Spotlight on Seniors

An inside look at Armenia’s homes for the aged  


If there’s anything the COVID-19 pandemic has brought to light is how societies value senior citizens, the most vulnerable of all to the virus. Global interest in the lives of elders peaked as those with family members in nursing homes grappled with maintaining social distances while still ensuring their loved ones felt seen and heard. 

However, when it comes to Armenia, the prevailing perception is that at least its elderly are living at home in the cocoon of their intergenerational families and therefore not subject to the double threat of being both older and over-exposed in a public facility.

There is much truth to this, as there remains an entrenched social stigma in Armenia surrounding putting one’s parents or grandparents in an institutional setting. But for those without the nuclear family safety net—who are impoverished, in declining health, or suffering from cognitive or mobility issues—the state is the last hope to take responsibility for these outlier citizens. This makes a survey of these geriatric facilities all the more important, in hopes of ensuring that no senior is robbed of his or her dignity and the care their waning health may require.

22% of Armenia’s population will be above 65 by 2050 and Armenia’s demographics are considered an aging population.

Today, an estimated 1,400 senior citizens live in nursing homes in Armenia, which houses a total of 11 nursing homes—four state-owned and seven independent. In visiting two of them—one public and one private—we discovered that the somewhat grim mythology surrounding out-of-home elder care did not match the more positive reality. While best practices senior care is still a work in progress in Armenia, the isolation, loneliness and neglect typically ascribed to such settings did not appear to be a dominant issue. Rather, many of the residents who were interviewed and observed seemed to have created surrogate families among fellow residents and aides. Moreover, those in better health still had connections to the outside world and were in contact with relatives.

The further we probed, it became clear the elderly are not necessarily undervalued and overlooked in Armenian society, but rather that the resources are lacking to assure their human rights under international and state law can be fully met. In fact, the United Nations Populations Fund (UNFPA) reports that by 2050, 22% of Armenia’s population will be above 65 and Armenia’s current demographics are considered an aging population. With the elderly most at risk for poverty and the current social security system inadequate to fully provide for the psychological, legal, health, and living accommodations to these at-risk citizens, it is up to the decision-making authorities to actively address today what could become a socio-economic crisis in years to come.

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Frames with black and white portraits hang together on a wall.

Frames with black and white portraits hang together on a wall.
Photo by Davit Hakobyan

The State-Run Model

The Nork Nursing Home in Yerevan admits seniors for a multiplicity of reasons. The most prevalent is urgent housing needs, as was the case for 88-year old Bavakan Poghosyan. As a result of her psychological trauma and family conflicts, she packed her bags and decided to find refuge in Nork. She recalls her very first moments at the home almost eight years ago. “At first it was very difficult and I wept all day. But now, I am fulfilled,” she remarks, commending Nork management and staff for their exemplary care. Poghosyan is just one of almost 200 residents living at Nork Nursing Home.

Though the many Nork residents have lived rich lives and can recall major moments in the nation’s history, many consider the coronavirus epidemic one of the most notable and heartbreaking. According to the press secretary of the Ministry of Health Sona Martirosyan, there were 17 coronavirus deaths at Nork Nursing home. In all cases, the patients had pre-existing conditions making them more susceptible to the virus. At the time of this publication, Nork is COVID free, a result of extra precautions taken by management and staff.

Seventy-nine-year-old Nyura has resided at Nork for seven years and splits her life into pre and post coronavirus times, forlornly reminiscing previous summers traveling throughout Armenia. “We usually have a busy and active life here. Every year we take trips to different parts of Armenia, like Sevan, Dilijan, Garni, and Geghard. Because of the coronavirus pandemic this year, we’ve had to stay inside these walls,” says Nyura tearfully, as she recalls the friends she lost in just a few weeks. Though the seniors are no longer able to take trips this summer, the staff ensures they are occupied inside the home with board games, access to television, social media, and Skype. 

“State-run institutions like ours have event organizers to arrange various artistic events for the seniors, such as visits to the theater, concerts, other cultural centers, and various sports tournaments, says Nork Press Secretary Martirosyan. “All national holidays and birthdays of the seniors are celebrated and there are artistic groups including painting, theater, and literature. Prior to the global pandemic, these performances were debuted outside of Yerevan in Gyumri and Vanadzor.

The seniors are also encouraged to take part in community service. “There have also been some social programs implemented with the participation of our residents. About two New Year’s ago, some of our seniors knitted hats and gloves that were donated to an orphanage,” recounts Arthur Melkonyan, director of Nork Nursing home. “There was also a large international exhibition organized here, which presented paintings by our residents, as well as works by the residents of other nursing homes in France, Great Britain, Georgia, and other countries,” he reports.

“I appreciate the attitude of the employees here,” says 83-year old Ararat, an active member of the Nork theatre group who seems to thrive when performing. “They respect us as if we’re their parents. I feel like I’m the center of attention here, and that’s why I don’t want to leave,” he says, adding that he speaks to his son and daughter every day. “In the era of the Internet, there is no longing anymore. I feel at home here.”

