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Palliative care and COVID-19: exploring the grey zone

Updated: Jun 1, 2023

Borja Arrue

Project and Policy Officer responsible for long-term care

AGE Platform Europe

The ongoing COVID-19 crisis is shedding light on the many shortcomings of long-term care systems for older people in Europe. Older people are at a particularly high risk of experiencing serious symptoms and death. To the point that, according to the World Health Organization, about a half of deaths caused by the new coronavirus are linked to care homes for older people.

Older people face vulnerability, experience the most serious symptoms and have the highest death rates. These three facts show the strong link between the ongoing crisis and the discussions on older people’s access to palliative care.

In fact, a very intense discussion on hospitalisation of older people has been going on across Europe. There have been widespread attitudes of rejection of older people’s priority or even right to be admitted to intensive care on equal footing with others. Whereas there may be different approaches, linked to different cultural preferences, AGE Platform Europe, the European network of organisations of older people, has stated, in a recent publication, that “age alone should never be a criterion for medical triage. Protocols based on non-medical criteria such as age or disability, deny persons their right to health and life on an equal basis with others”.

The same should apply to palliative care. Discussions on human rights in older age at the United Nations in 2018 and 2019 showed a wide consensus on stating the equality principle in access to palliative care. However, ensuring older people’s access to palliative care should not be seen as a substitute for hospitalisation and the enjoyment of the human right to health as a whole. It should not be one or another on the mere basis of age, and simultaneous access to both should always be considered.

Some key and very complex questions on the limits of hospitalisation will remain unsolved and will need deep and rigorous discussion. For some older people suffering from COVID-19 and with other serious and life-threatening health conditions, for instance, an impeccable assessment may show that hospitalisation would only worsen their conditions and prevent them from dying in dignity. In such cases, palliative care could be the main intervention and should be delivered in a timely manner to alleviate the pain and accompany the person and the relatives in this phase of life. All options should be considered, but always with the rejection of any discriminatory practices on the sole basis of age as starting point.

You can read more about older people and COVID-19 in the dedicated page of AGE Platform Europe’s website.

Resources list:

World Health Organization. Supporting older people during the COVID-19 pandemic is everyone's business. 03-04-2020.

AGE Platform Europe. COVID-19: Older persons' rights must be equally protected during the pandemic. 02 April 2020.

AGE Platform Europe. UN Open-Ended Working Group on Ageing - OEWG.

AGE Platform Europe. Coronavirus COVID-19.

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