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“It is all About Giving Priority to Older Adults’ Needs:” Challenges of Formal Caregivers in Two Old Age Homes in Ethiopia

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Abstract

With a growing older population needing long-term care in Ethiopia, this study examined the challenges and needs of formal caregivers at two older adult homes. A qualitative, exploratory design was employed. Purposive sampling was used to identify 14 formal caregivers and 6 key informants who engaged in in-depth interviews. Formal caregivers assisted older adults with personal care, medication administration, and emotional support. As a result of high workloads, long work hours, an absence of training, and minimal compensation, caregivers faced many challenges including managing older adults’ difficult behavior, exposure to health hazards, and task burden. The all-encompassing demands of caring for older adults in resource-poor environments contributed to negative consequences that spilled over into caregivers’ personal lives. The capacity of formal caregivers to meet the needs of long term care residents in developing nations can be enhanced through training in geriatric care, adequate compensation, and best practice guidelines for long term care.

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References

  • Aboderin, I. (2017). Coming into its own? Developments and challenges for research on aging in Africa. Journals of Gerontology, Series B, 72(4), 643–645.

    Google Scholar 

  • Ahmad, A., & Komai, S. (2015). Geriatrics and gerontology: Neglected areas of research in most developing countries. Journal of the American Geriatrics Society, 63(6), 1283–1284.

    Article  Google Scholar 

  • Apt, N. A. (2012). Aging in Africa: Past experiences and strategic directions. Ageing International, 37(1), 93–103. https://doi.org/10.1007/s12126-011-9138-8

    Article  Google Scholar 

  • Adamek, M., & Balaswamy, S. (2016, November). Long-term care for elders in developing countries in Asia and Africa: A systematic review. The 69th Annual Meeting of the Gerontological Society of America, New Orleans, LA.

  • Adamek, M., Kotecho, M., Chane, S., & Getachew, G. (2021). Challenges and assets of older adults in Sub-Saharan Africa: Perspectives of gerontology scholars. Journal of Aging & Social Policy. https://doi.org/10.1080/08959420.2021.1927614

  • Balaswamy, S. & Adamek, M. (2017, July). Institutional LTC for elders in Asia and Africa: Ownership, resident characteristics, and staffing. The 21st World Congress of the International Association of Geriatrics and Gerontology, San Francisco, CA. 

  • Batista, M. P. P., Barros, J. O., Almeid, M. H. M., Mângia, E. F., & Lancman, S. (2014). Formal caregivers of older adults: Reflection about their practice. Rev Saude Publica, 48 (5), 732–738. https://doi.org/10.1590/S0034-8910.2014048005270

  • Braun, V., & Clarke, V. (2006).Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.https://doi.org/10.1191/1478088706qp063oa

  • Cattell, M. G. (1993). Caring for the elderly in Sub-Saharan Africa. Ageing International, 20, 13–19.

    Article  Google Scholar 

  • Central Statistical Agency of Ethiopia. (2007). The 2007 Population and housing census of Ethiopia-statistical report. Addis Ababa, Ethiopia.

  • Chabeli, M. M. (2003). Health care needs of older people living permanently in a residential home setting in Gauteng. Curationis, 26(4), 14–21.

    Article  Google Scholar 

  • Chane, S., & Adamek, M. (2015). Factors contributing to elder abuse in Ethiopia. Journal of Adult Protection, 17 (2), 1-12. https://doi.org/10.1108/JAP-07-2014-0026

  • Changala, M., Mbozi, E. H., & Kasonde-Ng’andu, S. (2016). Challenges faced by care givers in old people’s homes in Zambia. National Journal of Advanced Research, 2(1), 1–8.

  • Chipps, J., & Jarvis, M. (2016). Social capital and mental well-being of older people residing in a residential care facility in Durban. South Africa. Aging & Mental Health, 20(12), 1264–1270.

    Article  Google Scholar 

  • Clarfield, A. M. & Rosenthal, A. (2017). Aging in Sub-Saharan Africa: Sub-par? Journal of the American Geriatrics Society, 65 (6), 1136–1138. https://doi.org/10.1111/jgs.14751

  • Conradie, G. (1999). Dealing with institutional abuse in a multicultural South African society. Journal of Elder Abuse and Neglect, 10 (1/2), 153–163.

  • Czuba, K. (2015). Understanding formal caregivers and work stress: An interpretive descriptive study. Auckland University of Technology. http://hdl.handle.net/10292/9831

  • Dotchin, C. L., Akinyemi, R. O., Gray, W. K., & Walker, R. W. (2012). Geriatric medicine: Services and training in Africa. Age and Ageing, 42(1), 124–128. https://doi.org/10.3389/fsoc.2019.00025

    Article  Google Scholar 

  • Dovie, D. A. (2019). The status of older adult care in contemporary Ghana: A profile of some emerging issues. Frontiers in Sociology, 4, 25. https://doi.org/10.3389/fsoc.2019.00025

    Article  Google Scholar 

  • Drower, S. J. (2002). A South African perspective. Journal of Social Work in Long-Term Care, 2, 9–14.

    Google Scholar 

  • Essuman, A., Gold, K. J., Vitale, C., Toma, G., Cigolle, C., Gyakobo, M., & Zazove, P. A. (2019). Establishing the first geriatric medicine fellowship program in Ghana. Journal of the American Geriatrics Society, 67(8), 1718–1723. https://doi.org/10.1111/jgs.16014

    Article  Google Scholar 

  • Flick, U. (2018). Triangulation in data collection. In U. Flick (Ed.). The SAGE handbook of qualitative data collection. (pp. 527–544). Sage.

  • Goh, Z., Lai, M., Lau, S., & Ahmad, N. (2013). The formal and informal long-term caregiving for the elderly: The Malaysian experience. Asian Social Science, 9 (4). https://doi.org/10.5539/ass.v9n4p174

  • Gutierrez-Robledo, L. M. (2002). Looking at the future of geriatric care in developing countries. Journals of Gerontology, 57, 162–167.

    Article  Google Scholar 

  • Habjanic, A. (2009). Quality of institutional elderly care in Slovenia. Acta University Oulu. University Press, Finland. http://herkules.oulu.fi/issn03553221/

  • Hansson, I., & Kuven, B. M. (2016). Moments of joy and delight: The meaning of traditional food in dementia care. Journal of Clinical Nursing, 25, 866–874.

    Article  Google Scholar 

  • Hungwe, C. (2011). The meaning of insitutionalisation to older Africans: A case study of a Zimbabwean old people’s home. Electronic Journal of Applied Psychology, 7(1), 37–42.

    Google Scholar 

  • International Federation on Ageing. (2014). Connecting the dots: Formal and informal care Senior Officials Meeting (SOM) Background Paper Retrieved from: www.ifa-fiv.org

  • Karikari, G., Huber, L., Lohrmann, D. K., & Ozdogan, Z. (2020). Medical students’ perspectives and consideration of geriatrics for future practice. An exploratory study of a public medical school in Ghana. Gerontology & Geriatrics Education, 1–14. https://doi.org/10.1080/02701960.2020.1724997

  • Kloppers, M. J. (2011). An educational, practice- orientated programme for caregivers of the elderly in old age homes in Windhoek and Rehoboth. (PhD thesis). Windhoek: University of Namibia. https://wwwisis.unam.na/theses/kloppers2011.pdf

  • Kpessa-Whyte, M. (2018). Aging and demographic transition in Ghana: State of older persons and emerging issues. The Gerontologist, 58(3), 403–408. https://doi.org/10.1093/geront/gnx205

    Article  Google Scholar 

  • Le Roux, M. C., & Kemp, R. (2009). Effect of a companion dog on depression and anxiety levels of elderly residents in a long-term care facility. Psychogeriatrics, 9, 23–26.

    Article  Google Scholar 

  • Lima, J. R., Leite Medeiros, A. F, Medeiros, T. A., & Nobregna, M. M. (2016). Profile of caregivers of institutionalized older adults. International Archives of Medicine section: Primary Care, 9(131), 1–8. https://doi.org/10.3823/2002

  • Malmedal, W., & Anyan, C. (2020). Elder abuse in Ghana: A qualitative exploratory study. Journal of Adult Protection. https://doi.org/10.1108/JAP-04-2020-0011.

    Article  Google Scholar 

  • Mehta, K. K. & Leng, T. L. (2017). Experiences of formal and informal caregivers of older persons in Singapore. Journal of Cross Cultural Gerontology, 32, 373–385. https://doi.org/10.1007/s10823-017-9329-1

  • Moges, A., Tamiya, N. & Yamamoto, H. (2014). Emerging population aging challenges in Africa: A case of Ethiopia. Journal of International Health, 29 (1), 11-15.

  • Muza, C., & Mangombe, K. (2019). Population development in Africa with special regards to ageing. African Population Studies, 33 (2), 4913–4926.

  • Ncube, N. (2017). Pathways to institutional care for elderly indigenous Africans: Navigating contours of alternatives. African Journal of Social Work, 17(1), 44–51.

    Google Scholar 

  • Ngubeni, P. (2011). An investigative study of the caregivers experiences in caring for the elderly, Master Thesis, University of Zululand, South Africa.

  • Our Impact. (2020, April 21). Mekedonia Home for the Elderly and Mentally Disabled. Retrieved April 21, 2020 from https://Mekedoniahomes.org/our-impact

  • Özçakar, N., Kartal, M., Dirik, G., & Güldal, D. (2012). Burnout and relevant factors in nursing staff: What affects the staff working in an elderly nursing home? Turkish Journal of Geriatrics, 15(3), 266–272.

