Matina Sostina S, Manderson Lenore, Brear Michelle, Rusere Farirai, Gómez-Olivé F Xavier, Kahn Kathleen, Harling Guy
MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
J Gerontol B Psychol Sci Soc Sci. 2025 Apr 7;80(5). doi: 10.1093/geronb/gbaf008.
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.
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.
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.
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.
老龄化人口对护理的需求将日益增加，其中大部分护理是由非正式方式提供的，尤其是在农村地区以及低收入和中等收入国家。在南非农村，正式支持极为有限，由于患病、过早死亡、就业和迁移等原因，成年子女常常无法提供照料。我们描述了家庭内部和家庭之间如何分担照料责任。
我们对南非姆普马兰加农村地区106名认知能力下降或有认知能力下降风险的老年人（年龄≥54岁）的1012名家庭成员和非家庭照料者进行了定量访谈。通过描述性统计和回归分析，我们描述了照料责任的分担方式，特别关注照料的代际模式。
配偶，其中大多数为女性，通常认为自己是主要照料者。非正式照料在家人、朋友和邻居之间分担，最常见的是由比受照料者年轻1或2代的无业女性亲属提供。少数付费照料者，也大多是女性，提供了最密集的照料。
老年人的非正式照料广泛分布，主要来自同住的家庭成员，但也有其他人的重要贡献。家庭对照料的投入反映了共同的历史、互惠的关系以及在家中轻松承担照料任务。深入了解老年人的非正式照料如何分担对于制定有针对性的干预措施至关重要。
