Long and winding road: Aged care use before death.

Objective: To understand how older Australians used Federal Government-funded aged care services in the eight years before their death.

Methods: The Australian Institute of Health and Welfare's Pathways in Aged Care (PIAC) database was used to examine individual patterns of aged care service use between 2002 and 2011 for the 116 481 people who died in 2010-2011 aged 65 or over.

Results: About 80% of Australians who died in 2010-2011 aged 65 or over had used aged care services in the eight years prior to their death. Most (84%) entered the system through a community-based programme (particularly Home and Community Care (HACC) and, to a much smaller degree, community packaged aged care programmes), with only 1 in 10 people first using permanent residential aged care. The most common pattern of age care service use was HACC only. Other common patterns of care use were HACC followed by permanent residential aged care, and permanent residential care only. In all, people used aged care programmes in more than 1500 combinations.

Conclusions: The comprehensive PIAC database allows research into patterns of use of aged care services that can inform decision-making by clients, carers, providers and funders of the services.