The system designed to look after older Australians is woefully inadequate and failing, the royal commissioners concluded after hearing horrifying evidence of widespread substandard care.

They plan to recommend a fundamental overhaul of the whole system including its funding in their final report in November 2020.

But the commissioners want urgent action to stop people dying while waiting for home care support, the overuse of drugs to 'restrain' aged care residents and younger people with disabilities being stuck in aged care.

Aged care services are underfunded, mostly poorly managed and all too often unsafe, the aged care royal commission's scathing interim report said.

"It is a shocking tale of neglect," commissioners Richard Tracey QC - who died earlier this month - and Lynelle Briggs wrote.

"The neglect that we have found in this royal commission to date is far from the best that can be done.

"Rather, it is a sad and shocking system that diminishes Australia as a nation."

The cruel and harmful system must be changed, they said.

"Our work over the past year has shown a system that needs fundamental reform and redesign - not mere patching up."

Stakeholders have repeatedly argued significant increases in government funding for aged care cannot wait for the final report and recommendations, which will come from Ms Briggs and new commission chair Tony Pagone QC.

But Mr Tracey and Ms Briggs made it clear that limited interventions, of the type that had "haunted" this area of government policy for far too long, are not enough to deliver an aged care system that meets the needs of older people.

They said short-term solutions at best temporarily stave off the worst problems and, at worst, produce another set of unintended outcomes requiring further inquiries, reviews and public funding, without addressing the underlying issues.

They also criticised a sector-wide focus on the need to increase funding and a culture of apathy about care essentials that had helped enable the aged care system to hide from the spotlight.

Older people and their families are left isolated and powerless in the hidden-from-view system, they said in rejecting the notion that most care is 'consumer-directed'.

"Despite appearances, despite rhetoric, there is little choice with aged care."

The shameful list of problems included dreadful food, distressed residents being left sitting or lying in urine or faeces, a high incidence of assaults and inadequate prevention and management of wounds that sometimes led to deaths.

Residents were commonly physically restrained to make them easier to manage, and there was widespread overprescribing of drugs to sedate them.

At the heart of the problems was an aged care system that depersonalised older people.

The royal commission said there was no reason to delay action on chemical restraints, younger people being stuck in aged care and in providing significant additional funding to immediately increase access to home care.

Waiting times of up to a year or more for higher level home care are unacceptable, with many people dying waiting, the commission said.

Federal Aged Care Minister Richard Colbeck said the government was working to improve all three urgent areas identified by the commission, with a focus on ensuring funding for home care places was flowing through and not sitting in government coffers.

Australian Associated Press