Once there was a woman, aged 94, whose husband had dementia and had gone into aged care. She still lived at home, with some help.

“She was a really proud gardener, loved her garden, and a real key part of her local community,” says Nicky Sloan, CEO of Community Industry Group.

“Then she fell and broke a hip.”

Hospital staff assessed her as unfit to return home. The woman waited, living in a hospital bed until a residential care place finally opened up.

“She couldn't even go into the facility where her husband was,” Ms Sloan says. “She died a few months later, separated from her husband and separated from her community.”

This story is one of several sad case studies that have come to light during Community Industry Group’s two-year investigation into the Illawarra Shoalhaven’s bed block crisis.

“We are the worst in the country,” Ms Sloan says.

Her group has found that each night hospitals are housing about 150 elderly and disabled people, who are living there because they have nowhere else to go – this is called 'bed block'.

Bed block begins with acute illness and a hospital admission, Ms Sloan says. “But then that illness is treated. They are eligible to be discharged, but they can't go back home. They need residential care, and there are no residential care spots available for them. So they are stuck living in hospital until they can find a facility.”

‘The little peak that could’

Based in Port Kembla and with just 11 staff, Community Industry Group is the peak body representing non-government community services industry in south-east NSW. Two years ago, the group launched an Illawarra Shoalhaven Regional Health and Aged Care Taskforce, their first step being to work out the size of the problem.

It was bigger than they imagined. 

"Our research showed that, despite the ageing population, and the enormous increase in demand, aged care bed numbers have barely changed in 10 years – there were 4325 aged care beds in 2015, and 4356 in 2024," Ms Sloan says.

"No wonder we are already over 1000 beds short.

“We probably didn't know the size and scale of the project when we first started, but we have an absolute commitment to the not-for-profit sector. And we have an absolute commitment to social justice – and access to residential care and access to healthcare is a social justice issue.

“So, yes, we are the little peak that could, so we just got on and did it.”

In September, the group shared their findings and discussed solutions at a meeting designed around a simple idea: bringing everyone together. Not just government, industry and not-for-profits, but all three levels and different departments of government.

It was the first time this had been done.

The September meeting attracted 32 people, including NSW Health Minister Ryan Park, Planning Minister Paul Scully and Wollongong’s new Lord Mayor, Tania Brown.

“Tania’s very committed to being part of the solution … but we also had the general manager from Wollongong City Council there as well. So, both from the politician side and the bureaucrat side, which is great,” Ms Sloan says.

“There was great willingness for collaboration and cooperation.”

September’s meeting produced short and long-term plans but the key was having the right people in the room to approve them.

“We got agreement from all of those stakeholders for those strategies.”

Treating bed block

Bed block affects new patients and hospital flow, but is a critical issue for people who need specialist geriatric or disability care, but are instead stuck in a lonely hospital bed, with none of their own stuff, no communal meals, exercise, activities or other social stimulation.

Solutions include changing government policy, increasing bed numbers in existing homes and boosting staff. For example, Ms Sloan says she would like to see the cap on international students’ working hours eased.

“We’ve got some great international students who are studying at the University of Wollongong who are already working in aged care. If we could just increase their hours, that would help their workforce significantly.”

Why we have Australia’s worst case

About 20% of Illawarra Shoalhaven hospital beds are now effectively being used for geriatric care, Community Industry Group has learned.

One big problem stands out.

“It is because we have not built an aged care facility in this region for about 10 years,” Ms Sloan says.

“Some of it is undoubtedly due to the fact that development applications were just unable to be approved. We saw facilities that providers had invested heavily in the design and application phase that never got through and have now been sold off.

“Warrigal, for example, was going to build 120 beds on Corrimal Street in Wollongong – they spent eight years and hundreds and hundreds of thousands of dollars to try and get that development application approved. They couldn't get it approved and in the end it's been sold off. It's a car yard now.”

Developments have failed for multiple reasons, including something as small as conflict over half a metre in building height.

“This is where it was really important to have people like the Planning Minister there [at the meeting], but also the general manager of Wollongong City Council, to see the impact of the inflexibility of the planning system,” Ms Sloan says. “Height was definitely one of the issues.”

Another problem is incentive: there’s no profit to be made in aged care, with Community Industry Group's reports showing providers have been losing money for years.

“It costs between $300,000 and $550,000 per bed to build an aged care facility,” Ms Sloan says.

“So if you are looking at a 100-bed aged care facility, then we know that you're looking between $30 million and $55 million to build that. And that's an awful lot of money, if you're not going to actually make that money back. So we do need government to be looking at capital grants.

“We need government to be incentivising aged care in this region.

“We know this issue is going to only grow in our region, but also right across the country.

“Years and years ago, government made the decision to make aged care a market … the fact that there's huge demand in this region and the market is not coming in tells us that the market's failed in this region.”

Planning to age well

For many people, the first time they realise the system is buckling under pressure is when they run into problems first-hand, such as finding an aged care spot for a parent.

“People are so shocked,” Ms Sloan says. “Because we have quite an ageist society, people have a kind of reticence about looking into aged care before they need it. That's one of the reasons that we've gotten into this mess because, as a region, we haven't been looking forward to the aged care needs of our region.”

Decision makers also need to consider elderly people’s support systems.

She points to the case of the 94-year-old woman who broke her hip but had “her whole community wrapped around her”, with neighbours popping in for tea, taking out her garbage and mowing her lawn.

“With some more elevated healthcare supports and home care, she probably could have realistically gone home.

“We have to be so careful about not infantalising our older people. When we get older, we are still adults, we should still be able to make decisions, we should still have the dignity to be able to risk.

“One of the things I would encourage everybody to do is to talk with their older relatives and make sure that they have things like advanced care plans, so that if an emergency does happen then everybody knows what that person's wishes are.

“Everybody should be receiving the care they need to lead the best life they can right up to the end.”

Want to help?

As part of its STARS program, Community Industry Group welcomes volunteers with experience in aged care, people who can help families and bed blocked patients cope with the system. Call 4256 4333 or visit the Community Industry Group website.