Mum can't go home again: Making the residential aged care decision in crisis.

Your Mum had a fall. She went to the hospital. And now the medical team is saying she can't go home.

Not "can't go home yet." Just: she can't go home.

The house isn't safe. She can't be alone. She needs more care than can be provided at home. She needs residential aged care.

Maybe you've been expecting this for a while. Maybe it's a complete shock. Maybe you feel relieved. Maybe you feel devastated. Maybe you feel all of these things at once.

However you're feeling about this - it's valid.

Here's what matters now: you need to make a decision quickly, and you need to make it well.

Let's work through this.

This is for you if:

• The medical team has said home isn't safe

• Your Mum can't be alone for any period of time

• You're being told she needs "permanent placement"

• She's currently in respite and it's becoming clear this needs to be permanent

• You're navigating family reactions to this decision

• You need to choose an aged care facility under time pressure

• You're trying to figure out what matters most when choosing

 

Before accepting this decision, confirm it's the right one.

The signs that residential aged care is necessary:

Functional needs:

• Cannot be safely alone for even short periods

• Needs help with most basic tasks (toileting, eating, dressing)

• Falls keep happening despite the equipment and modifications

• Medical needs require regular nursing oversight

• Cognitive decline means she can't remember medication, eating, calling for help

Home factors:

• Modifications aren't physically possible (structure, stairs, rental restrictions)

• Lives alone, and no one can be there daily

• Home is unsafe and can't be made safe enough

Support factors:

• No family can provide or coordinate daily care

• Home Care Packages won't be available for months

• Private care is unaffordable long-term

• Geographic distance makes oversight impossible

Her reality:

• She's terrified to be home alone

• She's confused and doesn't recognise danger

• Her partner can't manage her care needs

If multiple factors are true, residential care may be the right choice.

 

 

If your Mum is currently in residential respite, this is a common path to permanent placement.

Many families use respite care (up to 63 days, extendable by 21 days) as a trial period. During this time, you can:

• Observe how she adapts to residential care

• Assess whether she's settled or distressed

• Evaluate the facility's quality

• Make a more informed permanent decision

Converting respite to permanent:

• If the facility has a permanent bed available

• If you and she (if she can participate) agree

• Through My Aged Care for permanent approval

• The facility handles the administrative transition

 

Residential aged care provides:

• 24/7 supervision and care

• Professional nursing and personal care

• Meals, laundry, basic activities

• Safety from falls and medical emergencies

• Social interaction with other residents

Your role changes:

• From caregiver to your family role - daughter, or son - and advocate

• You visit, you monitor, you speak up

• You ensure quality care

• You bring connection and joy

You can still:

• Visit as often as works for you

• Take her out if she's mobile enough

• Bring favourite things to her room

• Be involved in care decisions

• Be her champion

 

You don't have months. You might have days. Here's how to make a good decision under pressure.

Step 1: Get the List

Call My Aged Care: 1800 200 422

Say: "My mother needs permanent residential aged care urgently. She's currently in hospital/respite. I need facilities with availability."

This gets you:

• Facilities within a manageable distance

• Which have beds available soon

• Which accept her level of care

Step 2: Narrow to 3-5 Facilities

Eliminate based on:

• Location: Can you visit regularly? (Be honest about "should" vs "will")

• Availability: Bed available in your timeframe?

• Quality: Check the Aged Care Quality and Safety Commission website for serious issues

• Care level: Can they meet her needs?

Step 3: Tour Your Shortlist

Book tours immediately.
Say it's urgent.

What to notice on tours:

The basics:

• Does it smell clean?

• Are residents dressed and groomed?

• Are residents in common areas or all in rooms?

The staff:

• Do staff interact warmly or just walk past?

• Do they seem calm or rushed?

• Do they know residents' names?

• Do they make eye contact and speak kindly?

The environment:

• Are the rooms clean with natural light?

• Is there space for personal items?

• Are common areas being used?

• Is there an accessible outdoor space?

 

 

Staffing:

• What's your staff-to-resident ratio?

