How to Prepare for an ACAT Assessment for Dementia in Australia

The aged care assessment is the gateway to funded services — in-home support, respite, and residential care all require it. When your parent has dementia, the stakes of this assessment are higher because cognitive decline is notoriously difficult to capture in a single visit. Here is how to make sure the assessment reflects what is actually happening.

What the Assessment Looks Like Now

The old Aged Care Assessment Teams (ACAT/ACAS) have been folded into the Single Assessment System, which launched its major operational rollout on 9 December 2024. The process is the same in substance: an assessor visits your parent at home (or in hospital if they are admitted) and evaluates their clinical, cognitive, and functional needs using the Integrated Assessment Tool (IAT).

The full process averages about five hours of total processing time — 1.2 hours of direct face-to-face evaluation, 1.4 hours of support plan formulation, and the remainder for intake, travel, and administrative review. Assessment organisations are expected to schedule home visits within two weeks of accepting a referral from My Aged Care.

The "Good Day" Problem

Parents with dementia often perform better in novel social situations than they do in daily life. An assessor arriving at the home triggers heightened alertness — your parent may appear lucid, conversational, and capable during the visit while struggling with basic tasks every other day.

This is the single biggest risk in a dementia assessment. If the assessor only sees the "good day" presentation, your parent will be underclassified and receive less funding than they need.

How to Prepare

Start a behaviour log two weeks before the assessment. Write down specific incidents with dates and times:

• Wandering episodes (leaving the house, getting lost in familiar areas)
• Forgotten or doubled medication doses
• Unsafe cooking (left stove on, burnt food, forgot to eat)
• Overnight disturbances (sundowning, agitation, calling out)
• Aggression, resistance to personal care, or verbal outbursts
• Falls or near-misses
• Repetitive questioning or confusion about time, date, or location

Share this log with the assessor. It provides concrete evidence beyond what they observe during the visit.

Gather medical documentation:

• GP referral letter with dementia diagnosis and type
• Specialist reports from geriatricians or memory clinics
• Current medication list (especially any psychotropic medications)
• Hospital discharge summaries from recent admissions
• Allied health reports (occupational therapy, physiotherapy)

Be present during the assessment. If your parent tends to minimise their difficulties ("I'm fine, I manage"), you need to be in the room to provide the carer's perspective. The assessor relies on input from both the care recipient and family members.

What to Say to the Assessor

Use specific language that maps to the assessment criteria:

• "My parent has experienced cognitive decline that affects their daily safety"
• "They require supervision for [specific tasks] because of memory loss"
• "We have had [number] incidents of wandering/unsafe behaviour in the past month"
• "Their behaviour escalates in the evenings — this is consistent sundowning"

Avoid vague statements like "Mum is a bit forgetful" or "Dad sometimes gets confused." The IAT is a standardised tool — assessors score against defined criteria, and understatement leads to underscoring.

After the Assessment

The assessment determines your parent's Support at Home classification (Class 1 through 8) for in-home care, or their eligibility for residential care if home is no longer safe.

If you believe the classification does not reflect your parent's actual needs, you can request a reassessment. Document new incidents or deterioration since the original assessment to support the request.

For a complete assessment preparation checklist, behaviour log templates, and the current 2026 funding tables, the Australian Dementia Care Support Toolkit walks you through every step of the process.

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