The Global Ageing Network has been hearing from friends worldwide on the conditions experienced during and steps being taken to respond to the COVID-19 (coronavirus) pandemic.  

Last month, prior to the coronavirus pandemic, we heard from Joyce Eid from the Moadieh Evangelical Center for Assisted Living, on how Lebanon’s social and political environment impacted its seniors. 

“Triggered by a stagnant economy, endemic corruption of the public sector, and condemnation of sectarian political rule, civil protests are taking place in Lebanon.” A series of events left Lebanon with challenges. A deepening financial crisis since October, has led to today where people could not access their own money from banks. The World Bank estimates half of the population is expected to be in poverty. Seniors are no exception. 

Last month, we heard from Joyce that, “some residents at Moadieh Evangelical Center (MEC) for Assisted Living in Beirut express their dismay to the new hurdles they are facing regarding withdrawing money from banks.” Dollar rationing policies and price hikes already began affecting lives of seniors. The deteriorating economic and social conditions diminished health care. All that, and more, only one month ago.

Recently, we heard from Joyce again, amidst the turmoil, with the novel coronavirus added to the stressful mix.

The Lebanese Interfaith Group shared ways they’re protecting their residents. Following World Health Organization Guidelines, they’re tackling the next obstacle. “It’s a challenge to implement social distancing in a close-knit culture,” Joyce Eid recently told us. “Lots of sessions regarding transmission mode of the virus and hand washing techniques are given to staff, residents and their families. Everyone uses face masks everywhere, glad they are available although they are becoming more expensive by the day.” Face masks are skyrocketing in price, for some jumping from 3 to 30 dollars.

Lebanon has almost 400 recorded coronavirus cases, out of which 12% of individuals with the virus are older than 65.

Despite the numbers, the story is familiar to many countries today. Waves of anxiety. Lack of respirators and other necessary equipment. Lebanon’s Ministry of Public Health enters its second stage to equip its hospitals. Mass closures of businesses, religious institutions, and gathering places. Work stagnates. Halted travel. Lack of consistent and clear information. 

Lebanon’s government changed social conditions further by calling a state of emergency with curfew paired with its “stay at home” campaign to prevent exponential rise in infection. Food stores, pharmacies and gas stations are working full time. Medical facilities, doctors, nurses, staff, and the Red Cross are always busy and working on in-hospital and at home isolation.

Joyce captures our anxieties, “Everyone at Moadieh Evangelical Center is safe for now but nurses panic whenever a resident shoots fever, they were all glad it was a urinary track infection. We try our best to keep safe, but we can never be sure of that. We pray for this to end soon and everyone goes back to regular lifestyle. You know, this made us all appreciate the daily habits that we took for granted like shaking hands, hanging out with friends, going out…”

With the new challenge compounding on a preexisting crisis, Global Ageing Network members are stepping up to support seniors worldwide. Lebanon is a part of our global community. Lebanon’s seniors are our seniors. If you as a member of our community would like to send us your story, please send an email to info@globalageing.org. 

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As the reported cases of COVID-19 increase across Australia and around the world, I know we are all extremely worried, noting particularly the population objective for containment includes the most vulnerable, elders. 

Across the globe, the Global Ageing Network (GAN) board members are in daily contact sharing their experiences from their countries, assessing how different countries, associations, and organisations are mitigating, preparing, and responding to this pandemic. 

We are encouraging all providers of aged care services to respond in line with localised government recommendations. We are reinforcing and heeding the expert advice and health messages from the World Health Organisation (WHO) and national and regional departments. The advice is reinforcing measures to minimalize infection and contain spread, with a focus on hand hygiene, social distancing, and self-isolation if unwell or following direct contact with someone confirmed as having COVID-19. 

Where the hard decisions are being made regarding isolating elders, it is imperative that consideration is also given to finding quick, accessible, sustainable, and easily implemented solutions to address the loneliness and isolation this will cause and the short- and long-term impact of these measures.   

Many seniors across the globe are already displaced and in a heightened state. There is already evidence that links social isolation and loneliness with increased risk for elders. We have been facing a loneliness epidemic for years, which has increasingly got worse, and will further get worse with the measures now being implemented to stop the spread of this new pandemic.

With the proposed measures, elders could become more cut off from assistance, support, and their families and friends—urgent responses are needed. We must work through the impact of any new measures involving elders. Isolation for elders and the potential of limited access to everyday services like food and medical supplies must be factored in to any, and all, decisions. Any decisions also need to bear in mind that some elders may be living with cognitive decline. Many responses will look to technology for solutions–the challenge we face is “what can be done about it–NOW.” The “now” requires practical solutions and using repositories of information, to share globally, on what is appropriate for elders. 

