The aged care system has a number of problems. But there's one that has been silenced for too long.

Statistically speaking, older women impacted by a cognitive impairment like dementia or those who have a high level of frailty are particularly vulnerable.

When it comes to data around who the perpetrator usually is, it's vague. But the most common scenarios are someone who works in the aged care facility, a fellow resident or sometimes a visiting family member.

Like with any woman, being believed can be an uphill slog. For older women who have shared their stories with Dr Barrett, she says the resounding theme is that they feel discredited or ignored.

"The response can be really frustrating — 'Oh she has dementia, or she must have a UTI, maybe she misconstrued a clinical procedure or intimate care being given, she must have delirium, he wouldn't do that he's a family man, she's an older woman why would he be interested?' It's ignorance, really. And it's similar to what lots of young women face, for example, 'What was she wearing, did she have too much to drink, was she flirting with him?'"

When it comes to older Australians and the topic of sex and consent, Older Women's Network's (OWN) CEO Yumi Lee said it's a topic we can find challenging to navigate.

"Many older people today may find it difficult to talk about [consent] because they grew up at a time when attitudes towards sex and consent are really different to what it is today," she said recently. 

"If you're talking about older people from culturally diverse backgrounds this could be even more pronounced and there's a lot of shame and taboo associated with sex. Consent should not be seen just as a younger person's conversation, even though it's very much depicted that way in the media. It should be an older person's conversation, too."

This sentiment rings clear when you consider that half of Aussie women aged 70 to 75 have reported having sex in the past year, as per the Australian Longitudinal Study on Women's Health.

As Dr Barrett notes: "Older people don't simply stop becoming sexual beings. Residential aged care providers need education on older people's sexuality and to ensure everyone knows their sexual rights and the need for consent and boundaries."

After deciding to finish up her career in nursing, Dr Barrett turned to academia and advocacy to try to get this issue to the forefront of public consciousness. Now it's slowly but surely being recognised.

10 years ago, Dr Barrett founded Celebrate Ageing, a not for profit combatting ageism and building respect for older people. She said it's been hard but gratifying work.

Dr Catherine Barrett. Image: Supplied.

Now we come to the pivotal question — what needs to be done to implement change and reform on this issue?

OWN's Yumi Lee said "entrenched ageism" plays a role in the barriers older women face to access justice. For Dr Barrett, she says reform will come down to a few factors.

One is as simple as listening — acknowledging the stories and listening to what older people say and what action they want.

Second is education. We need to understand that sexual assault in aged care settings does happen, and that it does have an impact. It's also important to know the indicators and warning signs of perpetrators. 

Third is providing support to those who have been abused. Recently the Older Persons Advocacy Network — which is one of the peak bodies in this field — has stepped up to the plate, Dr Barrett saying the network has said "they want to do something to prevent sexual assault" following the findings from the Commission. It's a step in the right direction.

"We needed that leadership from a peak CEO standing up and saying this is not okay," she says to Mamamia. "Just like with the issue of family violence, it takes a collective effort from advocacy groups, the federal government, our additional peak bodies, the system and us as individuals."

The fourth point is the need for older people, particularly older women, to be respected in society. This was something that prior to her death, Margarita Solis had been passionate about fostering. As she said in her film, it's support from other women that can make the biggest difference.