Key elements for inclusive practice

• Сhallenges of working remotely and sustaining a home-working environment (e.g. 1).
• Job loss, reduced working hours, and impossibility to continue working remotely in some sectors (e.g. 2).
• Restrictions on public transport, or just leaving home for people of a certain chronological age, which may impede their access to work (e.g. 3, 4).
• Retired doctors and nurses responded to the calls by several governments to help the health care system (e.g. 5, 6).

• Violation of the rights of older adults to paid employment.
• Reduced productivity due to inadequate working conditions at remote work and lack of training.
• Reinforcing negative stereotypes about the productivity of older adults and their high cost to the firm.
• Pushing older adults into retirement, healthcare leave, unpaid leave.
• Difficulties in finding a new job after the unemployment period.
• Healthcare professionals are working long hours, and their holidays have been postponed/cancelled.

• Leadership, education on new technologies and how to organise remote working.
• Recognition of individuals specific needs, and ensuring the availability of resources for fulfilling job obligations, including internet access, ergonomic solutions, headphones, providing flexible working arrangements.
• Paid sick leave/ unemployment benefits (by the government) to all employees, who are unable to work in the new circumstances.
• Special programmes for older adults to prevent extended unemployment.
• Removal of measures imposing restrictions only based on chronological age, if retired health care professionals are able to work, the same could be done for other essential sectors.

• Increase of use of the many existing technological solutions, by older adults, in the domains of social participation, health, fitness & care management (7, 8).
• Change in attitudes towards using the internet and technology and increase signups to internet services or telecom companies that offer free or cost-reduced signup) (9).
• Many services (official, social and commercial) have converted to online or tele platforms.

• Increased social isolation and deprivation of those who are not connected.
• Inaccessibility to services of people who do not have means or knowledge to access them digitally, which could prevent the fulfilment of their rights (e.g. filling an online form to receive an unemployment benefit).
• Simultaneously, the pandemic as an opportunity to increase digital engagement and reduce the digital divide.

• The active role of the government & municipalities in ensuring access to the Internet and means of using (computer, smartphone, etc.) as a fundamental right.
• Provide tools to healthcare professionals, companies, family members, etc. to facilitate and increase the use of technology with older adults.
• Expand and develop existing digital literacy programs.
• Make arrangements to overcome non-use due to sensory difficulties (e.g. use of hearing aids) (10).
• Provide alternative (not internet-based) communication and access to services.

• Free public transport for caregivers of homebound individuals (44, 45).
• Older adults and persons with pre-existing health conditions are asked to avoid the use of public transport to minimise the risk of contraction (46).

• Financial support for caregivers may create a potential for conflict across populations if only one specific profession is advantaged.
• Potential for intergenerational conflict in case older adults still want or need to use public transport.
• Vulnerable groups are at risk of losing their autonomy when having to avoid public transportation.

• Ensure free or discounted public transport for professionals involved in crucial sectors.
• Emphasise the heterogeneity among older adults all and avoid mentioning chronological age.
• Implement safety measures on public transportation to all users (e.g. masks (47)).

• Different age cut-off regarding vulnerability to COVID-19 and subsequent social distancing measures. People above the stated age are recommended or obliged to stay at home (e.g. 11, 12, 13, 14, 15).
• Harsher curfew recommendations/obligations for older persons (e.g. in 16).
• Suggestion to participate in the election for persons over 60 (e.g. 17)
• Help phone line for older adults (e.g. 18)

• The pandemic is represented as affecting only older persons; this leads to an underestimation of the risk of contagion across all ages.
• The idea that the pandemic concerns only older persons amplifies the stereotypical portrayal of older persons as vulnerable, in need of protection by other generations that need to bear the burden.
• Self-internalisation of negative age stereotypes and decreased perception of autonomy.
• Loneliness and loss of contact with the community, since remote communication may be unavailable due to lack of necessary devices and digital skills.
• Overlooking differences and vulnerabilities among age groups.
• The good practices enhance support from organisations and individuals; they enhance the possibility of avoiding social isolation while keeping physical distancing.

