The outbreak of coronavirus in early 2020 has proved the importance of age-friendly environments and advocacy with and for older people. The COVID-19 pandemic and response actions across the world have revealed the vulnerability of older people not only in terms of morbidity and fatality rates, but also in the approach towards them by the governments and younger cohorts.
Short summaries of age-related situations in the light of pandemic presented by Age-friendly Environments Activists Consortium partners from Austria, Germany, Italy, Lithuania and The Netherlands reveal the positive aspects of the coronavirus crisis, report the negative trends similar in all countries, and present the insights of experts and actions taken by organised groups of older persons.
AUSTRIA
COVID-19 pandemic in Austria: Older people between protection and exclusion
In March 2020, the Austrian Federal Government imposed extensive measures to contain the coronavirus. Older people (65+) as well as people with previous illnesses were henceforth considered a “risk group” and “particularly in need of protection”. They were advised to stay at home or in nursing homes and to avoid any contact with others.
One of the positive aspects of the corona crisis was the noticeable cohesion in society. Neighbourhood networks were created by local authorities, NPOs and private initiatives. Younger people went shopping for older neighbours or ran errands for them. Some shops also reserved time slots especially for people belonging to the risk group to do their shopping.
At the same time, the restrictions on going out and visiting meant that many older people could not see their children, grandchildren and friends. At the end of April 2020, the exit restrictions were lifted, and since then people have been able to meet and visit each other again – under strict hygienic and precautionary measures. Shops, schools and restaurants gradually reopened. However, until the beginning of June 2020, there were strict restrictions on visits to nursing homes, palliative care facilities and hospitals (e.g. prior appointments, restrictions on the number of visitors and visiting hours, no visits by children under 6 years of age, meetings in defined rooms at a distance).
Researchers, stakeholders and senior citizens themselves have expressed concerns about a strong trend towards discrimination and stigmatisation of older people. Whether in the press, social media or public discourse, older adults are often portrayed as vulnerable, frail and helpless. Often older people, regardless of their state of health and physical fitness, are labelled as a problem group. This has a lasting effect – also beyond the time of the pandemic – not only on their own experience of old age but also on the general image of older people in society. Experts called for more sensitivity and differentiation in the use of language.
Currently (mid-June 2020), several parties (e.g. research, media) are trying to change the current image of the “weak”, “vulnerable” older adults again.
GERMANY
COVID-19 pandemic in Germany: Older people at the centre of state policy-making processes
As in many other European countries, the German government decided in March 2020 to ban visiting hours for older people in nursing homes as part of general contact restrictions as a measure against the further spread of the new type of the corona virus. Such contact restrictions represent an isolation of important people in the lives of older people and thus the “most serious encroachment on fundamental rights in the entire Covid-19 period”, as criticised by the Federal Association of Senior Citizens’ Organisations (BAGSO).
A positive aspect of the current situation can be observed in the many private and institutional offers of help that reveal the cohesion in society. Both private individuals and individual municipalities or cities are organising shopping aids for older people or people in quarantine. The city of Potsdam in the federal state of Brandenburg has created its own online shop for this purpose called “Potsdam Delivers”.
In Germany, federal decision-making processes regarding the gradual relaxation of contact restrictions currently play an important role for older people.
Following a decision by the Federal Government and the Länder on 6 May, contact restrictions were partially relaxed for the first time by allowing people from more than one household to meet and by making visits to nursing homes generally permissible again. However, different regulations and recommendations for action apply depending on the federal state. In Baden-Württemberg or Bavaria, for example, a daily visit is permitted at the time of writing this article, while in Hessen or Hamburg the visiting time is limited to just one hour per week. In other federal states, such as Saxony or Schleswig-Holstein, visiting bans continue to apply, but it is up to the institutions themselves to decide which exceptions are permitted or not.
