Sense of belonging in community-based care amongst South African older persons : a rapid review

Abstract

The global older population, including in South Africa, faces increases in their absolute numbers. Simultaneously, there is the likelihood of various diseases and disabilities, which highlights the need for the future provision of care for older people. While the Older Persons Act 13 of 2006 in South Africa advocates for community-based care for older people and their wellbeing, there are many challenges associated with this type of care. Community psychology emphasises a sense of community, which highlights mutual care and belonging. Considering the importance of belonging for wellbeing, this study aimed to explore how existing literature describes sense of belonging in relation to community-based care amongst South African older people. Developing an understanding of sense of belonging could be used to inform relevant and emerging decisions regarding the care of the older population. This study was conducted methodically by means of a rapid review, using particular associated keywords and a time range of January 2009 to June 2020 to obtain the data (existing literature). The search for existing literature entailed three strategies, namely the EBSCO Discovery Service, Google Scholar, and grey literature. The findings were obtained from 23 existing literature sources after rigorous processes of appraisal. Via thematic synthesis, three core themes were identified that contribute to a description of sense of belonging in relation to community-based care amongst South African older people. These themes are: (a) belonging as tangible and intangible inclusion, (b) belonging as contribution and expectations/reciprocity, and (c) belonging as intersectoral inclusion. The absence of available research on this topic is of concern in view of the growing older population in South Africa, health challenges and the growing need for long-term care. Furthermore, the relevance but seeming disregard of the older population in the field of community psychology contributes to the concerns. The themes suggest that belonging in relation to community-based care amongst South African older people may be described as the

mutual dependence of intangible and tangible inclusion, and the nature of interdependence. Finally, while belonging in the context of policies, guidelines, and frameworks emerged as intersectoral inclusion amongst a range of areas, there was a lack in addressing the explicit feature of a sense of belonging of older people. The sense of belonging descriptors found in this study highlight inclusion and appear to be similar to an existing, theoretical definition of sense of belonging. However, a pronounced finding in the reviewed South African literature was the nature of interdependence that emerged as a close indicator of a sense of belonging. Deductions and viewpoints based on the study findings are discussed on three levels (conceptual, methodological and practice/policy) in relation to academic, policy and practice literature. By virtue of this study being exploratory in nature, limitations and recommendations are put forward and highlight a great need for research to establish and refine relevant community-based care policies and initiatives. The findings originating from this study may be