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Long-term caregivers are essential, whether formal or informal

The United Nations Economic Commission for Europe has reported women comprise 58 per cent of persons over the age of 65 years, and play valuable roles within their families and communities as caregivers, accounting for up to 95 per cent of all care needs1. While these are invaluable contributions to societies and nations, there are insufficient protections for caregivers working formally or informally to balance the emotional, financial, and physical impacts of caregiving. The Academy Award-nominated film, The Father, gives viewers the opportunity to explore and perhaps better understand the impact of cognitive decline on informal caregivers, oftentimes family members, and on those living with Alzheimer Disease. The movie, in which Sir Anthony Hopkins plays an octogenarian living with dementia, explores the difficulties in navigating familial impact of family caregiving, both on the father-daughter relationship, and on her “fraying marriage” as described in this New York Times review. However, it also sheds light on the difficulties in caring professionally for persons experiencing cognitive decline. Perhaps as a consequence of the COVID-19 pandemic, the long-standing under-appreciation of the caregiving profession is receiving well-deserved policy attention. In a recent CNN opinion piece, US Senator Elizabeth Warren, and Mary Kay Henry, President of the Service Employees International Union, report that “care jobs remain undervalued, understaffed, under protected and underpaid.” “Everyone who needs care deserves to live with dignity in the setting of their choice, supported by a workforce that is respected, protected and paid for the essential care they provide” This article argues that the under-valuing of caregiving work is directly linked to racism and sexism, with the vast majority of formal caregivers comprising women (86 per cent) and people of colour (59 per cent). The consequence of these forms of discrimination is low wages, a lack of benefits, insufficient training and inadequate funding for a workforce traditionally devalued as “unskilled labour.” The shameful and appalling impact of the coronavirus on the long-term care sector is often incorrectly characterized as taking place within institutional facilities. However, long-term care also includes services in the home and community, which deserves an equal consideration of standards of care, staffing, safety and investment by decision-makers, taking into account the essential contributions of family and staff. Within the context of the UN Decade of Healthy Ageing, long-term care is one of four action areas requiring concerted attention as population ageing, migration and urbanization converge. The IFA’s 15th Global Conference on Ageing represents a critical point of connection for all those advocating for the rights of older people, with a conference theme dedicated to deliberating issues within long-term care. If you are a journalist covering this topic – then let the experts help with your stories. Dr. Amy D’Aprix, Founder of Life Transitions by Dr. Amy Dr. Sytse Zuidema, Professor of Elderly Care Medicine and Dementia at the University Medical Center Groningen, the Netherlands Experts are available to speak with media about caregiving, long-term care, healthy ageing, and cognitive decline – simply click on either expert’s icon to arrange an interview today. 1United Nations Economic Commission for Europe. (2020). UNECE issues recommendations on gender equality in ageing ‎societies. Available at: https://bit.ly/3jjRr1l

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The G7 Pledge to Address Vaccine Inequity Globally and What This Means for Older Persons

