Aged Care Assessment Tips: Why Needs Get Understated and How to Prepare
- Louise Greene and Kerry Mann
The most useful aged care assessment tips come down to one thing: say what really happens, not what sounds polite. Most assessments that come back lower than expected were not got wrong by the assessor. The older person and the family played things down, usually without meaning to.
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On 6 October 2026, the Department published the technical details of the algorithm that sets Support at Home funding. It is predictable, and it is unforgiving: it can only use what is recorded on the day.
“Very well, thank you” might be the most costly answer in aged care. It is polite, it is usually true, and it can hide everything that keeps someone at home. Our assessment guide, updated for October 2026, sets out every question the assessor will ask, so older people and families can do a mini run-through first and the full story gets told.
- The Support at Home funding level is calculated by an algorithm from what the assessor records. The assessor cannot choose a different level.
- The algorithm looks at what the older person can do, how far those needs are being met now, and what makes things more complex, including whether help from family is available.
- Older people and carers often play down their needs in front of each other, out of pride, kindness or not wanting to seem ungrateful.
- Many older people are “dependently independent”: living on their own terms because family and friends quietly do much of the work. That help needs to be described.
- Knowing the questions beforehand, and doing a mini run-through at home, is the best preparation. Our updated October 2026 guide covers every question the assessor will ask.
Written by Louise Greene RN and Kerry Mann, aged care specialists. Reviewed October 2026. Sources: the Department of Health, Disability and Ageing, My Aged Care and the Aged Care Assessment Manual.
What the algorithm showed · Why needs get understated · Dependently independent · Giving an accurate picture · If the outcome looks wrong
What did the published algorithm show?
For almost a year, families were told the funding level came from “the system” without being able to see how. The Department has now published the rules behind the Integrated Assessment Tool (IAT) algorithm, including the decision tree and the scores it builds from the assessment.
The algorithm draws on three things the assessor records:
- What the older person can do. Walking, showering, dressing, toileting, cooking, shopping, managing medication and money.
- How far those needs are being met now. Including help from family, friends and any services already in place.
- What makes things more complex. Memory, mood, continence, vision and hearing, social isolation, medical conditions, and whether a carer is available.
The same answers always produce the same funding level, and since the Aged Care Act 2024 began, assessors cannot override it. Professor Kathy Eagar described the published detail as “extremely useful” for anyone wanting to understand the exact score. Others in the sector have pointed to gaps, saying clinical needs such as nursing carry very little weight.
For older people and families, the practical lesson is simple. The outcome is only as accurate as what is said and recorded on the day. Our article on the aged care assessment and what replaced ACAT explains the algorithm in more detail.
Why do people understate their needs at an assessment?
Because it goes against every natural instinct. Most older people have spent their lives managing. Sitting across from a stranger and listing what they can no longer do feels like giving up their independence, so they lead with what they can still manage.
Then there is who else is at the table. Very often the person doing the caring is sitting right there. A daughter may be exhausted and stretched thin, but she will not say so in front of her mother, because she does not want her mother to feel like a burden. And her mother may know the help is not enough, or not always there, but will not say that in front of her daughter, because it would sound ungrateful to the person doing her best.
So both of them soften the picture, out of love. The assessor records what is said, the algorithm uses what is recorded, and the outcome can fall well short of what is needed. We see this in assessments all the time, and it is the single biggest reason we encourage proper preparation.
What does “dependently independent” look like?
Many of the older people we work with are what we call dependently independent. They live on their own terms, and they can only do it because a quiet network of people is holding things together behind the scenes.
Picture a woman living alone outside a small country town. She drives herself into town, does her own shopping, goes to church on Sunday and has lunch with friends afterwards. She is a life member of several local organisations, still goes to meetings, and is known and respected across the district. Ask her at an assessment how she is managing, and she will say, truthfully, “Very well.”
What that answer leaves out is everything happening around her. She has little interest in food and would happily live on crackers. She will not use the stove or oven and does not want a microwave, so every meal is eaten cold. One daughter portions meals into containers and fills her freezer. A friend in the next town makes soups and a mild curry for her, and a relative a few hours away does the same. Her other daughters do her washing, change her bed linen and wash her hair, or drive her to a hairdresser in a bigger town.
It takes a village, not only to raise a child but to keep an older person living independently at home. None of that village shows up in “Very well” unless someone says it. And if one person in it stops, through illness, a move or simple exhaustion, the arrangement that keeps her at home starts to come apart. That is exactly what the assessor needs to hear. Our article on what happens at an aged care assessment covers the day itself.
