difference. Providers familiar with both NDIS and aged care systems, who understand regional considerations and maintain relationships with local specialists and services, can smooth the practical challenges of transition planning. The goal isn’t just managing a system change — it’s ensuring your later years maintain the dignity, independence, and community participation you deserve.
As you approach 65, remember that this transition is a normal part of aging with disability. You’re not alone in navigating these decisions, and resources exist to support you. Early planning, open conversations with providers and family, and understanding your rights all contribute to transitions that honour your autonomy while ensuring you receive appropriate support as your needs evolve.
Can I stay on the NDIS after I turn 65 years old?
Yes, existing NDIS participants can continue receiving support after turning 65, provided they maintain eligibility criteria and don’t move into residential aged care or commence regular home care services. Your NDIS support must remain disability-specific and aligned with your goals. However, if you choose to access aged care services like a Home Care Package or move into a residential aged care facility, you’ll automatically transition out of the NDIS. It’s important to discuss your options with your NDIS planner or support coordinator well before your 65th birthday to make an informed decision.
What’s the main difference between NDIS and aged care support for people over 65?
The primary differences involve funding structure, means-testing, and service focus. NDIS provides individualised, disability-specific funding that isn’t means-tested, typically offering more generous and flexible support tailored to your goals. Aged care operates through Home Care Packages ranging from $9,026 to $52,337 annually depending on assessed needs and is means-tested, potentially requiring co-payments based on income and assets.
How long before turning 65 should I start planning my transition?
It’s recommended to begin planning 12-18 months before your 65th birthday. This allows time to gather necessary documentation, obtain an Aged Care Assessment if considering aged care, and request a final NDIS plan review to ensure your support needs are fully addressed. Starting early helps avoid rushed decisions and ensures a smoother transition.
Will I lose my Supported Independent Living arrangement when I turn 65?
If you continue with NDIS after 65, your Supported Independent Living arrangement can continue provided you maintain eligibility and your support needs remain disability-specific. However, if you transition to aged care—by accessing regular home care services or moving into residential aged care—your SIL funding through NDIS will cease. It’s important to discuss your SIL arrangements with your support coordinator during your transition planning.
Are there extra supports available if I’m caring for someone aging with disability?
Yes, there are significant supports available for carers. Services like Carer Gateway provide information, counselling, respite, and connections to local resources. Additionally, both NDIS and aged care systems recognise the challenges faced by unpaid carers, and specific respite services and support programmes are available to ensure that the wellbeing of carers is also addressed.