Particularly problematic seems to be the accompanying stigmatisation of older people as the largest “risk group” that needs to be protected and is at risk, as a result of which the proportionality of some measures is at least considered debatable by organisations such as the Federal Association of Senior Citizens’ Organisations. Stereotypical views about older people are discussed and the handling of them with regard to “paternalism” during the Covid-19 pandemic are considered problematic. Since 8 June, for example, ice cream parlours and restaurants have been open again under specific hygiene regulations and, taking Hessen as an example, up to ten people are allowed to meet in private surroundings. At the same time, the creation of visiting concepts for nursing homes has only been mandatory since 15 June 2020 and continues to depend on the respective operator. This is one of the reasons why organisations are calling for a gradual and proportionate lifting of the ban on visits to nursing homes and assisted living facilities.
ITALY
The COVID-19 pandemic in Italy: a geronticide
The Decade on Healthy Ageing 2020 – 2030, launched by the World Health Organisation, has started in Italy with a geronticide.
After the 31 January 2020 State of emergency declaration by the Italian Government, it became apparent that older citizens would have been the most exposed age group to the pandemic: as the Head of State put it on March 21 the older generations are being decimated.
In spite of the fact that the victims have been concentrated mainly in four northern regions, with Lombardy being the most heavily hit one, the trend has been confirmed still until this month of June 2020.
The country is now discussing – through new policies, fresh national and EU funding for the medical and care networks, more robust nationwide initiatives to foster healthy active later life active citizenship and lifelong learning, increased awareness-raising campaigns on the importance of the elderly for their communities – how to avoid that similar dramatic situations may repeat in the future.
For the time being, though, the feeling of loss is still overwhelming.
Figures, updated to 11 June 2020, of the COVID-19 impact in Italy are available in the latest overall Istituto Superiore di Sanità – the National Health Institute – at the link: https://www.epicentro.iss.it/en/coronavirus/bollettino/Report-COVID-2019_ 11_j une_2020.pdf
Mean age of patients dying for SARS-CoV-2 infection was 80 years (median 82, range 0-100, IQR 74 -88). Women were 13,692 (41.6%).
Figure 1 shows that median age of patients dying for SARS-CoV-2 infection was 20 years higher as compared with the national sample diagnosed with SARS-CoV-2 infection (median age 62 years).
Figure 2 shows the absolute number of deaths by age group. Women dying for SARS-CoV-2 infection had an older age than men (median age women 85 – median age men 79).
LITHUANIA
COVID-19 pandemic in Lithuania: back to stigmatisation and discrimination
When the Lithuanian Government introduced quarantine measures to contain coronavirus on 16 March 2020, the primary focus was to help Lithuanian citizens get back home from other parts of the world and to supply hospitals with masks and other protective equipment. All people were advised to stay at home and most of them abided by the recommendations. The borders were closed, except for transit corridors for the citizens of the neighbouring countries to reach their homes. Retail trade was stopped except for food stores, pharmacies, and food markets. Hotels, restaurants, cafes and bars were closed, cultural events both inside and outside were cancelled. Special day care centres for children, people with disabilities, and older persons were closed. Visiting in hospitals and nursing homes was restricted and information was provided only by phone.
A dedicated website https://koronastop.lrv.lt/en was launched by the Lithuanian Government where the news about the situation and response measures were made readily available to the public.
The main messages in the public discourse were washing and disinfecting hands, wearing masks, disinfecting surfaces, keeping social distance, and staying at home.
All public authorities started providing only online services. National and municipal institutions shifted to virtual work.
Access to outpatient departments was restricted, medical consultations were provided by phone and medicine was prescribed using the e-prescription system.
Amidst all these events older people were left with a strict advice “Stay at home”. On the one hand, they were constantly reminded that they are the most vulnerable and the most cared for group, on the other hand, no targeted measures for this group were used. Older people were treated as a homogeneous risk group without considering their health condition, physical and cognitive capacities, lifestyle, preferences, etc. Some were denied the right to health as they could not receive the required treatment, planned surgeries were postponed for unspecified period time. Public services were unavailable for digitally excluded groups.
The quarantine restrictions were eased gradually, however not equally. People 60+ remained the main risk group and in response to Health Minister’s recommendations many public and private institutions, which resumed business at the end of May, posted notes at the entrances that people from risk groups, i.e. aged 60+ and/or having chronic diseases, are not welcome.
