The elderly during the coronavirus pandemic
A research by CIF Hellas
Written by Eugenia Katoufa
Translated by Christina Adelfopoulou
In September, following a proposal by Eugenia Katoufa (friend of CIF Hellas) we asked the CIF NBs and CPs to take part to ‘Elderly and Coronavirus’ research, asking about the measures that were taken to tackle the situation for the elderly.
During this pandemic, the thoughts concerning the question « what do we do for the elderly in this period of time» changed direction a lot of times. The conditions that were developed were unexpected, unpredictable and unmanageable, especially since they changed daily. Atthisstage, therefore, we considered useful to exchange information with other coworkers from different countries for the management of the problem. We submitted therespective questions and we received some answers from a few National Branches of CIF.
The main care for the elderly is obviously always the protection of life, the ensuring of the existence of the necessities of nutrition and the access to healthcare and medicine units. However, this pandemic also included the elderly’s loneliness, fear, confusion about the measures to be taken and their worry that they may die alone and helpless.
Some countries- as we were informed by our coworkers that are members of CIF- applied practices that we find useful and we present them to you:
Turkey distributed hygiene kits containing masks, gloves and disinfectant, as well as packages of cookedmeals daily. Municipal employees help the elderly with shopping, while there is also a psychological support service for those who live alone at home.
The municipality of Menemeni disinfected the homes of elderly people and frequently conducted tests to control the spread of the virus.
Finland also organized a test for the rapid risk assessment of the coronavirus disease, especially for people with chronic diseases that belong to high-risk groups.
At the same time, it distributed leaflets with information for those on how to protect themselves when they go to the grocery store, the pharmacy or to a health center, as well as on the personal hygiene measures they should take, (hand washing, distance of 1-2 meters from other people,avoiding the peak-hours and not spending more time in stores than necessary). The brochure reminded them not to cancel appointments with doctors for no reason and not to leave their illnesses unattended, but also not to neglect their interactions with the social services they need. Finland also created “virtual tools” so that those who stay at home can attend a concert, or an art exhibition, church service, gymnastics or a walk in nature.
In Austria, citizens were initially banned from visiting or leaving retirement homes. But they were provided opportunities for discussion with social workers and psychologists.
Private networks and neighborhood assistance were mobilized to help with the shopping. Day care centers for the elderly were closed for a while, but then reopened with strict hygiene rules. An open line in Vienna was available for a wide variety of questions related to daily needs.
Elderly people who do not have someone to look after them can call a Stadt-Wien phone for psychological support, or for the prescription of medication. The WohnserviceWien has also set up a neighborhood phone.People over the age of 65 were given a voucher for their taxi transportation.
An emergency service was activated for telephone counseling. Psychiatrists, psychologists and other professionals also offered their services through electronic communication.The Vienna Social Fund has published a list of home entertainment options (virtual museum tour, music, etc.).There are many other small-scale initiatives as well.
For the elderly who were found during the pandemic in institutions and care units, the procedures were unprecedented.
In Taiwan, the services have been mobilized by informing the residents and staff of the institution through small meetings. These meetings are often repeated in order to transmit to them the new information.
Social and physical activities are regularly organized, as well as preventive examinations, for example: daily blood pressure measurement, covid-19 weekly, etc.
In Denmark, with the advent of COVID-19, nursing homes closed immediately on 11th of March. Visits of spouses and all relatives were prohibited. Only staff and seniors remained inside the units. When the units opened, the elderly met their relatives in the garden, wearing masks, in special tents with chairs and tables set up for this purpose. The meeting took place at a distance of 2 meters. Inside the nursing homes, the elderly gather in very small groups of 3-4 people to sit in the living room or dining room, but not all together. The same goes for thestaff.
For the last 3 years or so each nursing home has signed a contract with a doctor-physician, who comes regularly and meets with staff to educate them about the illnesses of the elderly and prepare them for what they need to do if the need arises. The elderly have the option of choosing between their own family doctor or a nursing home doctor. In this matter, they are free to choose the doctor they want.
