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Distribution of Informal Caregiving for Older Adults Living With or At Risk of Cognitive Decline Within and Beyond Family in Rural South Africa

Matina, Sostina S; Manderson, Lenore; Brear, Michelle; Rusere, Farirai; Gomez-Olive, F Xavier; Kahn, Kathleen; Harling, Guy; (2025) Distribution of Informal Caregiving for Older Adults Living With or At Risk of Cognitive Decline Within and Beyond Family in Rural South Africa. The Journals of Gerontology: Series B , 80 (5) , Article gbaf008. 10.1093/geronb/gbaf008. Green open access

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Abstract

OBJECTIVES: Aging populations will increasingly need care, much of this provided informally particularly in rural areas and in low and middle-income countries. In rural South Africa, formal support is severely limited, and adult children are frequently unavailable due to morbidity, early mortality, employment, and migration. We describe how care is shared within and between households. METHODS: We conducted quantitative interviews with 1,012 household members and nonhousehold caregivers of 106 older adults (age ≥54) living with or at risk of cognitive decline in rural Mpumalanga, South Africa. Using descriptive statistics and regression analysis, we described how care is shared, with particular attention to generational patterns of care. RESULTS: Spouses, the majority women, commonly considered themselves primary caregivers. informal care was spread among family, friends, and neighbors, most commonly by unemployed female relatives 1 or 2 generations younger than the recipient. A small number of paid caregivers, also mostly female, provided the most intensive care. DISCUSSION: Informal care for older adults was spread widely, predominantly from coresident family but with important contributions from others. Family commitment to care reflected shared history, reciprocal relationships, and easy access to care tasks within the household. A deeper understanding of how informal care for older adults is shared is essential for developing targeted interventions.

Type: Article
Title: Distribution of Informal Caregiving for Older Adults Living With or At Risk of Cognitive Decline Within and Beyond Family in Rural South Africa
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/geronb/gbaf008
Publisher version: https://doi.org/10.1093/geronb/gbaf008
Language: English
Additional information: © The Author(s) 2025. Published by Oxford University Press on behalf of the Gerontological Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Familial care, Informal care, social networks
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10210193
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