In Australia, there currently exists a large disparity between the accommodation models available in the aged care and disability sectors, specifically in relation to institutional living. At the same time that institutions are actively discouraged (and legislated against in some areas) for younger individuals with disability, they remain a dominant and growing model for older members of society unable to care for themselves. Further to this, there is evidence that newer accommodation models are concurrently being held up as innovative in one sector and heavily criticised in the other. This article critically reviews the history of each sector in Australia to identify factors that have contributed to this schism. Factors highlighted range from government policy, advocacy, human rights legislation, and lack of alternatives, through to structural forces (such as universal healthcare). This comparative review also considers research from other parts of the world, where similar discrepancies have been identified. A number of solutions are proposed to this problem for researchers, policy makers, and front-line workers. Given that essentially both camps are grappling with the same core problem, specifically how to house and care for individuals who are unable to fully care for themselves, it is timely that we address this human rights issue and start working toward greater alignment and equity.