Cindy Bell is a Registered Nurse and Director at Deloitte Access Economics Health and Social Policy team. She has extensive experience leading health and aged care service reform, workforce strategy, corporate and clinical governance, and operational improvement initiatives across complex health and community service environments. She combines deep clinical expertise with strong strategic and commercial acumen and is deeply passionate about the care sector and sustainability of health and aged care services.
Decades In the Making: Rethinking Older Women’s Access, Choice and Security in Aged Care
Women are central within Australia’s aged care system. They comprise more than two-thirds of aged care consumers and dominate the composition of the aged care workforce. ¹ ² Yet, the aged care system in the way it is funded, the way it is delivered, and even the way entry and eligibility is assessed; is not optimised for women. This presentation takes a gendered lens to the way in which our aged care system is experienced by women.
The aged care system encounters women at the end of a life-course journey shaped by circumstances that have accumulated and interacted over decades. Women undertake a disproportionate share of unpaid care, experience greater workforce interruptions and enter retirement with lower superannuation balances than men. ³ These experiences can leave them with less income and capital to pay for care, which may contribute to fewer housing choices and less capacity to exercise meaningful choice within the system.
A life-course perspective also helps explain the severity and complexity of women’s needs when they seek care. Women live longer, comprise a large share of people living with dementia and may reach aged care with interacting health, mobility, housing and financial needs. ⁴ They are also more likely than older men to be widowed and to live alone, which may limit access to immediate, co-resident support.
These circumstances create two connected questions for aged care leaders: do women have the financial resources and support needed to access and navigate care, and, once they enter the system, do eligibility settings and service models recognise and respond to their needs? If assessment, funding and service design treat each circumstance separately or assume access to informal support, they may overlook cumulative disadvantage and deliver care that is not adequately responsive to women’s needs.
Drawing together Australian evidence and identified data gaps, this presentation will examine how women’s economic circumstances, caring histories, support networks, housing and health interact across the life course. It will identify where current evidence and data are insufficient to explain differences in aged care access, pathways and outcomes, set out priority questions for further research, and consider how policy and service design can better support older women.