In addition to the physical constraints of isolation, what is the impact on an older person’s emotional and social well-being? Every older person’s needs and requirements will be different. With the proposed measures, how will the impact of not seeing or feeling presence of loved ones for periods of time affect them? 

There needs to be a balance with compassionate and sensible approaches, in line with local authorities’ recommendations, including that of palliative and end-of-life care, ensuring people are not left to die alone. 

Consider the scenario of older people living alone at home with a partner in residential care—part of their life purpose, ritual, wants, and needs is being able to visit and support their partner, loved one, or friend in a residential care setting. Could we be denying two people their rights to live with dignity, exercise choice and control over their life, and at the same time place both at risk for equally serious reasons? 

In these challenging times we are required to react daily and sometimes hourly to a rapidly evolving environment. There is no right answer but there are questions and longer term considerations that need to be made. Decisions need to include a search for a balanced approach, which mitigates as much risk in holistically caring for our elders in care settings and at home in the community. Policy and the voice of elders have actively championed staying in the home, but now that advocacy may have them there alone and unsupported. 

We are all being inundated with information, often conflicting, from many channels. We need to be wary of conflicting messages and of fake news in social media, reported to be causing stress amongst our elders. It is of utmost importance to disseminate appropriate information without causing panic, where misinformation can lead to further complications by increasing elders’ stress levels and impact their health.

We must consider consequence of every decision now taken to protect elders, ensuring that those decisions are not further afflicting vulnerability. 

At GAN, we actively support continually monitoring expert advice from the WHO and national and regional departments to stay abreast of this rapidly changing environment.

Judy Martin is the current chair of the Global Ageing Network. She is based in Hobart, Tasmania, Australia.

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Immigration and ageing services may seem like 2 unrelated topics, but the 2 actually heavily depend on each other. Over a year ago, Katie Smith Sloan wrote that the key to filling the tremendous amount of job vacancies in aged-care services in most countries is through foreign-born workers. 

Today, many governments continue ignoring those employment gaps in aged-care services, often through restrictive immigration policies. A recent U.K. policy uses a new points-based immigration system that severely underestimates the skill level of care workers, as well as disregards how U.K. policy will harm aged-services employment. The National Care Forum (NCF), comprised of U.K. health and social care providers, along with several other of GAN’s expert members, have responded. They note that the policies are shortsighted.

High-skilled jobs that pay low wages are not “low-skilled” jobs.
This is a misnomer that is costing many countries, including the U.K. good policy. The U.K.claims carer jobs are “low-skilled,” despite the evidence that front-line staff provide high-skill care, because they are paid a low-wage. For example, nursing assistants are required to have a certain understanding of medical training and emotional intelligence that most other jobs do not require.  

However, due to the global reality of underfunding care systems, wages have not caught up with staff skill levels. NCF supports the high-skills required in this underpaid field. We cannot automate human care, we need people.

The New York Times reports that the British government “is trying to alter the composition of the migrant workforce, tilting it toward people with greater skills.” These new rules ignore the number of vacancies currently available, as well as the fact that providers train their own staff. NCF proposes a solution to use the points-based system to award extra points for care worker roles and give a 3-year visa for care workers. 

The new U.K. rules only amplify immediate staffing issues.
NCF says that restricting immigration will not fix low wages or fill job vacancies. Restricting immigration will only make it harder to recruit. One of the Global Ageing Network’s members, Donald McCaskill CEO of  Scottish Care, spoke to BBS Scotland, noting that the U.K. government had “not listened” to concerns and the new rules would put the entire care sector at risk of existence. 

Concerns with recruitment are felt in the U.S. as well. There are thousands of vacancies for nurses and nursing assistants and few applicants for most jobs. Home health aides and personal care aides were projected to be in the top 4 fastest growing U.S. occupations between 2016-2026. If these roles are not filled now, imagine how serious the worker shortage there will be with fewer native-born workers than ever before in the U.K., U.S., Canada, and Ireland.

Worker shortages will heighten global women’s issues.
As the new UK policies get implemented, the issue will become a heightened global women’s issue. Carers, the majority of whom are women, are already a largely unrecognized part of the labor force. Without carers, elder care systems crumple. Worker shortages will limit the number of slots available for older adults to access care, which means more people would have to quit their jobs to serve as caretakers for their loved ones. The burden of care will transition from paid to unpaid workers. Globally, that means women will lose on wages, exacerbating an already large pay gap. 

The issues the U.K. faces span 5 continents. GAN’s immediate past Board Chair anticipated the unpredictability of the global rise in nationalism on the care economy. He said the shortage of trained staff in developed countries calls for a global solution, often impeded by political leanings. GAN will continue to draw attention to these issues and seek solutions. One thing is absolutely clear – there is no quality care without a quality workforce, whether in the U.K., the U.S. or elsewhere.  

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