The hidden aged-care crisis inside Australia's hospitals

Australia's aged care crisis is worse than we think.

While much of the public debate has focused on nursing home scandals, a more insidious issue is unfolding behind the locked doors of our public hospitals.

A disturbing funding loophole across state-funded hospitals places elderly patients and people with disabilities - often kinless - at grave risk. Hospitals have repurposed existing wards into 'transition units,' reclassifying elderly and disabled patients as 'residents', effectively occupying beds that could otherwise be used for acutely ill patients.

This shift allows hospitals to transfer care costs from state healthcare systems to charge patients a large proportion of their age pension or NDIS funding. But here's the stark reality: these units operate without proper regulatory oversight.

Neither the Aged Care Quality and Safety Commission nor the NDIS Quality and Safeguards Commission has jurisdiction. The National Quality Aged Care Principles and the National Standards for Disability Services do not apply. Despite recent updates to Aged Care Quality Standards (2020) and NDIS reforms (2024) aimed at improving dignity and care, hospital transition units remain unregulated, leaving vulnerable people without the same protections as those in federally funded community-based services.

I witnessed this failure firsthand. For three months, I visited a regional hospital transition unit daily, observing an alarming pattern of mistreatment in a locked facility for elderly patients awaiting aged care placement. But 'short-term' is a cruel misnomer-residents languish here for months under conditions that should shame us all.

The facility is bleak. Residents are confined to chairs or beds with minimal mobility for months. Toileting assistance is inadequate, forcing most to rely on pull-ups due to staff shortages. Malnutrition silently kills, as meals arrive sealed in plastic with little help for those who struggle to eat.

There is no outdoor access to fresh air, no sunshine, and no dignity. Residents without family to bring clothes remain in hospital gowns for months.

Volunteers, who could offer crucial support, are inexplicably barred.

This is not a budget operation. These facilities charge more of the pension than standard aged care while delivering far less. How is it possible that a government-funded unit charges vulnerable Australians at a premium while offering substandard care?

Adding to the crisis is the routine use of off-label psychotropic drugs like Haloperidol, Olanzapine, and Risperidone to sedate the residents. These medications, prescribed to elderly dementia patients are contributing to preventable deaths.

Dementia Australia has repeatedly warned about the dangers of antipsychotic overuse in aged care, emphasising the need for specialist psychiatric oversight and non-pharmacological approaches.

This isn't just a medical failure, it's a societal one.

This crisis extends further than inadequate care. The use of hospital transition units is exacerbating bed block and ambulance ramping, as hospitals struggle to manage incoming patients while long-term care beds are occupied by individuals who should have been placed in separate appropriate residential aged care facilities. This adds further strain to an already overburdened healthcare system and worsens wait times for those requiring emergency care. This creates a vicious cycle that not only harms vulnerable patients but contributes to broader systemic inefficiencies.

In July 2025, new reforms under the Aged Care Quality Standards will strengthen oversight in residential aged care. These same standards must be applied to hospital transition units.

If the government truly wants to protect vulnerable Australians it must, while awaiting purpose-built off-site transition units, ensure these units meet the same rigorous regulations as external aged care and disability services.

We need a federal investigation into the deaths and suffering occurring in these hospital-based transition units.