Journal of Aging & Social Policy最新文献

In the wake of the COVID-19 pandemic in 2020, older people across Europe have adjusted their daily activities as personal risk avoidance and as an amendment to policy recommendations and restrictions. In this study, we use multilevel logistic regressions to examine to what extent sociodemographic factors are associated with activity reduction among the older population (50+) in Europe and whether these associations are moderated by governmental policy responses to COVID-19. By combining data for~35,000 respondents from the SHARE Corona Survey on reported changes in daily activities and stringency of restrictions at the national level, we find that older age, poorer health and being female versus male were (consistently) associated with greater activity reduction across all activities both in countries with weak and in those with strong restrictions. Associations between education, employment and living situation, on the one hand, and activity reduction, on the other, were weaker and less consistent. We conclude that differences between sociodemographic groups are rather similar for countries with weak and those with strong restrictions and hence argue that group-specific policy recommendation are relevant independent of stringency recommendations.

The rapid onset of the COVID-19 pandemic presented a multi-faceted challenge to older adults, carers, and care institutions globally. A wide range of policies aimed at protecting older adults from serious illness and death from COVID-19 - including prioritizing vaccination for older adults, mandating vaccination among health care workers, and stringent isolation measures - achieved some success in mitigating these outcomes. However, older adults continue to bear the burden of risk for these most severe outcomes. Additionally, some early efforts to protect older adults, often via extreme isolation measures both within care facilities and in the community, yielded unanticipated health and psychosocial impacts on older adults and care and service networks and revealed systemic ageism in health and social policies worldwide. This special issue of the Journal of Aging & Social Policy compiles research conducted both during and after the height of the pandemic on the impacts of immediate response efforts, while delving into the longer-term differential effects across population subgroups and organizations. Governments, agencies, and aging services organizations will benefit from fully considering lessons learned and incorporating them into future emergency response efforts.

Despite major restrictions on economic activity due to the first lockdown starting in March 2020, public financial support helped to limit the financial consequences of the COVID-19 pandemic in Germany. However, certain groups were more affected than others. Most significantly, people in the lowest income quintile were more affected than those who had higher levels of income prior to the pandemic. Although this aspect has also been analyzed in other studies, less is known about how income shocks affected living standards. In the present manuscript we combine descriptive and multivariate analysis in order to analyze changes in household income for people over the age of 45 years and changes in living standards for those who report negative changes in income. Results indicate that people over the age of 45 years with lower levels of income prior to the pandemic have been hit harder in terms of both lost income and the impact on their living standards. Furthermore, wealth seems to be relevant as a means of avoiding a drop in living standards in the event of a negative income shock. Results also indicate that by the end of 2020 and beginning of 2021 there is a recovery in living standards to pre-COVID levels. These results show the relevance of focusing on the needs of the most vulnerable groups when defining public financial support in times of crisis.

The COVID-19 pandemic has forced countries to issue public measures to address threats to the safety of citizens and the healthcare system. The role of chronological age in the ways in which different countries coped with the pandemic is particularly intriguing. Based on pool of purposely selected twenty-one countries, this article compares a variety of urgent public health policies that have been enforced during the first wave of the pandemic. It analyzes the ways in which countries introduced instructions related to older people and/or chronological age in relation to: Lockdown, exit and triage policies. It also examined whether the issue of long-term care settings (LTCS) received special attention in the primary guidelines developed in response to the lockdown and exit strategies. The analysis demonstrates inconsistencies within and across countries in the enactment and implementation of age-based measures. Moreover, it suggests that both acts of omission and commission based on age can be interpreted as ageist, arbitrary, not based on evidence, too inclusive, and offensive toward older people and neglectful of specific risk groups.

From the outset of the pandemic, Swiss federal authorities implemented numerous public health measures to contain the spread of SARS-CoV-2. In southern Switzerland, Canton Ticino legislated additional measures, some of which specifically targeted people aged 65 and over. We assessed how older adults perceived and experienced the introduction of these age-specific measures using data from a large, randomized sample of community-dwelling older adults aged 65+ collected between October 2020 and February 2021. We analyzed 788 open-ended responses on the experience of the introduction of the measures using a qualitative thematic analysis. At the individual level, 45% of the sample had a mostly positive experience, 29% had a mostly negative experience, 10% identified positive and negative aspects and 16% reported neither. We next assessed factors distinguishing the different types of experiences using bivariate and multivariate models. Older adults who were younger, unpartnered, had lower levels of education and higher levels of depressive symptoms and loneliness were more likely to report negative experiences. Our findings suggest the need to provide clear communication to older adults that accounts for the heterogeneity of this population, and to consider the potential for policies to have negative implications for those with fewer personal resources.

