Elderly Vulnerability

Vulnerability Defined

In my opinion, vulnerability is not an intrinsic character of the vulnerable, rather, it is an adverse outcome of socially induced limitations that result in disadvantaging a person, group, or a population as a whole. Hence, why there are so many different groups of vulnerable populations and various degrees of vulnerability in our societies. Vulnerability, as a concept, initially found its place in environmental sciences, where the concept was applied in the study of natural disaster impacts on human populations (Schroder-Butterfill & Marianti, 2006). Its application later expanded in identifying other groups in society that faced other threats based on the framework that vulnerability is a product of exposure, threat, coping capacity, and outcomes; hence, universally applied in identifying other vulnerable populations that face non-natural disaster threats (Schroder-Butterfill & Marianti, 2006). According to Egan (2006), some examples of vulnerable populations include the elderly, people with disabilities, the sick, single parents, racial and ethnic minorities, newcomers to Canada, low-income individuals and families, the marginally housed, battered women, children, etc. If we closely assess each of these populations, it’s evident that there are social factors that threaten each of these groups, which contribute to their vulnerability; change the factors, and they are not longer vulnerable (Egan, 2006). This article builds on this perspective and further expands on it in a highly important population – the elderly.

The elderly as a vulnerable group

The elderly face several threats that arise as a byproduct of old age. These threats include declines in health and physical strength, disability, loss of income, loss of a spouse, and separation from other support networks (Schroder-Butterfill & Marianti, 2006). Some of us will inevitably experience some of these threats in earlier stages of our life, which is why it is important to understand that exposure to a threat is only a fragment in the construction of vulnerability and not the full picture. Coping capacity, which is defined as “the crucial link between a hazard – or external threat – and a disaster” is what truly defines the notion of vulnerability (Schroder-Butterfill & Marianti, 2006). This explains why an older individual may be more vulnerable than a younger person when faced with the same threat. Therefore, empowering the vulnerable through coping mechanisms is a crucial step in reducing vulnerability.

Health implications of vulnerability among the elderly

As illustrated above, it is the potential for bad outcomes as a result of an inability to cope when faced with a threat is what constitutes a vulnerability. In the case of the elderly, vulnerability poses negative health implications in this population. A prime example would be the impact of the COVID-19 pandemic on this population (Government of Canada, 2020). The pandemic, which began in the later months of 2019 and has made headlines around the globe for most of 2020 has left, at the very least, a psychological footprint on almost everyone around the globe – hence, it is a common threat facing the human race in the 21st century. However, the impact of the pandemic has been devastating in the elderly population in particular, due to their inability to cope with this crisis – in part due to their frailty and in part due to a lack of social infrastructure and programs that could help them cope with this crisis.

The elderly are more vulnerable to COVID-19 for several reasons as identified in a handout distributed by the government of Canada (2020), including:

• They live in group settings where the COVID-19 virus may transmit more easily (e.g., long-term care facilities or group residences).

• Many of them face chronic medical conditions (e.g., lung disease, heart disease, hypertension, diabetes, kidney disease, liver disease, stroke, or dementia), which further impedes their ability to cope with this illness, leading to a higher mortality rate in this population.

• They face barriers that limit their ability to assess or implement effective public health measures (e.g., understanding the importance of social distancing and handwashing as an older individual living with dementia).

While helping as a respiratory therapist in long-term care facilities during the pandemic, I witnessed the health implications of the pandemic in this vulnerable population from the frontlines. It is interesting to note that the outcomes have and continue to be more favorable in the expensive higher-end private facilities. I visited facilities in Ottawa that had very low COVID-19 infection rates and near nil mortality rates. While, at the same time, there were facilities where the infection was soaring throughout the building at uncontrollable rates and mortality followed similar trends. These trends could be explained by the degree of the coping capacity of the residents at each facility. More expensive facilities undoubtedly have access to more resources (i.e., PPE, support staff, physical space, etc.) that increase their ability to contain the virus; whereas, cheaper facilities lacked in these areas, which further compromises an already vulnerable population, leading to poor outcomes.

Conclusion

In conclusion, vulnerability is not an inherent feature of the vulnerable; rather, it is a socially produced failure of society. Based on the framework identified above, vulnerability is a product of exposure to a threat, lack of capacity to cope with that threat, and the associated bad outcomes (Schroder-Butterfill & Marianti, 2006). As identified in the COVID19 example, coping capacity has a significant impact on reducing negative outcomes in a vulnerable population. Therefore, we can make seniors less vulnerable by increasing support systems to empower them with the tools they need to cope with such threats as COVID-19.

References

Egan, J. (2006, November). Vulnerable Populations. Retrieved from Government of Manitoba: https://www.gov.mb.ca/emo/pdfs/vulnerable.pdf

Government of Canada. (2020, 10 01). Government of Canada. Retrieved from Vulnerable populations and COVID-19: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/vulnerable-populations-covid-19.html

Schroder-Butterfill, E., & Marianti, F. (2006, January 12). A framework for understanding old-age vulnerabilities. Aging and Society, 26(1), pp. 9-35. doi:10.1017/S0144686X05004423