ACAT Assessment Questions: What to Expect During the Home Visit

The letter arrives confirming your parent's assessment date, and immediately the questions start: What will they ask? How long will it take? What if Mum insists she's fine when the assessor is sitting in the living room?

Since December 2024, the old ACAT teams have been folded into the Single Assessment System (SAS), but the comprehensive in-home assessment itself works similarly. Here's what actually happens during the visit, what the assessor evaluates, and how to make sure your parent's real needs are captured accurately.

How Long Does the Assessment Take?

A comprehensive SAS assessment typically runs between one and three hours, depending on the complexity of your parent's situation. The assessor visits your parent at home — this is deliberate, because the home environment reveals safety risks (loose rugs, poor lighting, bathroom hazards) that a clinical setting would miss.

The assessment is a structured conversation, not a medical exam. The assessor is a trained health professional — usually a nurse, occupational therapist, physiotherapist, or social worker — who uses the Integrated Assessment Tool (IAT) to guide the discussion.

What the Assessor Actually Asks

The IAT evaluates your parent across multiple domains. While the exact questions are clinically coded, they broadly cover:

Physical function and mobility: Can your parent walk safely around the house? Do they use a mobility aid? Have they had recent falls? Can they get in and out of bed, shower, and dress independently?

Cognitive health: Does your parent forget to take medications? Do they get confused about dates, appointments, or familiar routes? Have they left the stove on or wandered from home?

Daily living activities: Can your parent prepare meals, manage household cleaning, do laundry, and handle grocery shopping? How much help do they currently receive from family or friends?

Medical history and medications: What diagnoses does your parent have? What medications are they taking, and do they need help managing them? When did they last see their GP or specialist?

Social and emotional wellbeing: Does your parent feel isolated? Have they withdrawn from activities they used to enjoy? Do they feel safe at home?

Home environment: Does the home have stairs, grab rails, adequate lighting? Are there trip hazards? Is the bathroom accessible?

Existing supports: Who currently helps your parent, and how often? Is the current level of support sustainable for the carer?

The Masking Problem — and How to Address It

The single biggest risk during an assessment is your parent presenting better than they actually are. This isn't deception — it's a natural human response. Older Australians commonly put on a brave face for visitors, tidy the house beforehand, and minimise their difficulties out of pride or fear of losing independence.

The IAT is a rules-based algorithm. It scores responses against clinical thresholds. If your parent says they manage fine with cooking, the tool records that — even if the reality is they've been eating toast for three meals a day.

Three practical ways to address this:

1. Keep a 7-day functional diary in the week before the assessment. Document specific incidents: the fall on Tuesday, the missed medication on Thursday, the day they couldn't manage the shower. Hand this to the assessor at the start of the visit.

2. Ask to speak with the assessor privately. Most assessors expect this. You can provide additional context about daily struggles your parent may not volunteer.

3. Get a GP letter. A written summary from your parent's doctor, using clinical terminology that aligns with IAT categories, carries significant weight. Ask the GP to specifically address falls risk, cognitive decline, medication management, and any progressive diagnoses.

What Happens After the Assessment

The assessor submits their findings and your parent receives a formal Notice of Decision letter. This document outlines:

• Whether your parent has been approved for services
• What types of services they're eligible for
• Their Support at Home classification level (Class 1 through 8), which determines their quarterly funding budget
• Any approvals for short-term pathways like transition care

Your parent's name then enters the National Priority System for funding allocation. Once funding is assigned, they have 56 calendar days to select an approved provider and sign a service agreement — with an optional 28-day extension available on request.

If the assessment result doesn't reflect your parent's actual needs, you can request a reassessment or lodge a formal appeal through the Department of Health's three-stage review process.

How to Prepare

The difference between an assessment that captures your parent's real situation and one that understates it often comes down to preparation. Gather Medicare and pension cards, compile a medication list, document recent incidents, and arrange for a trusted family member to be present during the visit.

The My Aged Care and ACAT Assessment Guide includes a printable assessment preparation checklist, a 7-day functional diary template, and a GP letter template — all designed to align with the IAT's evaluation categories so your parent's needs are accurately recorded from the first assessment.

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