[From Editorial] Four of the five articles in this issue either deal explicitly with or refer to the effects of the AIDS epidemics in the authors' countries. The fifth paper deals with late-life chronic diseases of life-style. In the first paper, Akinsola examines effects of the epidemic on older Batswana and evaluates the effectiveness of his country's Community Home-Based Care programme against the programme's objectives, with special reference to the situation of older persons as primary caregivers to PWAs and AIDS orphans. He concludes that the situation of older carers calls for strong and urgent policy action to assist this highly vulnerable and marginalized group in its critical and valuable role and function as carers. In her paper on the provision of housing and care for older persons in Zambia, Sichingabula considers implications of the anticipated increases in AIDS morbidity and mortality, in the form of an increased demand for formal housing and care by older Zambians in the face of diminished traditional support. Given effects of the country's Structural Adjustment Programme and the Zambian government's inability to expand provision of formal support for the older population, the author makes recommendations for initiatives which NGOs can undertake towards meeting the needs and improving the quality of life of older persons. Next, Shaibu examines the experiences of caregivers to older persons in Botswana within a context of pervasive, abject poverty and multiple, unmet basic needs. The author notes how the HIV I AIDS epidemic, in addition to other social forces, impacts family structures and the capacity of Batswana to care for older relatives. In their paper, authors Patel, Steyn, Charlton, Bourne, Laubscher, Fourie and Jooste describe the risk-factor profile for chronic diseases of life-style, such as hypertension, hypercholesterolaemia and obesity, in the older black population of Cape Town and compare it with risk profiles in other South African ethnic groups. The authors note that although the study population is still at low risk of cardiovascular disease - for example, demographic changes, including urbanisation and the adoption of urban life-styles, are likely to lead to an increase in chronic morbidity in future older cohorts in this population. In a second paper, Sichingabula assesses the physical and social environment of Divine Providence Home, a residential care facility for destitute older persons in Lusaka, Zambia. She draws practitioners' attention to the prudence of incorporating design features in facilities built for older persons which enhance the users' mobility, independence and quality of life. She also highlights a lack of social stimulation and the inactivity of the residents at the home. The author makes the point that given an anticipated increased demand for admission to residential care facilities as a result of AIDS-related deaths and loss of traditional support for older persons, living environments in these facilities must be optimized. In sum, the AIDS-related research papers in this number highlight a need to identify and to strengthen social and care systems which can assist older persons in Africa, as traditional systems are increasingly affected by demographic forces, particularly the effects of the HIV/AIDS epidemics. Finally, Moller reviews a recent, landmark Help Age International report (1999), which is a compilation of 15 papers on ageing in developing countries and challenges facing research, policy and practice.

[From Editorial] In this special issue of SAJG, an attempt is made to demonstrate how a selection of studies were conducted and how the research outcomes have been translated into action. Heslop, Agyarko, Adjetey-Sorsey and Mapetla give us a paper in which they have evaluated the methodology used in studies in Ghana and South Africa to determine the contributions of older people. After long periods of implementation and learning, this participatory-research methodology has become synonymous with HAl's research work. The authors take us through the methodology, describe the studies carried out in the two countries, and provide us with a vivid picture of not only the problems which older people in the countries face, but also the immense contribution which they make to the well-being of other people. The impact which this work has had in both countries is notable. Older participants in the studies have taken it upon themselves to advocate their rights, and the governments in the two countries have started to put measures in place to address some of the problems identified in the studies. The paper by Van Vuuren and Groenewald examines the pattern of expenditure of pension income by black pension beneficiaries in the Free State Province of South Africa, against a backdrop of these persons' living circumstances. It goes into detail about issues regarding the payment of pensions, pension sharing within households and expenditure of pension money on specific items, and challenges allegations that pensioners are frequently robbed of their pension money and that they lose this income to loan sharks. Some of the findings of this paper contrast with the findings of the HAl studies conducted with partners in the Northem, Gauteng and Kwazulu-Natal provinces of South Africa (see the first paper in this issue by Heslop and colleagues). In their paper, Kowal, Wolfson and Dowd point out that there is a dearth of empirical and credible data on older people in Africa. Although some research has been conducted on this population, the authors note that by and large the available data derive from small samples, are scattered, and have neither been widely disseminated nor shared. The authors further note a lack of common approaches to data collection. Realising these gaps, the World Health Organisation arranged a workshop in Harare, Zimbabwe in January 2000, to begin a process to develop a minimum data set (MDS) for use by researchers in Africa. An overall aim of the MDS project is to provide