A journey without maps-Understanding the costs of caring for dependent older people in Nigeria, China, Mexico and Peru

作者:Mayston, Rosie*; Lloyd-Sherlock, Peter; Gallardo, Sara; Wang, Hong; Huang, Yueqin; Montes de Oca, Veronica; Ezeah, Peter; Guerra, Mariella; Luisa Sosa, Ana; Liu, Zhaourui; Uwakwe, Richard; Guerchet, Maelenn M.; Prince, Martin
来源:PLos One, 2017, 12(8): e0182360.
DOI:10.1371/journal.pone.0182360

摘要

Purpose of the study Populations in Latin America, Asia and sub-Saharan Africa are rapidly ageing. The extent to which traditional systems of family support and security can manage the care of increased numbers of older people with chronic health problems is unclear. Our aim was to explore the social and economic effects of caring for an older dependent person, including insight into pathways to economic vulnerability. Design & methods We carried out a series of household case studies across urban and rural sites in Peru, Mexico, China and Nigeria (n = 24), as part of a cross-sectional study, nested within the 10/66 Dementia Research Group cohort. Case studies consisted of in-depth narrative style interviews (n = 60) with multiple family members, including the older dependent person. Results Governments were largely uninvolved in the care and support of older dependent people, leaving families to negotiate a 'journey without maps'. Women were de facto caregivers but the traditional role of female relative as caregiver was beginning to be contested. Household composition was flexible and responsive to changing needs of multiple generations but family finances were stretched.