Aged Care Act 2024 Decision Making — What Changes for Families
Why the Aged Care Act 2024 Matters for Decision-Making
Australia's Aged Care Act 2024 replaced the ageing Aged Care Act 1997 from 1 July 2025, and one of its most significant shifts is how it treats decision-making for older Australians who receive funded services. The old framework barely mentioned consent or supported decision-making. The new Act puts them at the centre.
If you hold an enduring power of attorney or guardianship appointment for a parent receiving aged care, these changes affect you directly. The Act does not replace state-level EPOA and guardianship legislation — those instruments remain the legal source of your authority — but it changes how aged care providers must engage with substitute decision-makers and how consent works within the aged care system.
Supported Decision-Making Takes Priority
The Act introduces a formal hierarchy for how decisions should be made about an older person's care. Supported decision-making sits at the top. This means an aged care provider must first try to help your parent make their own decisions, even if they have some cognitive impairment, before turning to a substitute decision-maker.
In practice, this looks like providers offering information in accessible formats, giving your parent extra time to process options, and involving trusted supporters (which may include you as attorney) in discussions without assuming you will make the decision for them. Only when your parent genuinely cannot make a specific decision — even with support — should the provider look to a substitute decision-maker.
This is a meaningful shift from how many facilities operated under the old Act, where staff often defaulted to speaking with the family and bypassing the resident entirely once a dementia diagnosis was on file.
How Substitute Decision-Making Works Under the New Act
When supported decision-making is not possible for a particular decision, the Act recognises substitute decision-makers in a specific order:
- A person appointed under a state or territory instrument — your enduring power of attorney, enduring guardian, or advance care directive appointment
- A guardian or administrator appointed by a tribunal (VCAT, NCAT, QCAT, SAT, or their equivalents)
- A "person responsible" as defined by the relevant state hierarchy — typically a spouse, then an unpaid carer, then close family members
Your EPOA or guardianship appointment still comes from state legislation. The Aged Care Act 2024 does not create its own substitute decision-maker category. But it does set rules for how providers must interact with whoever holds that role.
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What Providers Must Do Differently
Aged care providers now have explicit obligations around decision-making that affect how they deal with you as attorney or guardian:
Consent before services change. A provider must obtain informed consent before starting, changing, or stopping a service. Under the old Act, many residential providers adjusted care plans and notified families afterwards. The new Act requires consent first.
Dignity of risk. The Act codifies a principle that was previously only in guidelines: an older person has the right to make decisions that others might consider risky. If your parent wants to continue walking in the garden despite a falls history, a provider cannot override that preference just because it creates liability. As substitute decision-maker, you need to understand this principle because providers may push back on restrictive requests you make on your parent's behalf.
Restrictive practices framework. The Act tightens the rules around chemical restraint, physical restraint, and seclusion in aged care. A provider must get consent from the substitute decision-maker before using any restrictive practice, and there are stricter reporting requirements to the Aged Care Quality and Safety Commission. If your parent is in residential care and a facility wants to use sedation for behavioural management, you should expect to be formally consulted rather than simply informed.
The Complaints and Enforcement Shift
The new Act creates the position of Aged Care Commissioner and strengthens the complaints pathway. For families acting as decision-makers, the practical effect is that you now have a clearer escalation route when a provider ignores your parent's documented wishes or overrides your authority without justification.
Under the old framework, complaints went to the Aged Care Quality and Safety Commission and often stalled in mediation. The 2024 Act gives the Commissioner stronger investigation and enforcement powers, including the ability to issue compliance notices and civil penalties against providers who fail to obtain proper consent.
What This Means for Your EPOA or Guardianship Documents
The Aged Care Act 2024 does not change the validity requirements for state-level instruments. Your Victorian EPOA, NSW enduring guardianship, or Queensland Form 2 still needs to meet all the witnessing and execution rules of its home jurisdiction. But the new Act does create practical pressure to ensure your documents are current and comprehensive.
Providers are now required to verify that a substitute decision-maker's authority covers the specific decision being made. If your EPOA only grants financial powers, a provider should not accept your consent for a care plan change — that requires a personal/lifestyle instrument (enduring guardianship, medical treatment decision maker, or equivalent). Facilities that previously accepted a financial EPOA as blanket authority are tightening their processes.
If your parent's documents predate the Act's commencement and you have not reviewed them recently, it is worth checking that the scope of authority matches the decisions you will need to make. The Enduring Power of Attorney and Guardianship toolkit walks through each state's instrument types and helps you confirm you have the right combination of documents for both financial and personal decisions.
The Bottom Line
The Aged Care Act 2024 does not replace your state EPOA or guardianship documents, but it changes the rules of engagement within the aged care system. Providers must prioritise supported decision-making, obtain informed consent before care changes, and follow stricter processes around restrictive practices. For families managing a parent's care, this means clearer rights — but also a higher expectation that your legal authority is properly documented and scope-matched to the decisions you are making.
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