"There's just that feeling that this isn't a proper life."
Merle Mitchell's words were direct when she fronted a Sydney hearing of the Royal Commission into Aged Care Quality and Safety this month.
The 84-year-old recalled the loss she felt after moving into a Melbourne residential aged care facility.
"[You're] told this is your home now ... well it's not, it's an institution," Ms Mitchell said.
"There's this feeling that the quicker it's all over, the better it is for everybody."
Asked what she saw as the most important things the commission should be looking at for change that would make a real difference to those living in a residential facility, Ms Mitchell had no hesitation.
"Ratios. Ratios. Ratios. Everybody will tell you that," she said.
"They [staff] don't have time to talk to residents because they're under so much pressure to be able to fill their requirements."
Earlier in her evidence, Ms Mitchell had told the commission that if she needed something in the middle of the night, "because there's only one nurse responsible for 170 patients, I wait a very, very long time".
She also believes more needs to be done about the mental and emotional impact of moving into an aged care facility - "and that gets back to training and, again, to the ratios".
While people in aged care should enjoy their final months or years, Professor Joseph Ibrahim described residential facilities as "stateless".
Professor Ibrahim, head of the Health, Law and Ageing Research Unit at Monash University's Department of Forensic Medicine, said that despite promises and inquiries, nothing had changed in aged care over the past 15 years.
He accused politicians of not caring.
"If they truly care they would do something or at least say something. They don't say anything. They don't act.
"If you have to go somewhere that is not your home, you deserve something better than you're currently getting.
"We accept people dying prematurely because we believe they're old and have no benefit to society, and that's just wrong."
Eresha Dassanayake told the commission of having to wash dried faeces from her 87-year-old mother's hands almost daily at a NSW facility.
She believed the soiling was due to her mother being left in a dirty nappy for long enough that she would try to remove it herself.
"Whoever tries to change her eventually, they're not washing her hands," Ms Dassanayake said.
"I find her hands covered in faeces every day."
Ms Dassanayake told the commission that after being unable to visit her mother for several days in July 2017, she found her mother barely able to talk.
"This was a woman who, a week before, was walking around with her walker," she said.
Her mother was taken to hospital suffering bed sores because she had not been out of bed for up to five days. She was also severely dehydrated.
In later Sydney hearings, the inquiry heard from a registered nurse about a woman with dementia being sexually assaulted after wandering into another resident's room in a facility.
The nurse told the commission that people with dementia may exhibit difficult behaviour but could also be "quite at risk".
"She [the resident] was wandering into a person's room who didn't have dementia, who was then sexually assaulting her.
"It was only because there was a person there who didn't have dementia and who was completely intact and was able to alert us to what was going on."
Meanwhile, the head of clinical services at HammondCare's The Dementia Centre, Associate Professor Stephen Macfarlane, told the inquiry aged care providers did not have a clear understanding of what constituted a chemical restraint.
He referred to proposed new standards around behaviour management and chemical restraint as "deeply flawed".
Under the proposed new standards, any drug prescribed for any reason other than the treatment of a diagnosed disorder would be considered a chemical restraint. "To me that's a nonsense because it demonises completely innocuous medications," Dr Macfarlane said.
The Sydney hearings have now wrapped up, with further hearings in other capital cities in the coming months.
As well as conducting hearings, the commission has visited aged care service providers and conducted what it calls "service visits" to a range of aged care services.
The visits are not inspections of the type provided by the Aged Care Quality and Safety Commission. Instead, they act as information-gathering exercises to provide context for the ways in which services are delivered.
So far, nine providers have been visited in Sydney and Melbourne.
Community forums have also drawn good response from the public.
A forum in west Melbourne in early May was attended by 250 people who had the opportunity to tell of their experiences of aged care and what they believe needs to change.
For more on the royal commission, read transcripts or view proceedings, click HERE
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