Learning from a Crisis: How to Protect the Elderly during a Pandemic

In many cases, the pandemic restricted the health access of older people. Photo: ADB
In many cases, the pandemic restricted the health access of older people. Photo: ADB

By Norma Mansor, Lilibeth Poot, Halimah Binti Awang

Older Malaysians faced multifaceted challenges—financial, health, and social—during the pandemic. This has highlighted policies that will help governments in the future.

Older people were among the most affected groups during the pandemic. Older Malaysians were no exception; 57% of the COVID-related fatalities between 19 March 2020 and 9 March 2022 were attributed to persons aged 60 and older.

 The pandemic not only caused fatalities but possibly left long-lasting scars on the lives of older persons, according to our research in the report The Malaysia Ageing and Retirement Survey (MARS) Wave 2 (2021–2022), released by the ADB and the Social Wellbeing Research Centre, Universiti Malaya.

 Older persons experienced financial shocks and stress during the pandemic. A large proportion of respondents aged 70–79 years old reported reduced income from either business (40% of respondents) or salaried employment (39%), had increased spending (31%), and were financially affected (40%). In addition, as many as 65% of those in their 40s supporting older persons were reported to be financially affected.

Survey data also indicates that the pandemic may have restricted the health access of older people.  Fifty-six percent of respondents had undergone a medical checkup in the past 12 months, which is substantially lower than 74% recorded in 2019.

This may be due to restrictions imposed by healthcare facilities to limit visits and nonurgent cases during the pandemic. Access to checkups was lower among males and declined by age among older persons from 64% among those in their 60s to 56% among those in their 80s and above.

Where medical facilities and operations are back to normal, it is important to urge people to come back to the regular routine of health checkups. Health facilities may consider offering more days for checkup services to accommodate a possible surge in demand.

More than 50% of the surveyed households reported receiving assistance in cash or in-kind during the pandemic and 88% of them received assistance from the federal government and 11% from the state government. 

Older persons experienced financial shocks and stress during the pandemic.

The survey findings point to a scope for improvement in delivering assistance. Of the households that received assistance, 43% self-assessed that they actually did not need the assistance, while 45% of households that did not receive social assistance reported that they needed some form of social assistance.

Moreover, one out of three survey respondents said that they did not know about the availability of any assistance or did not know how to apply. Dissemination of information on the availability of assistance at grassroots level and providing direct support to potential beneficiaries in applying for assistance, as well as improving targeting through better data and enhanced monitoring of the delivery of assistance, will help to efficiently allocate scarce resources earmarked for social assistance.

 Despite the concerns, older people showed resilience in coping with loneliness and fears during the lockdown. The proportion of respondents who were concerned about their health and said they were closer to family was highest among those aged 40–49, and decreased with age.

The proportion of respondents who were sad because they could not meet family members was highest among those aged 60–69 (66%), followed by those aged 70–79 (65%), and decreased among respondents aged 80 and older (60%).

What can we learn from these findings? Governments and those who care for older persons can take several key actions to improve their situation. This includes ensuring that older populations, especially those living alone or in remote areas, have easy access to health care. This can be achieved through mobile clinics, home visits, and the use of wearables or monitoring devices that can alert caregivers in emergencies.

Communication can also be enhanced between the government and citizens to ensure that social assistance programs, especially those introduced during crises like the pandemic, effectively reach their intended recipients. This includes addressing exclusion and inclusion errors in assistance programs.

Repeated longitudinal surveys are needed to generate a database on the older persons to better understand their context and provide evidence-based data to the government and other stakeholders to proactively identify policies and actions supportive of older persons.

Surveys such as MARS demonstrate the importance of aging and retirement surveys to better target the needs and promote the well-being of older people. More countries in Asia and the Pacific are starting similar surveys, and it is hoped that even more will join the effort.