An aged care worker who was captured on hidden camera slapping and hitting a dementia patient in a Sydney nursing home has been sentenced to at least six months in home detention.

Dana Gray, 59, was working in The Poplars aged care home in North Epping last year when one of her colleagues became suspicious of her behaviour and set up the camera.

The video shows Gray slapping and pushing the elderly lady and pulling off her clothes aggressively before taking a bag filled with rubbish and hitting her again.

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The 85-year-old lady, who cannot be named, can be heard screaming and sobbing in the video.

Gray pleaded guilty to common assault and in August was sentenced to 17 months in custody with a non-parole period of six months.

But Magistrate Robyn Denes adjourned the case so the former aged care worked could be assessed for home detention.

Today Magistrate Denes accepted Gray was suitable to complete her sentence at home, with strict conditions.

She will have to wear an electronic monitoring device and is only allowed to leave the house for authorised medical, psychological or corrections appointments and once a week to do the shopping.

She will also be subject to random visits from corrections officers.

In sentencing, Magistrate Denes said while Gray pleaded guilty to the abuse, she showed little remorse for her actions and accused her of "victim-blaming".

"This is domestic violence," Magistrate Denes said, adding that the offence involved "gratuitous cruelty".

She said Gray was in a position of trust and the victim was completely defenceless.

Grey would not answer questions as she left Burwood Court today.

Chief executive of Council on the Ageing Australia Ian Yates said the penalties for assaulting a vulnerable, elderly person should be reviewed.

He said the law needed to differentiate between assault charges that arose from a pub brawl, compared with the assault of an 85-year-old with dementia "effectively trapped in a room in a nursing home".

"The legal profession needs to have a discussion about the types of penalties that need to apply to be a clear deterrent and to ensure that people who do this never get to work in the [aged care] industry again," he told the ABC.

Russel Westacott, chief executive of Seniors Rights Service, urged anyone who suspects an elderly person is being abused or taken advantage of to speak up.

"Ageism occurs because there is a perverse lack of sense of worth that people hold towards older people," Mr Westacott said.

"Because of that we have a society where elder abuse occurs not only in aged care but right across society."

The Older Persons Advocacy Network in each state can be reached on 1800 700 600.

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