Response from South Africa
In June 2021, the country is at level 1 restriction, which eases restrictions on movements. Residents are allowed to receive visitors, whilst maintaining Covid-19 safety protocols. Visits are undertaken in controlled isolated areas, mostly indoors, with no hugging allowed. If residents go home to their family, they are expected to isolate for ten days upon return. The extent to which care homes have ‘opened up’ varies from facility to facility. There is renewed fear of a third wave of Covid-19 infections, due to a 39% increase in cases over the last week, which would bring with it stricter controls on movement, especially in care homes.
Source: https://ltccovid.org/2021/08/05/current-situation-in-relation-to-visiting-in-care-homes-and-outings-for-residents-ltccovid-international-overviews-of-long-term-care-policies-and-practices-in-relation-to-covid-19/3.07.03.-South Africa
Last updated: September 8th, 2021
Covid-19 vaccinations are completely voluntary in South Africa. The Constitution protects individuals’ rights to decide for themselves, without due influence. Care homes strongly encourage vaccination of staff (flu and Covid-19) but cannot make it compulsory or preclude staff from coming to work (this would become a labour law issue). The phase 2 of vaccination (general population – beyond health care workers) started during May 2020 and, at least the in Western Cape (if not the whole country) people in Long-Term Care Facilities and people aged 60 or over were being prioritized.
Source: https://ltccovid.org/2021/05/25/national-discussions-on-mandatory-vaccination-among-long-term-care-staff-in-23-countries-ltccovid-international-overviews-of-long-term-care-policies-and-practices-in-relation-to-covid-19-no-1-may/3.11.-South Africa-
Last updated: September 7th, 2021
South Africa has National Norms and Standards (2008) that outline acceptable levels of service to be provided to older people. Recent audits have found many facilities in partial non-compliance. In addition, informal racially discriminatory practices were observed in some facilities, both in terms of admissions and quality of care (source: https://www.who.int/publications/i/item/9789241513388).1.11.-South Africa-20210902
Last updated: September 2nd, 2021
Traditionally, long-term care has been seen as a family responsibility yet few schemes are in place to support family caregivers. Private retirement villages cater mainly to older people with financial means. Publicly funded long-term care is available to only a small fraction of the older population. The majority of this type of care is provided in residential facilities which tend to be clustered in urban settings. Applicants are subject to a comprehensive assessment of their current living situation, family support, financial means and care needs. Only those who meet the criteria are eligible for admission. Individual care homes usually have their own admission policies and procedures, in addition to the formal criteria for obtaining public financial support. Availability of beds is another hurdle: most facilities have waiting lists for admission (source: https://www.who.int/publications/i/item/9789241513388).1.06.-South Africa-20210804
Last updated: August 4th, 2021
South Africa’s Older Persons Act (2006), as well as more general legal and policy instruments, guides national action on long-term care. Coordination and implementation of national policy fall mainly to the Department of Social Development and to the Department of Health. The former administers old-age pensions and finances and oversees residential, community and home-based care, while the latter addresses older people’s health care needs. The Department of Human Settlements plays a lesser role, in that it regulates retirement villages. Overall coordination of long- term care across these Departments is lacking and clinical-level integration of health and social care is limited. Organized long-term care could be expanded to include a broader range of service approaches and settings (source: https://www.who.int/publications/i/item/9789241513388).1.04.-South Africa-20210803
Last updated: August 3rd, 2021
In South Africa, 35% of people between the ages of 65 years and 75 years require some assistance with daily activities. For those 75 years and older, the percentage increases to 45% (source: https://www.who.int/publications/i/item/9789241513388).1.01.-South Africa-20210803
Last updated: August 3rd, 2021
Last updated: December 22nd, 2020
Last updated: December 14th, 2020
Last updated: December 5th, 2020
Palliative care guidelines for families (The Association of Palliative Care Practitioners of South Africa)
The PALPRAC website dedicated to palliative care during the Covid-19 pandemic offers this section of handouts to families. It includes:
- A handout to assist families and carers in understanding what the elements of care are that needs to be paid attention to in this time.
- A flyer to give clear instructions to families on the use of oral morphine at home.
- A handout giving useful tips to patients and families in managing breathlessness, which is a common symptom of Covid
- A handout for families to tell health care care workers in hospitals or care facilities a little more about their loved one and to ensure that the right family contact details are available.
- PALPRAC Carer Guidelines to assist carers being able to stay safe while caring for COVID positive patients
Handouts to families. Association of Palliative Care Practitioners of South Africa (PALPRAC), 2020, online.
Last updated: October 8th, 2020