A member of Parliament addressed the Equal Opportunities Ombudsperson to evaluate such recommendations for age discrimination. In her statement of 20 May 2020 the Ombudswoman Agneta Skardžiuvienė noted that “the current trends when older people face unjustified restrictions and hostility could lead to their long-term social exclusion and form stereotypical societal attitudes about the morbidity, vulnerability and inadequacy of older people to participate in social life.” She also quoted recommendations from UN Policy Brief: The Impact of COVID-19 on older persons and AGE Platform Europe recommendations.
Meanwhile, older people joked that it’s not that bad to sit at home compared to the cattle wagons used to transport Lithuanians to labour camps in Siberia in 1940–1952. In May many of them moved to their allotment gardens outside the city to tend their vegetables and enjoy spring flowers.
COVID 19 statistics for Lithuania is available here: https://koronastop.lrv.lt/en#statistics-in-lithuania. As of July 2nd there were 1825 confirmed cases, 1536 recovered, 78 deaths.
THE NETHERLANDS
COVID-19 in the Netherlands: Older people’s social lives stuck in a public debate that shifted its focus from quality of life to safety & control
As many other countries, The Netherlands were not well prepared on the Covid-19 outbreak. Especially there was a huge shortage on testing material, protective clothing and face masks and intensive care beds with breathing equipment. Therefore, the government at first strongly focused on the capacity in hospitals. Workers in care and nursing homes, district nursing and home care, had to deliver their work at first unprotected and untested and the facilities were closed for visitors. This caused much anxiety and anger among workers, patients and families who were not allowed to see their partner, father or mother and growing concern about staff doing their work unprotected.
The general governments’ approach to reduce the spread of Covid-19 in the Netherlands is to achieve maximum control of the Coronavirus by shutting down most social and economic activities, prevention from overload in the health care sector and protection of vulnerable groups in Dutch society (www.rijksoverheid.nl). On 12 March 2020 the so called ‘intelligent lockdown’ was announced in a press conference. Everyone (except partner and family members living in the same house) was expected to keep physical distance (1.5 m), to work and stay at home and in case of complaints put themselves in quarantine (home isolation). Since recently, as the number of contaminations remains structurally low and sufficient testing facilities have been organized, the Dutch society is opening up again. The main rule is and remains social distancing of 1.5 meter, and if that is not feasible, to wear a face mask as in public transport facilities, at dentists and hair dressers.
At date, the number of contaminations in The Netherlands is over 50,000 (on a population of 17 million) and the number of deaths who are tested on corona is over 6,000. (It is calculated that the number of non-tested corona deaths is about 3,600.).
50% of the patients that were admitted to the hospital because of Covid-19 were older than 69. Of the deceased (that were tested on Covid-19) 75% was older than 76.
The Covid-19 crisis has enforced the already existing tendency to frame older people as a burden and people 70+ as vulnerable and a risk group, whereas concerns about the economy and struggles of young people are being used as a tool to pit generations against one another. The recent discussion about using age limits or age brackets in ethical guidelines about prioritisation of patients and health care resources in the Netherlands stresses the importance to address these issues.
In response to the political discussions about the Covid-19 crisis in the media and the parliament the National Council of Older people has called the minister of Health Care, Welfare and Sports to pay attention to the position of older people and advised the minister to prepare a public debate with professional organisations, advisory bodies, NGO’s, including older people/ older people’s organisations.
Due to the Covid-19 crisis, social technology turned out to be the only way for older people to communicate with family and friends when face-to-face contact was significantly reduced or not possible. In a recent study on what role social technology could have to help fulfill the social needs of older people, it is recommended to focus more on the talents and skills of older people and support them in the use of social technology (www.tilburgers.nl).
April 2020 a study project was launched about ‘The social impact of physical distance among vulnerable populations in the Netherlands’. Older people living at home were questioned (N= 2000) as well as residents with physical problems, care givers and family members of residents living in nursing homes spread across the Netherlands. Some of the interim results were:
- Increase of loneliness and mental vulnerability among older people because of Covid-19 measures; 30% of family members found their nearest to be ‘highly lonely’.
