Nurses and a physiotherapist have told the aged care royal commission they are struggling to provide adequate "person-centred care" due to low staffing levels and a "tick-a-box" approach to delivering some services.
Physiotherapist Anna Urwin said she was frustrated that her role provided a "box-ticking type of service" rather than being focused on addressing physical function.
"We tend to go in and assess these people for their pain ... but we don't find out where it's coming from, so we don't actually give them a full, proper assessment of the cause of the pain," she told the commission in Perth on Wednesday.
"Then we apply a standardised approach to every single resident.
"In the model that is currently in the system, I'm not able to use my clinical skills to treat the problems that are at hand."
For example, Ms Urwin said a therapeutic massage would not improve function or quality of life for someone with pain in their hip as a result of weak muscles.
Rather, functional rehab training would provide the resident with more dignity and a sense of independence, and take the workload off other staff so they would not be needed to help the resident with tasks such as using the toilet.
Nurse Emma-Kaitlin Murphy told the commission she was often caring for up to 60 residents and agreed there were challenges to providing person-centred care including time constraints, poor staffing ratios and limited doctor visits.
"We can't give the time and attention that each person deserves," she said.
Ms Murphy gave the example of a couple who lived in separate parts of a facility because the wife needed to be in a secure wing due to advanced dementia and a tendency to abscond.
She said the husband, who was less cognitively impaired but still needed supervision, was only allowed to see his wife for one hour twice a day, but there were times when he saw her only once day when staff were too busy.
Age Discrimination Commissioner Kay Patterson spoke about ageism and elder abuse.
"We are going to have the peak of aged care in the next 15 years," she said.
"We have no time to waste. I've been talking about this since 1976."
Dr Patterson wants a ranking system for best practice in the industry.
"The tick-a-box approach in meeting standards is just good enough, but what we should achieve through the royal commission is more than good enough," she said.
Personal care worker Patti Houston told the commission aged care in Australia needed a complete culture change.
Silver Chain chief executive Dale Fisher said palliative care at home should be prioritised.
Institute for Urban Indigenous Health general manager of aged and disability services Matthew Moore said there were no targeted strategies for Aboriginal aged care.
Mr Moore said an Aboriginal person living in an urban area did not necessarily have better access to services than people in remote communities.