The state of aged care monitoring in Australia: what needs to change

Keeping people at the centre in an AI‑shaped world

Australian aged care is facing a convergence of pressures that no single workforce initiative or funding increase can resolve alone. Workforce shortages, rising regulatory expectations, and an outdated approach to resident monitoring are creating risk for providers, staff, and the people they care for.

The question is no longer whether aged care monitoring needs to evolve. The question is how quickly providers can move from reactive to proactive approaches before the regulatory and financial consequences become irreversible.

The workforce reality

The numbers are confronting. Australia faces a projected shortfall of 110,000 direct care workers by 2030, with 65,000 workers leaving the sector annually. That is roughly one-third of the workforce turning over every year.

Night shift coverage sits at the centre of the problem. Agency registered nurses cost $125 per hour compared to $82 for permanent staff, and night shifts consume 29% of all agency RN minutes. For smaller regional facilities, maintaining 24/7 RN coverage is becoming operationally and financially untenable. StewartBrown data from September 2024 shows 59% of residential aged care homes operating at a loss, with operating deficits reaching $8.45 per bed day.

Manual observation rounds during overnight hours consume a significant proportion of nursing time. Staff are stretched thin, and the residents most at risk of falls and deterioration are often those who cannot press a call button or wear a monitoring device.

Why are wearables and cameras not the complete answer?

Wearable devices and camera-based monitoring both have roles in healthcare, but neither fully addresses the aged care monitoring challenge.

Wearable adoption in dementia populations remains consistently low. Residents forget to wear devices, remove them during the night, or find them uncomfortable. The population most at risk of unwitnessed falls and clinical deterioration during sleep hours is the same population least likely to comply with a wearable-dependent system.

Camera-based monitoring raises a different set of concerns. Dementia Australia has expressed opposition to broad video surveillance in residential aged care, citing privacy impacts during bathing, toileting, and personal care. State surveillance legislation in New South Wales, Victoria, Queensland, and South Australia restricts bedroom recording. Family acceptance of camera systems sits at 60-70%, compared to 85-95% for privacy-preserving alternatives.

Neither approach provides reliable, continuous coverage for the moments that matter most: the overnight hours when staffing is lowest and the risk of undetected deterioration is highest.

Regulatory expectations are rising

The Aged Care Act 2024, effective from 1 November 2025, introduces rights-based obligations with enhanced enforcement. The Serious Incident Response Scheme requires Priority 1 notifications within 24 hours for incidents causing injury, unexpected death, or unexplained absence. Falls during care delivery typically require ACQSC notification.

Quality Indicator reporting now directly influences Star Ratings. Falls and falls resulting in major injury are among 14 mandatory QIs reported quarterly. Quality Measures comprise 15% of Star Ratings calculations. Poor performance results in publicly visible 1-star ratings updated daily.

For providers, this means monitoring gaps are no longer just clinical risks. They are compliance risks, reputational risks, and ultimately financial risks that affect occupancy, funding, and viability.

The shift toward ambient, contactless monitoring

The sector is beginning to recognise that the next generation of resident monitoring needs to work without requiring patient participation. Contactless technologies, including ultra-wideband radar, can continuously detect heart rate, respiratory rate, movement, and presence without cameras, wearables, or patient cooperation.

This approach addresses several constraints simultaneously: it preserves dignity during personal care, it functions during sleep hours without staff intervention, and it supports early detection of vital sign changes before they escalate to clinical emergencies.

Research indicates that earlier detection of deterioration can reduce hospital transfers by 30-50%, which matters both for resident outcomes and for providers managing transfer costs averaging $8,500-$15,000 per event.

The Ericom view

Aged care monitoring in Australia is at a tipping point. The combination of workforce pressure, regulatory intensity, and ageing infrastructure demands a fundamentally different approach to how we keep residents safe.

At Ericom, we work closely with healthcare providers navigating these challenges. What we see consistently is that the providers moving earliest toward continuous, privacy-preserving monitoring are best positioned to meet regulatory obligations, retain staff, and deliver the standard of care that residents and families expect.

The technology exists. The evidence base is growing. The regulatory environment is tightening. For providers weighing their options, the cost of waiting is becoming harder to justify than the cost of acting.