- A strong decline of older people’s health and quality of life because of the visit ban, in particular people without cognitive problems;
- Even if there is contact, it is not sufficient, 35% of older people feel lonely during visits;
(ZonMw, consortium coordinated by University of Amsterdam, www.Coronatijden.nl)
ÖSTERREICH
COVID-19 Pandemie in Österreich: Ältere Menschen zwischen Schutz und Ausgrenzung
Im März 2020 verhängte die Österreichische Bundesregierung umfangreiche Maßnahmen, um die Ausbreitung des Corona-Virus zu stoppen bzw. zu verlangsamen. Ältere Menschen (65+) sowie Menschen mit Vorerkrankungen galten fortan als „Risikogruppe“ und als „besonders schutzbedürftig“. Ihnen wurde empfohlen, zu Hause bzw. in den Pflegeeinrichtungen zu bleiben und jeglichen Kontakt zu anderen zu vermeiden.
Zu den positiven Seiten der Corona-Krise gehörte der spürbare Zusammenhalt in der Gesellschaft. Von Seiten der Kommunen, NPO und privaten Initiativen entstanden Nachbarschaftsnetzwerke. Jüngere gingen für ältere NachbarInnen einkaufen oder erledigten andere Besorgungen, damit diese ihre Wohnungen nicht verlassen mussten. In einigen Geschäften wurden zudem eigene Zeiten reserviert, in denen Menschen, die zur Risikogruppe gehören, einkaufen gehen konnten.
Gleichzeitig bedeuteten die Ausgangs- und Besuchsbeschränkungen für viele ältere Menschen, dass sie ihre Kinder, Enkelkinder und FreundInnen nicht sehen konnten. Mit Ende April wurden die Ausgangsbeschränkungen aufgehoben, seither können sich die Menschen – unter Einhaltung von Hygiene- und Vorsichtsmaßnahmen – wieder treffen und besuchen. Für Besuche in Pflegeeinrichtungen, Palliativeinrichtungen und Krankenhäusern galten jedoch bis Anfang Juni strenge Besuchsbeschränkungen (z.B. vorherige Terminvereinbarungen, Beschränkung der BesucherInnenzahl und Besuchszeiten, keine Besuche von Kindern unter 6 Jahren, in definierten Räumen mit Abstand).
Mit Fortdauer der Maßnahmen regte sich Kritik an dem stereotypen Bild, das in den Medien und der öffentlichen Diskussion von älteren Menschen vermittelt wurde. AlternsforscherInnen, InteressensvertreterInnen und SeniorInnen selbst warnten vor Diskriminierung und Stigmatisierung älterer Menschen. Kritisiert wurde, dass ältere Menschen, unabhängig von ihrem gesundheitlichen Zustand und ihrer körperlichen Fitness, zu einer Problemgruppe zusammengefasst werden. Dies wirke sich nicht nur nachhaltig – also auch über die Zeit der Pandemie hinaus – auf das eigene Alterserleben, sondern auf das allgemeine Bild von älteren Menschen in der Gesellschaft aus. ExpertInnen und AkteurInnen forderten mehr Sensibilität und Differenzierung im Sprachgebrauch. So gelte es beispielsweise, gefährdete Bevölkerungsgruppen – unabhängig vom Alter – konkret zu benennen.
Aktuell (Mitte Juni 2020) wird von mehreren Seiten (z.B. Forschung, Medien) versucht, das stigmatisierende Bild der „schwachen“, „schutzbedürftigen“ „Alten“ wieder zurechtzurücken.
