The aged care royal commission has wrapped up its first hearing outside a capital city, in WA's Kimberley region, where indigenous elders were the focus.
The aged care royal commission has wrapped up three days of hearings in Western Australia's Kimberley region and moves on to Perth next week.
The focus in Broome was indigenous seniors in remote areas, and testimony gave the clear message they would rather stay on country surrounded by family and culture, not in nursing homes.
At the conclusion of proceedings on Wednesday, University of Western Australia researcher Roslyn Malay said that would best be achieved by indigenous people caring for their own.
She called for the urgent development of an Aboriginal and Torres Strait Islander aged care workforce employment strategy, which Commissioner Richard Tracey backed.
He also appeared impressed by the dedication of Faye Dean and her young support worker Ryan Hammond, Aboriginal people who work for Bidyadanga Community Care Centre.
"We've heard a lot of evidence about how aged care is provided in other parts of Australia, and I can tell you that it is nothing like what you do," Mr Tracey said on Monday.
The commission heard Ms Dean and Mr Hammond employ interpreters to help them with the area's five language groups, and sometimes use their own car to collect elders and take them on much-valued fishing trips on country.
Also on Monday, Royal Flying Doctor Service chief executive Martin Laverty said access to primary health care services such as dentists was poor in remote communities, reducing the chance of residents avoiding formal aged care later in life.
Residential and respite care is also in short supply.
That leaves people who care for their older relatives - often along with their own children and grandchildren, like Bidyadanga resident Madeleine Jadai - constantly exhausted.
General practitioner Kate Fox suggested improvements to Home and Community Care services, which give burnt-out family members some morning respite.
The commission heard service providers face distance, weather, cost and cultural challenges, so finding and retaining staff is hard.
The most shocking evidence was the discovery of maggots in the mouth of a 62-year-old palliative care resident at Germanus Kent House in Broome.
The woman had advanced dementia, suffered depression, had been unable to speak for some time, was either chair or bed bound and would not open her mouth when being examined.
Responding to the Aged Care Complaints Commissioner, the operators said they had identified four service gaps including not all staff being sufficiently equipped or experienced to provide the "extremely difficult and complex care" she needed.
Eleven actions taken included changing policy to only recruit staff with a certificate three in aged care and buying mosquito nets.
At the conclusion of the three-day proceedings, counsel assisting the commissioner Paul Bolster noted how many witnesses made it clear the federal government's My Aged Care website was "woefully inadequate".
Five days of hearings in Perth next week will focus on person-centred care, advanced care planning and palliative care.