Hidden victims of HIV/AIDS : the impact of caregiving on elderly caregivers

Abstract

The HIV/AIDS pandemic in South Africa and the concomitant high mortality rate of the middle generation has resulted in an increased number of orphans and vulnerable children (DVCs). The responsibility of care for these children has fallen to the extended family, especially elderly females. This study aimed to explore the impact of caregiving on grandmothers caring for DVCs in two Western Cape townships, and to statistically determine predictors of caregiver burden. Participants (n = 57) were members of a community-based supportive organisation, were grandmother caregivers to at least one grandchild, and lived in a household that was impacted by HIVI AIDS. A quantitative questionnaire, consisting of socio-demographic questions, as well as open-ended questions on participants' experiences within the organisation and of caregiving, was individually administered in Xhosa. The Burden Interview (BI), a standardised scale, was used to measure the impact of caregiving on the grandmothers across five dimensions (health, finances, psychological well-being, social life, and relationships). Descriptive statistical analysis of the socio-demographic questionnaire showed that caregiving occurred in the context of poverty, HIV/AIDS, chronic illness, and multigenerational households. Thematic analysis of the open-ended questions revealed that participants benefited financially and emotionally and gained knowledge and skills through membership of the community organisation. However, caregiving was commonly described as emotionally and physically exhausting. This burden was exacerbated by the age and health status of both caregiver and care-recipient, and behavioural difficulties in the care-recipient. A stepwise multiple regression analysis yielded three factors as significant predictors of burden (Rl = .41): the number of children for which the participant was the primary caregiver; the number of chronically ill people in the household; and the need for assistance with caregiving responsibilities. The latter finding probably implies that those who are the most stressed are most likely to require assistance with care. The findings highlight the important contribution of the elderly in buffering the psychosocial impact of the HIV/AIDS pandemic, sometimes at the expense of their own wellbeing. Policy-makers should consider the unique challenges and contributions of the elderly in this regard.