COVID-19 has continuously shown the disproportionate impact of the pandemic between the Global North and Global South. Since March 2021 there have been 117 million cases and 3.83 million deaths globally with the majority of deaths occurring in those 65 years of age and older. The pandemic has also highlighted more broadly the inadequate systems and models of care for older persons globally. Most recently the attention has turned to the reality of global vaccination inequity with 75% of COVID-19 vaccines having been distributed among 10 countries. As the variants continue evolving and emerging so does the number of deaths in the Global South where now countries that previously had been able to control the pandemic are faced with mounting number of infections and deaths but not enough vaccine supply to curb the numbers and stop the spread of variants. The G7 Summit took place on 7th June 2021, where G7 leaders announced a pledge and commitment to provide 870 million COVID-19 vaccines to be shared internationally. The pledge also states that at least half of these vaccines are to be delivered by the end of 2021 through COVAX. COVAX is one of the pillars of the Access to COVID-19 Tools (ACT) Accelerator that was launched by the World Health Organization (WHO), the European Commission and France. COVAX is a global collaboration to ensure equitable global distribution of vaccines. The pledge is an attempt to support global equitable access and to help end the continued impact the pandemic is having in the Global South as well as the emergence of new strains. Although the pledge is a step towards addressing issues of vaccine scarcity and inequity, questions arise as to how the vaccines will be distributed and if older persons will be prioritized in vaccination roadmaps. COVID-19 has made clear the vulnerability of older persons. Older persons are an integral part of societies and carry the collective wisdom of society. The pandemic has meant the continued isolation of older persons and much of the media’s focus has served to dehumanize older persons, ignoring their importance within communities and nations. With the prospect of vaccines reaching the most vulnerable in the Global South now is the time to prioritize the needs and wellbeing of older persons. To ensure older persons are no longer ignored and healthy ageing is prioritized as a strategic goal globally there are a series of tools and frameworks in place like the United Nations (UN) Decade of Healthy Ageing and World Health Organization (WHO) Immunization Agenda 2030. Both reports envision a world in which vaccination is a pillar to healthy ageing and now with the prospect of being able to immunize older persons in the context of the pandemic it is important that this pillar is recognized and implemented by Member States globally. The International Federation of Ageing’s (IFA) Vaccines4Life similarly envisions a world through which vaccination is a pillar to healthy ageing and is a platform that serves as a point of connection on adult vaccination. Follow the #Vaccine4Life platform to learn more about the work of IFA and multisectoral partners that comprise the World Coalition on Adult Vaccination on ending immunization inequity and how to join the movement and collaborate with global experts on bridging the inequity gap. The IFA within its 15th Global Conference on Ageing will be hosting a Vaccines4Life Summit which will further emphasize the importance of adult vaccination by bringing together experts and leaders in immunization, ageing, public health, healthy policy, health economics, government to inspire change. To learn more about the importance of adult vaccination please contact: Prof Roman Prymula, Director of University Hospital, University of Defense Dr Ian Philp, Deputy Medical Director at the Heart of England NHS Foundation Dr Mine Durusu-Tanriover, Professor of Internal Medicine, Hacettepe University

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Pertussis in Adults: The Hidden Problem in Europe

Pertussis, more commonly known as whopping cough, is a highly infectious respiratory disease transmitted through airborne droplets. The Bordetella pertussis is the causative agent producing toxins that damage the mucous membrane, causing the most common symptom, severe coughing episodes that can last on average 44 days. Globally there were 150, 000 cases of pertussis in 2018, and in Europe the incidence of pertussis varies from 0.01 to 50 per 100, 000 person- years. Fortunately, pertussis is a vaccine preventable disease and since the introduction of pertussis vaccinations in national immunisation plans, outbreaks started to decrease yet in more recent time there is a need for caution and concern. A recent study conducted by the University of Turku in Finland found that cases of pertussis among adults aged 40 – 59 years is more common that originally thought. DTP antibodies (diphtheria, tetanus, and pertussis) were collected from participants in 18 European countries to determine vaccine-induced protection. Findings revealed tetanus protection was sufficient, however, data for diphtheria and pertussis indicated severe under protection. Of the 18 countries studied, pertussis was most commonly found in Norway, France, and Denmark, with the lowest cases in Finland and Hungary. According to Professor Qiushui He the low levels of antibodies indicate that “herd immunity in middle-aged adults is decreasing” and a problem that needs to be addressed by the entire European continent. Higher rates of pertussis among adults are concerning because pertussis tends to present in an atypical manner in adults and often with greater complications (hemoptysis, pneumonia, rib fractures, etc.), especially for those aged 65 years and over as well as those with chronic obstructive pulmonary disease (COPD). Traditionally pertussis is commonly referred to as a children’s disease, yet it is clear from emerging trends globally that adults are at risk of contracting this disease with dire consequences. Alarmingly, many countries do not include adult pertussis vaccines as part of national immunisation schedules despite evidence that vaccine-induced protection is not life long. In line with the Decade of Healthy Ageing, it is important countries introduce policies that work to protect the health of older persons underpinned through a life-course approach. As the findings of this study illustrate, pertussis in adults is a problem that cannot be ignored, and countries need to re-evaluate existing plans to prevent and protect all age groups against this preventable disease. To learn more about vaccine preventable diseases and adult vaccination please contact: • Dr Paolo Bonanni, Director of the Specialization School for MDs in Hygiene and Preventative Medicine • Dr Mine Durusu-Tanriover, Professor of Internal Medicine, Hacettepe University • Dr Ian Philip, Founder, Age Care Technologies

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Working Together to Defeat Invasive Meningococcal Disease

April 24 is World Meningitis Day, and on this day, the International Federation on Ageing (IFA) together with the Confederation of Meningitis Organisations (CoMO) and Immunize Canada want to remind you that meningococcal disease is a health risk you should not take.

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The IFA has a long established and wide-ranging network of member organizations around the world. The network extends to over 75 countries covering every region. Together these organizations represent over 80 million older people.

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