The COVID-19 pandemic exacerbated risk factors for food insecurity among older adults, while also altering how government agencies and social service organizations could serve this population given their disproportionate vulnerability to the virus. The current study sought to understand social service providers' perspectives about how low-income community-dwelling older adults' access to food and related resources changed during the COVID pandemic. Data were collected via in-depth interviews with 22 social service providers from Oregon-based public and private social service agencies. Responses indicated that changes to older adults' food access during the pandemic stemmed from increases in public benefit amounts and social distancing guidelines. Participants indicated that temporary increases in SNAP allotments supported older adults' food security. Additionally, social distancing guidelines disrupted usual ways of procuring food, such as going to grocery stores, obtaining food with the assistance of family or neighbors, receiving deliveries from social programs, and visiting congregate meal sites. Food assistance programs changed their operations to reduce in-person interaction and increase the use of technology. When investigating older adults' food access, future research should consider adults' experiences of and barriers to SNAP receipt, social support from social networks and safety net programs, and technology access and knowledge.

The COVID-19 pandemic presented unprecedented challenges for residential care homes for older people. However, the obstacles they faced and their resilience strategies have received insufficient research attention. This study, focusing on 13 residential care homes in Southeast China, addressed this research gap. The homes were visited between February and March 2023; 38 staff members (managers, nurses, social workers, and care workers) were interviewed. Thematic analysis revealed that the homes faced multidimensional challenges, including infection risks, declining mental health among residents, heavy workloads, and financial difficulties. Despite these challenges, they exhibited organizational resilience, primarily in their ability to cope with immediate issues during the pandemic, although their capacity to anticipate and adapt was weak. Factors influencing organizational resilience included their knowledge base, critical resources, a stable team with high morale and motivation, better integration of healthcare services, and government anti-COVID policies. This research highlights valuable insights for improving the quality of care in residential care homes in the post-pandemic era and in aiding policymakers and administrators in strengthening the organizational resilience of residential care homes in future crises.

The COVID-19 pandemic required residential aged care facilities (RACFs) to meet the high care needs of residents in the context of stringent public health measures and staffing pressures. Given the likelihood of ongoing COVID-19 waves and seasonal surges in acute respiratory infection outbreaks, this study explored RACF staff experiences in providing care while limiting COVID-19 risk. Ten focus groups were conducted across six RACFs in metropolitan and regional New South Wales, Australia. Findings highlighted the impact of negative media representation on staff and the need for risk-based clear public health messages to reduce complacency. Findings also highlighted challenges in meeting clinical needs while keeping residents safe, and the benefit of new initiatives and opportunities for future training. Clear, targeted communication is essential to ensure ongoing understanding and adoption of public health measures when required. Awareness of the challenges provides RACFs and policymakers valuable insights for future planning including staff support and training needs. Key areas that require attention include promoting work in RACFs as a valued profession, clear public health risk messaging, strategies to facilitate prioritizing care, and broadened scope of skills.

Since the Nursing Home Reform Act of 1987, regular oversight of United States nursing home activities has been a key strategy to ensure minimum levels of care quality for residents. Oversight activities have included "standard" survey visits - that is, annual unannounced visits by state survey agencies (SSAs) that directly observe resident care and interview nursing home residents and staff. This study provides an overview of these activities, focusing on oversight delays arising from policy changes brought on by the pandemic. Data from the Centers for Medicare and Medicaid Service's (CMS) Quality, Certification and Oversight Reports, Survey Summary Files, and Provider Information Files were used to measure delays in survey completion across SSAs. Study findings reveal delays in inspection activities, which have resulted in a large backlog of uncompleted standard surveys far exceeding regulatory requirements. These delays exist across nursing homes with high and low levels of quality. As SSAs work through the backlog of surveys, they may prioritize the completion of surveys based on prior performance. This precedent may be expanded as CMS explores opportunities to produce processes that target the completion of surveys in the poorest performing nursing homes.

Previous research shows that minoritized (i.e. Black and Hispanic) older workers are more likely to work in jobs subject to employment disruptions and negative economic outcomes, including job and wage loss. Of the studies that have examined the pandemic-related employment and financial outcomes of minoritized older workers, few studies have accounted for the role that pre-COVID-19 financial precarity (i.e. ongoing financial strain) might play in post-COVID-19 financial precarity. Using data from the Health and Retirement Study, we evaluate the racial/ethnic differences in post-COVID-19 employment disruption and financial precarities among workers 51 years and older (N = 708 to 2,812 respondents depending on the outcome measure). Ordinary Least Squares regression and moderation analyses show that older Black and Hispanic workers were more likely to experience post-COVID-19 employment disruption and associated financial precarities (e.g. missed rent/mortgage payment). Furthermore, the consequences of preexisting financial precarity differed by race/ethnicity. Non-Hispanic white older workers without pre-COVID-19 financial precarity were uniquely protected from post-COVID-19 financial precarity, whereas Black and Hispanic older workers were more likely to experience post-COVID-19 financial precarity even in the absence of pre-COVID-19 precarity. Findings suggest that multi-level policies and interventions need to address structural inequity contributing to minoritized older workers' financial vulnerability during crises.