The Private Model

While state-funded nursing homes like Nork have the supplemental resources to ensure social protection to the elderly, other institutions must rely on other means to support their homes. One such non-governmental facility is Narek Nursing Home, founded in 1993, located in Yerevan’s Abovyan district. Founders Shoghik and Fridon Mikaeyelian, a couple happily married for over 50 years, remember witnessing extreme violence and looting after the Sumgait pogroms in Azerbaijan, where they, along with other Armenians were deported on masse in the early days of the Artsakh Liberation Movement thirty years ago.

“After the Sumgait tragedy, and then the 1988 earthquake, we sheltered dozens of people in our own home,” says Fridon, noting that Narek has also become a home her and her husband as well. Though the building houses only 36 residents and the conditions are far from perfect, there is a long list of people waiting to be admitted. According to Shoghik, “We simply don’t have space.”

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Founders of the Narek Nursing Home, Shoghik and Fridon Mikaeyelian are a happily married couple of over 50 years.

Founders of the Narek Nursing Home, Shoghik and Fridon Mikaeyelian are a happily married couple of over 50 years.
Founders of the Narek Nursing Home, Shoghik and Fridon Mikaeyelian are a happily married couple of over 50 years. Photo by Davit Hakobyan

Narek has only four employees, who all work on a charitable basis. One such passionate volunteer is Asatryan Aregnaz, who has been volunteering her time for the past four years. “I clean and wash everything here. I have a job as a caretaker, but as soon as I have free time I come here to help,” she says. Shoghik articulates that although they do not have money to pay the volunteers, they provide them with food and clothes instead. Narek’s funding comes from the monthly pensions of the residents, in addition to the out-of-pocket payments of the Mikaeyelians. With the pensions, Shoghik and Fridon purchase medicine, food, and pay off utility bills. They also maintain a small farm on Narek premises, crammed with chickens, ducks, pigs, turkeys, cows, and organic fruits and vegetables. Nevertheless, Fridon emphasizes that they don’t need extra funding. Their only wish is to have more space for the elders.

 Yet there are others who don’t recall how they wound up living in such facilities. The eldest resident of Narek nursing home is Zarik Abrahamyan, born in 1921 and a former nurse in the Great Patriotic War. Today she suffers from memory loss, typical of such an advanced age. “When the war broke out I volunteered as a nurse. But I do not remember what happened after that, where exactly I have been, how I came back,” she says. “I wandered for so many years, I didn’t have a place to live,” she says.

Senior Rights and Benefits

According to the United Nationals International Principles, and per subsection four of the Armenian Ombudsman’s Report, elders have a right to participate in cultural life and maintain relationships with the outside world. They also are entitled to a decent life and state services/NGO’s must provide this basic human virtue. The Ombudsman’s report delineates what state entities must provide to seniors: food, medical assistance, legal aid, psychological support, leisure time, and access to specialized care—with equal access and quality—regardless of socioeconomic standing, age, or cognitive ability.

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Fridon Mikaeyelian tending to the pigs at the small farm on the Narek Nursing Home property.

Fridon Mikaeyelian tending to the pigs at the small farm on the Narek Nursing Home property.
Fridon Mikaeyelian tending to the pigs at the small farm on the Narek Nursing Home property. Photo by Davit Hakobyan

Privacy

When it comes to such necessary means and conditions, the elderly, by law, must have access to personal space, care, and hygiene. Armenian law requires thatif a person is partially unable to bathe themselves, they must have a caretaker assist their bathing. Older adults in facilities should be provided with personal hygiene products and are required to bathe at least once a day and have unlimited access to showers as needed.

Proper Nutrition

According to the Ministry of Social Affairs, there has been a massive improvement in the menu provided to elders in nursing homes throughout Armenia. Including the elderly in the menu-drafting process has increased the will to eat regular meals, an important step to overall health.

New Alternatives

While admission to nursing facilities is limited, the popularity of home-care services has risen in recent years for those who refuse to leave home, notes Zaven Koloyan, director of Yerevan Home Care, a privately owned enterprise. In his opinion, caring for the sick or the elderly at home is much more efficient. “In my experience, wounds heal better at home in the presence of relatives and friends,” he says. “Armenia is not inferior to other countries in terms of service quality and auxiliary medical equipment. However, unlike the U.S., where this kind of service is government-funded, in Armenia not every family can afford to pay for it,” he determines.

Care from the Diaspora

Dr. Jane Mahakian of California is leading the change in elder care and treatment in Armenia, starting with research studies on dementia at Nork Nursing Home. “The resources and the availability of palliative care, as well as hospice care is something that has yet to be developed. Moreover, there have been no recent studies on the prevalence of dementia in the country of Armenia, though it is a public health crisis worldwide. So we trained social workers to use the MoCA Test, which looks at people’s baseline cognitive functioning. They were able to get 143 of Nork residents interviewed and tested last October. And we found that of those 143, about 80% of those tested showed some form of some kind of cognitive impairment,” she notes.

