THE EMERGENCE of promising vaccines to fight COVID-19 is certainly good news, but those older adults on fixed or limited incomes will continue to face serious issues in daily living in a variety of areas. Many of these issues existed before the pandemic, and some have been made worse as a consequence of the deadly virus. Older adults, especially those in nursing homes, suffered the highest rates of infection and death from the virus, and those rates were even more disastrous for older adults of color. The pandemic caused a serious look at the deficiencies in our long-term care system, both institutional and community-based, and most of these deficiencies will remain even after a large portion of Americans have been vaccinated.
In skilled nursing facilities, we’ve learned that older adults should not be forced to live with three or more unrelated elderly in the same room. We know that nursing home staff are underpaid and often need to work in two or more nursing homes to make a living. Many staff are also unvaccinated for influenza, and may have the same low rates of vaccination when COVID-19 vaccines are made available. We’ve also learned that infection prevention and control is an especially weak process in most nursing homes. These are all factors that made such facilities ripe for attack by COVID-19.
What we don’t know is what the nursing home industry, federal and state regulators, and policy makers will do about these continuing issues when the pandemic subsides. The risks, even during the annual flu season, are yet to be addressed for the future.
Long-term care’s chronic failings, however, represent only one aspect of the pandemic endured by older adults. The virus and its rapid spread resulted in a lockdown to the outside world. We may never know the depths of depression and isolation combined with the fear of succumbing to COVID-19 that affected so many older adults in both nursing homes and home care. Some non-COVID illness, and even death, was undoubtedly exacerbated during this lack of visitation and visitation limits imposed by nursing home management, who failed to consider the impact on mental health of residents.
The pandemic also had additional negative impacts on older adults in community settings. It created an economic crisis approaching that of the Great Depression. While there were some stimulus relief payments, according to Justice in Aging, the system for obtaining these payments was extremely difficult for those who needed the money the most, including low-income older adults. The virus, of course, has also outlasted the money provided. Even seniors who had been able to set aside savings had to spend much or all of what they had saved. Older adults in the community who no longer drive have difficulty visiting food banks, and even those who still have cars shouldn’t have to wait for hours sitting in cars in long lines. Elderly are also among those at risk of eviction for inability to keep up with mortgage or rent payments and utility shut offs that can impact heating or cooking.
Technological barriers and red tape caused many older adults to be unable to easily access the stimulus payments they desperately needed for rent, food, medications, and other necessities. We also learned of issues people were facing accessing and applying for Social Security, Social Security Disability Insurance, and Supplemental Security Income (SSI) benefits during the COVID-19 office closures. If, and when, there are additional stimulus packages, they need to ensure that older adults are included. Technology to be able to work from home is another barrier that needs to be investigated, just as much as for students attending virtual classes.
In Massachusetts, the governor and Legislature should ensure that sufficient funding for older adults is available for rental assistance vouchers, home-delivered meals, and public transportation as well as priority status for COVID-19 vaccines. Other seniors, who might have been working prior to the pandemic, need access to unemployment. As much as we need to fix the problems in skilled nursing facilities that became highlighted by the pandemic, these other challenges faced by older adults should be addressed if Massachusetts is to give meaning to the claim of being an “age-friendly Commonwealth.”
Richard T. Moore is a former Massachusetts state senator and served as associate director of the Federal Emergency Management Agency during the Clinton Administration. He is currently an active member of Dignity Alliance Massachusetts advocating for dignity in the lives of older adults and people with disabilities. His views are his own, and not necessarily the views of the Alliance.