💡The Big Idea
Nursing homes and other elder care facilities have needed to change since well before coronavirus. Now, after a horrific crisis, they finally might. Here’s the TLDR on our latest member-exclusive field guide on fixing elder care.
1️⃣ Nursing homes have been at the center of the Covid-19 pandemic.
2️⃣ Some took extreme measures and avoided even a single death.
3️⃣ The inequities in senior care have prompted a reckoning.
4️⃣ Experts anticipate that the pandemic will end “big box” senior living.
5️⃣ Along the way, senior caregiving has become a promising career for purpose-driven young people.
📝 The Details
The statistics about deaths from Covid-19 in nursing homes are so overwhelming that it can be hard to grasp the amount of pain and grief that they describe. In the US, nursing home residents and other seniors in residential settings have accounted for about 10% of total Covid-19 cases. But they have also represented a staggering 40% of fatalities to date, according to a New York Times analysis. The lessons learned from this battle, and the universal anguish and outrage over how the disaster unfolded, could make senior housing much safer, more enriching, more equitable, and better understood. It will almost certainly permanently alter the way nursing homes are designed and operated, and—if we’re fortunate—push people around the world to examine the deep biases we hold against the aged and aging.
Covid-19 deaths in nursing homes and assisted living centers were not inevitable. One nursing home in Baltimore has so far seen zero cases of Covid-19. Director Derrek DeWitt’s reading of the international news told him to ban guests, monitor staff closely, and buy masks and gowns right away. Now it appears that early action was in fact a key defense against a viral outbreak. Other facilities took even more extreme measures. One in Connecticut offered employees $15,000 to $20,000 to live at work until transmission rates went down—a strategy that nursing homes in Singapore undertook en masse. But these extreme measures come at a price and can be unsustainable for financially taxed businesses, overworked employees, and isolated residents.
Over the past few months, frontline caregivers have been heralded as heroes of the pandemic, alongside ER doctors or nurses, particularly by family members who saw them as a lifeline to loved ones. But they’ve also been unjustly made to look complicit in Covid-19 deaths, for showing up to work when they had unknowingly become virus carriers or working at more than one residence.
Caregivers often do not earn enough to make a living in one job and instead cobble together a few jobs to survive. Before Covid-19, the injustices in senior care had not “caught the imagination of the public,” says Robyn Stone, co-director of a research group focused on aging population issues. “I’m not even sure that you can put the blame on any one entity. I think it has been a societal failure,” Stone says. But the search for a truly sustainable and equitable model is now urgently sought around the globe.
The Village of Hope, a new model for senior living, is scheduled to open in central Pennsylvania by next summer. It will be populated by elegant, minimalist 3D-printed smart homes called Minka houses, created by noted geriatrician Bill Thomas. The Minka houses are designed as small standalone houses of 300 to 600 square feet, to accommodate one or two people, and they are not merely architectural solutions: They’re central to a philosophy that integrates seniors within a community rather than segregating them within a facility, no matter that some of those newer, trendier facilities are in a chic urban building, on a college campus, or part of a Zen retreat center.
Even before the Covid-19 pandemic, elder care was stretched thin with limited resources and growing demand worldwide. The number of adults over 65 is currently a little over 10%; by 2050, it’s expected to be 16%. Without a major overhaul of how governments and the private sector care for its seniors, systems will be quickly overwhelmed, just as they were with the pandemic. Some purpose-driven millennials have noticed this need, and have started careers advocating for and serving elders. Quartz spoke with five such individuals about their jobs.