The head of the aged care royal commission has backed calls to urgently develop an indigenous workforce to look after elders on country rather than in western-style nursing homes.
Many people told a three-day hearing in Broome this week older Aboriginal and Torres Strait Islander people living in remote communities want to stay there.
But services are lacking, including respite for family members who often care for multiple relatives.
University of Western Australia researcher Roslyn Malay, a Kija woman from the Kimberley region, said indigenous elders viewed nursing homes as "a death sentence".
"You go there to die," she said.
"Older Aboriginal people want to stay on country longer ... to ensure they have family connection, they stay connected strongly to the land, law and culture ... and pass all that knowledge down to the younger generation."
She said there was an urgent need for an Aboriginal and Torres Strait Islander aged care workforce employment strategy, which Commissioner Richard Tracey backed.
"I believe we'd save a lot of taxpayers money if we do it on our own," Ms Malay said.
"We don't need training in our culture. Our language wouldn't be an issue."
Mr Tracey said it would be good to spread the model of an aged care facility in the Torres Strait, where 80 per cent of staff are indigenous.
"The training is there, we just need Aboriginal people to take it up," he said.
Cairns-based Aboriginal and Torres Strait Islander health expert Venessa Curnow agreed efforts needed to focus on helping older indigenous people stay home, where they were not a burden but critical contributors to culture.
"They shouldn't be locked away somewhere - they should be enabled to be part of our communities and our families," Ms Curnow said.
"Generally, it's our cultural belief that looking after older people is part of who we are.
"We have that shared belief that older people are important in our culture, that we should look after them because they've looked after us."
General practitioner Kate Fox suggested improvements to Home and Community Care services, which give burnt-out family members some morning respite.
"Other than that there's nothing else on country".
With the only respite facility in Broome full, Dr Fox said she'd heard of people having to go further north to Derby and even to Perth especially if they needed dialysis, "which sounds ridiculous".
Australian Associated Press