Wife and carer 'dumbfounded' by husband's aged care assessment

Aged care tool under fire as man with late-stage MND loses appeal for higher funding Thu 18 Jun 2026 at 5:23am In short: Graham Crossan is 80 and has late-stage motor neurone disease, but has lost an appeal for higher support funding. His wife Gaynor was shocked at the decision, which was based around a new assessment tool introduced last year. Critics says the federal government's Integrated Assessment Tool is failing older people, with a large number of complaints received. Melbourne man Graham Crossan, 80, relies on his wife Gaynor to help him eat, move and even breathe. Graham is severely incapacitated with late-stage motor neurone disease and his 79-year-old wife is his primary, and often only, carer. Because he's over 65, Graham can't access the National Disability Insurance Scheme (NDIS), but receives some funding through the federal government's My Aged Care program. Last November, the federal government began using an algorithm, the Integrated Assessment Tool (IAT), to determine aged care support. Graham was told he would need a new assessment and expected to receive the highest level of at-home care. But the algorithm deemed him ineligible for higher funding, and the results couldn't be overridden by a human. Wife 'dumbfounded' by decision The couple appealed the decision, submitting a new report from a senior Occupational Therapist specialising in progressive neurological diseases, which supported his need for more help as the disease progressed. Last month, the Department of Aged Care again knocked him back. "They declined our request for review, they felt the initial assessment was correct," Gaynor said. She was left dumbfounded by the decision. "Quite honestly, I don't know what else would make them change their minds," Gaynor said. "He uses a [ventilator] between 22 and 23 hours a day … he will die if that ventilator malfunctions or is not being applied in a suitable way. "It needs at least two people to lift him. He cannot support himself. "I don't understand what else would be needed for them to grant a review." The Crossans' local federal member, Kooyong MP Monique Ryan, said it was the worst example she had seen of what she described as "Robo Aged Care". "The amount of financial support that his carer, his wife, is able to receive is manifestly inadequate for his needs," Dr Ryan told the ABC. "But what's going to happen, unless we can get some progress on his case, is he's going to have to move out of his home into residential aged care, which is not his preferred option or his wife's preferred option," she said. In a letter to Mrs Crossan explaining its decision, the "system governor" said the "original assessment took into consideration the extent of (Graham's) impairments and functional limitations". It said, as there had not been "a significant change in (his) functional independents (sic) or needs met from what was considered in the original assessment" a higher level of funding was not available. Algorithm 'clearly not working', says Kooyong MP Dr Ryan is incredulous at the response. "His needs haven't increased because they're already maximal," she said. "They couldn't be any greater than they are now and I can't say that anyone would argue that's not a reason to give someone as much support as you can." Dr Ryan said the algorithm clearly was not working. "We put the same rubbish in and we get the same rubbish out every time," Dr Ryan said. "The algorithm is inappropriate." Graham's case is far from isolated. The Department of Health, Disability and Ageing has received 1,117 requests for review from the period from the introduction of the algorithm on November 1 last year to March 31 this year. The Department has finalised 606 of those, upholding 92 of the original decisions and amending 132. The rest were withdrawn or deemed to have been "submitted by people without legislative authority to do so". The Commonwealth Ombudsman also confirmed it had received a number of complaints about algorithmic decision-making, but said it would not make any further comment until the investigation was complete. Minister for Health and Ageing Mark Butler has announced a three-month rapid review of the Support at Home "prioritisation mechanism" but has defended the algorithm as improving the consistency and fairness of how in-home aged care is allocated. Changes may not help people like Graham The typical life span from diagnosis of MND is 27 months and the minister said there would be a new fast-track process prioritising older Australians with MND for urgent funding. The member for Kooyong said those changes would not help people like Graham. "It doesn't really matter how quickly people are assessed if the assessment repeatedly gives them a level of service and support which is manifestly inadequate as it has in this situation," she said. "If the system spits out a formulation that what you deserve and what you can get is completely inadequate for your level of need, then it really doesn't matter how quickly it manages to come up with that formulation." In a statement, Federal Minister for Aged Care Sam Rae told the ABC the rapid review would "not be the end of the government's work to improve the fairness, efficiency and equity of aged care assessments". "While we know there's much more to do here, we'll continue to listen to the experiences of older Australians," Mr Rae said. Shadow minister plans to introduce new legislation Shadow Minister for Aged Care Anne Ruston said the government's review was an admission that the Integrated Assessment Tool was failing. She plans to introduce new legislation into the Senate next week. "Our private members' bill will allow for human override when the computer system spits out an outcome that the (human) assessor believes is not accurate in terms of the care needs of the individual," Ms Ruston said. "We also believe that anybody who's been assessed under this algorithm where there has not been any ability for human override, they all should have the ability to be reassessed if they want to." But Senator Ruston said the IAT should still be used for assessments. "Happy for it to be part of the process as long as at the end of the day the person who's receiving care knows that a person has actually made the decision as to the level of care and the priority of care that they get." Review outcome 'outrageous' Jo Whitehouse, the general manager at MND Victoria, welcomed the rapid review pathway announced by Minister Butler. "It's something that we have been fighting for," she said. "However, I think in scope the review process is something perhaps that we do need to revisit and do a bit more advocacy work on because that's clearly not meeting people's needs." She described the outcome of Graham Crossan's review as "outrageous." "I understand that there's a need for things to be efficient and as productive as possible, but I think in this instance when you're considering somebody's life here and how they're currently functioning, I think it's highly inappropriate." Under current funding, the Crossans can only afford to pay for nine hours of care a week — not enough to move Graham in and out of bed each day. Gaynor, friends and volunteers try to fill the gaps. She receives little respite herself. "I spend all my time looking after Graham and our home, and so I have very little time to care for myself," she said. Dr Ryan said the system made no sense. "It will cost much more to the system to have him in 24/7 care in the residential aged care system," she said. "And he'll probably die in a setting that's not his preference, not in his own home, because our aged care system can't provide the care that he deserves and needs." Dr Ryan was at last week's state funeral for MND advocate Neale Daniher, where the prime minister addressed the service. "He spoke beautifully about how important it is to support people with conditions like motor neurone disease," she said. "We spoke about the importance of supporting people who experience these sorts of conditions to die with dignity and as well as trying to maximise their ability to live independently for as long as possible. "But our system is not doing that." Gaynor described the system as "inhumane", and said her husband would be receiving more support under the NDIS. "I'm very disappointed that people who are over 65 are treated the way they are,"she said. "We have worked hard, paid our taxes, contributed to this country for 50 years and are now treated as second-class citizens. "I think it's sad."