The paradox of the policy ageing agenda in the time of COVID-19

Image: Dry’s Bluff Great Western Tiers -Tasmanian wilderness with characteristic dolerite bluff, circa 1957. Anthony Hart, Launceston Walking Club

COVID-19 has been called a lot of things, but from my perspective it has created a paradigm shift that has sharpened the experience of older people in many ways and brought into stark relief the dark shadow that ageism is casting over our society.

As the leading organisation in Tasmania speaking up for older Tasmanians, COTA Tasmania has been busier than ever since the pandemic hit the shores of Australia.

Let me rewind the clock to COTA Tasmania’s strategic planning refresher at Triabunna on the beautiful East Coast of Tasmania in August 2019.  It was to be a mid-plan review under the expert guidance of facilitator Graham Flower. However, due to Graham’s expertise, the Board committed to a new Plan to cover us for another five years and firmly committed to a strategic priority focus on tackling ageism:

Making ageism a thing of the past.”

The Board was firm that for 2020 this would be our focus, moving on from the 2019 theme of connections.

We reconvened in February 2020, after I had taken some annual leave to visit the sacred city of Varanasi in November 2019.  We looked at how to tackle ageism in the media, in aged care, in health and in employment.  Little did we know…..

So, to my reflections now on what has changed so much for older people with their experiences of COVID19.

We knew and had planned previously for the potential of another pandemic. In a previous life I was working for the Pharmacy Guild of Australia in Darwin in 2010 when the potential for a pandemic had increased due to H1N1 influenza outbreaks and scenario planning had been a strong focus of our activities with community pharmacies.  Ten Years later, the world has been shocked by the severity of this corona virus variant and the extreme measures needed to tackle it.

Varanasi is a holy city where Hindus travel from all over India and the world to spend the end of their lives and to die by the banks of the Mother Ganges. Now, with lockdown in India, Varanasi is like a ghost town, the ghats are empty and people’s deepest wishes are dashed.  World travel has stopped and cruise ships, so popular with retirees, have become death ships. And older people are told they are vulnerable and must STAY HOME.

At the very time when older people are facing a higher risk of more severe disease if they are exposed to COVID-19 they are being exposed to mixed messaging, paternalism, marginalisation and benevolent ageism[1] in public health alerts, as well as blatantly ageist commentary and blame seeking  associated with the economic woes due to lockdowns.  Benevolent ageism is described as compassionate yet paternalistic.

Yes, lockdowns were needed.  For example, the North West Coast of Tasmania was severely impacted as a flow-on from the Ruby Princess outbreaks, with the regional public hospital at the centre of the area closed, high rates of infections amongst staff and patients and, sadly, deaths of older people. But even in the midst of a health emergency, governments and policy makers have a responsibility to be sensitive to the impact of their words and actions on the lives of older people.

So, what do we at COTA Tasmania know about what older people are experiencing in the era of COVID-19.

What follows is list of issues raised with us from members of the public, our members, and our Policy Council, fellow community sector peak organisations and our Board:

  • distress due to the unfolding dramas at New March House residential aged care facility, during outbreaks in Tasmania;
  • North West Tasmania outbreaks and severe lockdown measures related to the NW Regional Hospital and the Ruby Princess;
  • lack of visitor access to residential aged care facilities during lockdown and with easing restrictions;
  • declining mental and physical health for residents in aged care facilities, including morale amongst residents;
  • fear related to COVID19 infection for wellbeing of people in residential aged care, particularly those with dementia or other neurodegenerative diseases;
  • inability for older people to leave aged care facilities (one described it as being “held against her will”);
  • Difficulty of navigating access to every day provisions including food and toiletries;
  • sometimes being prevented from paying for goods and services with cash;
  • increased risk of inappropriate access to bank accounts due to new issue of debit cards for older people who had previously only used passbooks and cash, including increased potential for elder abuse;
  • potential for increased “silent” cases of elder abuse if older people are self-isolating with a perpetrator or potential perpetrator of elder abuse;
  • underreporting of elder abuse;
  • increased negative consequences of the digital divide in Tasmania;
  • difficulty for some older people to access to up-to-date information when releases of important public health messages are done predominately online;
  • severe implications on older workers regarding age-based discrimination both in the workplace and from a recruitment perspective;
  • conflicting messaging about the need to get people back to work and how that might relate to older workers
  • the difficulty of connecting socially in a physically distant community, without the knowledge, skills, or financial security to access a digital community; and
  • physical and mental deconditioning of older people due to isolation at home.

This list highlights the growing tension between, on the one hand, hard-fought successes over many years in advancing policies that promote active/positive ageing and, on the other, COVID safe health policies and communications that are too often paternalistic or ageist.

In light of these issues, it seems paradoxical that 2020 kicked off the World Health Organisations Decade of Healthy Ageing.

COTA Tasmania’s vision is: “Ageing in Australia is a time of possibility, opportunity and influence”.

Last year, when we enthusiastically progressed our strategic planning, so expertly assisted by Graham Flower, we were confident we would be able to make meaningful progress in 2020 towards achieving that vision. Were we naive? Were we wrong? Despite all our efforts, is ageism on the increase because of heavy-handed policies and communications? One thing is certain: during COVID-19 older people are struggling to have a voice. COTA Tasmania’s job in these circumstances is to combat the ageism that silences them and make sure they are heard. We can do nothing less.

In closing, I want to pay one last tribute to our colleague and mentor Graham.

Along the way on this COVID “journey”, Graham left us all too soon.  He died of non-COVID causes during Easter 2020 at the age of just 58 – a self-confessed peak-bagger[2] who had revelled in the wilds of Tasmania.

I attended Graham’s funeral “virtually”. Only 10 people could be there in person. Vale Graham Flower April 2020 – COTA Tasmania acknowledges the significant contribution you made to the business, government and community sector in Tasmania, Australia and New Zealand.

[Source: Sue Leitch, M.Ageing; B.Pharm; CEO COTA Tasmania]

[1] Koepp,R.  Psychology Today; Posted June 22,2020; How is Ageism Affecting Older Adults During COVID-19?

[2]Wikipedia: *Peak bagger - Peak bagging or hill bagging is an activity in which hikers, climbers, and mountaineers attempt to reach a collection of summits, published in the form of a list.