The Real Cost of 24-Hour Care at Home for Elderly Australians in 2026

Here is the number most families are looking for, plainly stated at the beginning instead of buried under qualifications.

In Australia, a true, continuously staffed, paid home care service, constantly present and awake every hour, every day, will cost anywhere between $700,000 and $900,000 per year.

Support at Home, which replaced Home Care Packages from 1 November 2025, provides a maximum funding level of $78,106 per year.

That gap is the one fact in this subject that is nearly never put up front. This is not a reason to give up on care at home. It's why what families refer to as 24 hour care doesn't really mean 24 hours of care, and why you can create something that fits your budget and actually gets the job done.

In this article, we will present the facts, what it costs and where that money goes, and demonstrate what families are actually doing.

Why the Figure Is So High

The arithmetic is simple and unforgiving. There are 168 hours in a week. You can't have 168 hours of paid staff and pay for fewer than 168 hours.

The 2025-26 NDIS pricing structure mirrors the broader market and limits the cost of standard assistance with self-care to $70.23 per hour on a weekday daytime. The 2026-27 schedule sets the equivalent at $73.58. However, complex care does not observe business hours, and weekdays are only a fraction of the week:

Multiply that across the entire week, five weekdays, evenings, a Saturday and a Sunday, and you come up with a figure of about $14,000 to $18,000 per week. Annualised, that is the $700,000 to $900,000 figure.

For a person with high intensity needs, who needs trained workers, increase by about eight per cent. If two workers are required for any support, that doubles those hours.

Private and aged care rates differ from the NDIS price limits but not significantly enough to change the outcome. In whichever market you are buying, it is hard to find a family that is paying for a continual presence.

What "24-Hour Care" Actually Means in Practice

However, when one accepts the arithmetic, there's a useful change in the question. Instead of asking ‘can we afford 24 hour care?’, it becomes ‘how do we cover 168 hours?’.

In reality, most care that families would describe as 24 hour care is a combination of four factors.

Funded support hours focused where they make the greatest difference, typically at the times of day when the individual requires the most support, such as in the morning, evening or when they are most vulnerable.

Sleepover shifts overnight rather than active support, where that is clinically safe. This is the largest of all cost levers and deserves its own section below.

Family care, covering some hours directly. Typical, but more than families plan and more than is sustainable over time.

Equipment and home modifications doing work that would otherwise require a person: a ceiling hoist that turns a two-person transfer into a one-person transfer, a pressure-relieving mattress that reduces overnight repositioning, sensors that alert a worker rather than requiring someone to watch.

A well-constructed, realistic arrangement might be 8 to 12 funded hours per day, plus a sleepover, with family making up the difference. This is far less expensive than continuous care and many people find it most beneficial.

The Sleepover Rate: the Number That Changes Everything

If you learn one piece of pricing from this article, learn this.

Under the 2026-27 pricing schedule, an overnight sleepover shift costs $311.79, with up to 2 hours of active support per shift. Time over two hours will be charged at the hourly rate.

That's compared to active overnight support. An awake and working worker from 10pm to 6am, eight hours at night, will cost several times as much. The difference in cost between the two arrangements is in the tens of thousands of dollars per year, across seven nights a week.

It's not something you can pick and choose for your bill. It is clinical. In a sleepover it is assumed that the worker can sleep and can be awakened if necessary. It's fitting when one sleeps most nights and requires help now and again. It should not be used when repositioning is required every two hours, continuous suctioning is necessary, a seizure monitor is required, or when frequent ambulation and wandering are expected.

The bottom line is that anything that makes a sleepover clinically safe saves a ton of money. A mattress that alleviates the need to move around so much. A continence solution which doesn't require multiple changes at night. Improved control of a condition that leads to night waking. Technology that alerts a sleeping worker only when they need to be awake. These are not just tidying up; they can make the difference between something that is feasible and something that is not.

That's why it's important to conduct an occupational therapy evaluation early. Occupational therapy is clinical care and won't cost you anything regardless of income or assets, and the equipment it will recommend comes from a funding stream which won't impact on the number of hours you spend on support.

What Support at Home Actually Provides

Older Australians receive funding in Support at Home, and the structure is important.

From level 1 to level 8, there are eight classifications, from approximately $10,731 up to $78,106 a year. Funding is provided in quarterly budgets and 10 percent of each budget is allocated for care management before any service is bought, leaving 90 percent of the headline.

The top classification is about $1,500 per week or $78,106 per year. The average blended rate is about $70 per hour, which equates to about 21 hours of support per week, or three hours per day.

Three hours a day is genuinely useful. It's not 24-hour-a-day care.

But the contribution structure softens that considerably. Nursing, wound care, medication management, physiotherapy, occupational therapy and continence support are all fully funded with no contribution based on income and assets. The biggest remaining contribution, personal care, is phased out for most households from 1 October 2026, when personal care becomes fully funded for all. Everyday living services such as cleaning and gardening are 17.5 to 80 percent depending on means.

