By Amy Clotworthy, Center for Healthy Aging (CEHA), University of Copenhagen (Denmark)
First published in 1940, Hans Scherfig’s The Stolen Spring (Det Forsømte Forår) is both a satirical crime novel and a wry social commentary. Through his description of a school’s sociocultural dynamics and how administrators handle the murder of a teacher, Scherfig pointedly criticises particular patterns and structures in Danish society. As one reviewer analysed, “The small, scared schoolboys are made into big, scared men educated to sustain the system that deprived them of their own childhood”. Scherfig’s work highlights how such de-individualising systems can break down a person’s imagination, independence, and unique dreams for the future so thoroughly that they eventually perish.
Now, 80 years later, many of our elders are facing a similar fate due to the ‘stolen spring’ caused by the COVID-19 pandemic. Starting 12 March, when the national government implemented a societal lockdown in Denmark, all citizens were encouraged to self-isolate, increase hand hygiene, and remain physically distant from each other in order to prevent hospitals and healthcare workers from becoming overburdened by patients needing intensive medical care. But there was also an explicit call to protect vulnerable social groups at risk of serious consequences from the virus, particularly people with compromised immune systems or chronic diseases as well as those aged 65+ and especially those aged 80+.
Visiting in the context of besøgsforbud
This meant that, as soon as the lockdown was implemented, the national health authorities instituted a visiting restriction (besøgsforbud) at all of the country’s long-term care facilities (plejehjem) in order to protect the citizens who were most likely to be infected by COVID-19. Thus, according to the official guidelines developed by the Danish Health and Medicines Authority (Sundhedsstyrelsen) in collaboration with the Danish Patient Safety Authority (Styrelsen for Patientsikkerhed), people living in plejehjem were only permitted to receive visits from “close relatives in critical situations”. Moreover, the visitors could not have any symptoms of illness, and the visit itself had to be conducted outdoors “with a distance of two meters between all participants”.
As soon as I heard about these restrictions, I thought: This is not good.
Under ‘normal’ circumstances, I am an ethnologist at the Center for Healthy Aging at the University of Copenhagen (UCPH). But since 16 March, I have also been coordinating an interdisciplinary research project, “Standing together – at a distance: how Danes are living with the corona crisis”, based at UCPH’s Department of Public Health. This project has been documenting developments in the population’s mental health, including feelings of social isolation and loneliness, related to the pandemic and lockdown in Denmark. As part of our research, we conducted telephone interviews with 32 people across the country, including 14 people (8 women and 6 men) between the ages of 65 and 83, to gain insight into how the pandemic and lockdown affected their mental health, everyday behaviour, and social lives (both in person and on the internet/social media).
Isolating elders in plejehjem
Unfortunately, we have been unable to speak with elders living in plejehjem. The visiting restriction means that even close family members have found it difficult to obtain information. As one of our interlocutors, Karen* (age 64), explained, “My mother lives in a care facility, and she’s locked in there – you can’t come in to see her, and she can’t get out. And you don’t hear anything about anything because she can’t take the phone” (interview; 30 March). During the first weeks of the lockdown, many of our interlocutors (of varying ages) said that they felt like they were living in a “bubble” or a “prison”. But for people in plejehjem – who have been isolated in their rooms with little social interaction and just an hour a day outside in the yard – comparisons to incarceration and solitary confinement are all too striking.
The images below show the locked front doors (Image 1) and nearly empty parking lot (Image 2) at a plejehjem in my neighbourhood. At 5:00pm on a sunny Sunday (14 June 2020), this would typically be prime time for visits from family members and friends. (Photos by Amy Clotworthy)
As of this post, writing in August 2020, the rate of infection in Denmark has been stable, and many aspects of society – hairdressers, dentists, bars/restaurants, etc. – have re-opened. It’s ‘business as usual’ – although everyone is now required to wear a protective mask on public transportation. But the visiting restrictions in plejehjem have only slightly eased. Revised guidelines from the Ministry of Health (Sundheds- og Ældreministeriet), publicised on 9 June, state that residents may receive regular visits from up to two people designated by the resident, and the visit may occur indoors – but only if a resident’s health or the physical environment of the care facility prevents the visit from taking place outdoors. Visitors should still maintain a physical distance of two meters.