DEUTSCHLAND
COVID-19 Pandemie in Deutschland: Ältere Menschen im Zentrum landespolitischer Entscheidungsprozesse
Wie in vielen anderen europäischen Ländern, beschloss die deutsche Bundesregierung im März 2020 als Maßnahme gegen die weitere Ausbreitung des neuartigen Coronavirus die Besuchszeiten für ältere Menschen in Pflegeheimen im Zuge allgemeiner Kontaktbeschränkungen zu verbieten. Jene Kontaktbeschränkungen stellen dabei für ältere Menschen eine Isolation von wichtigen Personen ihres Lebens und damit die „schwersten Grundrechtseingriffe der gesamten Corona-Zeit“ dar, wie die Bundesarbeitsgemeinschaft der Seniorenorganisationen e.V. (BAGSO) bemängelt.
Ein positiver Aspekt der aktuellen Situation zeigt sich anhand vieler privater und institutioneller Hilfsangebote, die den Zusammenhalt in der Gesellschaft offenlegen. Sowohl Privatpersonen als auch einzelne Kommunen oder Städte organisieren Einkaufshilfen für ältere Menschen oder Personen in Quarantäne. Die Stadt Potsdam in Brandenburg hat hierfür einen eigenen Onlineshop namens „Potsdam liefert“ ins Leben gerufen.
In Deutschland spielen aktuell vor allem föderale Entscheidungsprozesse bzgl. schrittweiser Lockerungen der Kontaktbeschränkungen eine wichtige Rolle für ältere Menschen.
Nach einem Bund-Länder-Beschluss am 6. Mai wurden Kontaktbeschränkungen erstmals zu Teilen gelockert, indem ein Treffen von Personen aus mehr als einem Haushalt ermöglicht wurde und Besuche in Pflegeheimen grundsätzlich wieder zulässig sind. Je nach Bundesland gelten jedoch andere Regelungen und Handlungsempfehlungen. So ist in Baden-Württemberg oder Bayern mittlerweile ein täglicher Besuch erlaubt, in Hessen oder Hamburg ist die Besuchszeit jedoch auf lediglich eine Stunde pro Woche begrenzt. In anderen Bundesländern wie Sachsen oder Schleswig-Holstein gelten weiterhin Besuchsverbote, den Einrichtungen ist es aber selbst überlassen, welche Ausnahmeregelungen zugelassen werden oder nicht.
Besonders problematisch scheint dabei die einhergehende Stigmatisierung älterer Menschen als größte zu schützende und gefährdete „Risikogruppe“, wodurch einige Maßnahmen in ihrer Verhältnismäßigkeit von Organisationen wie der Bundesarbeitsgemeinschaft der Seniorenorganisationen e.V. zumindest als diskutabel eingeschätzt werden. Stereotype Ansichten über ältere Menschen werden diskutiert und der Umgang mit ihnen bezüglich einer „Bevormundung“ während der Covid-19-Krise problematisiert. So sind seit dem 8. Juni etwa Eisdielen und Restaurants unter spezifischen Hygienebestimmungen wieder geöffnet und es dürfen sich am Beispiel Hessen bis zu zehn Personen in privatem Umfeld treffen. Gleichzeitig ist die Erstellung von Besuchskonzepten für Pflegeheime erst seit dem 15. Juni 2020 verpflichtend sowie weiterhin abhängig vom jeweiligen Betreiber. Mitunter deshalb fordern Organisationen eine schrittweise und verhältnismäßige Aufhebung der Besuchsverbote in Pflegeheimen und betreuten Einrichtungen.
ITALIA
La pandemia COVID-19 in Italia: un geronticidio
Il Decennio per l’Invecchiamento Attivo 2020 – 2030, lanciato dall’Organizzazione Mondiale della Sanità, é iniziato in Italia con un geronticidio.
Dopo la prima dichiarazione dello Stato di emergenza del 31 gennaio 2020 da parte del Governo italiano é stato subito chiaro che gli anziani sarebbe stato il gruppo d’età più colpito dalla pandemia: come ha dichiarato il Presidente della Repubblica il 21 marzo: le generazioni più anziane vengono decimate.
Nonostante il fatto che le vittime siano state concentrate in quattro regioni del nord del Paese, con in assoluto il maggior numero di casi in Lombardia, la tendenza é stata confermata fino a questo mese di giugno 2020.
