Former ward of the state Norman Latham fears he will be abused again if he ends up in an aged care home.
"The thought of going into a home sometimes triggers memories of abuse," said the 69-year-old, who was abused by two youth officers in a Victorian state-run facility in the 1960s.
"I fear being vulnerable and helpless in such an environment."
Counsel assisting the child abuse commission Dr Peggy Dwyer said those fears were not uncommon.
"Many survivors have expressed to the royal commission that as a result of the abuse that they suffered, which has been far-reaching, and as a result of their issues in terms of lack of education and trauma, they have a fear of being institutionalised again in aged care facilities."
Victoria's Department of Health and Human Services secretary Dr Pradeep Philip said the Australian government oversaw regulations around aged care but he would raise the issue with his federal counterpart.
"I'm not aware of explicit steps that have been taken to ensure that any move into aged care is smooth and as less traumatic as it otherwise might be and the care and attention is provided as required in a dignified and respectful way," he said.
Dr Philip said it was extraordinarily distressing hearing the evidence of former wards of the state and juvenile offenders to the royal commission's inquiry into abuse at three Victorian state-run youth training centres from the 1960s to the early 1990s.
"No matter what we do to our system, unless we do something at the front end, in terms of primary prevention, we are going to be here far too many times," he told the hearing which finished on Friday.
Care Leavers Australia Network executive officer Leonie Sheedy said care leavers and former state wards would feel euphoric that they had been listened to during the two-week public hearing, but many people still did not know what happened in Australia's 900 orphanages.
"People who work in the department who are responsible for the welfare of children who are removed from their families need to know what went on for us, because they're sadly looking after some of our children in care today or grandchildren," she said.
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