The woman was among the 10,574 Australians who made submissions to the inquiry, and also shared a harrowing account of her husband's treatment in a Launceston aged care home as part of the 2019 Tasmanian hearings.

However, she said the reprisals she faced after testifying publicly meant she was now too scared to be formally identified.

Related: Should all Australian pay a levy or tax for a better system for all?

With the outcomes of the commission handed down this week, including 148 recommendations aimed at fixing a sector found to have been mismanaged by successive governments, the woman says she wants action.

"A report has been handed down, but what now? My husband remains in aged care and nothing has changed," she said.

Tasmania's Council on the Ageing says significant issues remain within the state's residential aged care facilities, including fears of retribution for family who speak out.

Handed down on Monday, the report found one in three aged care residents in Australia had suffered substandard care.

The commission also determined that up to 18 per cent of residents had been either physically or sexually assaulted while in care.

Related: Systemic aged care flaws: royal commission final report released

"They use words like 'continuous improvement', but they don't have that in place," the woman said.

"That's why a lot of families and residents don't say anything. Because they know if they do, they are in trouble.

"Even though people are trying to change the system, it hasn't changed."

After testifying as part of the commission, the woman said she installed a security camera in her husband's room over fears of what might happen.

Despite claiming to have 14 months of video evidence showing staff repeatedly neglecting and abusing him, she said management had failed to take any action.

"Let's not go over what I spoke about in 2019, I can tell you what happened to him last week," she said.

"He was not toileted, he didn't have an alarm to be able to call staff to help him.

"I walked down the corridor the other day and there were four different people crying out 'help me' and staff were walking by."

The commission's final report has called for sweeping reforms of the aged care sector, with the federal government pledging an initial $452 million to help address the issues.

Among the key findings were recommendations for a rights-based system, including a new Aged Care Act to underpin reforms, as well as a Medicare-style aged care levy.

It also calls for stronger, more independent governance and improvements to the sector's workforce capabilities and conditions.

COTA Tasmania chief executive Sue Leitch said getting actions on complaints and assurances for family members who raise concerns was something that had been called out throughout the commission. However, she said many issues remained.

IN OTHER NEWS:

"There are still significant issues in aged care facilities. Not every facility, but we are certainly hearing of people who are still experiencing challenges with their loved ones who are in aged care," she said.

"We are certainly aware that there is a fear of retribution by family members. Their loved ones are in a vulnerable position if things aren't working well in a facility.

"That's been something that's been expressed to us on a number of occasions. That's why the work of the royal commission is so needed and we will be watching with interest to see how the government approaches the report and what they decide to do."

Having worked as a nurse for more almost three decades, the woman said she knew there were a lot of staff within aged care who were good at their job.

However, she said many were severely under-qualified, with future recruitment within the sector also at risk.

IN CASE YOU MISSED IT: Why Harry Fowler took photos of Launceston buildings on the brink of destruction

"There are good staff in aged care. They have kept these facilities going, despite the chronic mismanagement," she said.

"They need to be recognised and they need to be paid appropriately and they need the staff numbers so the system works properly.

"But a lot of people are leaving the system because it is so broken, or they can't recruit into it because it is so broken. That's a massive problem. However, we also have staff who are not qualified for the jobs they've been given. That needs to end."

IN CASE YOU MISSED IT: How a community rallied to find a lost little boy

With cabinet now considering the report's recommendations ahead of an expected major overhaul of funding in the May federal budget, the woman implored the government not to turn their backs on those who have spoken out.

"It is a trauma that shouldn't be inflicted on people who have got to the stage of needing aged care or on their families," she said.

"It is a sad enough situation needing to make the decision to use an aged care facility - you need to be able to trust that facility to give the care to your loved ones that they deserve.

"They have contributed to our country, they deserve to be looked after."

Our journalists work hard to provide local, up-to-date news to the community. This is how you can continue to access our trusted content: