Coronavirus and Older Adults: A Highly Vulnerable Group

Older adults are among the largest groups at risk for the coronavirus and they have the highest fatality rate in several countries. Learn about the resources and materials that we offer to guide caregiving and public policy on aging and long-term care in countries in the region.

Nursing Homes: Dangerous Infection Hotspots

Since the outbreak of the coronavirus epidemic, it has been confirmed that older adults are the most vulnerable age group. They are at a higher risk due to their weakened immune systems and because they are more likely to have chronic diseases or comorbidities, such as diabetes, cancer, or hypertension. If older adults contract the virus, there is a substantial probability that they could have severe complications or even die. In this situation, nursing homes are very dangerous potential transmission hotspots. In fact, in such countries as Spain and the United States, COVID-19 has widely spread within several nursing homes and many of their residents have died; people over the age of 60 have the highest COVID-19 fatality rate in Italy, Spain, and the United States.

Realities Revealed by the Pandemic

This pandemic has underscored how fragile the most robust healthcare systems are when faced with a health emergency caused by infectious diseases. It has revealed that there is a lack of information on how to prevent the spread of COVID-19 among caregivers, who traditionally have little training on how to handle this kind of situation. The surge of cases of older adults left to their own devices in nursing homes, as well as nursing homes not following protocols to minimize the risk of contagion is also concerning. Hospitals’ lack of capacity to provide care renders palliative care the only treatment that elderly patients receive, and there have even been cases of older adults who have died at home without receiving any care.

What Is the Situation Like in Latin America and the Caribbean?

Family traditions are still strong in the region, and many older adults tend to live in multigenerational homes. Although they have the support of their family members, even in these households some members are usually unaware of the extra protection measures that older adults need to avoid getting COVID-19. On the other hand, 14% of adults over the age of 60 live alone and this number increases to 20% among adults over the age of 80; in countries like Argentina and Uruguay, these numbers are equivalent to 20% and almost 30%, respectively. In terms of the percentage of adults who live in care centers, considering twelve countries in the region, 0.54% of adults over the age of 60 (i.e., 166,000 people) live in a residential care setting. This percentage is low when compared to Europe. However, there is a risk of there being outbreaks like those that are occurring in Europe and the United States because these facilities have become hotspots for the spread of COVID-19.

In our Age with Care publication we estimate that eight million older adults in the region are care-dependent and, for the time being, countries in the region do not have consolidated care systems to provide them with the support they need. Caregiving falls mainly on the family, and particularly on women, without any kind of compensation, support, or training. In the few cases in which caregivers are hired in the labor market, people who perform this work tend to do so under precarious employment conditions, for example, as informal, low-wage work. This poses a major challenge for social and healthcare systems in the region.

Today, more than ever, we need care workers who are trained to support older adults in basic activities of daily living, such as feeding and bathing themselves, and who help them with tasks such as shopping, following treatment plans, taking medications, and doing physical therapy exercises, as well as provide them with emotional support. We also need detailed information on how to minimize the risk of infection in older adults regardless of where they live or with whom. Moreover, we need information on how to handle cases of older adults who have been infected, which should be available to older adults, their home caregivers, and nursing home and day center providers. It is imperative that countries adapt and expand their care service provision, especially at home, to minimize exposure and avoid resorting to the healthcare system.

How Are We Addressing This Through Our Panorama of Aging and Long-Term Care?

At the IDB, through our Panorama of Aging and Long-Term Care, we have been working on the topic of older adult care and we have recently made available several materials and resources to address the challenges posed by COVID-19. On April 30, 2020, at 10 AM (EDT) we would like to invite you to attend our “Mitigation of the COVID-19 Pandemic in Nursing Homes and Day Centers” webinar (held in Spanish with simultaneous interpreting into English), in which Lourdes Bermejo, Vice President of the Spanish Society of Geriatrics and Gerontology, will share Europe’s experience and Cecilia Aldave Ruiz, Peru’s Vice Minister for Vulnerable Populations, will share Peru’s experience.

In a forthcoming blog post, we will share several measures that countries in the region have implemented regarding COVID-19 and older adults.