Working in aged care can be sad, morbid and even terrifying, particularly when staff are trying to look after someone "living a life of hell", an inquiry has been told.
Clinical consultant Jennifer Abbey says staff suffer when they are unable to help because they do not know what to do or how to do it properly.
"They're looking after people who in many cases, for example people with dementia, are virtually living a life of hell," she told the aged care royal commission on Wednesday.
"And the people who are looking after them know they are living a life of hell and they know there is very little they can do to help them.
"They haven't got the time, often they haven't got the expertise."
Dr Abbey said the situation in aged care today generates cognitive dissonance for staff and family, leading to burnout, compassion fatigue and complicated grief, all of which can contribute to abuse.
The semi-retired nurse said she will never forget the look of terror on the face of a staff member who did not know how to cope with a particular resident.
"I thought how terrible it must be for that person to have to come to work every day, being so frightened, unsure what to do, and is it any wonder that they don't do a good job because they're terrified."
Dr Abbey said the aged care industry has changed from being a cottage industry with small organisations often run by ex-nurses to "complete corporatisation".
"Now we've got what seems to be to many people a profit-driven, industry-driven organisation that is employing people on very low wages.
"In the old days we really had people who cared, who came to work because that was the job they wanted to do.
"Now unfortunately we seem to get people who come to work because they can't do anything else and profit seems to be a motive rather than caring."
Carer Lisa Jones said she nearly quit the industry after working in traditional aged care facilities.
"I've worked in traditional aged care for many years and it took a toll on me as a person because it was really sad and quite morbid to go there," she told the Cairns hearing.
"I felt many staff were there just for a wage. They didn't actually care."
Ms Jones now works as a house companion at a Queensland "microtown" for the elderly at NewDirection Care at Bellmere, which 89-year-old resident Elsie Scott describes as light years ahead of traditional aged care facilities.
Consultant nursing gerontologist Drew Dwyer said the aged care industry treated staff poorly, failing to look after them and give them the education and resources to do a very important job.
He said nurses working in aged care were generally paid $400 a week less than those in the hospital system, yet looking after the elderly involved much more complex work than people realised.
Australian Associated Press