A Charles Sturt University (CSU) academic has taken her long-term advocacy for quality care in residential aged care facilities to NSW policy-makers.

Dr Maree Bernoth, from the CSU School of Nursing, Midwifery and Indigenous Health, has given evidence to an inquiry by a Legislative Council committee

The inquiry is examining the need for registered nurses (RNs) in residential aged care.

"People in residential aged care have multiple chronic conditions with competing care needs. There are people with disabilities, there are people with neurological impairments and there are a lot of people requiring palliative care.

"All of those require complex care, competing care needs that need to be juggled and prioritised."

Dr Bernoth told the Committee that a sophisticated level of knowledge is needed to provide that care.

"I am concerned that we are questioning the role of the RN when really we should be looking at how we can support that role and increase the skills and knowledge of registered nurses working in aged care and that has multiple responsibilities."

Dr Bernoth has also addressed the issue of cost shifting in the public health system.

"It is not reasonable for an unskilled aged care worker to know the difference between a delirium and dementia or a delirium superimposed on a dementia.

"When the condition of a resident deteriorates, care workers can call an ambulance to move the elderly person to acute care. 

"However there are costs associated with this and it would be much better to have a registered nurse in the facility who could undertake a skilled assessment and initiate the right care where the older person lives."

Dr Bernoth has also raised with the inquiry her concerns about the absence of staffing ratios in residential aged care as there is in child care.

"Residents and their families are often surprised when they learn there are no staff ratios. This is an area which needs further discussion."

The 2011 Productivity Commission Inquiry Report, Caring for Older Australians foundover one million older Australians receive aged care services and by 2050, that figure will grow to over 3.5 million Australians.

"In advocating for RNs in aged care, I am advocating for quality care for frail members of our community. It is not about prolonging life unnecessarily. It is about appropriate care to underpin quality of life."

Dr Bernoth gave evidence to the Inquiry into Registered Nurses in NSW Nursing Homes on Monday 10 August.