data to influence policy and decision makers in various areas which affect older persons. / Needs-driven research on nutrition and ageing, carried out by HAl in collaboration with the London School of Hygiene and Tropical Medicine, is reported by Busolo, Ismail and Peachey in their paper. Nutrition and ageing in developing countries is an area which bas received scant attention. The nutritional requirements of older persons in these countries have not only been inadequately investigated but as a result, nutrition practitioners in various settings simply shoot in the dark. The authors take us down the path which the research took, from bow the needs were identified, to how the research was conducted, to how an intervention programme was set up. They give us some key findings of the research, describe the dissemination process and the application of the findings, and suggest a way forward. An Africa-wide programme currently being implemented as a direct result of this work is aimed at providing knowledge and information on the nutritional requirements of older people to key nutrition institutes, older people's organisations, N GOs (particularly those working in emergency situations), donors and governments. HelpAge International earlier conducted research in the Magu district of Tanzania on the plight of older women who are victimised on suspicion of their being witches (cf. Forrester Kibuga, 1999). Forrester Kibuga and Dianga now draw on this work in their paper. The authors take us through facts pertaining to the witchcraft-related killings, some of the problems which older people in the district face, the changing roles of older people in that area, beliefs and customs of the communities, and the stance of the government and the church on witchcraft. The dynamics of gender issues are also discussed. Following on this research, HAl designed and is now implementing a programme aimed at addressing some of the factors which lead up to these killings and developing sustainable structures to protect older people from violence. In his paper, Gorman draws on the work of HAl in various parts of the world, particularly in Africa - including Tanzania, Ghana, South Africa and Kenya. He argues that violence against older women and men in Africa cannot be attributed to a single, straight-forward problem but must be understood within a complex web that touches on history, family structures, and social and economic factors. He makes practical suggestions on what needs to be done to deal with the problem of violence. HelpAge International will soon be implementing an Africa-wide programme as a response to some of the issues which have been raised in its research on violence. While there is a clear need for more research on ageing in Africa, the research should not be done in a vacuum. There is a simultaneous need for greater collaboration and sharing of research results, and perhaps most importantly, for more action based on research outcomes. At the end of the day researchers should never forget that they have an ethical commitment to their subjects, to society and to their colleagues. / Thanks are due to Karen Peachey and Alex Dianga in the HAl Africa Regional Development Centre for the co-ordination of this special issue. Special thanks are due to Monica Ferreira for dedicating the issue to the experience and work of HAl, and for her commitment to addressing issues pertaining to ageing in Africa. She has worked tirelessly to ensure the success of not only this issue of SAJG but of previous issues as well. I have found her a pillar of support and a pleasure to work with. Tavengwa M. Nhongo.

The world population is ageing, and this is also relevant to South Africa. At the same time the potential support ratio (the number of persons aged 15 to 64 years per one older person aged 65 years or older) is falling, and the dependency burden on potential workers increases. To alleviate the financial burden on the aged, and their families, it has become necessary to develop a financial plan to cover the cost of frail care. The overall purpose of this research is to determine whether any financial plans exist which are relevant. If nothing existed, a plan had to be developed. The research methodology for this study comprised the following steps: Firstly, the demographics of the world and South Africa were researched. The concept of frail (long-term) care in the United States of America and New Zealand was investigated to determine what is available. The subsidisation concept of the South African Government towards caring for the elderly was also investigated. Secondly, a questionnaire was sent to the residents of five retirement complexes in George to determine their interest in such a plan. The records of the frail care unit that these residents utilise were analysed to determine the number of residents needing frail care. A comparative study of the cost of frail care in the Southern Cape was undertaken. Thirdly, two options to partly subsidise the cost of frail care were examined, where the first option covers the running cost, and the second option, subsidising one third of the frail care cost, builds up a sustainable fund after the first five year period. The funds of the second option can then be utilised in the subsequent years to increase the subsidisation portion of frail care cost. The final step of this study entailed the formulation of recommendations to implement the frail care nursing levy as soon as possible, with special attention given to the following: a) It must be compulsory for new residents to join the fund. b) A yearly capital amount of R100 000 or more is needed to sustain the fund. c) A contract must be drafted to set out all the rules and regulations to the residents. d) An attitude change amongst some residents is required. Individuals must realise that the success of this plan depends upon themselves and with the necessary support could make a significant contribution towards their own peace of mind if and when frail care is needed.