How do you give an accurate picture without exaggerating?
This is not about learning the “right answers” or overstating anything. It is about helping the assessor see what life actually looks like. A few things make the biggest difference:
- Do a mini run-through first. Sit down together a few days before and go through the questions the assessor will ask. Answers that have been thought about once come out far more clearly on the day.
- Describe the worst days, not only the good ones. If walking needs a stick at home and a frame outside, say both.
- Name the help behind each task. Who helps, with what, how often, and how long it takes.
- Say how reliable that help is. Whether it can continue, and what happens when it is not available.
- Do things as you normally would. If the assessor asks to see a task, do not push harder than usual.
- Give the carer a voice. Carers sometimes find it easier to write a short note for the assessor about what they do and how they are coping, rather than saying it aloud in front of the person they care for.
The older person should still lead the conversation where they can. Preparation simply means the conversation covers what matters.
This is what our assessment guide is built for, and we have just updated it for October 2026 to reflect the latest rules. It explains each step of the process and sets out every question the assessor will ask, domain by domain, so older people and families can do that run-through together.
What if the assessment outcome already looks wrong?
There are set ways to have it looked at again.
- Talk to the assessment organisation that did the assessment.
- Ask for a reconsideration by writing to the Department within 28 days of receiving the Notice of Decision, with concrete examples and any letters from the GP.
- Ask for a support plan review if needs have changed since the assessment. A reassessment can raise the funding level, and the place in the queue is still counted from the original approval date. Our Support at Home guide explains what each funding level provides.
Two newer safeguards sit alongside these. Since 29 June 2026, the delegate can send an assessment back to the assessor once to correct factual errors or fill gaps. And on 15 October 2026, Parliament passed a law creating a review pathway for exceptional cases, where the assessment organisation can ask the Department to review the funding level or priority category with the older person’s consent. It applies to decisions made up to 31 December 2027, and the detailed rules are still being finalised.
Frequently asked questions
Can you see how the aged care assessment algorithm works?
Yes. In October 2026 the Department of Health, Disability and Ageing published the technical details of the Support at Home classification algorithm, including the decision tree and how each score is built. It is detailed and technical, but it confirms the funding level depends entirely on what the assessor records.
Does help from family affect the Support at Home funding level?
It can. The algorithm considers how far the older person’s needs are being met now, including by family and friends, and whether a carer is available. That is why it matters to describe exactly what family members do, how often, and whether that help is reliable and can continue.
Is it exaggerating to describe your worst days?
No. Describing the worst days gives the assessor an accurate picture of the support needed across a normal week. Needs that only show up on bad days are still real needs. The aim is to be accurate and specific, with real examples, not to overstate what is happening.
Can a family member speak to the assessor?
Yes, with the older person’s agreement. A registered supporter, family member or friend can sit in on the assessment, and the assessor will ask whether they can speak with the people who provide support. A family member does not need to be registered to attend.
Can the assessor change the funding level if it seems too low?
No. Under the Aged Care Rules 2025, the assessor must accept the algorithm’s outcome. Since 29 June 2026, a delegate can return the assessment once to fix errors, and a new review pathway covers exceptional cases. Otherwise, the options are a reconsideration within 28 days or a support plan review.
How do you prepare for an aged care assessment?
Gather Medicare and identification, a medication list and any GP or hospital letters. Think through each daily task, the help behind it, and what happens when that help is not there. Decide who will attend, and arrange an interpreter through My Aged Care if needed.
The bottom line
The algorithm behind aged care funding is now public, and it confirms what we have long told families. It is fair in one sense, because the same information always produces the same result. But it has no way of knowing what is not said.
The hardest part of an assessment is not the questions. It is being willing to describe the real situation, in front of the people who matter most, without softening it. Older people protect their independence. Carers protect the people they care for. Both are acts of love, and both can cost the support that is needed.
The best protection is understanding the process and knowing the questions before the assessor arrives. Our assessment guide, updated for October 2026, walks through both, so older people and families can do a mini run-through together and go into the assessment prepared.
Aged Care Conversations is independent and commission-free. It does not provide financial, taxation, legal or medical advice.
Program rules are set by government and change over time. Information in this article is current as at October 2026. Always confirm current details with My Aged Care on 1800 200 422.
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