Home-Based Care in Botswana: Experiences of Older Women and Young Girls

Abstract

In this exploratory and descriptive study we investigated the experiences of and impact on young girls and older women caring for family members living with HIV/AIDS and other chronic and terminal illnesses at home in three districts of Botswana. Using qualitative research methods, we conducted 70 interviews with family caregivers and key informants such as community home-based care (CHBC) team members and government officials. Older women reported feeling overwhelmed with the magnitude and multiplicity of tasks they had to perform. They reported feeling exhausted, malnourished, depressed, and often neglectful of their own health. Young girls often missed school and they were sexually and physically abused, sexually exploited, and depressed. In addition, these caregivers experienced poverty, social isolation, stigma, psychological distress, and a lack of basic caregiving education. We made recommendations to improve services and care to the CHBC teams and to the national government.

The psychosocial impact of caregiving on the family caregivers of chronically ill AIDS and/or HIV patients in home-based care: A qualitative study in Zimbabwe

“…23 Tiredness and psychosomatic complaints from the caregivers were common in this and other studies. 1,6,19 These included headache, abdominal pain, chest pain and anorexia.…”

“…1,7,22 In Botswana, 1 it was found that elderly caregivers did not use the care package they were provided with because they felt that using gloves would imply that they do not love the person in their care. In contrast, caregivers in a Namibian study 7 expressed anger at the risk they were exposed to.…”

“…9 Religious issues similar to those of the study were found in other papers. Fifty-seven per cent of AIDS caregivers in one study 1 found religion to be a comfort and felt that their faith in God had increased as a result of the illness, while 17% no longer went to church or worshipped at home because of caregiving commitments. Female caregivers in India went through the different stages of questioning God, anger towards Him and finally hope and belief in His compassion.…”

“…1,2,3,4,5,6 The overall results revealed that these caregivers suffer from significant psychosocial problems. The problems encountered included depression, anxiety, loneliness, anger, fear, stigmatisation and economic difficulties.…”

“…In a Botswana study, 1 older women complained of exhaustion because they were often caring for multiple family members. Their physical care for the ill patient as well as the general household chores like fetching firewood and water, cooking and cleaning resulted in neglect of their own health.…”