M.A. (Social Work) / Relevant literature clearly indicates a steady increase in not only the number of aged persons but also the demented population. Consequently it has become imperative that the nursing staff responsible for the day - and night care of demented patients in a residential setting, acquire appropriate knowledge of dementation as such, and clarity on their roles in an endeavour to decelerate the dementation process. They, furthermore, need to be aware of the special needs of demented aged persons --needs which call for particular professional skills. In this study the emphasis is on the development and evaluation of a group work programme for nurses in two homes for demented aged persons. The programme is based upon knowledge on dementation, and its contents are directed at a repertoire of skills which, when effectively practised, will serve as a support system to nurses. Researcher made use of an indirect measuring method: an experimental - and control group were established at two homes where direct observation was done in respect of the behaviour of the residents and the nature of nursing. A questionnaire was completed by the experimental - and control group, prior to and following on the provision of a group work programme. The target universe consisted of fifteen nurses at two homes for demented aged persons. Nine and six members of the nursing staff were respectively connected to the experimental - and control groups. The experimental group attended nine sessions which incorporated the mediating - goal model designed by Papell and Rothman (in du Preez 1979:73)...

Text in Afrikaans / Verpleegktmdiges het 'n etiese en professionele verantwoordelikheid om elke bej aarde se reg op selfbeskikking te erken, bulle in die uitvoering daarvan te ondersteun en op volgehoue basis te ontwikkel met die oog op die bereiking van die hoogste moontlike vlak van onafhanklikheid in die daaglikse lewe. Die doel van hierdie studie was om die mate te bepaal waarin professionele verpleegkundiges werksaam in geregistreerde, gesubsidieerde tehuise vrr bejaardes in die Pretoria-omgewing hierdie verantwoordelikl1eid uitleef Ontleding van die data, wat deur 'n vraelys ingewin is, dui daarop dat verpleegktmdiges sonder twyfel die bejaarde se reg op selfaktualisering erken. V erpleegkundiges ervaar egter onsekerheid oor die praktiese wyse van selfsorgondersteuning sowel as die wenslik11eid van gesondheidsbevordering by die gelnstitusionaliseerde bejaarde. Ten einde die sinvoll1eid van die gelnstitusionaliseerde bejaarde se bestaan te verseker, sentreer die belangrikste aanbevelings in hierdie studie rondom die voorsiening van opleidingsprogramme aan gerontologiese verpleegktmdiges asook gesondheidsvoorligting aan die bejaarde self / Nurses have an ethical and a professional responsibility to acknowledge the elderly's right to self-determination, to support them in this regard and to ensure ongoing development so that they may attain the highest possible level of independence in their daily life. The purpose of tllis study was to determine to what extent nurses working in registered, subsidized homes for the aged in the Pretoria area live up to tllis responsibility. Analysis of tl1e data, obtained by questimmaire, has clearly shown that nurses acknowledge the right of the elderly to self-actualization, but they feel uncertain about the practical ilnplementation of self-care support and tl1e desirability of promotil1g health amongst the il1stitutionalized aged. In order to ensure that tl1e institutionalized aged person leads a meanil1gfullife, the mail1 recommendations of tllis study centre on providil1g educational progrmes for gerontological nurses as well as health education for the elderly. / Health Studies / M.A. (Nursing)

Thesis (PhD)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: This study is a pastoral care strategy for the affirmation of the dignity of the poor Black older persons. In this study there is a discussion of how the poor Black older persons suffered the defacement of their dignity under Apartheid and how to a large extent their dignity is still being defaced under the new democratic dispensation in South Africa. These poor Black older persons are victims of various forms of older person abuse. They experience the prejudice of ageism intensely as it is exacerbated by racism; and with no appropriate medical and health strategies in place to provide quality health care; and with inappropriate housing, social services, and residential care services, their dignity is denied. Due to past discriminatory laws and policies these vulnerable older persons suffer the consequences of low levels of formal education within an environment of engineered poverty and racial discrimination which made it impossible for them to enter into quality employment which would enable them to provide adequately for old age. The deprivation thus experienced made it difficult for them to flourish economically and otherwise. At present they are still marginalised and they experience intense forms of loneliness. These poor Black older persons continue to suffer