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Valuing And Caring For Older Adults – Expert Reaction

 

As New Zealand’s COVID-19 death toll rises, it is obvious the older members of our community have so far been hit hardest.

The fatalities to-date have included six residents from one Christchurch aged care facility.

The SMC asked experts to comment about older members of our communities and the impact of COVID-19 on aged care.
 

Professor Christine Stephens, School of Psychology, Massey University, comments:

“I was somewhat alarmed to find myself, as a 70-year-old, suddenly categorised as a member of a particularly vulnerable group.

“This is a group of people based only on the number of years that they have lived who have been singled out as needing to be extra careful and isolated earlier than others during the Covid-19 pandemic. Of course, this is for the protection of our health and signals society’s concern and protection of members of the population who are clearly more at risk.

“As we age, we are more likely to suffer the underlying health issues which also make people more vulnerable to this virus. Unfortunately, using such a crude indicator of vulnerability as age alone has its downside. Categorising people in this way feeds into prejudice against older people and a deficit view of ageing that is already circulating in our society. Such ageist attitudes depict people in terms of their age alone and obscure the huge diversity that actually exists among older people.

“For a start, people continue to develop and change between 70 and 100. Grouping all people over 70 is like treating those from ages 10 to 40 as one homogeneous group. In addition, people bring their diverse lifelong backgrounds into older age where physiological, social, and health differences actually widen. Although some are vulnerable, many older people are healthy and can survive disease. Using generalisations, which target a very broad group, can be damaging to that group.

“In the case of the current pandemic, we can see how ageism becomes the basis of spurious oppositions, the economy versus the lives of older people, or the future of the young versus the health of the old, that threaten all older people’s position in society.

“To further counteract the opinions that threaten to reinforce an intergenerational divide we must recognise the contributions that older people make to society. Depicting all people over 70 as a burden to younger generations, completely fails to recognise that many older people continue to support their children emotionally, physically, or economically. Many are currently employed, some in essential services. Many other older people are engaged in volunteer services. A high proportion of older people are engaged in essential care giving, for their elderly parents, their spouses, or their grandchildren. At present my relatives, both over 70, are caring for their grandchildren, whose parents are both health care workers. Our current research projects include older caregivers who are also in paid employment. We will be back to them soon to see how the pandemic has further complicated their difficult lives. All of this work is often unacknowledged but is worth millions of dollars to the economy.”

Full comments available on Sciblogs.

No conflict of interest declared.

Jacqui Maguire, Registered Clinical Psychologist, comments:

“Older adults (70+) and immune-compromised individuals will be required to remain in self-isolation until the country de-escalates to Level 1. Many older adults live alone, and pre COVID-19 loneliness was already a global deadly epidemic in this population. Chronic loneliness (the subject feeling of being lonely) which should not be confused for isolation (an objective lack of social contact) has a physical and psychological toll on wellbeing, including but not limited to: increasing blood pressure, heart rate, the stress hormone cortisol and inflammation. Increased rates of depression, dementia and early mortality are also at risk. Evidence highlighting prolonged loneliness is equivalent to smoking fifteen cigarettes a day, twice as consequential as obesity.

“To cut to the core of the issue, COVID-19 is a threat to vulnerable populations, but so too is prolonged loneliness. Individuals can do all that is in their control to protect their wellbeing: staying connected by telephone and video calling, eating well, getting outside daily, engaging in purposeful activity. However, I believe as a country we have a collective social responsibility to proactively care for our vulnerable.

“Initiate contact with those in your life who will have to remain in self-isolation, and be creative with it. Stand outside their window and chat whilst you can see each other. Wave and say hello to neighbours as you go about your walk. Write letters and have the kids draw pictures. And let’s not forget our furry friends. Older adults with pets are 36% less likely to experience loneliness than their non-pet counterparts. If someone vulnerable in your life doesn’t have a pet, can you lend or purchase them one? It could do wonders for those in solo bubble living.”

No conflict of interest.

Dr Sally Keeling, research associate, Massey University, comments:

“Early restrictions on visiting aged care facilities, while essential, are likely to have a major impact on quality of life for those in aged residential care, particularly those with dementia. Similarly, such restrictions also impact on staff workloads – especially with reduced communal activities, and increased need for one to one care (such as feeding assistance) when some residents may have previously had a regular family member – particularly a spouse – assisting with personal care of this kind.

“We need to be mindful that the age profile of those in New Zealand aged residential care facilities suggests that their primary family caregivers and regular visitors, i.e. partners, sons and daughters, are themselves likely to be aged in their 60s and 70s – and some of them may in turn have raised health risk factors.

“Staffing patterns in aged care facilities, including ratios of registered nursing staff/ residents, vary according to level of care and are based on national service specifications. There is also a range of arrangements between facilities and primary medical care, such as local GP, or a ‘house’ GP, which I expect may have been disrupted during the Covid response. It’s important to understand that we have a variety of ownership models, also – community trust, big chain, local private ownership – and a range of contracted relationships with DHB – such as respite care, palliative care.

“Background issues in the aged care workforce relating to pay rates, staff turnover, staff training and increasing complexity of care demands have been well documented in the past, along with periodic media interest in matters relating to ‘quality of care’ – my concern is that media coverage has on occasions, lacked balance and context in the past, and the Covid crisis is another reminder that even under ‘normal circumstances’, the residential aged care is ‘out of sight, out of mind’ until a problem emerges.

“I have watched in recent weeks with alarm, the experience of Europe and the UK, and now the US, where the heavily age-weighted impacts of the virus on older people, especially those in care facilities has been fully reported, and in some respects seen as ‘inevitable’. Having also lived and worked through the Canterbury earthquakes, and researched as a consequence the prevalent view that older people commonly do fare worst in any disaster (e.g. Hurricane Katrina, French heat wave), I however am proud that New Zealand is again resisting that kind of received wisdom. I have no critique of the clinical notion that older people, especially those who are assessed as frail, do have diminished reserve, and that these people do meet the clinical criteria for admission to care in NZ.

“It is because of the high standards of care and the commitment and dedication of staff in the NZ health system, including aged residential care, and due to the philosophy of ‘shared care’ between professionals and the community and families surrounding NZ’s older people, that I believe that NZ’s experience of the management of the Covid threat to our entire population can and will tell a unique story of resilience.”

No conflict of interest.

© Scoop Media

 
 
 
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