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. 2015 Jan;35(1):169-202.
doi: 10.1017/S0144686X13000615. Epub 2013 Sep 4.

Who cares? Implications of care-giving and -receiving by HIV-infected or -affected older people on functional disability and emotional wellbeing

M Nyirenda  1 , M Evandrou  2 , P Mutevedzi  3 , V Hosegood  1 , J Falkingham  2 , M-L Newell  4
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Free PMC article

Who cares? Implications of care-giving and -receiving by HIV-infected or -affected older people on functional disability and emotional wellbeing

M Nyirenda et al. Ageing Soc. 2015 Jan.
Free PMC article

Abstract

This paper examines how care-giving to adults and/or children and care-receiving is associated with the health and wellbeing of older people aged 50+ in rural South Africa. Data used are from a cross-sectional survey adapted from World Health Organization's Study on Global Ageing and Adult Health (SAGE) conducted in 2009/10 in rural South Africa. Bivariate statistics and multivariate logistical regression were used to assess the relationship between care-giving and/or care-receiving with functional disability, quality of life or emotional wellbeing, and self-rated health status, adjusted for socio-demographic factors. Sixty-three per cent of 422 older people were care-givers to at least one young adult or child; 27 per cent of older people were care-givers due to HIV-related reasons in young adults; 84 per cent of participants were care-recipients mainly from adult children, grandchildren and spouse. In logistic regressions adjusting for sex, age, marital status, education, receipt of grants, household headship, household wealth and HIV status, care-giving was statistically significantly associated with good functional ability as measured by ability to perform activities of daily living. This relationship was stronger for older people providing care-giving to adults than to children. In contrast, care-givers were less likely to report good emotional wellbeing; again the relationship was stronger for care-givers to adults than children. Simultaneous care-giving and -receiving was likewise associated with good functional ability, but about a 47 per cent lower chance of good emotional wellbeing. Participants who were HIV-infected were more likely to be in better health but less likely to be receiving care than those who were HIV-affected. Our findings suggest a strong relationship between care-giving and poor emotional wellbeing via an economic or psychological stressor pathway. Interventions that improve older people's socio-economic circumstances and reduce financial hardship as well as those that provide social support would go some way towards mitigating this relationship.

Keywords: HIV-infected; South Africa; care-giving; emotional wellbeing; functional disability; older people; self-reported health.

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Figures

Figure 1.
Figure 1.
Odds of being in good health by health measure for older people giving care to adults, South Africa, 2010.
Figure 2.
Figure 2.
Odds of being in good health by health measure for older people giving care to children, South Africa, 2010.
Figure 3.
Figure 3.
Odds of being in good health by health measure for older people receiving care, rural South Africa, 2010.
See this image and copyright information in PMC

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