Aboriginal culture was being lost because of the treatment of its older members in nursing homes, the royal commission into aged care has heard.
A week of hearings in Darwin ended with a warning that older indigenous people received the worst treatment, and it was up to governments and not just the aged care industry to fix that.
Diabetes was 10 times more prevalent among Aboriginal women than the national rate, with death rates from the disease also much higher.
The problem is compounded by poor quality of life, poverty and remoteness, counsel assisting the commissioner Peter Rozen said on Friday.
Mildred Numamurdirdi, an Aboriginal elder from Numbulwar, appeared in person in a portable bed and told how she cried for a month after being forced to move 800km from her home and family to an aged care centre in Darwin last year.
"Can I ask for aged care in remote communities, we don't have aged care," she said.
Mr Rozen said the forced removal of older indigenous Australians from family and country to the nearest aged care accommodation, sometimes 800km away, had a "profound impact on quality of life".
He quoted Danila Dilba Health Service chief executive Olga Havnen's evidence that "Aboriginal people have by far the most complex health conditions and most complex level of needs but receive the least level of service".
The stark challenges faced by Aboriginal people living in the Northern Territory included poverty, food insecurity, service accessibility, a lack of culturally safe and secure services and distance, Mr Rozens said.
"We heard how we have got senior people with cultural knowledge of particular bits of land in Australia and that has been passed on to them and they're away from their country," he said.
"If they don't get the opportunity to return to teach their kids and their grandkids their cultural heritage, it is lost not only for those families but the whole community and the whole of Australia loses that knowledge."
Older Aboriginal people sacrificed their own welfare payments to ensure their grandchildren were fed, Mr Rozen said.
He pointed out that Dr John Boffa of the Central Australian Aboriginal Congress told the commission this week that there were remote towns around the NT that didn't have aged care accommodation but would anywhere else based in the country based on their size.
"As he said, it is a myth that it is impossible to recruit health workers in remote locations, if you provide the necessary accommodation, and infrastructure it is possible to attract and retain staff."
Australian Associated Press