Along with many others I signed a letter this last Thursday which was sent to the UK Prime Minister and the United Kingdom Government. Key organisations working with and for older people throughout the UK came together to call on the Prime Minister to take further action to support older people in the Ukraine, and those seeking refuge in other countries, and to ensure that our response to the escalating humanitarian crisis takes account of the specific impacts and challenges older people will face.

As we have witnessed the increasingly distressing images of war from Ukraine many of us have felt helpless as we have heard the stories of children, young people and women, to say nothing of the men staying behind to fight and defend. A voice rarely covered in the stories has been that of older people and those with conditions which limit their ability to flee and escape easily.

The joint letter sets out the action required, highlighting that many older people in Ukraine will be trapped and isolated in their homes, with limited support available from families, friends and neighbours, as they will be unable to make the treacherous journey towards safety due to limited mobility or ill-health. As well as expressing real concerns over food, water, and other supplies, we have also called in the letter for the removal of visa restrictions to ensure that more older people are able to find safety and sanctuary in the UK. This includes a call to:

• Use all possible avenues to ensure that humanitarian access is given to all civilians in Ukraine, including older people.
• Ensure that explicit attention is given to the needs and rights of older people in Ukraine and surrounding countries in preparing and implementing the humanitarian response with other national governments and international organisations.
• Ensure older people in Ukraine or those seeking refuge in neighbouring countries have access to appropriate medical supplies, medication and mobility aids through donations, funding or the sharing of technical expertise.
• Remove the visa requirements on Ukrainians fleeing the war to ensure that older people without relatives in the UK are able to seek refuge here.
• Consider the needs and rights of older Ukrainians who are seeking refuge in the United Kingdom and what support they may need upon arrival.
• Continue to provide support to charities involved in the humanitarian response including HelpAge International and Age International to ensure that they and their partners can provide the crucial support that older people in Ukraine desperately need.

Can I also draw attention to the amazing work of Age International who have set up a dedicated fund to support older people in Ukraine. Please consider giving a donation and you can get more information at https://www.ageinternational.org.uk/donation/ukraine-appeal/#step1

A colleague wrote to me yesterday to highlight that the national flower of Ukraine is the sunflower which has become a sign and symbol of hope amidst the trauma. In a lovely gesture his Edinburgh company Home Instead are giving sunflower seeds to people to plant hope into the hard ground, and also giving a donation on their behalf to  Age International.

I have often said in this blog and elsewhere that the mark of any civilised society is the way in which those without voice are heard, that we witness equality of treatment and response regardless of age, and that we recognise the particular and especial needs of those who are frail, elderly, and old.

Those sentiments are very much in my mind as this weekend we mark several anniversaries of the Covid19 pandemic.

Two years ago the World Health Organisation (WHO) officially declared COVID a pandemic and in that time an estimated 6 million plus people worldwide have died from COVID-19, while nearly 448 million cases have been recorded. The vast majority of those who died were older individuals but more positively it is estimated that almost half a million people aged 60 plus were saved due to vaccines against COVID-19.

Today also marks the two-year anniversary that many care homes went into voluntary lockdown in Scotland in response to the pandemic and evidence from Europe and tomorrow (13^th) two years ago saw the publication of Scottish Government Guidance on managing the coronavirus in care homes and other settings.

A lot of hurt and pain, sadness and regret has happened since. Too many lives have been lost and to many memories have not been shared. Too many people have spent their last days in hospital or care, both from Covid and other conditions, without the presence of those they love beside them. The public inquiries – including the UK one whose terms of reference have been published this past week – will, I hope, give space and opportunity for people to tell their story and share their experience as well as to hear an account of clinical, political and system response during the last two years. But for so many the pandemic even on this two year anniversary is far from over.

In the last week right across the United Kingdom we have seen a rise in cases of Covid, a rise in hospital and ICU admission, a rise in the number of care home staff and residents who are contracting the virus and sadly a rise in the number of care home residents dying from the virus. These are hard times.

On the one hand we want all of us to nurture the restoration of normality not least in terms of care home visiting and access to families recognising the huge damage that has been done by disproportionate exclusions, by limiting the quality of life of residents in such drastic ways, but on the other there is a growing fear about what the virus will do in the next few weeks and months. Will it ‘burn itself out’, will there be diminishing impact, or will there be increasing numbers of cases, more lockdowns, more damaging isolation periods insensitive to the particular needs of residents, families and staff? Will there be a new wave and if so, will it as some argue be less of a threat or will we see a strain developing which escapes the protections we have. This last week we have seen the start of a fourth vaccination round which most would agree is very necessary as increasingly those admitted to hospital are older people whose immunity and protection is depleting following their 3^rd vaccination some months ago.

I do not have black and white and hard answers to most of these questions and suppositions, but as we approach the second anniversary of so much pain, I am very aware that we need collectively to not just learn the lessons of the past but to make sure that those lessons alter our actions into the future.

No more lockdowns in the name of infection, prevention, and control, which are disproportionate, insensitive to the trauma which isolation causes, and blunt in its use as an instrument of protection.

Let us re-define what we mean by an ‘outbreak’ so that living with the virus means that we will not constantly see the cycle of infection leading to perpetual exclusion and isolation.

Let us remove the use of masks to all but a minimum of high-risk situations.

Let us use testing in the short term as a safeguard and be prepared both to increase but also critically to decrease its use.

Let us urgently get Public Health advice which is reflective of reduced risk rather than which continues to increase the risk of individual harm. We need infection prevention control approaches which embed human rights and person-led care and support.

Let us find a collaborative way of working together, families and advocates, residents and staff, managers and providers, clinicians, and public health, so that in community and care home, we take control over from national ‘guidance’ and instruction and enable local decision-making.

Let us get real about what we mean by public assurance and stop victimising care home professionals by using disproportionate scrutiny and fallacious ‘support’; let social care take back the ground of compassion stripped from it by others in the name of oversight and regulatory expertise.

Let us restore the trust in the professionalism and skill, the compassion and care of frontline nurses and staff, rather than denude their integrity even further by spurious politicised interventions.

Let us begin to value the story and life of every resident and let care homes start to be homes again and avoid the creeping clinicalisation of places which have the very real potential of bringing life to fulness.

Let us find our way back to hope and celebration, to community and integrity.

Let us plant a sunflower of hope to shatter the dismay and hurt, and to bring forth healing and togetherness.

As we stand on the edge of the third year of living with Covid let our future be markedly differ from our past. Whether in the Ukraine or in our own communities, let us stand in solidarity with older age, rather than the pretence of care and support whilst in truthful reality we walk by on the other side.

Donald Macaskill