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Care Homes Should have been Places to Live, Not Just Die

The high number of COVID-19 related deaths in care homes in the past few months has revealed a need to change how we view the elderly

Thousands of elderly people have died from COVID-19 while living in care homes. These people are not just numbers. They are parents and grandparents who have passed during this pandemic, often alone.

How did we get here? How do we change? And, above all, are we willing to? 

Care homes’ issues were already there

Experts believe the root of the problem behind the high rates of care home deaths was evident before COVID-19. In a 2018 report, the European Commission warned about the precarious situation in the care sector.

The study notes that across countries the division of responsibilities causes a lack of integration between health and social care for the elderly. The report also reveals that poor working conditions and job precariousness detracts people from working in the care sector. 

Age UK, a non-profit organisation that provides elderly care, has long been criticising the limited financial resources, the significant challenges care workers face, and the increasingly complex needs of the population. 

In a call for action last April the organisation said, “Even before the coronavirus crisis hit, there were big worries about financial resilience and the capacity to deliver consistently good care across the care home sector.”

The pandemic only intensified these problems that led to the immense human tragedy of the past few months. More than 50 per cent of coronavirus-related deaths in Europe happened in care homes, according to the World Health Organisation (WHO).

In some cases, according to Age UK, care workers’ jobs have been reduced to providing end of life care without sufficient support. Workers are often unable to admit patients to the hospital because hospitals consider the medical care already available at care home facilities when prioritising which patients to take in.

As weeks passed, governments focused on containment plans to minimise spread of the virus and resulting deaths in care homes.

Culture, the root of the problem

The pandemic intensified already existing problems in the care sector leading to terrible consequences. Image: Steven Lilley. Flickr. (CC)

Meanwhile, a debate emerged. The idea that there is a need to change how our culture looks at the elderly has taken root. Discussions have included the need for new models of care homes and financing to adopt such changes.

International organisations like WHO have begun openly supporting the need to change our mentality towards the elderly.

“We must care for them. It is our duty to leave no one behind,” said Hans Henri P. Kluge, WHO Regional Director for Europe, in an April statement calling for the construction of sustainable, people-centred long-term care homes in the wake of the pandemic.

Thousands of people, including prominent European personalities from politics, economics, journalism, and the arts, have signed an appeal urgently calling for a radical change in our mentality towards the elderly.

“We have committed a capital sin: pride,” says Lourdes Bermejo, vice president of the Spanish Society of Geriatrics and Gerontology (SEGG). In her opinion, “We need to change the way we see the elderly immediately. We should offer them a life with possibilities and goals.”

Mayte Sancho, an expert in gerontological planning, stresses the need to actively fight stereotypes, which can lead to issues like the infantilisation of older people and subsequent abuse. “We must impose equal treatment; they are citizens and have rights,” she says.

The need for a structural change

In the last few months, studies reviewing the model of care homes have resurfaced. One of the more recent reports by The Royal Commission into Aged Care Quality and Safety in Australia talks about the importance of community-based, intergenerational models of care homes.

*Elderly people in residence having Christmas dinner (Stock photo)* Residences should feel like homes and not hospitals, experts say. Image: Bengt Nyman/Flickr. (CC)

Another study by the Center for Ageing Research in the Environment (CARE) in Singapore, similarly argues care homes should be focused on the community with individual treatment.

According to experts, it is too early to know how these studies will impact current care home residential structures. But they agree there is an immediate need for change.

“We need to put an end to the large-scale care home model and focus on a person-based and community-centred model,” says Heitor Lanzarón, an architect specialising in elderly care.

He adds that we should focus on modifying existing care homes and avoid the use of residences conceived as hospitals.

Are we willing to change?

However, funding is required to carry out these cultural and structural reforms. This is difficult to attain. According to elderly rights advocate, Lourdes Bermejo, these reforms clash with European social attitudes towards the elderly. “Many see them as vulnerable people who do not make a contribution to society and therefore do not deserve our financial effort,” she says.

Bermejo maintains that we will not be able to implement these reforms if we do not shift our perspective, beginning with changes to young people’s educational curriculum and the language of our political rhetoric.

Experts agree that becoming aware of this need for change is the first step. Bermejo concludes, “Care homes have to be places where you live and not [just] where you die.”

Read more about the care home crisis in Canada here.

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