Designing and delivering aged care services for older Aboriginal and Torres Strait Islander Peoples: A rapid review

Purpose Despite national reforms, Aboriginal and Torres Strait Islander older adults continue to face significant barriers to accessing quality and culturally safe aged care. Identifying the design and delivery elements of aged care service models that enable Aboriginal and Torres Strait Islander Peoples to age well in aged care is important for improving health outcomes and supporting wellbeing. Methods A rapid review was conducted to scope evidence on aged care design and delivery for older Aboriginal and Torres Strait Islander peoples. Primary, peer-reviewed studies published in English (January 2019–October 2025) were retrieved from CINAHL, ATSIHealth, PubMed and Scopus. Eligible quantitative, qualitative or mixed-methods studies focused on older Australian and Torres Strait Islander peoples and services supporting ageing well (including aged care and community support). Data were synthesised into a narrative summary. Main findings From 513 screened articles, six met the inclusion criteria. Five themes were identified, which indicated that for Aboriginal and Torres Strait Islander populations to ‘age well', services must balance individual independence with strong social connections. Essential service elements included cultural responsiveness addressing intergenerational trauma and the ongoing impacts of colonisation; structural flexibility by implementing flexible funding and accounting for the social and cultural determinants of health; and self-determination moving towards Aboriginal-controlled service models. These findings align with recommendations from the Royal Commission and the Aboriginal and Torres Strait Islander Aged Care Framework, highlighting critical facilitators for reform. Principal conclusions Supporting older adults to age well in aged care services requires a paradigm shift beyond standard service provision. This shift must fundamentally focus on transforming how services are designed and delivered. Success depends on strengths-based approaches shaped by community priorities. This necessitates embedding co-design at every stage, engaging older adults in decision-making and investing in a culturally safe workforce. Flexible funding is required to ensure that services are responsive to the diverse needs of Aboriginal and Torres Strait Islander populations.