People with dementia and their caregivers have been advised against applying for home support services due to concerns that a government algorithm might reduce their care, according to documents obtained by Guardian Australia through freedom of information (FoI) laws. The algorithm, rolled out in November, is used to determine funding levels and priority of need for older Australians requiring home care. These packages are crucial for preventing unnecessary hospital visits, worsening health, and early placement in residential care. Before the algorithm was introduced, the government restricted aged care assessors from overriding its decisions, even when those decisions were deemed incorrect or insufficient. Dementia Australia raised concerns in late December, citing a case where a man caring for his wife with dementia was told not to seek a reassessment. His wife had been on a level three home care package, providing around eight hours of support weekly, but her condition had worsened. Local assessors reportedly warned that using the algorithm could lead to reduced or no support, despite increasing needs. The Older Persons Advocacy Network (Opan) also expressed serious concerns in February, noting that some people with extreme care needs had died due to the algorithm's shortcomings. They highlighted cases where individuals were denied funding upgrades despite rapid health decline, forcing them to pay for private care. Opan criticized the over-reliance on automated decisions, stating that clinicians could not intervene effectively, leading to preventable deterioration and, in some cases, death. In response to these concerns, the government has proposed a new "assessment escalation pathway," allowing assessors to refer complex cases to a higher authority, such as the secretary of the Department of Health, Disability and Ageing. This would complement the existing review process, where individuals can request a reassessment. However, advocates warn that current review processes are slow, and many older Australians are at risk of worsening health or even death while waiting for a decision. Opan’s director of policy, Samantha Edmonds, called for more clarity on the government’s new system, stating that without it, the effectiveness of the changes remains unclear. Advocates and carers stress the importance of human oversight in decision-making, as the algorithm has repeatedly failed to account for the complexities of conditions like dementia. A recent report from Ageing Australia, the national peak body for aged care, highlighted several cases where individuals were under-assessed, including people with Parkinson’s disease who were denied additional support despite worsening health and complex care needs. These concerns have been echoed by state and territory health officials, including Dr. Shirley Bowen, head of Western Australia’s health department, who warned of "catastrophic" outcomes. The Commonwealth Ombudsman is currently investigating the issue, as the algorithm's flaws continue to raise serious questions about the safety and adequacy of aged care assessments.