Effective Relationships Between Younger Caregivers and Older Care Recipients Across a Continuum of Formal Residential Care Settings: A Scoping Review and a Critical Analysis.

Objective: This article aims to conduct a scoping review of what constitutes effective relational interactions between caregivers (CGs) and older persons (OPs) across formal residential care settings. Methods: A scoping review of publications between January 2000 and December 2021 yielded 10,929 articles, and after removing duplicates and applying exclusion criteria, 36 articles were analysed. Results: Articles were scrutinised for interactions involving both CGs and OPs, using a thematic framework analysis to identify effective relational constructs. Four themes emerged: 1) Diverse perspectives on the same context: for OPs it is home, and for CGs, workplace. 2) CGs move for a one-up position and OPs submit to a one-down, or as friends. 3) Relational qualities have been mostly associated with CGs, confirming care as a unidirectional action 4). Relationships between CGs and OPs result either in effective or ineffective care outcomes. Conclusion: The dual meanings attached to the same context limit the authentic interactions between CGs and OPs. We propose a relational caregiving approach by considering the interactions of both CGs and OPs, changing the relational definition, and demonstrating effective relational qualities.

Individual and Community-Contextual Level Factors Associated With Wellbeing Among Older Adults in Rural Zambia.

Objective: This article aims to identify individual and community-contextual level factors associated with the wellbeing of older adults (50 years and older) in rural Zambia. Methods: Data from the nationally representative 2015 Living Conditions Monitoring Survey (LCMS) was used. Employing multilevel mixed effects, the individual and community-contextual factors on wellbeing were determined. Results: Overall, 31.7% of rural older adults perceived their wellbeing as good. Both individual and community-contextual level factors are associated with the wellbeing of older adults in rural communities. At the individual level, wellbeing was associated with higher education attainment. Community-contextual factors significantly associated with wellbeing included improved housing, access to piped tap water within the premises, own charcoal or income to purchase firewood. Conclusion: The findings foreground the imperative to analyse both individual and community-contextual level factors of wellbeing to generate and present evidence for investments in education across the life course and for the development of infrastructure towards increasing the wellbeing of rural older adults. Additionally, the results provide a basis for planning by devising policies and programmes for older people to thrive and for no one to be left behind regardless the setting.

Loneliness of older black South African women subjected to forcible relocation.

Background: A cohort of older black South African women, forcibly relocated during apartheid, has grown old in these places. Even after 50 years, residents in a rural township expressed no connection to place and ruptured intergenerational relations. Their sense of community was based almost exclusively on their links with others who shared their history of relocation. Objective: This article seeks to understand loneliness of a group of older women who have been rendered vulnerable by longstanding exclusion from community, services and material resources. We use loneliness as a metric for exclusion from social relations. Methods: Sixteen Setswana-speaking women in Ikageng, a township in North West Province of South Africa (age 61-73), participated in the Mmogo-method® and open-ended interviews. Textual data were analyzed using thematic analysis, visual data analysis of elements and symbolic representations of loneliness. Results: Loneliness is a powerfully unpleasant experience of not being able to interact with other people in general, or more specifically as a result of the loss of particular people (including spouses, parents and children) and isolation provoked by the impact of relational interactions and group dynamics. Loneliness was mitigated by socializing and gathering for traditional activities, performing spiritual rituals, and keeping busy individually or with others, thus reinforcing a core theme that any social interaction alleviates loneliness. Conclusions: Even though loneliness is powerfully unpleasant, it is an expression of the importance of social interactions formed in a particular context. In the face of longstanding societal exclusion and disconnection from community, social connections are central to identity and to survival.

Intergenerational Care Perceptions of Older Women and Middle Adolescents in a Resource-Constrained Community in South Africa.

