Older adults' experiences of formal community-based care services in Sebokeng : implications for long-term care management
Rankin, Susanna Maryna
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South Africa’s older population is faced by far-reaching implications for long-term care. Informal long-term care is increasingly becoming less efficient in providing in their care needs. Families are rendered unable to care for their older family members by issues such as poverty, migration of younger adults, and HIV/AIDS. Non-communicable conditions such as diabetes and hypertension require life-long management and add to the financial strain families experience in providing long-term care for their older relatives. Residential care as formal long-term care option is not a viable solution either, as it is inaccessible to the majority of the older population. Formal long-term community care as a third option is advocated by South African policies and scholars alike. Even though formal long-term community care is perceived as a solution, studies show that community-based care poses some major challenges. There is, however, a gap in research, especially in South African literature, as to older adults’ grounded experiences of the current formal day care and home-based care services. The study undertook a grounded exploration of older adults’ experiences of current formal community-based care services in Sebokeng. This exploration aimed at addressing the gap between the ideal of formal community-care systems and delivery, and its effective implementation in practice. The secondary aim was to ascertain what the older adults from this group perceived as good care. The study was conducted using the interpretive descriptive design with an ethics of care approach as heuristic framework. In-depth interviews provided rich, descriptive data, which was then analysed using thematic analysis. The research sample consisted of 10 older adults making use of community day care services and 10 using community home-based care. Participants were between the ages of 63 and 85 and the group consisted of 15 women and 5 men. Findings showed that this group of older adults experience existing formal community-based care as fragmented and inadequate in meeting their care needs. Older adults address this care deficiency by making use of other forms of care such as informal care provided by family, friends or neighbours, and care from other community institutions (such as churches). Findings on what older adults regard as good care showed that there are four care principles to good care: access to resources, infrastructure and good care; attentiveness and responsiveness; companionship, and dignity. These four principles broadly correspond with the conceptualisation of good care in the ethics of care approaches. The study concluded that long-term care for older adults should be provided and managed by government in partnership with communities (in support of family/informal care). For long-term programmes to provide good care, an ethics of care approach could be used to ensure that the needs of older adults are adequately and wholly met in a relational and situational manner.
- Health Sciences