Investigators: Makhosazane Ntuli, PI, Sphiwe Madiba, Co-I.
Description:
Introductions
Older people are at less risk of contracting HIV than young adults. However, this does not mean they are immune to the disease. Some may be infected whilst many are affected by the HIV epidemic in a number of ways. Many elderly people in the developing countries provide care giving to the infected ill young adults. Studies have identified that the majority of females shoulder this burden of the care giving more than the male counterparts. This is coupled with some risk factors such as cultural gender biases, little education, living in rural and poor households with little or no resources or assets.
Research has shown a relationship between AIDS mortality rate and a proportion of the elderly people living alone due to AIDS related deaths. AIDS mortality is closely associated with changes in the living conditions of the elderly people. There are those living without prime age adults; increased number of those living by themselves with children aged 10 years and decreased prime age adults living together with elderly individuals in the same household.
Effects of HIV/AIDS of the elderly
The HIV epidemic has negative impact on the elderly. The elderly either stayed with the people with HIV and AIDS (PHA) or are called to provide care to them when they are ill. They provide strenuous care giving services. Many parents reported levels of unhappiness than three ago before the death of their children who died of AIDS related diseases. Many experience anxiety, insomnia, fatigue, muscle strain, headache and stomach aches during the time they cared for their ill children (J.Kespichayawattana et al., 2002).
Most elderly parents who stayed with their ill adult children reported that the care giving tasks included preparing food, feeding, bathing, dressing them, cleaning, helping with toilet, giving medicines, lifting and moving were most problematic, Both the Thailand and South African studies cited emotional strain and negative reaction from the community. Mothers were more likely to experience the negative outcomes than fathers. Research shows that PHA move back home when they are very sick or parents are called to move in with them when their condition worsened. There are thus links between AIDS migration and residential morbidity (J.Knodel et al., 2003).
The elders in the developing countries face concerns about ill health care, social and security and old age care. Over and above this, they face consequences of high levels of prime aged adult morbidity and mortality. This affects the support they receive and contribution they have to make to their families. Chatz in his study cites South Africa as a country with high unemployment, non marital births that are often left with maternal grand parents and the elderly are overburdened with sick children as well fostered and orphaned young children. The elderly women contribute to their families through financial, emotional and physical means which often become a continuations of duties provided to their children when they were growing up and now have to take it up again. As care givers the elderly experience emotional, financial stress, deterioration of health, increased loneliness and isolation due to family structure and stigma from the community. They are often left with debts from the illnesses.
Conclusion
The elderly need support networks from the immediate and distant family, community support groups, and health facilities, social services, and religious organizations, traditional and political leaders. Educational and support including opportunity for discussing the fears and questions will be useful. The local health professionals should identify and treat the elderly who do not recover from physical and mental strain. Management of pain, sleep, anxiety and other forms of palliative care could alleviate suffering and the feeling of helplessness for both the elderly care givers and the PHA (J.Kespichayawattana et al., 2002).
Coverage: South Africa.
Sponsor: World Health Organization.