The tragedies in long-term care brought on by the pandemic have put a welcome spotlight on elder care, according to Dan Levitt, executive director of Tabor Village, a senior living community in Abbotsford, British Columbia.

Levitt was one of the panelists speaking during a Wednesday webinar about “Elder Care Providers & COVID-19: Cross-Cultural Perspectives,” a report from the Global Ageing Network that examines how elder care providers in 11 countries responded to the challenges of COVID-19 in residential care settings, including assisted living communities, nursing homes and group homes.

“There is some silver lining that people are now, finally, from a public policy point of view, paying attention to the plight of the elderly, the rights of elder persons,” Levitt said, adding that societal support for elders is critical. “We can’t go back to the way it was before. We need to keep that spotlight and really push that public agenda.”

The study examined the provider experience during the first nine months of the global pandemic. Future studies should update the status of providers, including vaccination strategies, and should look at the financial effects of COVID-19, said Emi Kiyota, Ph.D., an environmental gerontologist and author of the report.

“More than a year after the world began living with COVID-19, we are still learning how to protect elders from the virus’ devastating effects,” Kiyota wrote. “Traditionally, there has been too little global collaboration and information exchange in the long-term care sector, but this pandemic provides us with an opportunity to improve on that record.”

LeadingAge President and CEO Katie Smith Sloan, who participated in the webinar, said that the purpose of the Global Ageing Network is “to share, to learn and ultimately make the world a better place to grow old.” LeadingAge was a sponsor of the report.

Kiyota interviewed academics, policymakers, executive directors of elder care associations, chief executive officers and chief operating officers of senior living and care facilities from Argentina, Australia, Canada, Japan, Mexico, The Netherlands, Nigeria, Singapore, South Africa, Spain and the United Kingdom. The interviews were conducted between September and November, before the vaccine rollout.

Provider inequities

The pandemic shed light on inequities among providers in different parts of the world, including financial resources, medical care, workforce, training and education, testing and technology, according to the report. The pandemic also revealed how unprepared elder care systems were to respond to challenges that require global coordination, including the shortage of personal protective equipment.

The research focused on emergency and infection control plans, immediate response, policies and guidelines, operations and workforce issues, and maintaining quality of life for residents.

Although providers in all 11 countries had infection control plans in place before the coronavirus pandemic, none of those plans was adequate in helping them prepare for the COVID-19 outbreak, according to the report. Kiyota attributed that to the virus’ high infection rate, the possibility of asymptomatic infection, the many early unknowns about its progression and treatment, and other unusual features of the virus that are still coming to light.

All providers offered in-service training for their staff members, with a strong focus on infection control, including protocols for PPE. Securing the financial resources necessary to cover this training was a challenge, with some providers turning to e-learning and social media blasts to quickly share information.

Staff members received three types of pandemic-related support: financial, emotional and recognition. Some of this support was funded by national governments, but providers shouldered the majority of the burden.

Singapore and Japan gave bonuses to all elder care workers. Providers in the Netherlands, Australia and the United Kingdom received financial support from their governments to cover paid leave. Low- and middle-income countries supported quarantined staff members by reassuring them that their jobs were secure as well as by providing housing, meals and PPE.

Conflicting guidance

Most providers noted that a gap often existed between policies and guidelines required by the governments and the practical approaches that providers felt they needed or found useful. They also said that sets of guidelines could be confusing or event contradictory, especially when developed without consultation with providers or provider associations.

Viv Allanson, CEO of Maroba Aged Care, a residential care community in New South Wales, Australia, said her facility didn’t have one positive case of COVID-19 during the pandemic, despite the growing number of cases in her region. Having been faced with conflicting advice from the commonwealth, state and local governments and public health departments, Allanson stressed the importance of “standing your ground and knowing what you can manage within your service and capacity.

“We all know our capacities were stretched like old elastic in old ladies’ knickers,” Allanson said. “Most of our announcements, we were a week or days ahead of government announcements as to what strategies we were going to put in place based on the risks that we knew were in our region and around New South Wales.”