The former nurse convicted of murdering 11 nursing home residents in a fire at Quakers Hill has been jailed for life without parole.

Roger Dean, 37, pleaded guilty to 11 counts of murder and eight of recklessly causing grievous bodily harm after setting fire to the nursing home in Sydney in 2011.

Judge Megan Latham of the New South Wales Supreme Court said Dean's crimes were in the worst category but said he had shown some remorse to friends and psychiatrists.

"The pain and terror suffered by all of the victims must have been horrific," she said.

"A worse fate is difficult to imagine."

More than 100 relatives of victims packed the public gallery, some with photos of their loved ones pinned to their jackets.

The relatives of the victims cried and applauded, but Dean said nothing and did not look at the families before he was led away.

Amanda Tucker, a granddaughter of one of the victims, said she was glad sentencing was over.

"He stole away family, he stole away memories," she said.

"Our memories aren't of a sweet lady who passed way of natural causes - we had to give DNA to know that that was our grandmother."

Elly Valkay, whose mother Neeltje died in hospital from her injuries, has thanked prosecutors for securing a sentence with no parole.

"It's been nearly two years holding our breath and now all this is over, never to be released - life - [it's] wonderful," she said.

"I hope he suffers as much in jail, as my mother suffered in the last four days of her life."

Bill Beck, whose 96-year-old mother Doris died in the fire, was part of the large crowd in court when the sentence was read out.

"You might have heard me say 'you beauty', because that's exactly how I felt," he said.

"We've been waiting all this time for this to happen and it has."

One woman fainted during the sentencing and had to be carried out of the courtroom.

Judge Latham said Dean had a reckless indifference to human life and conducted himself in a self-serving manner.

She said his victims, aged from 73 to 97, were in a high dependency ward and vulnerable.

The judge said Dean's moral culpability was not in any way diminished by his self-obsessed personality disorder.

There were several murmurs through the public gallery, including one following Judge Latham's comment that she did not believe Dean was on heavy drugs when he committed the murders.

Judge Latham said she would not accept that as any sort of excuse.

The court had previously heard Dean created a "living hell" for the families of the victims, with one relative noting the terror in his father's eyes before he died.

Another relative spoke of how his mother had soot pumped from her lungs.

Other family members spoke of the guilt they feel at having put their loved ones in the home.

Dean used a cigarette lighter to start fires in two beds then watched them take hold.

There were 88 residents in the home. Some died in the fire and others from their injuries.

Police say Dean set the fire to cover up his theft of a large amount of painkillers.

In video footage of his police interview, Dean said he loved the residents but he had been "corrupted with evil thoughts", saying Satan was talking to him.