Health care services for older people in COVID-19 pandemic times – A Nordic comparison

Abstract

Objective

To explore the Nordic municipal health and care services’ ability to promote principal goals within care for older people during the COVID-19 pandemic.

Design and setting

Two surveys were conducted among managers of municipal health care services for older people in Denmark, Finland, Norway and Sweden; the first around 6 months into the pandemic (survey 1), and the second around 12 months later (survey 2). Data were analysed through descriptive statistics, and multiple regression (OLS).

Subjects

1470 (survey 1, 2020) and 745 (survey 2, 2021) managers. 32% in home care, 51% in nursing homes, 17% combined.

Results

In all countries the pandemic seems to have had more negative impact on eldercare services’ ability to promote an active and social life, than on the ability to promote or enhance older people’s mental and physical health. The regression analysis indicates that different factors influence the ability to promote these goals. Managers within nursing homes reported reduced ability to promote mental and physical health and an active social life to a significantly lower degree than managers of home care. The effect of three prevention strategies (lock down, testing, and/or organisational change), were explored. Organisational change (reorganize staff and practice, restrict use of substitutes) tended to impact the units’ ability to promote a social life in a positive direction, while lock down (areas, buffets etc) tended to impact both the ability to promote mental/physical health and a social life in a negative direction.

Conclusion

Measures that can improve opportunities for an active and social life during a pandemic should have high priority, particularily within home care.

KEY POINTS

• It is important to learn from how the COVID-19 outbreak in 2020 affected the municipal health and care services’ ability to achieve principal goals within care for older people.

• The pandemic had a more negative impact on the services’ ability to promote an active and social life, than on their ability to promote or enhance mental and physical health.

• Measures that can improve opportunities for an active and social life during a pandemic situation should have high priority, particularily within home-based care.

Keywords:

• Primary health care
• eldercare
• older people
• COVID-19
• pandemic
• managers
• Nordic countries

Acknowledgements

The authors wish to thank the health care managers in the four countries who participated in the study, and two anonoymous referees for constructive comments to an earlier version of the paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Work on the paper has been supported by The Velux Foundations, Denmark, the Stiftelsen Eschnerska Frilasarettet Foundation, Finland (grant number ÅA/293/01.00.02/2018), and the partner institutions of the research team.