GAN calls for balanced approach to aged care decisions

Where hard decisions are being made to isolate the elderly, it is imperative to offer quick and accessible solutions to address loneliness and isolation, writes Judy Martin.

Where hard decisions are being made to isolate the elderly, it is imperative to offer quick and accessible solutions to address loneliness and isolation, writes Judy Martin.

As the reported cases of COVID-19 (coronavirus) 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, the elderly.

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 responding to mitigate, prepare and respond to this pandemic. 

Judy Martin

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 minimalise infection and contain spread with a particular focus on hand hygiene, social distancing and self-isolation if unwell or following direct contact with someone confirmed as having COVID-19.

Create accessible sustainable solutions

Where the hard decisions are being made regarding isolating the elderly, it is imperative 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 the elderly. 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 the elderly 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 the elderly. 

Isolation for the elderly and the potential of limited access to everyday services like food and medical supplies has to be factored into any, and all, decisions. Any decision also needs to bear in mind some elderly 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 the elderly.

In addition to the physical constraints of isolation, what is the impact on an elderly person’s emotional and social wellbeing? Every elderly person’s needs and requirements will be different. 

Respond with compassion

With the proposed measures, how will the impact of not seeing or feeling the 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 elderly 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 indeed 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 elderly in care settings and at home in the community where policy and the voice of elderly have actively championed staying in the home, but now may have them there alone and unsupported.

Seek authentic information

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 elderly. 

It is of the upmost importance to disseminate appropriate information without causing panic, where misinformation can lead to further complications by increasing the elderly’s stress levels and impact on their health. We must consider the consequence of every decision now taken to protect the elderly ensuring that it is 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, and director of Australian aged care study tour program SAGE. 

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