• Acknowledge and pay attention to the diversity within age groups.
• Ensure that individuals confronted with loneliness stay connected with their communities.
• Refrain from creating measures and recommendations based solely on chronological age.
• Use inclusive language, also in the demonstrations of positive examples, for example: not “shopping for seniors”, but for “people who may require additional assistance.”
• Take into consideration the individual difference (psycho-social factors), social support, living conditions.
• Guarantee access to services and technologies
• Take care of the psychological consequences of all individuals in social isolation.
• Promote a bottom-up approach and the involvement of older individuals in the creation of policies.
• Support the spontaneous intergenerational solidarity and the readiness of the population for mutual assistance.

• Reserved opening hours for shops and services for specific age groups and individuals in vulnerable situations (e.g. 19, 20, 21).
• Reserved slot for online grocery delivery (e.g. 22).
• Different NGO, local and national authorities give the possibility to older people and people with vulnerabilities to have the grocery and pharmaceutical purchases delivered at home (e.g. 23)

• Secure safety of people more at risk of severe consequences.
• Increase the potential for intergenerational conflicts and age comparisons.
• Reinforce negative age stereotypes and self-stereotypes.
• Support initiatives increase intergenerational solidarity, give support to people in vulnerable situations, reinforce the sense of community.

• Use inclusive language.
• Consider all the vulnerable situations and refrain from using only chronological age as a foundation for measures.
• Provide adequate safety equipment (e.g. masks and gloves) to clients as well as workers in the shop.
• Engage the target population when formulating policies

• Age-based triage protocols (e.g. 24).
• Transfer of visits to the doctor to an online format or telephone consultation (e.g. 25).
• Cancellation of planned receptions, operations, rehabilitation (e.g. 26).
• Shortage or restrictions to prescribing and dispense several drugs as a potential drug to treat COVID-19, which could be essential to people with other diseases (e.g. 27).

• Violation of the rights of older people to receive medical treatment according to their medical conditions.
• Deterioration of health for people with chronic diseases, the inability to implement therapy and supportive procedure.
• Inaccessibility of remote consultations for some people due to lack of necessary equipment (smartphones, Internet connection) or lack of skills in using it.

• Triage should be based on scientific evidence and case specificity, not chronological age.
• Ageism-free health care, including access to medical care and appropriate long-term care services.
• Special measures for people who experience difficulties with receiving remote medical advice.

• High prevalence of COVID outbreaks in nursing homes (28).
• Differences between countries on testing policy and restrictions in long term care and care at home (29).
• Shortage of staff and use of untrained volunteers (30).
• Decrease of care given at home due to restrictions, or avoidance of contact (31).

• Late detection of outbreaks in long term care facilities.
• Excessive death rates in long term care facilities.
• Neglection in treatment & deprivation of needs.

• Taking measures to prevent the spread of COVID in nursing homes while still providing care.
• Early identification and testing.
• Provide personnel and carers with training and equipment to ensure safety measures and knowledge on how to use protective measures while providing care ( 32).
• Facilitating work of carers at home (e.g. providing designated transportation).
• Consider additional care needs affected by the situation – physical activity, social needs, etc. (33).
• Specific considerations should be used for people with dementia (34).

• Physical activity programs for young and old emerged (check the collection by AGE platform Europe (35)).
• Online educational classes (36) (37).
• Clinical led exercise programme (38).

• Some individuals without Internet access or skills may be excluded from these interventions.
• This can have a severe impact on individuals’ mental and physical health.
• Increased opportunities for intergenerational contact because of older adults’ greater Internet use (e.g. online gaming or watching movies).

• Communicate the importance of intergenerational contact through online entertainment or cultural activities.
• Ensure equal Internet access in order to increase participation in entertainment and cultural events (39).
• Support the creation, implementation and advertisement of new initiatives.

• All kinds of educational inputs, courses and training are offered online (40).
• T.V. programs with educational purposes (mainly for students) (41).
• Radio channels broadcast educational programs (42).

• Some individuals without Internet access or skills may be excluded and even more socially isolated.
• Can have a severe impact on individuals’ mental and physical health. Moreover, social isolation can lead to cognitive decline. Educational inputs may decelerate the process of cognitive deterioration.
• The greater use of the Internet by older adults for educational reasons may increase opportunities for intergenerational contact and decrease the stigma of “the technology-alienated older adult”.

• Ensure access to lifelong learning for all members of society (educational T.V. programs, online learning opportunities).
• Ensure access to the Internet to all members of society (43).
• Raise awareness of existing educational opportunities.