Younger people who view their lives in nursing homes as "hell" and "a prison sentence" have been neglected and left isolated, a royal commission says.
They are the lost and hidden Australians the aged care royal commission maintains should not be forced into nursing homes.
"It's truly shocking and shouldn't be allowed to continue," commissioner Lynelle Briggs said of the difficult and isolated lives of younger aged care residents.
The federal health department denies it has forgotten about the 6000 people aged under 65, who have a disability and are stuck in aged care facilities.
Senior department official Nicholas Hartland said it was far too high a number.
"I think it's fair to say that the 6000 is not acceptable and is a stubbornly high figure but I don't think that I would say that young people in residential aged care have been forgotten or left out of policy debates," he said.
"But it's going slower than we would have liked."
Ms Briggs suggested evidence to the royal commission showed younger people in aged care have been neglected.
"It would be true to say, wouldn't it, ... that young people with disability have been somewhat neglected if not left isolated, not given rehabilitation that might enable them to live a more fruitful life than they can in an institution fundamentally designed for people many years older than themselves."
Dr Hartland agreed, but said the confronting cases did not mean the basic building blocks being put in place were fundamentally flawed.
The federal government announced a plan to reduce the number of younger people entering residential aged care "with much fanfare" in March.
But senior counsel assisting the commission Peter Rozen QC said it will not do enough, soon enough, to fix the problem, partly because of a lack of investment in suitable alternative accommodation.
He said younger people were ending up in aged care because of deliberate policy decisions made by the federal, state and territory governments over many years.
"We will demonstrate that nonsensical funding arrangements have perpetuated younger people entering into and remaining in aged care," he said.
Mr.Rozen said recent developments may have made it more likely that younger people will enter aged care.
"We can no longer be satisfied with the aged care sector acting as a band aid for the failings of other systems."
Lisa Corcoran, 43, describes living in a nursing home as hell while 35-year-old James Nutt refers to his seven years in aged care as a prison sentence.
Catherine Roche said her husband Michael Burge would still be alive if he had not been forced into an aged care facility after suffering a stroke.
The 59-year-old died in June 2017, which Ms Roche blamed on complications from a fall in aged care two months earlier.
"In my view if Michael had not entered residential aged care and if other options had been available, he would still be here today," she said.
"Changes need to be made so that no other family has to go through what Michael and I endured together, and what I still live with every day," she said through tears.
Australian Associated Press