The impact of the COVID-19 pandemic on older adults around the world has been nothing short of breathtaking. Like any sudden crisis, it begs a few common questions: What actually happened and how did we respond? What lessons should we take from that experience? And, most importantly, what do we do now?
In a special double-issue of the Journal of Aging and Social Policy, dedicated to the COVID-19 pandemic crisis, leading gerontology researchers tackle those questions from a wide range of perspectives. The issue, Older Adults and COVID-19: Implications for Aging Policy and Practice, offers 28 scholarly articles available online free of charge.
“The COVID-19 pandemic has devastated populations and economies globally but older adults have been particularly hard hit, due both to direct exposure to the virus itself and to the adverse consequences of efforts taken to mitigate its effects,” said Edward Alan Miller, a University of Massachusetts Boston gerontology professor and JASP’s editor-in-chief.
“This urgent situation led us to put together our special issue in record time, pulling together high quality and insightful contributions from leading scholars from around the world to quickly inform aging policy and practice,” said Miller, whose introductory article provides a complete overview of the special edition.
The double-issue focuses on the implications of COVID-19 for long-term services and supports and other high-risk populations and looks closely at the pandemic’s impact on families and caregivers of older adults. It studies community-based responses, analyzes economic consequences for elders and looks forward to a time when the world has recovered from the virus.
Long-term services and supports (LTSS) in the U.S. and abroad
Among nine articles covering LTSS topics, University of Ottawa professor William Gardner, along with University of Michigan professors David States and Nicholas Bagley, document the elevated risk for older adults in long-term care facilities directly from the virus itself and indirectly from increased isolation and the potential for neglect.
From the University of Pennsylvania, professor Mary Naylor and post-doctoral research fellow Liza Behrens propose a framework to facilitate decision-making and collective action to address COVID-19 within the nursing home sector.
An article by University of Minnesota associate professor Tetyana Shippee and colleagues examine racial and ethnic disparities in the quality of LTSS that grew worse during the pandemic. They recommend near-term actions to recognize those disparities and longer-term ideas to address them.
Two articles focus on U.S. financing of LTSS in the context of Medicaid during the pandemic. University of Minnesota professor Lynn Blewett and research fellow Robert Hest observe how states have taken advantage of new authority to streamline and increase flexibility of Medicaid LTSS eligibility. Georgetown University professor Judy Feder explains why she sees increasing the federal share of Medicaid spending during the crisis as only part of the solution due to the inadequate and inequitable nature of Medicaid LTSS funding across the states.
Three articles examine LTSS responses to the pandemic in Canada, England and Hong Kong. The first two highlight quality, availability and funding challenges in England and Canada. University of Hong Kong professor Terry Lum and colleagues explain how lessons from the 2003 SARS epidemic helped inform Hong Kong’s successful effort to manage and contain COVID-19.
Families and caregivers of older adults
The special edition dedicates four articles to care staff, families, intergenerational relationships and bereavement. Among them, Marc Cohen and Robyn Stone, co-directors of the LeadingAge LTSS Center @UMass Boston, professor Christian Weller of UMass Boston and Beth Almeida describe the economic characteristics and financial vulnerability of the 3.5 million people who make up the nation’s direct care workforce.
UMass Boston assistant professor Jeffrey Stokes and postdoctoral fellow Sarah Patterson describe how families and intergenerational relationships can pose COVID-19 risks. Boston University professor Deborah Carr, UMass Boston associate professor Kathrin Boerner and Boston College associate professor Sara Moorman describe how many COVID-19 fatalities exemplify “bad deaths,” distinguished by physical discomfort and care discordant with patient preferences. They offer recommendations that could help the bereaved adapt to loss during the pandemic.
Local community response
Four articles focus on local and community response to COVID-19, including work by Miami University research scholar Traci Wilson and colleagues highlighting how Area Agencies on Aging managed rapid and significant adjustments to service delivery models to meet the basic needs of local seniors.
Jacqueline Angel, a professor at the University of Texas at Austin, and Stipica Mudrazija, a senior research associate at the Urban Institute, highlight the role local government can play in helping vulnerable older adults to remain at home during the crisis. They use Austin as their case example.
High risk older adults in communities
Among three articles on higher-risk elders, University of Minnesota assistant professor Carrie Henning-Smith examines the unique circumstances of older adults living in rural areas. Cohen and LTSS Center fellow Jane Tavares look at the risks facing community-based seniors with respiratory disorders. Naylor and University of Pennsylvania colleagues draw attention to the transitional needs of older adults discharged from hospitals with COVID-19.
Economic risks for older workers and retirees
Among three articles, UMass Boston graduate research assistant Yang Li and professor Jan Mutchler report how the economic downturn resulting from the pandemic could have especially devastating consequences for older adults living in U.S. counties with high levels of both infection rates and general economic insecurity.
Anna-Marie Tabor, director of the Pension Action Center at UMass Boston, argues for the importance of ensuring that recovery of lost or unclaimed pension funds is part of the economic recovery. Her recommendations focus on retiree access to information and mandates for pension plan disclosures.
In the issue’s final article, Washington University professor Nancy Morrow-Howell and colleagues look ahead to recovery from the pandemic. They identify challenges still to overcome but also highlight opportunities created in the crisis, from improved connectivity through technology to increased attention on the need to expand the aging services workforce.