humiliation and indignity in spite of legislation and policies purporting to ensure their well-being. Within a society embracing a neo-liberalist philosophy they are considered unimportant as they do not contribute productively to the economic well-being of the community and are therefore relegated to the lowest ranks of society. With the effacement of their dignity through socially constructed systems their human development is seriously hampered, resulting in a disintegration of human wholeness. The inequality that the poor Black older persons suffer is an indictment against humanity as these older persons have the right to feel at home on the planet. Due to the fact that they are not recognised as having been created in the image and likeness of God, their uniqueness and distinctness as human beings are denied, their identities distorted, and they are not considered worthy citizens. In order to affirm the dignity of the poor Black older persons a practical theological methodology as proposed by Osmer (2008) and consisting of four tasks, has been employed. The notion of a moral economy for the affirmation of the dignity of these poor Black older persons has been utilised. With the moral economy orientation linked with a Liberation Theology methodology the dignity of the poor Black older persons is affirmed as a personal attribute based on the older persons being a category of people being carried into old age by God, enjoying privileged positions of honour and respect, and being eschatological signs and symbols of God’s goodwill towards restored communities in Christ. Within a moral economy the values of reciprocity, responsibility, and interdependence are used to affirm the dignity of these older persons intergenerationally and contextually. / AFRIKAANSE OPSOMMING: Hierdie studie is ʼn pastorale sorg strategie vir die bevestiging van die menswaardigheid van die arm Swart ouer persone. In hierdie studie word daar aangedui hoe die arm Swart ouer persone se menswaardigheid onder Apartheid en in ‘n groot mate in die nuwe demokratiese dispensasie geskend is. Die arm Swart ouer persone het die slagoffers geword van verskeie vorms van misbruik. Die diskriminasie teen ouderdom word intensief deur hulle ervaar soos dit vererger word deur rassisme; en met geen behoorlike mediese en gesondheidstrategieë in plek om in die behoefte van hierdie kwesbare ouer persone te voorsien nie; en met gebrekkige behuising, sosiale dienste en onvoldoende plekke van sorg vir ouer mense, is die menswaardigheid van hierdie ouer mense erg misken. Weens historiese diskriminerende wette en regeringbeleid ly hierdie kwesbare ouer persone die gevolge van lae vlakke van formele opvoeding binne ‘n omgewing waar armoede kunsmatig geskep is en waar rassediskriminasie geheers het. Hierdie omstandighede het dit vir hulle onmoontlik gemaak om kwaliteit werk te kry wat hulle in staat sou stel om toepaslik vir die ouderdom voor te berei. Die ontberinge wat gevolglik gely word, maak hulle ekonomiese en andersydse ontwikkeling onmoontlik. Hulle is gemarginaliseerd en ly aan intense eensaamheid. Hierdie arm Swart ouer persone gaan voort om vernedering en onmenswaardighede te ly ongeag van wetgewing en beleidstukke bedoel vir hul welsyn. Binne die gemeenskap wat ‘n neoliberalisties filosofie aanvaar, word hierdie ouer mense misken omdat hulle nie produktief tot die ekonomiese welvaart van die gemeenskap bydra nie, en daarom word hulle beskou as sonder enige sosiale kapitaal wat hulle dan sosio-ekonomies op die laagste vlak van die gemeenskap sonder enige erkenning van hulle menswaarde en menswaardigheid plaas. Met die skending van hul menswaardigheid deur sosiaal gekonstrueerde sisteme word hul menslike opbloei ernstig gestrem wat lei tot die disintegrasie van menslike heelheid binne die demokratiese bestel van die Republiek van Suid- Afrika. Die ongelykheid wat die arm Swart ouer mense ly is ‘n klag teen die mensdom omdat hierdie ouer mense ontuis voel op die planeet. Hierdie groep is na die beeld van God geskape, maar hulle uniekheid en besondersheid word miskien. Om die menswaardigheid van hierdie arm Swart ouer mense na te gaan, is ’n praktiese teologiese metodologie gebruik soos voorgestel deur Osmer (2008) en word die vier teologiese take soos deur hierdie metodologie voorgestel, gevolg. Betreffende die vierde taak van hierdie metodologie is die konsep van ’n morele ekonomie gebruik vir die bevestiging van die menswaardigheid van die arm Swart ouer persone. Met die skakel van hierdie morele ekonomiese oriёntering met die Bevrydingsteologiese metodologie is die menswaardigheid van die arm Swart ouer persone bevestig as ’n persoonlike eienskap gebaseer of die feit dat hulle ’n kategorie van mense is wat deur God in die ouderdom gedra word, wat dan bevoorregte posisies van eer en respek geniet as eskatologiese tekens en simbole van God se toegeneëntheid teenoor herstelde gemeenskappe in Christus. Binne ’n morele ekonomie word die waardes van wedersydsheid, verantwoordelikheid, en interafhanklikheid gebruik om die menswaardigheid van hierdie ouer mense intergenerasioneel en kontekstueel te bevestig.

