The current pandemic requires rethinking long-term care provision in Europe

In the latest edition of the European Social Network’s (ESN) webinar series on COVID-19, ESN put the spotlight on how the virus impacted long-term care. Speakers from Austria, Germany, Hungary and Scotland discussed challenges and immediate responses provided by public authorities, opening a debate on which tools and policy changes are needed to be better prepared for any future crisis.

COVID-19 has disproportionally affected older people, impacting on the provision of long-term care dramatically over recent months. According to the European Centre for Disease Prevention and Control deaths in care homes represented 30-60% of all COVID-19-related deaths in the first month of the outbreak. To maintain long-term care provision and protect the lives of users and carers, public authorities had to respond to multiple challenges.

Multiple challenges

According to the webinar speakers, a lack of personal protective equipment for care staff was one of the main challenges. In addition, workforces were significantly reduced due to suspected and actual COVID-19 cases among care staff. The rapidly changing situation required a constant communication flow in order to keep employees, relatives and residents updated about protection and care requirements. This was particularly the case regarding, users with special conditions such as dementia who had difficulties following the protective measures. Social distancing and isolation often had a negative impact on residents’ health and well-being. Lack of cooperation between health and social sectors impeded an effective response to the outbreak in some countries. Test results were not always as swiftly communicated as necessary.

Swift and Integrated Reponses

Dagmar Vogt-Janssen, Head of Department for Older People of the City of Hannover (Germany), reported that Hanover swiftly took a number of measures, such as setting up an emergency information phone line, forming a crisis intervention team and creating areas for patient isolation. The close cooperation of the social and health authorities was decisive in the containment of the pandemic. To prevent social isolation, visitor boxes were installed in care homes and open-air concerts were organised for the residents.

Teodóra Ráczné Németh, Head of Department of Methodology in the Hungarian Directorate-General for Social Affairs and Child Protection, explained that her department provided guidance and methodical advice to long-term care professionals in order to help them adapt to the abrupt changes in their day-to-day routines. To cope with the shortages of staff, the Hungarian Government passed a regulation that allowed care providers to rely on workforce support from other sectors such as education and culture.

Peter Macleod, CEO of Scottish Care Inspectorate reported that his agency temporarily stopped standard inspections, in order to prevent infections by external visits.

Lessons for future planning

Dagmar Vogt-Janssen underlined the importance of keeping updated pandemic guidelines in care facilities, having a crisis management team on standby, and conducting regular staff training on how to setup quarantine and isolation areas. Special protocols for hospital discharges should be established to avoid outbreaks in care homes due to admissions of infected persons.

Teodóra Ráczné Németh highlighted the necessity of a more integrated approach between health and social care for an effective crisis response.

Peter Macleod recommended establishing care at home as the new normal for the future and insisted that institutional care for older people should only be maintained for groups with special needs. He said: “Out of the 86.000 people receiving care at home in Scotland only a small minority of 80 persons, tragically passed away, whereas almost 2000 people have died in care homes, representing 46 % of the total COVID19 fatalities in Scotland (as of 9 July 2020).”

Dr. Kai Leichsenring, Executive Director at the European Centre for Social Welfare Policy and Research, stressed that informal care at home can be vulnerable to pandemic situations as well, for example in Austria where migrant carers were not able to enter the country due to border closures. He underlined the need to develop care models that are based on the community and not only the family. Alfonso Lara Montero, CEO of ESN, concluded that fostering home care in the community will be one of the key aspects of making long-term care systems more resilient. Digitisation will play an important role in making that change sustainable.


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