L’Italia discute sulle misure da adottare per evitare che la stessa situazione si possa ripetere in futuro: nuove politiche, nuovi fondi nazionali e UE a favore delle strutture mediche e assistenziali, nuove iniziative che favoriscano la cittadinanza attiva nelle fasi avanzate della vita e nuove campagne di sensibilizzazione sull’importanza degli anziani nella società.
Per ora la sensazione dominante resta quella della perdita.
I dati e le analisi aggiornate all’11 giugno 2020 sulle conseguenze del COVID-19 in Italia sono disponibili al link dell’Istituto Superiore di Sanità: https://www.epicentro.iss.it/en/coronavirus/bollettino/Report-COVID-2019_ 11_j une_2020.pdf
Mean age of patients dying for SARS-CoV-2 infection was 80 years (median 82, range 0-100, IQR 74 -88). Women were 13,692 (41.6%).
Figure 1 shows that median age of patients dying for SARS-CoV-2 infection was 20 years higher as compared with the national sample diagnosed with SARS-CoV-2 infection (median age 62 years).
Figure 2 shows the absolute number of deaths by age group. Women dying for SARS-CoV-2 infection had an older age than men (median age women 85 – median age men 79).
LIETUVOS
COVID-19 pandemija Lietuvoje – vėl stigmatizavimas ir diskriminavimas
Kai 2020 m. kovo 16 d. Lietuvos vyriausybė įvedė karantino priemones koronaviruso plitimui sustabdyti, pagrindinis dėmesys buvo skirtas padėti Lietuvos piliečiams grįžti namo ir aprūpinti ligonines kaukėmis ir kitomis apsauginėmis priemonėmis. Visiems žmonėms buvo patarta likti namuose ir dauguma laikėsi rekomendacijų. Šalies sienos buvo uždarytos, išskyrus tranzito koridorius su kaimyninėmis valstybėmis. Mažmeninė prekyba buvo sustabdyta, leista dirbti tik maisto parduotuvėms, vaistinėms ir maisto produktų turgavietėms. Uždaryti viešbučiai, restoranai, kavinės ir barai, atšaukti kultūriniai renginiai patalpose ir lauke, uždaryti dienos globos centrai vaikams, neįgaliesiems ir vyresnio amžiaus žmonėms. Asmenų lankymas ligoninėse ir slaugos namuose buvo apribotas, informacija teikiama tik telefonu.
Lietuvos vyriausybė sukūrė internetinę svetainę https://koronastop.lrv.lt, kurioje nuolat skelbiamos naujienos, statistika ir kovos su pandemija priemonės.
Pagrindinės žinutės viešoje erdvėje buvo apie rankų plovimą ir dezinfekavimą, kaukių nešiojimas, paviršių dezinfekciją, socialinio atstumo laikymąsi ir saviizoliaciją.
Viešojo administravimo įstaigos teikė tik internetines paslaugas. Viešojo sektoriaus valstybės ir savivaldybių institucijose, valstybės ir savivaldybių valdomose įmonėse darbas buvo organizuojamas nuotoliniu būdu. Poliklinikos buvo uždarytos, išskyrus atvejus, kai reikėjo atlikti tyrimus, konsultacijas gydytojai teikė telefonu, o vaistai išrašomi naudojantis e-recepto sistema.
Šiuo laikotarpiu vyresni žmonės buvo primygtinai raginami likti namuose. Viena vertus, jiems buvo nuolat primenama, kad jie yra pažeidžiamiausia visuomenės grupė, kuria visi labai rūpinasi; kita vertus – šiai grupei nebuvo sukurta ir naudojama jokių tikslinių priemonių. Vyresni žmonės tapo vienalyte rizikos grupe, neatsižvelgiant į jų sveikatos būklę, fizinius ir kognityvinius gebėjimus, gyvenimo būdą ir kt. Teisės į sveikatą buvo apribotos, nes žmonės negalėjo gauti reikiamo gydymo, planinės operacijos buvo atidėtos neapibrėžtam laikui. Skaitmeninių įgūdžių ir priemonių neturintiems žmonėms tapo neprieinamos viešosios paslaugos.
