Disability Support for Seniors: When Aged Care and NDIS Intersect

Imagine dedicating years to supporting your loved one through their disability journey, only to face a complete system overhaul when they turn 65. The services, funding, and support coordination you’ve come to rely on suddenly shift to an entirely different framework – one that may not recognise the complexity of their needs. For 2.3 million Australians aged 65 and over living with disability – representing 52.3% of this age group – this isn’t a hypothetical scenario. It’s a reality that demands understanding, preparation, and advocacy.

The intersection between disability support and aged care creates one of Australia’s most complex navigational challenges for seniors, families, and carers. As Queensland continues to see growth in both NDIS participants over 65 and older Australians requiring disability-specific support, understanding where these systems meet – and diverge – becomes essential for ensuring continuity of care and quality of life.

What Happens When You Turn 65 and Need Disability Support?

The 65th birthday marks more than a milestone celebration for Australians receiving disability support – it represents a critical juncture in service provision. Under current legislation, the National Disability Insurance Scheme (NDIS) primarily serves Australians under 65 years of age with permanent and significant disabilities. Meanwhile, the aged care system becomes the default pathway for those 65 and over.

For existing NDIS participants approaching this threshold, the situation becomes nuanced. If you were enrolled in the NDIS before turning 65, you may continue receiving NDIS support. However, those who were 65 or over when the NDIS commenced in their region were automatically excluded from eligibility. This created a cohort of older Australians with disabilities who never had access to the individualised, well-funded support that NDIS provides.

The numbers tell a compelling story. NDIS participants aged 65 and over are projected to increase by 267.8% – from 16,581 in June 2021 to 60,987 by June 2030. Correspondingly, payments for this age group are expected to surge by 479.4%, from $1.2 billion to $7.1 billion during the same period. These figures underscore the growing recognition that disability doesn’t diminish at 65, and the need for appropriate support continues throughout life.

For seniors in Cairns and Brisbane navigating this transition, the complexity multiplies. Queensland’s support landscape encompasses not only NDIS and aged care systems, but also the Disability Support for Older Australians (DSOA) programme, state-based disability services, and Commonwealth programmes – each with distinct eligibility criteria and funding structures.

How Do NDIS and Aged Care Systems Differ for Seniors with Disabilities?

Understanding the fundamental differences between NDIS and aged care is crucial for informed decision-making. These systems operate under separate legislative frameworks, creating distinct experiences for participants.

The NDIS embodies a person-centred philosophy with choice and control at its core. Funding is individualised based on assessed support needs, not means-tested, and covers daily living support, transport, assistive technology, home modifications, and therapeutic services. For individuals with complex conditions, NDIS packages can be substantial – averaging approximately $302,000 annually for conditions like Motor Neurone Disease as of 2024.

In contrast, Australia’s aged care system, which underwent significant reform with the Support at Home programme launching in November 2025, operates quite differently. This new programme replaced the Home Care Packages system with eight classification levels for ongoing services, providing annual funding ranging from approximately $10,731 for Level 1 to $78,106 for Level 8.

Feature	NDIS	Aged Care (Support at Home)
Primary Age Group	Under 65 years	65+ years (50+ for First Nations peoples)
Funding Approach	Individualised, needs-based	Classification levels (8 tiers)
Means Testing	No	Yes, with income-based contributions
Annual Funding Range	Varies widely (up to $302,000+ for complex needs)	$10,731 to $78,106 (plus AT-HM funding)
Participant Contributions	No co-payments	5-80% depending on service type and income
Assistive Technology	Included in package	Separate funding ($500-$15,000 annually)
Service Philosophy	Choice and control, disability-specific	Clinical care and everyday living support

The means-testing component represents a significant departure from NDIS principles. Full pensioners pay minimal contributions (5% for independence services like personal care, 17.5% for everyday living services like cleaning), whilst self-funded retirees face substantially higher contributions (50% and 80% respectively). Clinical care services, including nursing and allied health, attract no participant contribution.

This structural difference has profound implications. Older Australians with disabilities who never accessed NDIS – or who transition from it – may find themselves paying out-of-pocket for services previously fully funded, even as their support needs remain unchanged or intensify with age.

Why Is There a Funding Gap Between NDIS and Aged Care for Complex Disabilities?

The disparity in funding between NDIS and aged care for seniors with complex disabilities represents one of the most contentious issues in Australian social policy. This gap isn’t merely administrative – it directly impacts people’s capacity to maintain health, independence, and quality of life.

