“Holiday home” is not often how aged care facilities are described.

Key points:

  • An Aged Care Royal Commission finding spoke of a vision for smaller, lower-density care homes
  • Facilities in the Northern Territory and Tasmania are proving it can be done successfully
  • Their models of care are more personalised and directed to individual circumstances

But that’s how 95-year-old Hannah Kirk views her nursing home in northern Tasmania.

“That’s what I call it … it’s like a holiday home I’m living in and honestly it is, I have never seen as good a place,” she said.

“Some of the big places we went to were not what we wanted, but this was like home.”

Like many elderly Australians, Mrs Kirk was apprehensive about moving into an aged care facility, but she doesn’t regret the move to her room at Cadorna House at Riverside.

An aged care resident sits in her chair and looks out a window

Tasmanian resident Hannah Kirk made the move into care 18 months ago.(

ABC News: Maren Preuss

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Resident numbers at the privately run facility are capped at 33 — about half the size of most others — and Mrs Kirk enjoys the close connections she says come from the smaller setting.

Thousands of kilometres away in the Northern Territory, family and cultural connections are paramount.

On the shores of a bay more than 500 kilometres from Darwin, a 10-bed facility is catering for a community of about 2,300 people.

An elderly Aboriginal woman sits on her walker

Former teacher Josephine Cooper sits on her walker at the Mala’la Aged Care Centre.(

ABC News: Laetitia Lemke

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For Josephine Cooper it’s a secure home in an area grappling with overcrowding – and she is close to family.

“It’s good, we are happy here,” she said.

“Every afternoon we go for a walk — me and Lillian — we go for a walk.”

These two women at either end of the country are in very different aged care settings.

But the places they now call home share one important thing in common. They are both small.

Keeping strong ‘physically and mentally’ 

It might sound like a case of stating the obvious, but a focus on small facilities was also one of the key outcomes of the nation’s multi-million-dollar inquiry into the sector.  

Putting the brakes on building bigger and bigger facilities was singled out by Lynelle Briggs, one of two people leading the Aged Care Royal Commission.

Part of the solution, she said, was transitioning away from large institutional settings in favour of smaller facilities that resembled people’s homes.

She wrote:

“My vision is that, over time, large aged care ‘facilities’ will give way to smaller, more personal residential care accommodation, located within communities, towns and suburbs.

Smaller, lower-density congregate living arrangements generally promote a better quality of life for everyone.”

These two homes in the Top End and Tasmania are proving that point.

Run by the Mala’la Health Service Aboriginal Corporation, the Maningrida centre also supports dozens of others in the community on home care packages.

A young Aboriginal woman sits smiling at a table

Mala’la Aged Care support worker Kahleah Baker at work in the Northern Territory.(

ABC News: Laetitia Lemke

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It’s a model staff and residents believe could benefit other remote communities.

Maningrida local Kaleah Baker has only been working there a few months, but is passionate about caring for community elders “to keep them strong, go fishing, and to keep them safe and healthy”.

But not all communities in the Top End are so fortunate.

An Aboriginal man in a colourful shirt stands next to a pole

Mala’la Aged Care’s Lalaparr Durilla says more funding is needed to expand community-specific aged care in the Territory.(

ABC News: Laetitia Lemke

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Lalaparr Durilla has seen elders have to leave country to access care.

“We don’t have these services in East Arnhem region, but we’d love to see this so we could bring back our people that are in Darwin,” he said.

“Bring them back to family and country to be good for [their] mental health.

Mr Durilla enjoys working in aged care, particularly in a smaller model like Mala’la.

“You get to spend more time with clients, patients, you get to sit and actually talk with them,” he said.

“In clinical [work] you only get a certain amount of minutes to talk.

“Getting to know them is good … to know the environment and the people I’m working with [treat them] … appropriately with respect.”

Mala'la aged care exterior

The Mala’la Aged Care Centre is home to seven residents but is also a hub for the community at Maningrida.(

ABC News: Laetitia Lemke

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An empty wheelchair on a balcony with a bay in the background

The Mala’la centre can cater for 10 people.(

ABC News: Laetitia Lemke

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He and others want to see more funding to set up similar facilities in other remote communities to “bring the families back” together.

“It’s such a good example for other communities … [they] only have meals on wheels, they don’t have the proper care they need.

“Here they get meals clothes, meals, everything that they need but in other communities in East Arnhem Land it is not there.” 

Aged care resident at Maningrida

A resident at the Mala’la centre chats to a support worker.(

ABC News: Laetitia Lemke

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An elderly Aboriginal woman holds a colourful painting

Resident Lillian holds one of her paintings at the Mala’la centre.(

ABC News: Laetitia Lemke

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The Federal Government has earmarked $29 million for the remote East Arnhem region for an aged and palliative care facility in Nhulunbuy and the service provider, the Australian Regional and Remote Community Services (ARRCS), says construction has begun.

But even in the NT capital of Darwin, aged care spaces are low.

The situation is so dire the Territory Government’s waded into the space, bidding successfully for 60 provisional aged care beds to establish a specialised dementia centre.

A man walks on a sandy beach with trees in the background

Fishing is one of the activities residents can enjoy at the Maningrida centre.(

ABC News: Laetitia Lemke

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But funding for home care packages is also needed says Joanne Kova, who runs a business caring for seniors in their homes across the Top End.

She says people are dying before being able to access funding.

