Some people feel like prisoners in nursing homes but there is often no realistic alternative, a royal commission has been told.
Ageing and dementia expert Professor Henry Brodaty says he is concerned about the involuntary detention of residents in nursing homes.
Prof Brodaty told the aged care royal commission he has assessed patients for depression whose main complaint is they don't want to be in the aged care facility.
The professor, from the University of NSW's Centre for Healthy Brain Ageing, told the aged care royal commission on Friday that some residents feel trapped.
"They feel they're prisoners. They say 'I'm a prisoner here'," he told the commission on Friday.
"Sometimes they are in a locked section of the nursing home and physically cannot "escape", Prof Brodaty said.
Others simply did not have the means or ability to leave the facility, the professor said.
"Unfortunately, there is no realistic alternative," he said in a statement to the commission.
"Family are unable or unwilling to care for them and they are unable to care for themselves."
The psychogeriatrician and doctor gave the example of a patient who was paralysed down one side after strokes, which also caused a decline in his executive abilities such as planning and having insight.
The resident wanted to return to his home but needed 24/7 care by two helpers, which Prof Brodaty said would cost probably $2000 a day.
His family did not have the means or capacity to care for him.
"There was no option for him but to stay in the nursing home," Prof Brodaty said.
"He was angry, cursing everyone and swearing vilely. I sympathised with him but was powerless to assist."
The royal commission's eight-day hearing in Sydney focusing on residential aged care, particularly for people with dementia, wraps up on Friday.
Australian Associated Press