The elderly with a pension have the opportunity to get a place in a nursing home if they want to and if there is no possibility to stay in their home. Staying in a nursing home costs 15,000 Danish (approximately EUR 2,000) per month and the amount is the same everywhere. If a person has a very small pension or no pension at all, then the amount of money is covered by the Municipality so that all the elderly have the same ability to the provided care.
In all Municipalities of Denmark there is a program called “Help at Home”, according to which the staff of the program visits the elderly in their homes to provide the necessary assistance. The frequency of the visits depends on the health status of each elderly person according to the evaluation made by the staff of the program.
The “Help at Home” program is basically provided free of charge to all the citizens in order to facilitate their stay at home for as long as their physical condition allows. The program includes a wide range of benefits such as cleaning (in the more affluent municipalities, seniors can have cleaning services more often than in other municipalities.There is also nursing care, pharmaceutical monitoring, psychological support, distribution of meals, etc. The elderly can order electronically from the local supermarket the necessary first-aid items (food, fruit, vegetables, bread, milk etc.) and have those necessities brought to their home. These services are offered not only at this stage of COVID-19 and the pandemic, but on a permanent basis.
As mentioned above, the philosophy and goal of the ‘Help at Home’ program is: To do our best to keep the elderly at home as long as possible. For example, the municipality of Gentofte has a total population of about 70,000 people and of these only 3 seniors live with their children. The rest live alone in their homes or have been transferred to nursing homes and other organizations of the Municipality.
In recent years, however, due to the global financial crisis, the government has been trying to cut thesocial welfare spending. This has had a similar impact on the‘Help at Home’ program, which means that the frequency and timing of home visits has been significantly reduced.
In total, the Municipality of Gentofte has 800 care facilities for the elderly, either in the form of nursing homes or independent apartments, of autonomous, semi-autonomous, or dependent living, depending on the needs of each individual. These structures are sufficient to meet the needs of the elderly of the municipality. The waiting time to be accepted is not long (about 3 months on average).
People with disabilities and mobility difficulties can access similar municipal structures. Thus, many manage to live independently, with the support of the “Help at Home” program and the care and support services provided on a 24-hour basis if necessary. These municipal structures consist of apartments to which disabled citizens have wheelchair access. This allows them to move around the apartments on their own with the help of a special elevator installation. Their children often come to visit them but this varies from one part of the country to another. It’s not the same everywhere.
All elderly citizens are entitled to participate in the “Help at Home” program if they need it. The elderly citizen completes an application and is then visited by a carer to discuss and decide together what kind of package of services will be needed. To be classified as “elderly” one must be over 70 years of age but the majority of those served are over 80.
This program also offers daily meals. Elderly people pick up meals from a catering service once a week, place them in the freezer and heat them in the microwave. If the elderly person does not have this option, the caregivers of the program warm up and serve the meal and make sure that the elderly person has his daily meal. Each pharmacy has a special service which brings medicines to the homes of elderly citizens for a very small fee.
Older couples, who can no longer live in their own home, are accepted either in nursing homes or in other structures such as semi-detached apartments. The Municipality of Gentofte has special apartments for couples. These structures do not oblige the healthy spouse to take care of the patient. What is required is that the healthy spouse does not consume all his/her strength to be exhausted. Instead, the couple must have the energy and strength to do beautiful and enjoyable things together.
Recently, however, due to financial cuts, as the elderly increase, the staff decreases. And that, particularly, is one of the reasons the staff suffers from exhaustion and lack of energy. In general, despite the benefits offered by municipalities in the elderly, the issue of loneliness exists and is a reality.
Some nursing homes were hit by COVID-19 and a number of seniors left due to other underlying diseases. In a state of great emergency the staff calls 112 and the patient is transported to the hospital. The alternative is for the staff to call the unit doctor and then for the doctor to notify the “acute team”. This is a team in charge of emergencies, consisting of certified nurses with very good knowledge of the subject.