This study describes intergenerational care perceptions in a resource-challenged community. Ten women (aged 60+) and eight middle adolescents (3 boys and 5 girls) participated in the Mmogo-method®, a visual data-collection method. Textual data were analysed thematically, and visual data by applying Roos and Redelinghuys (2016) proposed steps. Both groups provided physical and instrumental care to the other. Older women cared for adolescents by teaching and disciplining them, while the adolescents cared for them by obtaining an education and by showing respect. Older women felt being cared for when adolescents helped them, obeyed and complied with instructions and discipline, while the youngsters expressed it when their basic needs were addressed and school attendance was enabled. Older women's expressions of caring about were vague, while the younger people detected, act and elicited reactions from the elders. The adopted care approach informed care perceptions. Joint intergenerational activities are proposed to discover care currencies and contributions of generational members.

A partial validation of the WHOQOL-OLD in a sample of older people in South Africa.

BACKGROUND: This paper describes the psychometric properties of the WHOQOL-OLD, an add-on module to the World Health Organization's Quality of Life measure for older people in a South African sample. The WHOQOL-OLD module was further condensed into three short versions which contain the best items of the original module. The psychometric properties associated with the three short versions of the WHOQOL-OLD are also described. METHOD: Data were collected from Afrikaans-speaking older people (n=176) residing in long-term care facilities in Potchefstroom, situated in the North-West province of South Africa. The mean age of participants was 77 years (SD=8.1). Fifty participants were males and 126 were females. All reported average-to-good health and cognitive ability. RESULTS: The current study found encouraging results related to the original factor structure of the WHOQOL-OLD as well as the three short versions of this instrument. Results stemming from the data of the current sample seem to be a good fit with the original factor structure of the WHOQOL-OLD. The reliabilities associated with the various sub-dimensions point to a reliable instrument. CONCLUSIONS: The WHOQOL-OLD with its 24 items or any of the three short versions of this instrument can, therefore, be utilised in a South African context (Version 3 of the short versions seems to be the better fitting version).

(Re)creating community: Experiences of Older Women Forcibly Relocated During Apartheid.

This article explores sense of community with a group of older African women, who were forcibly relocated during apartheid. The situation of a marginalised group, with a history of disconnection from younger generations and from place, provides an opportunity to consider the relevance of community in later life. The research was conducted at a day centre for older people in the North West Province of South Africa, more than 50 years after forced relocations took place. Eleven older women (70 years and older) participated. Qualitative data were obtained through visual research methods and group discussions and were thematically analysed. Findings were that place and sense of belonging as well as elements of community were relevant. Participants reported limited connections to place in either childhood or current communities. Post relocation, a sense of belonging was expressed only in relation to a shared-interest community of peers that addressed their needs for safety, emotional support and instrumental care. Also, generational relations were strained, giving rise to a sense of loss of a community where both young and old were responsible for each other. Constrained resource communities have a profound impact on opportunities to create a sense of belonging. © 2013 The Authors. Journal of Community & Applied Social Psychology published by John Wiley & Sons Ltd.

The role of context and the interpersonal experience of loneliness among older people in a residential care facility.

Older people are more prone to experience loneliness when living in residential care facilities. The purpose of this study was to explore older people's experiences of loneliness in the context of institutionalized care. A voluntary and convenience-based sample of 10 white South African older people (age range 62 to 82 years; three men and seven women) was drawn. Data on the subjective experience of loneliness were then gathered through the Mmogo-method, whereby drawings were employed to explore matters and issues of importance in the lives of older people that could be used to deal with loneliness. Data were analyzed thematically and visually as well as through the use of keywords in context. The results showed that older people experienced loneliness in terms of having unavailable interactions due to loss, and an absence of meaningful interpersonal interactions. Meaningful interpersonal interactions were described as when the older people had regular contact and a variety of interactions. Ineffective interpersonal styles (e.g. taking a controlling position in relationships and being rigid) elicited rejection and isolation, and were associated with a lack of confirmatory interpersonal relationships. It is recommended that greater emphasis should be placed on creating awareness of unhealthy group dynamics as well as on psychosocial interventions to develop group support. Interpersonal styles, either effective or ineffective, take place in a social context, which, in this research, was observed to be unsafe, lacking in care, and a non-stimulating environment.