Nuo balandžio palaipsniui pradėti mažinti karantino apribojimai, tačiau ne visiems vienodai. 60 metų ir vyresni žmonės išliko pagrindine rizikos grupe. Kai kuriose gegužės pabaigoje veiklą atnaujinusiose valstybinėse ir privačiose įstaigose prie įėjimų atsirado skelbimai, raginantys nesilankyti rizikos grupėms priklausantiems asmenims, t.y. 60 metų ir vyresniems ir (arba) sergantiems lėtinėmis ligomis.
Seimo Teisės ir teisėtvarkos komiteto narys kreipėsi į Lygių galimybių kontrolierę išsiaiškinti ir įvertinti, ar sveikatos apsaugos ministro – valstybės lygio ekstremalios situacijos ir valstybės operacijų vadovo Aurelijaus Verygos sprendimais nustatyti ribojimai vyresniems nei 60 metų ir kitoms rizikos grupėms priklausantiems asmenims patekti įstaigas, patalpas ir gauti įvairias paslaugas – nėra diskriminuojantys ir neprieštarauja Konstitucijai. 2020 m. gegužės 20 d. išplatintame pranešime Lygių galimybių kontrolierė Agneta Skardžiuvienė pažymėjo, kad „Šiuo metu matomos tendencijos, kai vyresnio amžiaus asmenys susiduria su nepagrįstais ribojimais ir priešiškumu, kontrolierės teigimu, gali suformuoti ilgalaikę šių žmonių socialinę atskirtį ir paskatinti stereotipines visuomenės nuostatas apie vyresnių žmonių ligotumą, pažeidžiamumą ir netinkamumą dalyvauti socialiniame gyvenime“. Ji taip pat citavo Jungtinių Tautų informacinį dokumentą, kuriame rašoma, kad vyresnio amžiaus žmonių populiacija yra itin įvairi grupė, o chronologinis žmonių amžius nebūtinai sutampa su biologiniu. Todėl svarbu, kad pandemijos suvaldymo priemonės ir komunikavimas neiškraipytų to, kokią įtaką pandemija daro vyresnio amžiaus žmonėms. Cituodama tarptautinio nevyriausybinių organizacijų tinklo „AGE Platform Europe“ rekomendacijas valstybėms, kontrolierė akcentavo, kad bet kokie karantino ribojimai turi būti proporcingi, atliekami iš būtinybės, apriboti laike ir taikomi nediskriminuojant.
Tuo tarpu vyresnio amžiaus žmonės juokavo, kad sėdėti namuose nėra taip jau blogai, lyginant su kelione gyvuliniuose vagonuose į Sibirą ir išgyvenimą tremtyje 1940–1952 m. Gegužę daug vyresnių žmonių pradėjo vasaroti soduose, ėmė rūpintis būsimuoju derliumi ir mėgautis pavasario gėlėmis.
NETHERLANDS
COVID-19 in Nederland: het sociale leven van ouderen klem in een debat waarin de focus is verlegd van levenskwaliteit naar veiligheid en controle
Net als veel andere landen bleek Nederland niet goed voorbereid op de Covid-19-uitbraak. Al gauw ontstond een enorm tekort aan testmateriaal, beschermende kleding, gezichtsmaskers en intensive care-bedden met ademhalingsapparatuur. Om die reden zette de overheid in eerste instantie sterk in op het verhogen van de capaciteit in ziekenhuizen. Personeel in zorg- en verpleeghuizen, wijkverpleging en de thuiszorg moesten hun werk lange tijd onbeschermd en zonder te zijn getest doen en zorgvoorzieningen werden gesloten voor bezoekers. Dit veroorzaakte veel angst en boosheid bij personeel, patiënten en gezinnen die hun partner, vader of moeder niet mochten zien en groeiende bezorgdheid over het onbeschermd moeten werken bij het personeel.