So the position for most older people is that there is a meaningful level of clinical support free of charge, personal care soon to be free of charge, and the limiting factor is not what you can afford to pay, but what the money can buy.

Where the Money Goes That Nobody Mentions

Families are always surprised by four things.

Weekend and public holiday loadings. Care does not pause on Sunday. A plan that is built based on weekday rates and rolled out over 7 days is short, and the deficit accumulates incrementally over a quarter. Model the actual week.

Two-worker requirements. If a physiotherapist or occupational therapist has determined that transfers require two people, these hours are double. This is uncovered after you have costed your plan.

The quarterly rollover cap. Only $1,000 or 10% of your quarterly budget can be carried over from one quarter to the next. At classification 6, at approximately $12,028 per quarter, a person spending $7,000 carries approximately $1,203 and permanently loses approximately $3,825. Underspending is NOT saving.

Travel and minimum shift lengths. A two-hour minimum turns a forty-minute visit into a two-hour charge. Across a large number of visits per day, that is substantial. Discuss travel charges with each provider and seek to know the minimum engagement.

Where the Money Is Saved That Nobody Mentions

Similarly, four things make it less expensive and are commonly overlooked.

The rate you pay per hour. Support workers are generally between $45 to $70 per hour in Sydney, and $40 to $65 in most other markets, against $65 to $95 per hour via a traditional full-service agency. If you are on a 20-hour package, this equates to a few extra hours of support for the same price. Price caps were set to start from 1 July 2026 and then postponed in May 2026, so there's a legal variation and sometimes a big one in prices between providers, compare the prices published on their websites, and providers are obligated to publish them.

Free clinical services, used fully. There is no cost to nursing and allied health. During an OT home assessment, changes often are found that allow for fewer paid hours.

Equipment from capital funding. Hoists, beds, pressure mattresses, sensors and bathroom modifications are not included in your support hours.

Consumables funded separately. Including feeding supplies, wound dressings, and continence products. Families who buy these privately are often entitled to have them funded.

What Families Actually Do

After some hard numbers, here is what real sustainable solutions look like.

Most often, funded support is grouped together around specific times, like the morning and evening (when personal care, meals, and medication are required) and an overnight sleepover, with the rest of the day covered by family and other supports on the weekend.

If family capacity is limited, additional hours are purchased during the day and the individual is left alone part of the day with sensor or check-in arrangements, which is suitable for some and not others.

A private top-up (where allowed by funds) supplements the funded package. This is more prevalent than the sector realises, and it is important to recognise whether it will be sustainable year-on-year, as opposed to month-on-month.

The picture is different if the person has other funding streams, or is under 65 with high needs, as then it can support much more.

Where continuous care is genuinely required and cannot be safely reduced, most families eventually find that residential care offers on-site staffing that is not available at home at any affordable price. That's not a failure. It is arithmetic.

The Question Worth Asking Instead

The question of whether or not we can afford 24-hour care invariably produces the answer no.

If you get a list out of ‘what would it take to keep this safe’, you can solve it. Often the answer is very specific: a hoist, two additional hours in the morning, a fortnightly respite booking, a sleepover four nights a week, better overnight continence management. This package is affordable for many families within a Support at Home classification, and provides most of the benefits of continuous care.

The families who manage this well are the ones who give up on the word ‘coverage’ and adopt the word ‘risk’. Which hours of the day are you really at risk if left alone? What would make them safe? That's a lot less than 168 hours.

The Bottom Line

Continuous paid care at home costs $700,000 to $900,000 a year. The maximum Support at Home classification is $78,106. Those two numbers constitute the whole of the topic.

The magic of home care is not working every hour but working the right hours and using sleepover (as opposed to active night) support when it is clinically acceptable, letting equipment do work that would otherwise require a person, and paying an hourly rate that equates to more hours within the same budget.

The single highest-value action for most families is an occupational therapy assessment, as it is free, it comes with funded equipment from a separate funding stream, and often an unaffordable arrangement becomes an affordable one.

A Worked Example, With Real Numbers

Abstract figures are hard to act on, so here is a concrete household.

Joan is 87 years old, lives alone in her own home, has moderate dementia and a history of two falls in the last year. She needs help dressing and bathing in the morning, supervision in the evening when she is most confused, twice-daily medication reminders, and something to address the nights, as she has twice been seen in the front garden after midnight.

She has been assessed at classification 6 and is funded approximately $48,114 per year, or approximately $12,028 per quarter. After the 10 percent care management deduction, the remaining funds available for services are around $10,825 per quarter (or $832 per week).

What she buys:

Two hours each weekday morning and one hour each weekday evening, at $58 per hour through directly engaged workers, comes to $870 per week. Just a bit over budget, so her daughter covers two mornings and it works out to about $700 per week.

Free on top: a community nurse checks up on her medication management each month, and an occupational therapist has evaluated the house. Neither costs Joan anything, as clinical care does not involve any contribution based on income or assets.

