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In looking to future directions in residential care, this paper considers a number of factors that make for stability and others that are likely to see a continuation of present trends before turning to sources of new development. While recent policy measures to integrate nursing homes and hostels have focused attention on higher levels of residential care, the scope for change here is seen to be limited by funding and other constraints. Instead of a return to the continuum view of residential care, a redrawing of the paradigm is proposed that builds on initiatives that promote more varied combinations of care and accommodation, more flexible funding arrangements, and more interaction with community care across a range of housing settings. Support for this paradigm of diversification is found in current international developments.

Objectives: To compare the Home and Community Care Program (HACC) target population defined on the basis of the ABS Survey of Disability, Ageing and Carers (SDAC) with 2006 census data on need for assistance. Methods: The number of people with different levels of core activity limitation as defined in the SDAC was estimated for the 2006 population aged 65 and older and compared with the number reporting a need for assistance in the 2006 census. Results: The two target populations differ in size, age and disability levels, but the differences are reconciled when components within the total SDAC-defined target population are taken into account. Discussion: Assessment of different definitions of target populations in terms of validity in identifying program beneficiaries, accuracy in measurement and usefulness in monitoring program performance leads to the conclusion that the bigger SDAC-defined population is better aligned with the goals of the HACC program.