Text in Afrikaans / Verpleegktmdiges het 'n etiese en professionele verantwoordelikheid om elke bej aarde se reg op selfbeskikking te erken, bulle in die uitvoering daarvan te ondersteun en op volgehoue basis te ontwikkel met die oog op die bereiking van die hoogste moontlike vlak van onafhanklikheid in die daaglikse lewe. Die doel van hierdie studie was om die mate te bepaal waarin professionele verpleegkundiges werksaam in geregistreerde, gesubsidieerde tehuise vrr bejaardes in die Pretoria-omgewing hierdie verantwoordelikl1eid uitleef Ontleding van die data, wat deur 'n vraelys ingewin is, dui daarop dat verpleegktmdiges sonder twyfel die bejaarde se reg op selfaktualisering erken. V erpleegkundiges ervaar egter onsekerheid oor die praktiese wyse van selfsorgondersteuning sowel as die wenslik11eid van gesondheidsbevordering by die gelnstitusionaliseerde bejaarde. Ten einde die sinvoll1eid van die gelnstitusionaliseerde bejaarde se bestaan te verseker, sentreer die belangrikste aanbevelings in hierdie studie rondom die voorsiening van opleidingsprogramme aan gerontologiese verpleegktmdiges asook gesondheidsvoorligting aan die bejaarde self / Nurses have an ethical and a professional responsibility to acknowledge the elderly's right to self-determination, to support them in this regard and to ensure ongoing development so that they may attain the highest possible level of independence in their daily life. The purpose of tllis study was to determine to what extent nurses working in registered, subsidized homes for the aged in the Pretoria area live up to tllis responsibility. Analysis of tl1e data, obtained by questimmaire, has clearly shown that nurses acknowledge the right of the elderly to self-actualization, but they feel uncertain about the practical ilnplementation of self-care support and tl1e desirability of promotil1g health amongst the il1stitutionalized aged. In order to ensure that tl1e institutionalized aged person leads a meanil1gfullife, the mail1 recommendations of tllis study centre on providil1g educational progrmes for gerontological nurses as well as health education for the elderly. / Health Studies / M.A. (Nursing)

In South Africa prior to 1994, community-based care and support services were established for whites only. The majority of older African (black) persons received informal support from their adult children and relatives. This has waned over the years due to the social and economic changes that have put into doubt the continued viability of such support. The Older Persons Act of 2006 requires social workers to establish community-based care and support services for older persons. Hence, the study was conducted to understand the factors that influence social workers in establishing CBCSS for older persons in Bloemfontein in the Free State Province. A qualitative research method was undertaken to accomplish the goal of the study. Purposive and snowball sampling techniques were used to identify suitable participants. Face-to-face semi-structured interviews were conducted with fifteen social workers who provide services to older persons. The data was analysed through Tesch’s (cited by Creswell, 2009:186) eight steps of qualitative analysis and data verification was conducted following Guba’s (Kreftling, 1991) model. The major finding is that there is a need for social workers to specialise in older persons programmes (gerontology). For the programmes to be a success, it is recommended that the Department of Social Development (DSD) strive to retain social workers who are knowledgeable and experienced in older persons programmes. / Social Work / M.A. (Social Science)

In South Africa prior to 1994, community-based care and support services were established for whites only. The majority of older African (black) persons received informal support from their adult children and relatives. This has waned over the years due to the social and economic changes that have put into doubt the continued viability of such support. The Older Persons Act of 2006 requires social workers to establish community-based care and support services for older persons. Hence, the study was conducted to understand the factors that influence social workers in establishing CBCSS for older persons in Bloemfontein in the Free State Province. A qualitative research method was undertaken to accomplish the goal of the study. Purposive and snowball sampling techniques were used to identify suitable participants. Face-to-face semi-structured interviews were conducted with fifteen social workers who provide services to older persons. The data was analysed through Tesch’s (cited by Creswell, 2009:186) eight steps of qualitative analysis and data verification was conducted following Guba’s (Kreftling, 1991) model. The major finding is that there is a need for social workers to specialise in older persons programmes (gerontology). For the programmes to be a success, it is recommended that the Department of Social Development (DSD) strive to retain social workers who are knowledgeable and experienced in older persons programmes. / Social Work / M.A. (Social Science)