Australia has a growing need for aged care, with existing services struggling to meet demand. The ageing population is increasing pressure on care services, exacerbated by a reduction in the supply of workers as the proportion of Australians of working age declines.

Aged care is delivered formally by paid workers (including residential, respite and home care programs) and informally by unpaid carers (family, friends and volunteers). 

Of course, unpaid carers are a vital part of aged care delivery, but the focus of this article is on the paid aged care workforce.

In 2023, Australia had an estimated 500,000 aged care workers. The numbers have been increasing, but not fast enough. According to a federal government report this year, demand for aged care services is increasing faster than the workforce can grow and, at the same time, the needs of older people are becoming more complex, particularly as the numbers of older adults living with dementia increases. 

There’s already a shortfall, but this is expected to grow. By 2063, it’s been projected by the Australian government that the population aged 65 and over will double and those aged 85 and over will triple.

Who are our aged care workers?

As shown in the government’s Aged Care Worker Survey, aged care workers are mostly (87%) women, aged 47 on average. Almost half (43%) are born overseas and nearly one in five (17%) are migrant workers on temporary residency visas. 

This is an ageing workforce. Older and more experienced aged care workers are those most at risk of leaving the sector as they struggle to meet the heavy physical demands of the work.

Given the high demands on workers, staff sickness and absence is high, and staff are leaving the sector. Aged care had a 29% turnover in 2021, well above the 7.5% figure for Australia as a whole. 

In 2024, aged care workers wanting to leave the sector said they were burnt out (48%), unsupported (46%), the work was too stressful (45%) and/or the pay was too low (43%). 

Although government reforms have helped with rates of pay and work organisation, they’re not doing enough quickly enough.

Demands of aged care work

The nature of the work – with its high demands, low support and poor remuneration – leaves this workforce at serious risk of psychological injury. Ongoing staff shortages mean staffing remains well below that required to meet basic standards of care of 200 minutes of care per resident per day, as recommended by Australia’s Royal Commission into Aged Care. 

Psychological injury (for example, burnout and stress) is a major cause of morbidity and disability worldwide. 

There’s plenty of evidence that aged care workers suffer high levels of psychological illness, distress, depression, anxiety and burnout.

Instead of focusing on prevention of burnout and distress, we wanted to initially find out what could improve the wellbeing of aged care staff. However, there’s currently no universal definition of “wellbeing”. 

So, our first step was to find out what aged care workers think their wellbeing is and what enhances it through qualitative research with a sample of aged care workers. Our work is being conducted under the banner of Monash’s National Centre for Healthy Ageing with support via philanthropic donation from the Arcare Family Foundation.

According to 2024 data, aged care workers choose their work for positive reasons, including making a positive change to the lives of older people (71%), because they’re interested in older people (64%) and because the work aligns with their personal values (31%). 

Consequently negative media attention on aged care workers during and after the COVID-19 pandemic had taken a toll on their wellbeing.

What helps aged care workers’ wellbeing?

It’s perhaps therefore not that surprising that the study – the results will be published – found that aged care workers want to provide good-quality care for their clients and residents. Importantly, when they can provide the care they think is needed, every worker told us it enhances their own wellbeing. 

They told us that having meaningful relationships with clients, even when these were challenging, was really important for wellbeing. They derived a sense of purpose and satisfaction from these relationships and enjoyed “making a difference”. 

They did, however, describe frustration when these relationships were not seen as important or valued by their employers. They also revealed that, although illness and death was expected in this type of work, they wanted their loss and grief to be acknowledged and supported. 

Aged care workers also talked about the importance of relationships with co-workers and supervisors in and out of work. They talked about the ill-effects of COVID-19 on physically being together for training or social activities. 

When workplace relationships were good, this could effectively buffer the challenges of the work. Feeling appreciated and heard by their supervisors was also important, as was having a positive work culture.

Thirdly, aged care workers explained the importance of having the resources and staff available to provide high-quality care. When there were shortages of staff, time and/or equipment, the negative effects on quality of care made work stressful. This took away the workers’ sense of fulfillment and wellbeing.

It’s not about resilience or massage chairs

Aged care workers were very clear that their wellbeing was strongly related to their capability and capacity to provide excellent care for their clients. They recognise the challenges of their job but choose it, despite these challenges. 

When enabled and allowed to do their work well and in a caring fashion, they benefit their own wellbeing. They wanted skills and education to do the best job they could and enough time and staff to deliver good-quality care.

They had no interest in being taught how to avoid burnout or “tokenistic” approaches to help them.

Person-centred care could be a ‘win-win’

The new Australian Aged Care Act advocates person-centred care, putting the needs and preferences of the older person at the centre. Our research suggests that doing this effectively could not only enhance the experience of the older person, it could also enhance the wellbeing of the workers providing the care. 

What’s needed is worker-person-centred care to get the best outcomes for all in the aged care sector. Doing this well, with enough resources, could be a “win-win”.

To confirm our findings, we’re carrying out an independent anonymous survey of a large sample of aged care workers across Australia. If you, or someone you know, works in the sector, please direct them here.