• What's your staff turnover?

Care:

• How do you handle falls and incidents?

• How do you communicate with families?

• What's your dementia care approach (if relevant)?

Practical:

• What's the total cost?

• How much notice is needed to move her in?

• What can she bring?

• What are the visiting hours?

 

You're choosing safe and acceptable, not perfect.

Compare your top options:

• Which felt best?

• Which can she move into soonest?

• Which can you visit most easily?

Make a choice. You can move her later if needed. This isn't unchangeable.

 

1. Confirm placement

• Contact facility

• Confirm move-in date

• Understand the paperwork needed

• Ask about deposits/payments

2. Sign the agreement

Read the Residential Aged Care Agreement carefully.

Key items:

• Basic daily fee (government-set)

• Accommodation payment (RAD lump sum or DAP daily payment)

• Additional service fees

• Exit terms

Get help understanding this if needed.

3. Notify Services Australia

• Your Mum's pension may be affected

• Call 1800 227 475

4. Prepare her room

Bring:

• Comfortable clothes

• Photos in frames

• Small furniture, if allowed

• Favourite items (blanket, pillow)

• Toiletries she likes

Don't bring:

• Valuables

• Irreplaceable items

• Too much stuff (rooms are small)

 

 

If your Mum is cognitively sound and can understand:

Be clear: "The doctors say home isn't safe. We've found a place where you'll be looked after."

Validate feelings: "I know this may not be you wanted."

Don't promise what you can't deliver: Don't say "temporary" if it's not.

Do say: "We'll visit." "We'll bring your things." "You'll be safe there."

If she has dementia:

Keep it simple: "We're moving you to a new place with people to help you."

Stay calm and reassuring.

She might ask repeatedly or never fully accept this. That doesn't mean it's wrong.

 

Expect different responses:

• Relief that there's a solution

• Guilt about not providing home care

• Anger at the situation

• Disagreement about the decision

• Fear about what this means

All are valid reactions to a difficult situation.

If there's conflict:

Family meeting:

• Present medical facts

• Present what you've explored

• Present the decision

• Invite input, but be clear about the final decision

Set boundaries:
"I understand your perspective. The decision is made based on Mum's safety. You're welcome to be involved in her care."

Document:
Keep records of medical advice and the decision-making process.

 

Practically:

• Bring belongings

• Set up the room

• Introduce yourself to the staff

• Share her preferences and routines

• Leave contact information

Emotionally:
However this feels - sad, relieved, guilty, all of it - is okay.

After:

• Call that evening

• Visit within a few days

• Stay involved

 

Your Mum may:

• Ask to go home repeatedly

• Be confused or upset

• Decline initially (change is hard)

• Refuse activities

This doesn't mean you made the wrong choice.

Adjustment takes time. Most people settle within 4-6 weeks.

You can:

• Visit regularly (2-3 times per week is fine)

• Bring familiar items

• Participate in care meetings

• Advocate if needed

• Take her for outings if able

 

Red flags:

• Unexplained injuries

• Poor hygiene

• Medication errors

• Staff don't know her

• Your concerns dismissed

What to do:

1. Document concerns

2. Speak to the facility manager

3. Contact Aged Care Quality and Safety Commission: 1800 951 822

4. Consider moving to another facility

She can move if this facility isn't right.

 

Your mum needs residential care. You're making this decision based on safety, not convenience.

This is what matters.

However you feel about this decision - relieved, devastated, guilty, practical, heartbroken, or all of these - is valid.

The decision quality matters more than the feelings around it.

You can still be involved. Visiting, advocating, ensuring quality care - that's your role now.

 

 

If you need to understand costs:
→ Read: Understanding Aged Care Costs: RAD, DAP, and Basic Daily Fees 

If family conflict continues:
→ Read: The Siblings Who Disappeared All Year Suddenly Have Opinions 

If managing from far away:
→ Read: When You Can't Be There in Person 

If you're struggling:
→ Read: You're Not Just Tired. This Is What Burnout Actually Feels Like