- In most cases
- Under 65 = NDIS
- dementia onset before age 65 is the defining criterion
- Even for NDIS clients
- ACAT still matters
- residential aged care placement always requires ACAT approval
- NDIS + aged care coexist
- Dual funding
- understanding the split prevents gaps and duplication
The legislative framework is clear in principle but creates practical complexity. Under-65 dementia clients are typically NDIS-eligible but ACAT assessors play an important ongoing role, and documentation written well serves both systems.
Which Pathway Applies?
Age at access and age at onset together determine the primary funder:
NDIS is the primary pathway
Submit the NDIS access request. ACAT assessment is still required if residential placement is needed.
My Aged Care is primary
Your ACAT assessment determines Home Care Package or residential aged care eligibility.
Explore NDIS regardless
If dementia onset was before 65, NDIS eligibility should be explored regardless of existing aged-care enrolment. Contact the NDIA for a pathway determination.
ACAT's Ongoing Role for NDIS-Eligible Clients
ACAT is not out of the picture when a client is NDIS-eligible four scenarios remain within ACAT's remit:
Even for NDIS participants, residential aged care entry always requires ACAT approval. An NDIS participant requiring residential placement needs an ACAT assessment for that placement.
NDIS participants approaching 65 can choose to stay on the NDIS after 65. Begin transition planning 12–18 months before the birthday. After 65, new NDIS access is not available.
Where a client has both NDIS funding and CHSP or a Home Care Package, ACAT informs the aged-care component. The NDIS covers disability-specific support; aged care covers domestic, meals, and clinical nursing.
For under-65 clients not yet approved for the NDIS, CHSP can provide bridging support. ACAT documentation of functional need supports expedited NDIS access in complex cases.
Documentation That Assists NDIS Planning
ACAT assessment documentation used as NDIS supporting evidence should include these elements:
Functional impairment by specific domain what the client can and cannot do, with the degree of assistance required.
Safety risks explicitly named with their likely consequences if unmitigated.
Carer situation documented who provides support, their capacity, any stress indicators.
Dementia type and stage from treating specialist reports where available.
Professional opinion on support intensity required not just service categories approved.
For clients approaching 65 who are already on the NDIS: continuity of support-worker relationships across that transition is a clinical priority. Disruption of familiar workers at this stage can trigger significant behavioural and functional deterioration.