The outcomes of the OT assessment: sensor mats by the bed, better light fittings on the path to the bathroom, a day-night clock, grab rails in the bathroom, and a raised toilet seat. All funded from capital, none of it taking away from her hours of support.

The GP review resulted in a diagnosis of UTI which was treated, and a change of diuretic from evening to morning. Her night waking reduced markedly.

The night: with the lighting, the medication change and the sensors, a sleepover became clinically appropriate instead of an active night. Her daughter stays two nights a week, and a sleepover worker covers two more at about $290 a night, funded through about $580 a week from a private source.

The total position: about $700 per week funded, $580 per week private, plus family care, and all clinical input and equipment free. Not continuous care. But Joan is still at home two years after the family thought she could not be.

The point of the example is not the specific numbers. It is that the arrangement was built by reducing the need, treating the infection, changing the medication, adding sensors, improving the lighting, rather than trying to buy enough hours to compensate for the risk. That's how home care is affordable.

Questions Worth Asking a Provider About Cost

There is a direct link between generic questions and generic answers.

What is your published price for personal care on weekdays, evenings, Saturdays, Sundays and public holidays? Their duty is to publish it. Get it in writing.

What is your minimum shift length? If the visit is forty minutes long but has a two-hour minimum, it will cost two hours.

Am I charged for worker travel, and will it be deducted from my budget?

Is the overnight shift a sleepover or active support, and what is done if the worker is awake for more than two hours?

Do two workers need to be involved with any part of this support?

What exactly does the care management part involve?

If I'm spending too little in a quarter, how will you let me know? With the rollover cap, it's money that is lost if you spend less than the amount. A quality provider will catch that and alert you before you miss the chance.

Frequently Asked Questions

What is the cost of 24 hour care in the home per week?

Continuous active support is about $14,000 to $18,000 per week at 2025-26 and 2026-27 rates, including loadings for weekends and public holidays. Most real arrangements are a lot cheaper because they include family care, funded hours and sleepover overnight, instead of active support.

How much Support at Home can be provided?

The annual amount for classification 8 is approximately $78,106, paid in quarterly instalments, 10% of which is used for care management (prior to purchasing services). At an average blended rate that buys about 21 hours of support per week.

What is the difference between overnight care and a sleepover?

A flat shift rate of $311.79 (under the 2026-27 schedule) is a sleepover, with up to 2 hours of active support. Active overnight care is where the worker is awake, available and working, charged hourly at night rates, and costs several times a sleepover across a week. Which applies is a clinical question, not a billing preference.

Is nursing included in the cost?

With Support at Home, any clinical support, such as nursing, OT, physio and podiatry, is fully funded by the government, and you do not need to pay a contribution based on your income or assets. This is one of the most under-used entitlements in the system.

When does personal care become free?

Personal care (showering, dressing, grooming and continence support) is reclassified as clinical support and will be fully government funded for all within the allocated budget, from 1 October 2026.

Can equipment really reduce the cost?

Substantially. A ceiling hoist can turn a two-worker transfer into a one-worker transfer, halving those hours. A pressure-relieving mattress can be enough to eliminate the need for overnight repositioning, thereby avoiding expensive active support, worth tens of thousands of dollars per year. Equipment is sourced from capital funding, so it does not impact your support hours, and the OT assessment that recommends the equipment is free.

Why do provider prices vary so much?

Price caps were legislated to begin on 1 July 2026, but were deferred in May 2026 and have not been set for a new start date. Providers are still required to provide comprehensive price lists and may not impose administration, entry or exit fees, but prices fall within the parameters of the law. The biggest shield you have is to compare published price lists.

What happens if we underspend our quarterly budget?

Only $1,000 per quarter or 10 percent of the quarterly budget can be carried over. Anything over that goes back to the government at the end of the quarter. On a mid-level classification, if you're running $5,000 beneath budget for a quarter, you can be losing almost $4,000 of your money forever.

Is it cheaper to engage workers directly?

Generally yes. With direct engagement, you will pay between $40 and $70 per hour, depending on the market, but there's no agency margin between you and the worker. That difference equates to several more hours of support, with the same funding, on a twenty hour week.

When is residential care more affordable?

If it is truly continuous care that you can't afford to cut back on without compromising safety, residential care is typically more affordable than home care and offers on-site staffing that is not possible at any price at home. Home care is nearly always less expensive and more effective when the care needs are predictable or intermittent. The only honest comparison is made if you don't assume that the home option will require continuous paid support.

Support Network can assist families to understand what their funding will actually pay for. See our 24 hour care services or call 1300 671 931, and we will let you know clearly what we can achieve, including if the answer is that home care is not the right fit.

Sources and further reading

• NDIS Pricing Arrangements and Price Limits 2025-26; NDIS Pricing Schedule 2026-27
• My Aged Care, Support at Home funding classifications and participant contributions
• Aged Care Act 2024 and supporting Aged Care Rules
• Aged Care Quality and Safety Commission, provider pricing obligations