This study presents a comprehensive national investigation into the ageing experiences of people who spent their childhoods in forms of institutional or out-of-home care in Australia. It draws on a mixed-methods design: a national survey of 105 care leavers aged 50+, together with 24 in-depth interviews with care leavers and three focus groups with aged-care professionals. 

Key findings

• Formative harm in childhood: participants reported extensive abuse, neglect, loss of education and dehumanisation in children’s institutions, leaving long-term scars across health, housing, relationships and trust in systems.
• A life course of disadvantage: institutional harm cascaded into adulthood, producing high rates of chronic illness, disability, mental health conditions, housing insecurity, family violence, coupled with limitations in engagement in education and employment, and for some, involvement in the criminal justice system.
• Guarded engagement with aged care: residential aged care was overwhelmingly rejected by older care leavers.
• Conditions for safer aged care: care leavers and professionals identified what makes aged care acceptable.

The report presents eight key policy and practice recommendations. 

1. Trauma-informed aged care as the foundation
2. Priority access and identification
3. Expand the Care Finder program
4. Home-first and flexible services
5. Safe and inclusive residential care options
6. Workforce development and training
7. Role of specialist agencies
8. First Nations response.