The latest research report released by the Royal Commission into Aged Care Quality and Safety estimates nearly 40% of Australian aged care residents experience emotional or physical abuse or neglect.

Researchers at the National Ageing Research Institute (NARI) conducted the study which the Commission previously published in Research Paper 13 – Inside the system: aged care residents’ perspectives, the first detailed study of its kind in Australia. Further analysis of the residential care survey identified 23 responses that fit the working definition of elder abuse drafted by the Australian Institute of Family Studies:

a single or repeated act or failure to act, including threats, that results in harm or distress to an older person. These occur where there is an expectation of trust and/or where there is a power imbalance between the party responsible and the older person.


Neglect was estimated at a prevalence of over 30%, with 18.3% of residents having a main concern about neglect of their personal and health care.  5.9% reported concerns about how they are helped to use the toilet and 5.7% reported concerns about how they are helped with continence aids – for example, being changed when they need to be, given enough supplies, or quality of supplies. A further 1.2% of residents reported concerns or complaints with how catheters are used. Assistance with toileting was a main concern for twice as many residents as assistance with continence aids.

Other top concerns for residents were medication management and pain management. The biggest overall concern was that “care staff are rarely able to spend enough time attending to my individual needs”, with 9.3% reporting this as their main concern.

Emotional abuse

Emotional and psychological abuse was estimated at a prevalence of 22.6%. Resident concerns or complaints about not being treated with dignity and respect included 4.4% being forced to wear continence pads, 7.5% being treated like a child and 7.6% not having their specific care needs thought about or listened to.

Physical abuse

3% of residents reported being hurt or roughly treated by staff with 1.5% reporting being physically restrained and 1.2% not being allowed out of bed/chair/room, or not being allowed outside.

The Royal Commission has highlighted the need to protect and promote the human rights and dignity of older people who require assistance with the most intimate of personal care tasks such as toileting or managing incontinence.  These research findings support improved practice in continence care and management in residential aged care to both improve the resident experience and reduce tolerance of substandard care, abuse and neglect. The Continence Foundation of Australia has funded NARI to develop a best practice model of continence care for residential aged care informed by residents, relatives, expert advice and scientific evidence.


Batchelor F, Savvas S, Dang C, Goh A.M.Y, Levinger P, Peck A, Katz I, Dow B. Inside the system: aged care residents’ perspectives. National Ageing Research Institute: Parkville, Victoria, Australia. 2020.

Royal Commission into Aged Care Quality and Safety. Research Paper 17 – Experimental Estimates of the Prevalence of Elder Abuse in Australian Aged Care Facilities. December 2020. Available from: