TY - JOUR
T1 - A journey without maps—Understanding the costs of caring for dependent older people in Nigeria, China, Mexico and Peru
AU - Mayston, Rosie
AU - Lloyd-sherlock, Peter
AU - Gallardo, Sara
AU - Wang, Hong
AU - Huang, Yueqin
AU - Montes De Oca, Veronica
AU - Ezeah, Peter
AU - Guerra, Mariella
AU - Sosa, Ana Luisa
AU - Liu, Zhaourui
AU - Uwakwe, Richard
AU - Guerchet, Maëlenn M.
AU - Prince, Martin
A2 - Larson, Bruce A
PY - 2017/8/7
Y1 - 2017/8/7
N2 - Purpose of the study
Populations in Latin America, Asia and sub-Saharan Africa are rapidly ageing. The extent to which traditional systems of family support and security can manage the care of increased numbers of older people with chronic health problems is unclear. Our aim was to explore the social and economic effects of caring for an older dependent person, including insight into pathways to economic vulnerability.
Design & methods
We carried out a series of household case studies across urban and rural sites in Peru, Mexico, China and Nigeria (n = 24), as part of a cross-sectional study, nested within the 10/66 Dementia Research Group cohort. Case studies consisted of in-depth narrative style interviews (n = 60) with multiple family members, including the older dependent person.
Results
Governments were largely uninvolved in the care and support of older dependent people, leaving families to negotiate a ‘journey without maps’. Women were de facto caregivers butthe traditional role of female relative as caregiver was beginning to be contested. Household composition was flexible and responsive to changing needs of multiple generations but family finances were stretched.
Implications
Governments are lagging behind sociodemographic and social change. There is an urgent need for policy frameworks to support and supplement inputs from families. These should include community-based and residential care services, disability benefits and carers allowances. Further enhancement of health insurance schemes and scale-up of social pensions
are an important component of bolstering the security of dependent older people and supporting their continued social and economic participation.
AB - Purpose of the study
Populations in Latin America, Asia and sub-Saharan Africa are rapidly ageing. The extent to which traditional systems of family support and security can manage the care of increased numbers of older people with chronic health problems is unclear. Our aim was to explore the social and economic effects of caring for an older dependent person, including insight into pathways to economic vulnerability.
Design & methods
We carried out a series of household case studies across urban and rural sites in Peru, Mexico, China and Nigeria (n = 24), as part of a cross-sectional study, nested within the 10/66 Dementia Research Group cohort. Case studies consisted of in-depth narrative style interviews (n = 60) with multiple family members, including the older dependent person.
Results
Governments were largely uninvolved in the care and support of older dependent people, leaving families to negotiate a ‘journey without maps’. Women were de facto caregivers butthe traditional role of female relative as caregiver was beginning to be contested. Household composition was flexible and responsive to changing needs of multiple generations but family finances were stretched.
Implications
Governments are lagging behind sociodemographic and social change. There is an urgent need for policy frameworks to support and supplement inputs from families. These should include community-based and residential care services, disability benefits and carers allowances. Further enhancement of health insurance schemes and scale-up of social pensions
are an important component of bolstering the security of dependent older people and supporting their continued social and economic participation.
U2 - 10.1371/journal.pone.0182360
DO - 10.1371/journal.pone.0182360
M3 - Article
SN - 1932-6203
VL - 12
JO - PL o S One
JF - PL o S One
IS - 8
M1 - e0182360
ER -