People living in residential aged care facilities are left stateless in a system waiting for them to die and "no one seems to give a toss", an expert says.
Professor Joseph Ibrahim says residential aged care should be a place where people can enjoy the last few months or years before they die.
"They know they're going to die. We know they're going to die," he told the aged care royal commission on Thursday.
"What currently happens is most of us sit around waiting for them to die and if they die quickly then it's a good job done.
"Everyone thinks that's a good thing and it's clearly not."
Prof Ibrahim said federal and state governments do not care about people living in aged care facilities.
"Residents are stateless," he told the Sydney hearing.
"The parliament does not care about people in residential aged care.
"If they truly cared they would do something or at least say something. They don't say anything. They don't act."
The head of the Health, Law and Ageing Research Unit within Monash University's Department of Forensic Medicine said nothing had changed in the past 15 years despite numerous inquiries and promises.
"If you have to go somewhere that is not your home, you deserve something better than you're currently getting."
Referring to a typical aged care resident, Prof Ibrahim said the result of being stateless was "an 80-to-90-year-old woman who had a hard time, sacrificed her life for the betterment of everyone else and is still doing it, and no one seems to give a toss".
Prof Ibrahim said society seemed to accept people dying prematurely in nursing homes, such as through falls.
"We believe they're old and have no benefit to society and that's just wrong."
Prof Ibrahim also criticised the lack of focus on residential aged care during the federal election campaign.
"The election is on Saturday and there's not been a word spoken," he said.
Labor this week pledged to ensure registered nurses and the appropriate mix of properly trained staff are at residential aged care facilities at all times.
The coalition has defended its investment in aged care while in government and has introduced new regulations for the industry from July.
The royal commission heard the new regulations on the use of physical restraints will mean residents in aged care facilities cannot be held in wings behind keypad-locked doors, unless specific conditions are met.
Health department assistant secretary Amy Laffan agreed it could mean a significant number of aged care providers have to put on more staff to care for residents.
The commission heard the department estimated the cost of having to allow people currently residing in wings behind keypad-locked doors to freely move around a facility at $30 million over 10 years, in terms of staffing, training and documentation.