The royal commission will investigate the quality of aged care provided in residential and home aged care to elderly Australians, but will also include young Australians with disabilities living in residential aged care settings.

As was the case in the royal commission into institutional abuse, Australians should be bracing themselves for many months of distressing first-hand accounts, this time of how elderly people are treated in aged care facilities.

Commissioner Richard Tracey said at the opening of the inquiry that the royal commission was a “once in a lifetime opportunity” for the nation to create a better system that aligned with community expectations.

“The hallmark of a civilised society is how it treats its most vulnerable people and our elderly are often amongst our most physically, emotionally and financially vulnerable,” he said.

Inevitably, the commission will highlight that depressingly often, as was the case with residents being restrained, mistreatment is due to lack of funding and of proper staffing to deal with high-needs patients.

There are also desperate and fearful family members and disgruntled staff to take into account, as the commission is set to lift the lid on a sector that causes many of us to instinctively look the other way.

Although many of us don’t want to admit it, Australia’s stricken aged care sector is a symbol of how modern society treats its elders.

While most aged care providers are committed to high-level care, one of the main focuses of the commission will be on whether nursing homes are unnecessarily turning elderly residents into “zombies” amid high rates of sedative medication use.

Linked to this will be accounts of neglect and abuse, as residents steadily lose agency, and staff and managers are just as rapidly forced to make difficult choices around limited resources.

The commission will also force us to confront uncomfortable truths about the value of life for a person reaching the end of it, in a society that has evolved to value independence, and a move away from familial care.

One of the core problems is the lack of trained staff to provide care, in what has become an undervalued profession.

Couple with that is a profound sense of guilt and fear on behalf of many families who have been confronted by the realities of substandard care for their loved ones.

Some say the commission is too late for what is a sector in crisis; for too long, advocates have lobbied for lasting change, only to be confronted with bandaid solutions in the face of inertia or misplaced confidence in outdated regulations and legislation.

But we should also be prepared to take the government at face value, when it announced the commission last year.

This an opportunity for real reform with positive outcomes; if it takes some serious soul-searching on how we as a society treat our elders, then so be it.