Consider the stark reality: the difference between the highest level Support at Home funding (Level 8 at $78,000 annually) and an average NDIS package for Motor Neurone Disease ($302,000) amounts to $194,000 per year. Even when combining Support at Home Level 8 with the maximum assistive technology and home modifications funding ($15,000 each), the total reaches only $108,000 – still drastically below NDIS equivalents for similar conditions.

This funding shortfall contradicts the Royal Commission into Aged Care Quality and Safety’s 2021 recommendation that by July 2024, every person receiving aged care who is living with disability should receive daily living supports equivalent to those available under NDIS for the same or similar conditions. As we move through 2026, this recommendation remains largely unimplemented, leaving older Australians with significant disabilities underserved.

The situation becomes particularly acute for those transitioning from the Disability Support for Older Australians (DSOA) programme. This programme, which served older people who were 65 or over when NDIS commenced in their region, no longer accepts new clients. Recipients transitioning to Support at Home report funding reductions of 36-64%, with many expressing that they can no longer access the specialist disability-focused care essential to their wellbeing.

Beyond funding quantum, the nature of support differs fundamentally. NDIS emphasises disability-specific expertise, assistive technology, and therapies designed to maximise functional capacity. Aged care, whilst now incorporating greater focus on independence and reablement through the Support at Home programme, historically oriented towards compensating for decline rather than building capacity. For seniors whose disabilities require ongoing specialist intervention – progressive neurological conditions, acquired brain injuries, complex physical disabilities – this philosophical difference translates to real-world service gaps.

What Support Options Exist for Seniors with Disabilities in Cairns and Brisbane?

Queensland seniors navigating disability support have multiple pathways available, though understanding which applies to your circumstances requires careful assessment. The landscape in Cairns and Brisbane includes both national programmes and state-specific services.

For NDIS Participants Turning 65: If you’re already an NDIS participant before turning 65, you have the right to remain in the scheme. This continuation applies unless you enter residential aged care or begin receiving ongoing home care through the aged care system, which triggers automatic transition. Early planning – ideally 6-12 months before your 65th birthday – allows thorough review of your current NDIS plan, future care needs, and comparison of what each system offers for your specific circumstances.

For Those 65+ Seeking Support: My Aged Care serves as the single entry point for aged care services in Queensland. Contact 1800 200 422 to initiate an assessment under the Support at Home programme. The assessment determines your classification level (1-8) based on care needs, which then determines your annual funding allocation. Separately, you may access Assistive Technology and Home Modifications funding (Low tier: $500, Medium: $2,000, High: up to $15,000 annually) to support equipment and environmental modifications.

Commonwealth Home Support Programme (CHSP): For entry-level support needs, CHSP continues operating until July 2027, providing services like domestic assistance, personal care, and social support. This programme suits those requiring less intensive support than Support at Home classification levels.

State-Based Disability Services: Queensland maintains some state-funded disability services for specific cohorts outside NDIS eligibility. Contact Disability Gateway (1800 643 787) to explore whether state services might complement or supplement aged care supports.

Specialist Disability Accommodation: For NDIS participants, Specialist Disability Accommodation (SDA) funding supports housing designed for people with extreme functional impairment or very high support needs. Understanding how SDA interfaces with aged care housing options becomes crucial when planning long-term accommodation.

In both Cairns and Brisbane, accessing locally-based providers who understand the regional context – available services, wait times, and community resources – enhances support effectiveness. Providers offering both NDIS and aged care services can facilitate smoother transitions and provide continuity when circumstances change.

How Can Queensland Seniors Navigate the Transition Between Disability and Aged Care Systems?

Navigating the intersection between disability support and aged care requires strategic planning, advocacy, and understanding of your rights. This process need not be overwhelming with the right approach and support.

Start Early and Document Everything: Begin transition planning at least six months before turning 65. Document your current support arrangements, equipment needs, therapy schedules, and daily care requirements. This documentation becomes invaluable during aged care assessments, ensuring assessors understand the full scope of your disability-related needs.

Engage Support Coordination: Both NDIS support coordinators and aged care case managers can help navigate system complexity. If you’re an NDIS participant, utilise your support coordination funding to facilitate transition planning. Once in aged care, request a case manager to coordinate services and troubleshoot issues as they arise.

Understand Assessment Processes: The aged care assessment system differs significantly from NDIS planning. Assessments may be conducted via telephone or face-to-face, and you have the right to request face-to-face assessment if telephone assessment doesn’t adequately capture your needs – particularly important for communication disabilities or complex conditions. Be prepared to clearly articulate how your disability impacts daily living, not just age-related limitations.

Consider Financial Implications: Unlike NDIS, aged care involves means-tested contributions. Consult with a financial adviser who understands both systems to plan for potential out-of-pocket costs. Understanding your pensioner status and asset position helps estimate your likely contribution levels under Support at Home.

Access Advocacy Services: Organisations like the Older Persons Advocacy Network (OPAN, 1800 700 600) and Aged and Disability Advocacy Australia provide free advocacy support. Advocates can attend assessments with you, help interpret complex information, and escalate concerns when services don’t meet your needs.

Explore Concurrent Supports: Whilst current legislation generally prevents simultaneous NDIS and aged care access, the Independent Review of the NDIS recommended legislative change to allow concurrent supports. Stay informed about policy developments that may expand your options. In some circumstances, you might access specific supports from different systems – for instance, NDIS-funded specialist disability equipment alongside aged care personal care services.

Address Assistive Technology Needs Proactively: The Support at Home programme provides separate funding for assistive technology and home modifications, but the annual limits ($500-$15,000) may not match your requirements if transitioning from NDIS. Identify essential equipment and modifications early, prioritise based on safety and independence needs, and explore whether NDIS funding can cover major items before transitioning if you’re still within the scheme.

What Rights Do Older Australians with Disabilities Have Under the New Aged Care Act?

The Aged Care Act 2024, which commenced on 1 November 2025, establishes a strengthened rights-based framework fundamentally reshaping how aged care operates. Understanding these rights empowers you to advocate effectively and ensure services meet your needs as an older person with disability.

The Act establishes a Statement of Rights emphasising that older people have the right to make decisions about their own lives, receive safe and quality care, and be treated with dignity and respect. These principles directly counter ageist assumptions that older people should passively accept whatever services are offered. You have the right to choose your service providers, change providers if dissatisfied, and direct how your funding is utilised within programme guidelines.

For seniors with disabilities, these rights hold particular significance. The right to safe and quality care means services must be appropriate for your disability-related needs, not just general aged care supports. If you require disability-specific approaches – specialised communication strategies, specific manual handling techniques, or therapeutic interventions – you have the right to expect providers possess relevant expertise or arrange appropriate specialist input.

The single entry point and assessment system aims to simplify access, but you retain the right to request reassessment if your circumstances change or if you believe the initial assessment inadequately captured your needs. For progressive conditions like Motor Neurone Disease, Parkinson’s disease, or multiple sclerosis, regular reassessment ensures your classification level and funding adjust as your condition evolves.

Importantly, whilst the Aged Care Act strengthens consumer protections, disability advocacy organisations note it contains limited specific intersection between ageing and disability. This gap means you may need to actively assert your disability-related needs within an aged care framework primarily designed around frailty and age-related decline. Understanding both your aged care rights and general disability rights under the Disability Discrimination Act 1992 provides a comprehensive foundation for advocacy.

If you believe your rights have been violated or services fall short of legislated standards, complaint mechanisms exist. The Aged Care Quality and Safety Commission handles complaints about aged care services, whilst the Disability Discrimination Commissioner addresses discrimination based on disability. Don’t hesitate to escalate concerns – your feedback drives system improvement and protects others facing similar challenges.

Moving Forward: Creating Better Support for Seniors with Disabilities

The intersection of disability support and aged care in Australia remains a work in progress. Whilst the Support at Home programme represents an improvement in flexibility and funding levels compared to previous Home Care Packages, significant gaps persist for older Australians with complex disability support needs. The promise that seniors with disabilities would receive equivalent support regardless of which side of the arbitrary age 65 dividing line they fall remains unfulfilled as we progress through 2026.

However, understanding the landscape empowers better navigation. Whether you’re an NDIS participant approaching 65, a senior with disability seeking support for the first time, or a family member advocating for a loved one in Cairns or Brisbane, knowledge of how these systems operate – and where they fall short – enables strategic planning and informed decision-making.

The demographic reality is undeniable: with 2.3 million Australians aged 65 and over living with disability, and projections showing continued growth in both ageing and disability prevalence, the imperative for system integration intensifies. Advocacy from individuals, families, disability organisations, and progressive service providers drives policy reform. Your voice matters in this evolution – sharing your experiences, articulating gaps, and demanding equitable support contributes to systemic improvement.

In the meantime, accessing quality disability support as a senior requires persistence, planning, and often professional advocacy. Engage early with both NDIS (if applicable) and My Aged Care systems. Build relationships with providers who demonstrate genuine understanding of disability alongside aged care expertise. Document your needs comprehensively. Utilise support coordination and advocacy services freely available to you. Assert your rights under the Aged Care Act whilst recognising the ongoing advocacy needed to achieve true equity.

The journey through disability support systems as you age shouldn’t require navigating two incompatible frameworks with vastly different resources. Whilst we work toward that integrated future, understanding the present landscape remains your most powerful tool for securing the support you need and deserve.