Experiences of Familial and Non-Familial Caregivers of Older Adults in Remote Rural Tanzania

Abstract

Older adults have traditionally been cared for by familial caregivers, but urbanization and HIV/AIDs has shifted their reliance to non-familial caregiving, especially in Sub-Saharan Africa (SSA). This shift has created diverse caregiving ‘networks’ comprised of close and distant family members, neighbors, friends and volunteers. In SSA, familial and non-familial caregiving have been explored separately in the literature, but there is little evidence examining networks comprised of both familial and non-familial caregivers of older adults. This study explores the experiences of familial and non-familial caregivers of older adults in rural remote Tanzania. Using a qualitative descriptive design, semi-structured interviews were conducted with familial (n=5) and non-familial (n=5) caregivers for older adults in two villages. The data was analyzed using thematic analysis and revealed three themes: dual pressures experienced by caregivers, contrasting facets of caregiving, and the caregiving safety net. All caregivers experienced a dilemma between the obligation to provide care and personal resource limitations, but the result of these two pressures differed between networks. Trust and team stability were stronger facets of familial caregiving. In all caregiving contexts a ‘safety net’ was formed, which was founded in an organized caregiving system and strengthened by mobile communication and access to health resources. Older adults living without familial caregivers were vulnerable to weak safety nets, thereby ‘falling through the cracks’ and missing necessary care. Recommended implications of these findings include mobilizing local leadership to improve informal caregiving network coordination and improving resource allocation to support non-familial community caregivers.

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