Additionally, the Municipality of Gentofte has four “Open Day Care Centers for the Elderly” staffed mainly by volunteers. The Centers are open to the elderly who are mobile, physically fit and have access to the Center from their home. There is a lending library where they can read books, participate in discussions in the book club, play cards, billiard, and organize many other activities
The volunteers collaborate with specific contact people of the Municipality of Gentofte. All costs are covered exclusively by the Municipality.
The Municipality of Gentofte also has “Open Daily Institutions” exclusively for people with serious health problems. These people can go there during the day and work on various programs. If there are mobility problems, they are transported from their home to the Center and back home by the Municipality’s mini-buses. They are engaged in many activities organized by the Centers, drink their coffee and talk with friends. There is also the possibility to bathe in the Center if they cannot do it at home due to lack of assistance or appropriate equipment.
If there is a healthy spouse at home, it is necessary for him / her to have some rest time for himself/herself. So these “Daily Institutions” are not only for the elderly but also for people with disabilities. They are staffed with professionals of various specialties and there is the possibility of physiotherapy and training of people with mobility disabilities to regain the skills they were deprived of.
Lastly, an important goal of the Municipality of Gentofte is the mobilization and active participation of citizens in the issues that concern the municipality in order for them to express their opinion on these issues. In this way, the citizens express themselves individually and collectively in the decision-making, they interact with each other and with the municipal authorities. The citizens are informed about the topics for discussion through the local newspapers, then the interest for participation is expressed and finally the participants are selected!
In Russia the majority of the elderly (over 60 years old) reside with their families. Additional quarantine restrictions have been put in place for them. These restrictions vary in different regions of Russia.
Everyone over the age of 65 who are still employed in St. Petersburg and Moscow, work separately from others.
Pensioners can leave the house to visit the nearest shop. They can also take their pets for a walk on the road or occupy themselves with a work-out or any kind of sports.
In every district of the city there is a social service center, where social workers, psychologists and nurses are employed. Social workers buy food for the elderly. They also help with the cleaning of the house, the writing of letters and so on.
Before there was a pandemic, the elderly could be engaged in these centers with handicrafts and gymnastics. These programs are now closed.
Many non-governmental open structures for seniors have started operating online using Zoom. Through the internet, they perform creative activities and fitness classes.
Closed institutions for the elderly continue to operate. However, if someone gets sick, the whole institution is quarantined. During the summer, it was very difficult to put an elderly person in a closed institution due to the quarantine.
Information on the corona virus infection and the applicable rules can be found at https://стопкоронавирус.рф. I am sending you a guide for the elderly, which can also be found on the same site. There is other information about the pandemic and the measures taken there as well. TV and radio shows have been aired, talking about the pandemic and the necessary measures for the elderly.
In Greece, the pandemic found most municipalities with reduced staff and money, due to the economic crisis that lasts more than ten years. However, conscientious employees offered admirable work, depending on their capabilities. In the municipality of Kaisariani, the executives of KAPI (Day Care Center for the Elderly) visited every home of an elderly person. In addition to the employees, the social service also activated some members of KAPI to offer support services (phone calls, food distribution, etc.)
In the municipality of Chalandri, an Emergency Center was organized with the 4-digit number 1526 where the lonely and homeless elderly could ask for medicine, food, shopping in the supermarket, nursing services, cleaning or a support visit. The theatrologist gathered in the summer groups of 3-4 people for the theater group and rehearsed with them in the garden of KAPI. The musician implemented a communication system for three people. Each had the power to communicate with three other people. He/She now teaches choral music by video conference. Not all the elderly members of the choir are willing, but little by little they become jealous and begin to learn to communicate with social media.
In general, the elderly in Greece have a family that takes care of them or is just attentive even occasionally. However, it was observed that during the pandemic the deaths of elderly people increased not from the coronavirus, but from other diseases and even suddenly (cardiac, cerebral, etc.) The death of people who were very active and were taking part in the activities of the KAPI was unexpected. The employees explained that the most active people suffered, because they lost the objects and contacts that kept them in action, giving them energy, color and meaning in their lives. There were many elderly people who died in nursing homes. The owner of such, a 42-year-old doctor, killed himself when he found out that many of their residents had contracted the virus, even though he had taken serious protective measures.