De aanpak van de centrale overheid om de verspreiding van Covid-19 in Nederland te verminderen, is om maximale controle over het Coronavirus te bereiken door de meeste sociale en economische activiteiten stop te zetten, overbelasting in de gezondheidszorg te voorkomen en kwetsbare groepen in de Nederlandse samenleving te beschermen (www.rijksoverheid.nl). Op 12 maart 2020 werd tijdens een persconferentie de zogenaamde ‘intelligente lockdown’ aangekondigd. Van iedereen (behalve partner en gezinsleden die in hetzelfde huis wonen) werd verwacht dat ze fysieke afstand (1,5 m) aanhielden, werkten en thuisbleven en in geval van klachten zichzelf in quarantaine plaatsten (thuisisolatie). Nu sinds kort het aantal besmettingen structureel laag blijft en er voldoende testfaciliteiten beschikbaar zijn, gaat de Nederlandse samenleving steeds meer van het slot. De hoofdregel echter is en blijft een sociale afstand van 1,5 meter, en als dat niet haalbaar is, het dragen van een gezichtsmasker, zoals in het openbaar vervoer, bij bezoek aan tandartsen en kappers.
Op dit moment is het aantal besmettingen in Nederland meer dan 50.000 (op een populatie van 17 miljoen) en het aantal sterfgevallen dat wordt getest op Covid-19 is meer dan 6.000 (Er is berekend dat het aantal niet-geteste corona-sterfgevallen ongeveer 3600 is).
50% van de patiënten die vanwege Covid-19 in het ziekenhuis werden opgenomen, was ouder dan 69 jaar. Van de overledenen (die waren getest op Covid-19) was 75% ouder dan 76 jaar.
De Covid-19-crisis heeft de reeds bestaande trend om ouderen als last en mensen van 70 jaar en ouder als kwetsbaar en een risicogroep te beschouwen, versterkt terwijl bezorgdheid over de economie en de worsteling van jongeren worden gebruikt als instrument om generaties tegen elkaar op te zetten. De recente discussie over het gebruik van leeftijdsgrenzen of leeftijdscategorieën in ethische richtlijnen over prioriteitstelling van patiënten bij de toegang tot de IC-zorg in Nederland benadrukt de noodzaak om deze discussies breed op te pakken.
Als reactie op de politieke discussies over de Covid-19-crisis in de media en het parlement heeft de Nationale Raad van Ouderen de minister van Volksgezondheid, Welzijn en Sport opgeroepen aandacht te besteden aan de positie van ouderen en de minister geadviseerd een openbaar debat voor te bereiden met professionele organisaties, adviesorganen, maatschappelijke organisaties, waaronder ouderen c.q. ouderenorganisaties.
Door de Covid-19-crisis bleek sociale technologie vaak de enige manier voor ouderen om met familie en vrienden te communiceren, wanneer persoonlijk contact aanzienlijk verminderd of niet mogelijk was. In een recent onderzoek naar de rol die sociale technologie kan spelen bij het vervullen van de sociale behoeften van ouderen, wordt aanbevolen om meer te focussen op de talenten en vaardigheden van ouderen en hen te ondersteunen bij het gebruik van sociale technologie (www.tilburgers.nl).
In april 2020 is een onderzoeksproject gestart over ‘De sociale impact van fysieke afstand onder kwetsbare bevolkingsgroepen in Nederland’. Thuiswonende ouderen werden ondervraagd (N = 2000), maar ook bewoners met lichamelijke problemen, verzorgers en familieleden van bewoners van verpleeghuizen verspreid over heel Nederland. Enkele van de tussentijdse resultaten waren:
- Toename van eenzaamheid en mentale kwetsbaarheid bij ouderen door Covid-19 maatregelen; 30% van de gezinsleden vond dat hun naaste ‘zeer eenzaam’ was.
- Een sterke achteruitgang van de gezondheid en levenskwaliteit van ouderen door het bezoekverbod, met name mensen zonder cognitieve problemen
- Als er wel contact mogelijk was, bleek dit niet voldoende, 35% van de ouderen voelt zich eenzaam tijdens bezoeken;
(ZonMw, consortium gecoördineerd door de Universiteit van Amsterdam, www.Coronatijden.nl).