Strengthening the capacities of caregivers to improve long-term care in comprehensive care centres for the elderly in Panama

Panama

Photo: PAHO/WHO Panama/Ángel Tuñón Paho A group activity during a training for caregivers in comprehensive care for older adults in Panama

Improving care in elderly care centres

During the recent COVID-19 pandemic, older people, particularly those residing in nursing homes, became one of the most vulnerable groups, facing increased risks of illness and death. Caregivers, who were already under immense pressure due to the emotional toll of losing patients and the logistical challenges of isolation protocols, lacked specialized resources and training. Panama's Ministries of Health and Social Development (MoHSD) conducted a comprehensive needs assessment in several care facilities, both public and private, identifying areas in need of improvement. This evaluation revealed the need to strengthen adherence to existing standards. At the same time, health workers called for further training, especially given the increased importance of mental health during the pandemic.[1] In response, Panama's MoHSD joined forces with the Pan American Health Organization/World Health Organization (PAHO/WHO). Together, they developed and executed a training program for caregivers in Comprehensive Care Centers for Older Adults. This training equipped them with essential skills in mental health, self-care, and basic psychosocial support, raising the standard of care and reinforcing adherence to human rights frameworks. This initiative is in line with Action Area IV of the Decade of Healthy Aging, emphasizing access to long-term care for older adults and strengthening caregiver capabilities. It also aligns with PAHO's action plan for enhancing elderly care, supporting the goals of the Decade of Healthy Aging in the Americas 2021-2030.

WHO's Key Contributions

Provided coordination and funding for the implementation of the workshop.
Offered advisory support, based on guidelines and resources established by WHO.
Supported the development of a more structured and scalable training plan.

How did The Panama, with the support of PAHO/WHO, achieve this?

In response to the assessment conducted by the MoHSD, PAHO/WHO provided technical and financial support for the development of a specialized elder care training program. This program was meticulously designed to address key areas of need, including mental health, self-care, psychosocial skills, and fall prevention. PAHO/WHO’s role was critical in enabling the program to adhere to the PAHO/WHO Guidelines for Frontline Personnel during COVID-19 and the Human Rights Framework for Older Persons.[2][3] In addition, the program took inspiration from the WHO-led United Nations Decade on Healthy Ageing (2021-2030) initiative which aims to enhance the lives of older people, their families, and communities, by incorporating best practices and valuable resources sourced from the Decade for Healthy Ageing Platform and PAHO's Virtual Campus for Public Health.[4][5][6]

^{Caregivers were trained in comprehensive care for older adults in Panama.}Photo credit: PAHO/WHO Panama/Ángel Tuñón Paho

WHO provided coordination support for workshop implementation, and the training actively engaged mental health professionals. A feedback session conducted by facilitators after the workshop aimed to assess participant satisfaction and identify areas for improvement. Caregivers expressed enthusiasm, recognizing the immediate relevance and practicality of the acquired skills and knowledge. They also proposed new topics for inclusion in a longer-term training plan, showcasing a commitment to ongoing improvement and responsiveness to evolving needs.

Both the Ministry of Health and the Ministry of Social Development conduct routine visits to participating facilities, evaluating compliance with established standards of care and collecting valuable feedback from caregivers and residents. These visits serve as a continuous feedback loop, informing and refining the program over time. Substantial improvements have been observed in the compliance of participating centers with established care guidelines. Additionally, there is a notable surge in interest from other centers seeking to enroll their staff in similar training programs, highlighting the program's positive impact and its growing recognition within the caregiving community

We should always be on the lookout for seniors, but staff should also take care of themselves, collect energy, and share it with the seniors we care for."

Eva Batista, San Juan de Dios nursing home, Panama

To address the escalating demand for elder care services, the Ministry of Health and the Ministry of Social Development have proposed extending the initiative to underserved areas across the country. Collaborating with partner organizations, including PAHO/WHO, both ministries aim to develop a more structured and scalable training plan, ensuring long-term sustainability. Notably, the Ministry of Health has elevated this issue on the Agenda of the National Technical Commission for the Promotion of Healthy Aging, created by Executive Decree No. 175 in May 2019. PAHO/WHO provides advisory support to the commission which includes multiple government institutions, civil society organizations, academic and research institutions, and the National Association of Geriatrics Professionals - Asociación Panameña Geriatría. This collaborative effort aims to achieve concerted interventions in the short, medium, and long term.

"The asylum has become my home. I always emphasize to the residents that they are also my family."

Monica Munoz, physiotherapist at a nursing home in San Juan de Dios, Panama

A key lesson learned from this initiative was the importance of involving caregivers in the design of training programs. Initially focused on clinical and administrative perspectives, training prioritized elder care issues. However, engaging in dialogue with those directly responsible for caring for older individuals revealed additional critical needs, including those related to caregiver resilience and mental health.

Panama's collaborative training initiative has yielded substantial improvements in caregivers' skills, notably enhancing the quality of long-term care for seniors. The initiative has fostered a stronger, more resilient, and ethically grounded approach, emphasizing human rights and dignity in the care of older adults.

References

Findings from an evaluation by the Ministry of Health and Ministry of Social Development, based on Ministerial Resolution No. 927-A of June 21st, 2018, which adopts and approves the Technical-Administrative Standards for Adult and Older Adult programs.
World Health Organization. First psychological help: guide for field workers [guideline in Spanish]. First psychological help: guide for field workers, accessed 5 March 2024.
Mental Health and Psychosocial Support Reference Group (MHPSS RG) from the Inter-Agency Standing Committee (IASC). Basic Psychosocial Skills: Guide for frontline personnel responding to COVID-19 [guideline in Spanish]. Basic Psychosocial Skills: Guide for frontline personnel responding to COVID-19, accessed 5 March 2024.
World Health Organization. WHO’s work on the UN Decade of Healthy Ageing (2021-2030) [web portal]. WHO’s work on the UN Decade of Healthy Ageing (2021-2030), accessed 1 February 2024.
Decade of healthy ageing. The platform [web portal]. Decade of healthy ageing. The platform, accessed 1 February 2024.
Pan American Health Organization/World Health Organization. Virtual campus for public health (VCPH): Bringing knowledge to practice [publication]. Virtual campus for public health (VCPH): Bringing knowledge to practice, accessed 1 February 2024.