  • Popli, U. K, & Panday, R. (2018). Caregivers burden of hospitalized elderly. Journal of Gerontology and Geriatrics Research, 7, 483. https://doi.org/10.4172/2167-7182.1000483

  • Puckree, T., Chetty, T. P., Ramlakan, S., Simelane, T. V. S., & Lin, J. (1997). An evaluation of the functional status of the residents of a geriatric residential facility in South Africa. Disability and Rehabilitation, 19(12), 552–555.

    Article  Google Scholar 

  • Ramlall, S., Chipps, J., Bhigjee, A., & Pillay, B. J. (2014). Sensitivity and specificity of neuropsychological tests for dementia and mild cognitive impairment in a sample of residential elderly in South Africa. South African Journal of Psychiatry, 20(4), 153–159.

    Article  Google Scholar 

  • Robb, L., Walsh, C. M., Nel, M., Nel, A., Odendaal, H., & van Aardt, R. (2017). Malnutrition in the elderly residing in long-term care facilities: A cross sectional survey using the Mini Nutritional Assessment (MNA®) screening tool. Southern African Journal of Clinical Nutrition, 30(2), 34–40.

    Article  Google Scholar 

  • Roos, V. (2004). Intergenerational interaction between insitutionalised older persons and biologically unrelated university students. Journal of Intergenerational Relationships, 2, 79–94.

    Article  Google Scholar 

  • Roos, V., & Du Toit, F. (2014). Perceptions of effective relationships in an institutional care setting for older people. South African Journal of Industrial Psychology, 40(1), 1–9. https://doi.org/10.4102/sajip.v40i1.1139

    Article  Google Scholar 

  • Roos, V., & Malan, L. (2012). The role of context and the interpersonal experience of loneliness among older people in a residential care facility. Global Health Action, 5, 18861.

    Article  Google Scholar 

  • Schatz, E., & Seeley, J. (2015). Gender, ageing, and carework in East and Southern Africa: A review. Global Public Health, 10(10), 1185–1200.

    Article  Google Scholar 

  • Shrestha, L. B. (2000). Population aging in developing countries. Health Affairs, 19 (3). https://doi.org/10.1377/hlthaff.19.3.204

  • Teka, A., & Adamek, M. (2014). "We prefer greeting rather than eating:" Life in an elder care center in Ethiopia. Journal of Cross-Cultural Gerontology, 29 (4), 389-404. https://doi.org/10.1007/s10823-014-9244-7

  • United Nations, Department of Economic and Social Affairs, Population Division. (2017). World population ageing 2017: Highlights (ST/ESA/SER.A/397). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2017_Highlights.pdf

  • United Nations, Department of Economic and Social Affairs, Population Division. (2019). World population aging 2019: Highlights (ST/ESA/SER.A/430).

  • Van Biljon, L., & Roos, V. (2015). The nature of quality of life in residential care facilities: The case of White older South Africans. Journal of Psychology in Africa, 25(3), 201–207.

    Article  Google Scholar 

  • Van Biljon, L., Roos, V., & Botha, K. (2015). A conceptual model of quality of life for older people in residential care facilities in South Africa. Applied Research Quality Life, 10, 435–457.

    Article  Google Scholar 

  • Wagiman, A., Mohidin, H. H., & Ismail, S. A. (2016). Elderly care centre. IOP Conference Earth Environmrnt Science 30 012008. https://doi.org/10.1088/1755-1315/30/1/012008

  • World Health Organization. (2017). Towards long-term care systems in sub-Saharan Africa. WHO.

    Google Scholar 

  • Zelalem, A., Kotecho, M., & Adamek, M. (2020). "The ugly face of old age:" Elders' unmet expectations for care and support in rural Ethiopia. International Journal of Aging & Human Development, 0091415020911900

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Correspondence to Margaret E. Adamek.

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Informed Consent

All research participants provided informed consent to be interviewed. Participants were informed that they did not have to answer any questions they chose not to answer. They were aware that they could stop the interview at any time. All participants agreed to have their interviews audio-recorded.

Research Involving Human Participants

Research participants were adults age 18 or over who were employees at one of two age old homes in Addis Ababa The study objectives and data collection methods were explained to all participants. Participants agreed to be interviewed in a private office at their work place.

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Dawud, M., Kotecho, M.G. & Adamek, M.E. “It is all About Giving Priority to Older Adults’ Needs:” Challenges of Formal Caregivers in Two Old Age Homes in Ethiopia. Ageing Int 47, 847–865 (2022). https://doi.org/10.1007/s12126-021-09436-8

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