Attachments
Executive Summary
The COVID-19 pandemic is causing untold fear and suffering for older people across the world. As of 26 April, the virus itself has already taken the lives of some 193,710 people, and fatality rates for those over 80 years of age is five times the global average. As the virus spreads rapidly to developing countries, likely overwhelming health and social protection systems, the mortality rate for older persons could climb even higher.
Less visible but no less worrisome are the broader effects: health care denied for conditions unrelated to COVID-19; neglect and abuse in institutions and care facilities; an increase in poverty and unemployment; the dramatic impact on well-being and mental health; and the trauma of stigma and discrimination.
Efforts to protect older persons should not overlook the many variations within this category, their incredible resilience and positivity, and the multiple roles they have in society, including as caregivers, volunteers and community leaders. We must see the full diversity of people within the older persons category. Women, for instance, are over-represented among both older persons and among the paid and unpaid care workers who look after them. We must also recognize the important contribution of older persons to the crisis response, including as health workers and caregivers. Each of us – States, businesses, international organizations, companies, communities, friends and family – need to step up our effort to support older persons. We must do everything possible to preserve their rights and dignity at all times.
Across society, COVID-19 presents a range of particular risks for older persons.
Life and death: Although all age groups are at risk of contracting COVID-19, older persons are at a significantly higher risk of mortality and severe disease following infection, with those over 80 years old dying at five times the average rate. An estimated 66% of people aged 70 and over have at least one underlying condition, placing them at increased risk of severe impact from COVID-19. Older persons may also face age discrimination in decisions on medical care, triage, and life-saving therapies. Global inequalities mean that, already pre-COVID-19, as many as half of older persons in some developing countries did not have access to essential health services. The pandemic may also lead to a scaling back of critical services unrelated to COVID-19, further increasing risks to the lives of older persons.
Vulnerability and neglect: Some older people face additional vulnerabilities at this time. The spread of COVID-19 in care homes and institutions is taking a devastating toll on older people’s lives, with distressing reports indicating instances of neglect or mistreatment. Older persons who are quarantined or locked down with family members or caregivers may also face higher risks of violence, abuse, and neglect. Older persons living in precarious conditions – such as refugee camps, informal settlements and prisons – are particularly at risk, due to overcrowded conditions, limited access to health services, water and sanitation facilities, as well as potential challenges accessing humanitarian support and assistance. Furthermore, older persons are also often among the caregivers responding to the pandemic, increasing their risk of exposure to the virus. This is particularly true of older home-based carers, the vast majority of them women, who provide care for older persons, especially in contexts where health systems and long-term care provision are weak.
Social and economic well-being: The virus is not just threatening the lives and safety of older persons, it is also threatening their social networks, their access to health services, their jobs and their pensions. Those who normally receive care at home and in the community – such as women over 80 years of age who are more than twice as likely to live alone as men – risk being disproportionately affected by physical distancing measures. Prolonged periods of isolation could have a serious effect on the mental health of older persons, with older persons less likely to be digitally included. The income and unemployment impacts will also be considerable given that, at a global level, the share of older persons in the labour force has increased by almost 10 per cent in the past three decades. Social protection can provide a safety net, but the coverage gaps in some developing countries are sizeable, with less than 20% of older persons of retirement age receiving a pension.
This policy brief elaborates on these impacts and identifies both immediate and longer-term policy and programmatic responses needed across four key priorities for action:
1. Ensure that difficult health-care decisions affecting older people are guided by a commitment to dignity and the right to health. Health care is a human right, and every life has equal value. Particular risks faced by older persons in accessing health care, including age discrimination, neglect, maltreatment and violence, in residential institutions, need to be properly monitored and fully addressed.
2. Strengthen social inclusion and solidarity during physical distancing. Restrictions on freedom of movement and physical distancing can lead to a disruption of essential care and support for older persons. “Physical distancing” is crucial but needs to be accompanied by social support measures and targeted care for older persons, including by increasing their access to digital technologies.
3. Fully integrate a focus on older persons into the socio-economic and humanitarian response to COVID-19. The devastating social and economic impact of COVID-19 on older persons needs to be addressed in both the crisis and the recovery phase. A more urgent and ambitious response is needed to meet UN calls for financial support for developing countries and those in humanitarian crises, where the human and economic impact of pandemic could be devastating. In addition, the structural causes that have left older persons behind and vulnerable in this crisis need to be addressed if we are to recover better and ensure, care, support and opportunity across the life cycle, including by investing in universal health coverage, in social protection and by strengthening the national and international legal framework to protect the human rights of older persons.
4. Expand participation by older persons, share good practices and harness knowledge and data. We need to broaden our partnership with civil society and others and consult older persons to harness their knowledge and ensure their full inclusion in shaping the policies that affect their lives. We also need to tackle ageism and stigma against older persons head-on. The unprecedented nature of the crisis has highlighted the invisibility of older persons in public data analysis. Innovative approaches, backed by evidence and data disaggregated by age, but also sex and relevant socio-economic characteristics, are essential to effective public policy making that is inclusive of older persons.
COVID-19 is causing upheaval across the world. The value of respect for older persons is deeply ingrained in societies across the world, because of deeply held gratitude towards parents and mentors, the value and wisdom of experience, and because of their much-valued contributions to our communities. It is important to ensure proper planning and investment for societies and caring environments that foster healthy ageing and the human rights and dignity of older persons.