“I think we need aged care packages set aside for people who are palliative to walk straight into — they don’t have to wait they are discharged from hospital straight into a package,” she said.

‘Seeing quadruple’ in 40 years

An elderly Aboriginal man in a baseball cap

Michael Dennis wants to see more aged care facilities in remote parts because too many people are being sent into Darwin away from country and family, and they are dying earlier.  (

ABC News: Laetitia Lemke

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Two Aboriginal woman do the hair of an elderly Indigenous woman

Rose Karbaranga gets her hair done at the Mala’la centre.(

ABC News: Laetitia Lemke

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Demographers are predicting the number of Aboriginal people requiring aged care in the Territory will quadruple over the next 40 years as life expectancy improves.

The aged care cohort is spread across a land mass 20 times the size of Tasmania.

Associate Professor Andrew Taylor from Charles Darwin University says the change is “unprecedented”, particularly for remote communities.

“That’s phenomenal growth that will need to be thought about and that cohort’s going to have particularly culturally sensitive needs around ageing and aged care,” he said.

Aboriginal women take part in a craft session at an aged care facility

Aboriginal women take part in a craft session at Maningrida.(

ABC News: Laetitia Lemke

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A rapid increase in seniors is also predicted in Tasmania, which already has the oldest population in the country.

It now has the fastest ageing cohort due to younger people leaving the state and older people making the move south.

Demographer Lisa Denny says the number of people aged 85 and older is expected to double in the next 40 years.

“We’re projected to have around 27 per cent of our population aged over 65 by the mid-2060s,” she said.

‘There was another way’ 

A middle-aged woman in a blue uniform sits on a chair

Leeanne Reeves started Cadorna House near Launceston 30 years ago.(

ABC News: Maren Preuss

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Leeanne Reeves started the privately owned Cadorna house Hannah Kirk likens to a “holiday resort” almost 30 years ago.

She says it is no more expensive than its larger counterparts, it’s funded exactly the same, but the difference is how they manage overheads.

Mrs Reeves and husband Rob are hands on with everything and she says the home is not top-heavy with administration.

“I’d worked in a large aged care facility for a number of years and just felt there was another way to deliver care for the elderly,” she said.

An older person's hands hold a magazine

A Cadorna resident reads a menu.(

ABC News: Maren Preuss

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“We know all of our residents intimately and form a close relationship with the resident and their family, we welcome everybody in as a family and we’ve got a good group of staff here and some have been here for 27 years.

“Our staff ratio is higher than the benchmark, we also have two staff on leisure and lifestyle for the 30 residents.”

But being small comes with challenges as nursing homes deal with more acute care needs and keeping low-paid staff.

A poodle cross dog on a pink lead

Hollie’s owner brings her into the Cadorna aged care home to lift the spirits of residents.(

ABC News: Maren Preuss

)

An elderly man's legs walk onto a ramp

An elderly man is helped onto a bus for an outing at Cadorna House.

“Definitely [with]  the funding we really need to be offering an increased wage incentive for staff,” Mrs Reeves said.

“The aged care award is well below what’s being paid for assistants in nursing in hospitals, clinical nurses in hospitals are paid well above the aged care award for nurses and I don’t think there should be that discrimination in the wage.”

‘No lonely people here’

Research has shown the smaller more domestic model of care results in few hospital admissions and better outcomes for those with dementia.

Eighty-six-year-old Dennis Sayer has lived at Cadorna for four years and says it is very different to other aged care homes.

Aged care resident looks out a window

Dennis Sayer enjoys the range of activities on offer at Cadorna House near Launceston.(

ABC News: Maren Preuss

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“A lot of them just sit in their rooms and don’t do anything and that makes a big difference to get out and do things,” he says.

He enjoys working with Lego, spending months creating complex creations.

Elderly people paint at a craft session in an aged care facility

Craft sessions are also popular at Cadorna House.(

ABC News: Maren Preuss

)

With the help of the centre’s leisure coordinator Adam Page he has now branched out to art classes for the social connection.

Mr Page says the smaller facility enables staff to tailor their support to what people enjoy doing.

Lego model of a ship's bridge

One of  Dennis Sayer’s Lego creations at Cadorna House.(

ABC News: Maren Preuss

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“The people that live here, they’re really close … have really bonded,” he said.

“There’s no lonely people here.

“I’ve witnessed with the art therapy people who have no passion, suddenly have it. they see their artwork hanging on the wall in their room … the pride and the look on their face, they talk about it for weeks.”

“It was mentioned in the Royal Commission that smaller facilities within the suburbs may be the way to go and I think we’ve certainly proved that it’s effective and works,” Mrs Reeves said.

An elderly woman in a red cardigan sits smiling in a lounge chair

Hannah Kirk says she has made many friends since moving into Cadorna House.(

ABC News: Maren Preuss

)

Hannah Kirk is living proof.

Since moving into Cardona 18 months ago, she has not looked back.

“And I sat down a saw the river, this beautiful place and said ‘it’s alright I’m staying here’ and I did stay.

“This was like my home.”

A woman sits next to a resident in an aged care bed

Cadorna House sits near the Tamar River in northern Tasmania.(

ABC News: Maren Preuss 

)

An aerial view of a setting sun on a small settlement next to a tropical bay

Maningrida’s aged care centre is situated on the shores of a bay 500 kilometres from Darwin.(

ABC News: Hamish Harty

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Posted , updated 

‘We welcome everybody in as a family’: How these small aged care homes in Tasmania and the NT are making a difference
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