Australia’s population is aging, and this demographic shift intersects with persistent inequities in access, cultural safety, and outcomes for Aboriginal and Torres Strait Islander Elders. Mainstream aged care systems often do not reflect First Nations worldviews, histories, or strengths, resulting in barriers to culturally safe, accessible, and outcome-driven care for Elders. This paper integrates reform directions and community-informed advocacy practice. These include co-design, culturally safe assessment and care pathways, workforce development for Aboriginal and Torres Strait Islander communities, and community-controlled service models. The approach draws on specific community-led initiatives and co-design projects, such as Queensland-based models that successfully implement culturally adapted digital care pathways, flexible funding models, and workforce development programs that embed cultural safety and trauma-aware practices in everyday care. • Innovation must be relational, emphasizing trust, yarning, continuity, and respect for Elders’ authority, rather than purely transactional. Community-controlled models exemplify this approach. • Digital tools, flexible funding, and place-based delivery can strengthen connection to kin, culture, and Country when implemented under community control. Culturally adapted digital tools are most effective when integrated with community-led service delivery. • System redesign should embed cultural safety, dignity, choice, control, and trauma-aware practice across assessment, care planning, and service delivery, as mandated by strengthened Aged Care Standards and the Aboriginal and Torres Strait Islander Aged Care Framework 2025–2035. • Accountability mechanisms, such as community oversight panels and transparent reporting, are necessary to ensure aged care systems are responsive to Aboriginal and Torres Strait Islander aspirations, including ageing on Country and maintaining cultural connections.