Experiences and practices of caregiving for older persons living with dementia in African countries: A qualitative scoping review

Abstract

Background The increasing awareness and diagnosis of dementia in Africa necessitate documentation of caregiving practices to understand local patterns and improve the quality of care. Caregiving in African communities is rooted in informal-communal social organization. This scoping review analyses caregiver characteristics and experiences, and practices of caregiving for persons living with dementia in Africa. Methods A total of 152 references were retrieved, with 64 references obtained from PubMed, 85 from AJOL, and three from Scopus. Based on the relevance of titles, 83 references were further retained from PubMed (64), AJOL (16), and Scopus (3). A rapid review of abstracts was done in Distiller SR, and finally, six relevant articles were content-analyzed using Atlas ti 8.4 qualitative analysis software. Results All six included studies were published between 2003 and 2018. Four themes were identified: article characteristics, caregiver characteristics, caregiver in context, and caregiver potentialities (challenges and opportunities). Studies reported findings from research conducted in four African countries: three from Nigeria, and one each from South Africa, Egypt, and Tanzania. Caregivers of persons living with dementia typically had eight years or less of formal education, were unpaid, and spent a daily average of 13 hours in caregiving. Cultural thresholds and individual caregiver differences underlie the interpretation of stressors across cultures. Caregivers lack the right training and information as well as support systems to improve their role performance and reduce accumulated stress. Conclusion In African countries, informational and educational platforms are essential for improved individual dementia caregiving, vis-à-vis strengthened roles of governments, and religious/traditional leaders and organizations.

Cognitive performance, burden and stress in aged caregivers of older adults with and without cognitive impairment

“…There were differences between the groups referring to age, schooling and care hours, with the CI group being older, with lower schooling mean, and more time devoted to care. The sociodemographic characteristics of the aged caregivers are similar to those observed in the national and international studies 28,29 .…”

Patient and caregiver experiences of living with dementia in Tanzania

“…Suggestions for public health education, using a range of media platforms, to tackle these misconceptions and help the many unknowingly affected (with support from government schemes) reinforces previous findings (Adedeji et al, 2022;Larweh, 2021;Oliver, 2020). However, with only 40% of the population accessing electricity (The World Bank, 2022a), suggestions for radio and television announcements may not be able to reach all those affected.…”

“…Caregivers took away responsibilities from people with dementia, showing "malignant social psychology" where people with dementia are devalued (Kitwood, 2002), reinforcing ageist attitudes and potentially predisposing to poor outcomes, as described previously (Paddick et al, 2013). Caregivers consequently felt overwhelmed, lacking knowledge and skills in how to care for people with dementia as previously seen (Adedeji et al, 2022), unlike support existing in HICs (Clarke et al, 2013;Lopez-Hartmann et al, 2012). This may have predisposed caregivers to social isolation, as described by Brodaty and Luscombe (Brodaty & Luscombe, 1998).…”

COVID-19 experiences of social isolation and loneliness among older adults in Africa: a scoping review

“…Ideally, to stay socially connected and receive adequate support, older adults need to be embedded in supportive social networks. However, in Africa, geriatric care relies heavily on kinship systems ( 3 , 6 ). At the same time, formal service approaches tend to be weak or non-existent because of a lack of funding and political will ( 7 ).…”