Concerning 50 per cent malnutrition rates are very common in Australian residential aged care facilities, the royal commission into aged care has heard.
Combined Pensioners and Superannuants Association of NSW policy manger Paul Versteege told the commission on Tuesday inadequate nourishment was one of several recurring safety breaches in the sector.
"We are talking about people who have moved into care and are still malnourished," he said.
Mr Versteege said "quite horrific" abuse and exploitation at the hands of other residents or staff members is another regular issue.
He said figures released each year did not reflect the true extent of the problem because they detailed only the number of reportable assaults.
"The reporting obligation is for staff assaults on residents to be reported - that's what it boils down to," he said.
"Other assaults are not counted in the reporting ... in many facilities they are not even recorded.
"There is probably a lot of abuse resident on resident."
Earlier in the day, Older Persons Advocacy Network chief executive Craig Gear told the commission that waiting times for some home care packages were blowing out to as much as two years.
"The capped system is not meeting the demands, supply is not meeting demand in Australia," Mr Gear said.
"At the moment that is equating to 18-to-24-month waiting times and we would say that's not acceptable and older people are telling us that's not acceptable.
"Anything under three months would be something we would be looking for."
Mr Gear also addressed the issue of some people refusing to accept interim care packages.
He said people often had concerns that they might be stuck with a lower level of support or were worried about the time it might take for the support to increase.
In his submission to the inquiry, Mr Gear highlighted the difficulty some people had in navigating the aged care system, in particular getting information about the types of services available.
"It is then the challenges of negotiating through the My Aged Care system, the registration, waiting for the assessment," he said.
Mr Gear said in some cases, people who moved into a residential care facility, did so because of the difficulties accessing home support.
The royal commission hearings will continue in Adelaide on Wednesday and then again next week.
The commission will also take evidence at further hearings planned for interstate capitals as well as regional centres.
It has already received 800 public submissions and responses from about 900 of Australia's 2000 approved aged care providers.
Australian Associated Press