However, these restrictions are problematic. As Karen said, “It’s such an ethically strange thing, I think, that a 95-year-old woman can’t see her family”. And I agree. The visiting restriction reinforces a de-individualising system that both ignores and devalues older people’s essential personhood and denies their agency – as well as their need for human touch. In general, all humans need physical and social contact to thrive. But, as the visiting restriction continues with no end in sight, these elders may spend the next months – very possibly the final months of their lives – enduring “crushing isolation and (…) a great deal of stress and uncertainty” (Landry et al. 2020).
Older people, rights, and the pandemic
In an article about deaths from COVID-19 in U.S. nursing homes, the American Civil Liberties Union (ACLU) wrote that the landmark 1999 U.S. Supreme Court decision Olmstead v. L.C. recognised that the “unjustified institutional isolation of persons with disabilities is a form of discrimination”. Such confinement limits every part of a person’s life and “perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life”. Similarly, we must consider how older people’s quality of life and well-being are affected by policies and restrictions that demand their social isolation; confining them indefinitely and preventing them from having contact with their loved ones during a pandemic seems a particularly cruel and unusual punishment.
The COVID-19 pandemic is illuminating many societal weaknesses – and there is a pressing need to discuss how to reform and re-design long-term care institutions so that residents can remain safe while respecting their essential personhood, value, and right to human sociality. As Hans Scherfig suggested 80 years ago, certain institutional systems can break a person down so thoroughly that they eventually perish. I fear that, as our stolen spring extends into a stolen summer and beyond, social isolation and visiting restrictions may break our elders down so thoroughly that they prematurely perish.
* All of our interlocutors have been given a pseudonym, and we have removed identifying features from their quotes so that it is not possible to recognise them.
Review of Det Forsømte Forår: https://litteratursiden.dk/analyser/scherfig-hans-det-forsomte-forar
Danish Health and Medicines Authority (DHMA, Sundhedsstyrelsen) guidelines for the elderly and people with chronic illness to protect themselves against coronavirus/COVID-19: https://www.sst.dk/da/Nyheder/2020/Hvad-kan-aeldre-og-personer-med-kronisk-sygdom-goere-for-at-beskytte-sig-mod-coronavirus-COVID-19
Danish Health and Medicines Authority (DHMA, Sundhedsstyrelsen) and Danish Patient Safety Authority (DPSA, Styrelsen for Patientsikkerhed) guidelines for visiting restrictions: https://www.sst.dk/-/media/Udgivelser/2020/Corona/Genaabning/Plejecentre/Til-dig_-der-skal-besoege-en-paaroerende-paa-et-plejecenter-A5-digital.ashx?la=da&hash=FB716535A71AD9B6EC984995E6089CB6EC810687
Center for Healthy Aging (CEHA), University of Copenhagen: https://healthyaging.ku.dk/
Interdisciplinary research project “Standing together – at a distance: how Danes are living with the corona crisis”: https://coronaminds.ku.dk/english
Ministry of Health (Sundheds- og Ældreministeriet) revised guidelines for visiting restrictions: https://sum.dk/Aktuelt/Nyheder/Coronavirus/2020/Juni/Gradvis-genaabning-paa-plejehjem-og-sygehuse.aspx
Landry, M.D., Van den Bergh, G., Hjelle, K.M., Jalovcic, D., and Tuntland, H.K. (2020). “Betrayal of Trust? The Impact of the COVID-19 Global Pandemic on Older Persons” in Journal of Applied Gerontology 39(7): 687–689. doi:10.1177/0733464820924131
ACLU article about COVID-19 deaths in U.S. nursing homes: https://www.aclu.org/news/disability-rights/covid-19-deaths-in-nursing-homes-are-not-unavoidable-they-are-the-result-of-deadly-discrimination/
U.S. Supreme Court decision, Olmstead v. L. C., 527 U.S. 581 (1999): https://supreme.justia.com/cases/federal/us/527/581/
Amy Clotworthy holds a Ph.D. in ethnology and a Master’s degree in applied cultural analysis, both from the University of Copenhagen. In her position at the interdisciplinary Center for Healthy Aging (CEHA), she teaches and conducts research on how health and social policies targeting older people influence the sociocultural dynamics of later life. With an emphasis on everyday health practices, her research also investigates how the Danish healthcare sector, hospitals, and municipal authorities can improve professional practices by recognising the complexity of older people’s life histories as well as the individual needs and priorities they express in their personal narratives.
This is the eighteenth post in The Age of COVID-19 series, co-edited by Celeste Pang, Cristina Douglas, Janelle Taylor and Narelle Warren. Please send your contribution to Narelle.Warren@monash.edu
All contributions will also be published on Somatosphere