Alan Mozes, contributor REUTERS HEALTH:
OLDER MEN and women who provide much of the care and support for people with AIDS in sub-Saharan Africa, are experiencing crushing physical and psychological hardships, World Health Organisation (WHO) researchers say in a new report.
"Older caregivers are under serious financial, physical and emotional stress due to their care-giving responsibilities," WHO researchers state in the publication "Impact of AIDS on Older People in Africa".
The research team, led by Robert deGraft Agyarko of WHO's Geneva-based Ageing and Life Course division, chose the sub-Saharan African nation of Zimbabwe as a case study to investigate the role of older community members in caring for adults and children with HIV/AIDS.
Agyarko and his colleagues point out that such care is tremendously important in a world where at least 40 million people are estimated to be living with HIV/AIDS. Sub-Saharan Africa, in particular, accounts for almost 85 per cent of all AIDS deaths and is the locale for 70 per cent of all new HIV infections.
The researchers interviewed 685 men and women 50 and older living in six rural and urban provinces in Zimbabwe. Women formed more than 70 per cent of the sample.
Most study participants were either current or former main caregivers for a family member who was terminally ill with AIDS, or for one or more children orphaned by AIDS. Some participants were not main caregivers, but rather heads of households in which a terminally ill AIDS patient resided.
The researchers found that most of the terminally ill patients were the caregivers' sons or daughters nearly three quarters of whom were between the ages of 15 and 49. The older people surveyed also cared for grandchildren, spouses, heads of households, in-laws, brothers, sisters, cousins, nieces and nephews, and most cared for at least one orphan defined as a child who had lost at least one parent.
Caregivers lived
in poverty
Most older caregivers lived in poverty. Over half were peasant farmers, and one quarter were unemployed. Almost nine out of every ten caregivers earned no regular monthly or yearly income. Subsistence farming, gardening, baby-sitting, ironing and begging were the principal means by which the caregivers made ends meet.
Limited resources notwithstanding, the older caregivers were called upon as the sole providers of a wide range of physical, emotional and financial assistance, such as washing patients and their clothes and providing food, care and
companionship.
Older caregivers generally receive little recognition for their efforts from their community, local health caregivers or government leaders, WHO states. Nearly two thirds said they suffered from a range of community abuses such as AIDS-related stigma or verbal and physical violence.
Additionally, less than one third described their own health as good. Nearly 60 per cent who said they were in "poor health" attributed this problem to the fatigue, stress and burnout that accompanied their role as primary caregiver.
Compassion and
satisfaction
Nonetheless, many elder caregivers reported feelings of compassion and satisfaction from the task.
The researchers concluded that such older caregivers urgently need more support. Governments should, they suggested, provide older caregivers with better access to health care via improved transportation and subsidised medicines. As well, governments must enable the elderly to provide AIDS care by helping them find ways to earn income and offering them psychological counselling and material supplies--while promoting AIDS awareness throughout the population, the researchers say.
In an interview with Reuters Health, Agyarko said that the quality of life of both AIDS orphans and those living with AIDS across Africa would be greatly improved by empowering their caregivers emotionally and financially.
"Support for these older guardians (will) improve their efficiency and widen the support network needed, in response to an increasing demand for patient care," he said.