 Dr. Mahakian partnered with engineering students at the Worcester Poly-technic Institute to create games for

the elders to encourage exercises and techniques to enhance the memory of a person with cognitive impairments. The students joined her for an eight-week study of older adults and were instrumental in creating a program at Orran in Vanadzor, which became a pilot. The students spent two hours twice a week launching the Healthy Aging Memory Club, which offered varied activities that included fine motor skills, art, music, and other cognitive exercises. Says Dr. Mahakian: “Keeping their days structured with activities that are cognitively stimulating is crucial. For those living in the past, keeping that past alive through reminiscence-type activities is huge.”

One of Nork’s newer residents is Robin the Robot, a research project funded by The Hirair and Anna Hovnanian Foundation. Working in partnership with Expper Technologies, the friendly robot will examine the role of emotional support tools for institutionalized elders in Nork. Evidently Dr. Mahakian is pushing the state to make strides on behalf of these vulnerable cognitively impaired elders through sustainable programs.

Signs of Success

For Armenia’s seniors, age is more than just a number. It is the fine line between receiving social assistance, housing, and a reliable source of nutrition, and perhaps more importantly, feeling protected, respected and loved. Nork resident Arakelyan sums it up in a nutshell: “The only thing we really need is love.

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Senior Citizens of Artsakh

Senior Citizens of Artsakh
Photo by Areg Kozmoyan

Coping with War and Loss

According to the Ministry of Labor and Social Affairs in Armenia, there are approximately 22,047 senior citizens in Artsakh. Though over 60 percent of the population is confirmed to be displaced after the Artsakh War, experts are still unable to identify the number of displaced pensioners who have lost their homes, a crisis compounded by pre-existing conditions like Alzheimer’s and dementia, and of course—COVID-19.

The Hanganak Elder Clinic in Stepanakert is actively working to identify as many displaced seniors as they can. Of those identified and housed, a majority come from Shushi. To date, they have accommodated 255 elders and hope to care for more displaced seniors and integrate them into their home with carefully curated programs for those suffering from trauma. The clinic, led by Dr. Gohar Hovhannisyan, typically provides medical and social support to those 63 and older without any living family members and those who are homebound. But it has since shifted its mission.

Dr. Jane Mahakian believes that thoughtful and empathetic care is paramount for seniors as grief and loss always loom on the horizon. She maintains that both elders and clinicians could benefit from support groups, plus gerontological training classes for healthcare workers on how to evaluate and treat depression among seniors, how to identify and handle dementia, and how to mitigate the sense of loneliness and isolation.

With that in mind, Dr. Mahakian’s Artsakh Elder Care Program has plans to send a cohort of Hanganak healthcare professionals and displaced seniors to the Armenian Nursing & Rehab Center in Jamaica Plain, Massachusetts—a facility that has successfully vaccinated all of their patients. There, the health workers can receive expert coaching and guidance so they can return home to train other Hanganak employees back in Stepanakert. Such experiences and resources can help elders feel fulfilled, or as Dr. Mahakian defines it, living with purpose and “life meaningfulness.”

AGBU Senior Dining Centers

From the Early days of Armenia’s independence, when economic hardship was widespread due to the fall of the Soviet system, many of Armenia’s seniors faced additional constraints when their pensions were reduced, thrusting them below the poverty line.

Fortunately, AGBU stepped in to ensure that such vulnerable citizens were able to receive a hot meal up to six days a week at one of its three Senior Dining Centers located in the outskirts of Yerevan.

Based on the soup kitchen model but with a varied menu, the program entitles each patron to a homemade entree, fresh bread and ample portions of fresh fruit and vegetables, served by caring volunteers. For those unable to travel, meals are delivered to their homes.

Administered by the Holy See of Etchmiadzin on the premises of AGBU Childrens’ Centers, the program has grown in capacity to serve as many as 600 seniors who are welcomed to the the table to break bread with their neighbors and friends.

When the COVID-19 pandemic made its way to Armenia, it was imperative that the lifeline these elders had come to depend on would not be interrupted.

This meant putting senior dining patrons on the top of the list for AGBU food boxes, prepared and distributed by AGBU Armenia volunteers and scouts.

AGBU Senior Dining Centers are supported by donors and benefactors of AGBU.

Banner Photo by Davit Hakobyan

Originally published in the March 2021 ​issue of AGBU Magazine. end character

About the AGBU Magazine

AGBU Magazine is one of the most widely circulated English language Armenian magazines in the world, available in print and digital format. Each issue delivers insights and perspective on subjects and themes relating to the Armenian world, accompanied by original photography, exclusive high-profile interviews, fun facts and more.