
A research paper that examines age-appropriate residential care for people under 65 with high and complex needs, outlining design, funding and technology strategies that support independence, dignity and community connection.
Thousands of Australians under 65 live in residential aged care because suitable alternatives are scarce. Many are discharged from hospitals into settings that are not designed for rehabilitation or age-appropriate life. The National Disability Insurance Scheme creates an opportunity to change this picture by funding Specialist Disability Accommodation and enabling genuine choice of where and how to live. This paper reviews contemporary models that prioritise personal agency, social inclusion and high-quality design over institutional solutions.9
From houses to habitats
Care settings should function as homes within neighbourhoods. Applying the BISI framework means integrating the built environment, infrastructure networks and social capital so that residents can participate in everyday community life.
Age-appropriate environments
Younger people require housing that supports autonomy, study, work and social relationships. Environments should be adaptable for changing needs and should avoid the cues and constraints of aged-care institutions.
NDIS and SDA as enablers
SDA funding allows participants to invest in accessible new builds or modifications and to separate housing from support providers. Clear pathways and transparent management improve choice and control.
Technology that supports independence
Smart home systems, environmental controls, ceiling-mounted hoists and alert technologies reduce reliance on staff for routine tasks and give residents greater privacy and confidence.
Three case studies, three pathways
Design quality matters
Across models, success correlates with natural light, outdoor connection, generous circulation, high-quality finishes and homes that look and feel domestic rather than clinical.
Purpose: outline viable, age-appropriate alternatives to residential aged care for younger people with high and complex needs.
Purpose-built or integrated supported housing can move younger people out of aged care and into homes that support growth and participation. Freedom Housing demonstrates the value of colocating a compact care pod with individual dwellings. The Abbotsford model shows how accessible apartments embedded in mainstream developments can reduce stigma and keep people connected to services and transport. Youngcare’s program illustrates how clear design principles and smart technology raise dignity and independence. Collectively, the evidence suggests that diverse typologies are essential and that high-quality, non-institutional design contributes directly to wellbeing.

Get the complete publication including the BISI context, case studies, terminology guide and a summary of funding and management strategies.

Scope: literature review and three built or prototyped case studies that compare typology, funding and care delivery.
Principles: person-centred design, adaptable homes, separation of housing and supports, community integration and technology-enabled independence.
Outcomes: improved rehabilitation potential, greater personal choice, reduced carer burden and better long-term quality of life.