This article highlights the challenges encountered by older persons as they age, the implications of Nigeria’s current socio-cultural realities on ageing and long-term care of older persons, and the potential challenges younger persons face in their desire to fulfil their obligations to their parents.
It also highlights some of the progress made so far and recommendations for future action and hopes that it will stir conversation on the need to evolve practical solutions to a problem that receives little or no attention from policymakers and society at large.
Years ago, an American colleague of mine casually mentioned to me that his aged mother lived in an old people’s home. With an indifferent voice, he proceeded to explain to me why that arrangement is the most convenient for all parties involved (all parties being, him, his wife, and mother). Several days after that conversation, I kept asking myself a simple question: “Why would a man abandon the care of a mother who has obviously sacrificed a lot if not everything to ensure he became the man he is- to strangers’. And no matter how much I tried at the time, I could not find a suitable justification for his action. I was sure that he also couldn’t understand why it was such a big deal to me.
My reasoning was not far-fetched. I grew up in a culture that considers it a blessing to be able to care for one’s aged parents. How do I explain to this American that in Nigeria, when a child takes care of their aged parents, it is considered a source of blessing? How do I explain that parents sacrificed a lot to ensure the wellbeing and success of their children with the hope that the children will pay back in kind when they (the parents) grow old? I realized quickly that there was no way he would understand that as Nigerians, “abandoning” aged parents in their time of need is tantamount to ‘using your own hand to do yourself’ and attracting negative repercussions, as we would say. We lived in different realities.
The reality I live in is such that our religious and cultural norms place priority on strong family ties and the obligation of a child to her/his parents as they age. Most people are acutely aware of the enormous sacrifices parents and in some cases, extended families made to ensure they reach their full potential in life. They are also aware of the expectation that it is their responsibility to care for the wellbeing of their parents when the parents age. So, the thought of placing one’s aged parents in an older person’s home to be looked after by strangers would feel at best, cold, insensitive, and callous in the eyes of many Nigerians, not to mention that many Nigerian parents would hardly agree to such arrangements.
On the other hand, for my American colleague, while he understands and appreciates that older persons (including his parents) must be cared for, his reality is completely different from mine. He lives in a system that allows him to care for his mother in a way that is “convenient for all parties”. He doesn’t have to (especially if he or his mother can afford it) carry the burden of expectation to be primarily responsible for his aged parents’ everyday care and he does not have such expectations of his own daughter. We both live in different contexts and our actions are guided by our socio-economic realities. Over time, I have come to the realisation that we are at a point where we need to embrace a new way of thinking about older persons’ care or wellbeing.
Facing the Reality of Ageing
The cycle of caring for aged parents worked well in the past, when social networks were stronger and unaffected by economic and social trends like unemployment, urbanisation and migration. Life was easier and less demanding and the socio-economic realities at the time supported the entrenchment of a strong close-knit family that can draw on its collective resources to cater for the needs of the family as a unit. So many factors such as poverty, unemployment, and urban migration contribute to making this way of living difficult today.
It is important to note here that I am by no means advocating that children should abandon their aged parents or completely outsource the care and responsibility to the government or professionals. In fact, I still believe that children have an obligation to take care of their parents in their old age. Especially because as people age, they become more dependent on others for their wellbeing, also, their need for a strong connection and acceptance within the community increases. But what happens when you are unable to provide adequate care for your aged parents even though you desire to? What happens when your parents, against all advice, refuse to move in with you and insist on living in their own houses in the village or in town? What happens when in spite of your best efforts, you can barely afford to care for your parents in the midst of your other obligations? This is the reality for many Nigerians, and it is the reality we must face. It is a reality that requires urgent attention to curb the rising cases of elder abuse and neglect.
I am yet to meet anyone in Nigeria who does not pray “to live long, eat the fruit of their labour and see their great grand-children”. This is a common prayer in Nigeria, so it is safe to say that everyone desires to live a long life. It is also safe to say that everyone expects to age when they live long enough. Fortunately, it seems that this prayer is being answered with a global increase in the number of older persons. A United Nations report (2019) showed that by 2050, one in six people would be above 60 years old. The United Nations explained that the size and age of the population are driven by a combination of fertility, mortality, and migration. Nigeria is currently experiencing higher fertility and reduced mortality, coupled with the increased migration rate of young working age due to economic factors.
Ageing is an inevitable process that occurs in all living beings, including humans. It involves a complex and continuous interplay of physiological, psychological, and sociological changes. I have heard it said that ageing starts from the day we are born. However, we only begin to see its implications later in life. These changes have far-reaching consequences, not just for individuals but also for families, local communities, and even global society.
The erosion of family and societal beliefs and systems also impacts the strength of social support for older persons and increases risk of neglect and abuse. The twin malaise of rural-urban migration and the increasing trend of overseas migration by younger adults in search of greener pastures worsens this situation for rural dwellers. In addition to these, ignorance about how to care for the mental and physical needs of the elderly as well as the general poor perception or understanding of dementia/Alzheimer’s compounds the challenges of ageing in Nigeria.
The need for a New Reality
Ageing is a spectrum, on one end of the spectrum are older persons who are healthy and economically secure with skills to contribute to economic development. On the other end of the spectrum are individuals who are dependent due to a number of factors further made worse by sociological trends like ageism, urbanization, migration, insurgency, poverty and humanitarian crisis. As persons age, there is an increased tendency for dependence especially for those with declining capacity for various reasons (chronic health challenges with disability such as vision loss, hearing loss and mobility constraints from disabling joint diseases). This dependence is worse still for those who are poor or have very little income or savings, live in rural areas or have no meaningful social support (no children or wards). Such individuals are at risk of psychological issues such as depression, anxiety, and social issues of neglect, abuse and loneliness. These all contribute to poor quality of life and suboptimal wellbeing.
A new reality will recognize both ends of the spectrum and distinguish between older persons who still have the capacity to live independently and contribute meaningfully to social and economic development and those who have limited capacity of have lost the capacity to live a healthy life on their own. A new reality will also recognize that increasing rural-urban migration also affects family members’ ability to provide care. Traditional family bonds are more likely to be eroded in urban centers, therefore affecting social networks older persons need to thrive. Older persons’ care has always been and still is the primary responsibility of their immediate and sometimes extended families, but as stated above, this is becoming increasingly difficult. It is time we face the reality of ageing and how current reality is foisting the need for a new perspective and changing the roles of critical actors including older persons themselves.
What Future Reality Should Look Like
Is it possible to imagine a reality where older persons have the enabling environment to live a dignified life without putting too much strain on the wellbeing of their kin? I believe so, but to achieve this, the first step is to understand that older persons are not homogenous. They do not have uniform needs and therefore cannot be provided a one size fits all solution. As stated earlier in this article, there are older persons who are capable of productive activities, but do not have the means or opportunities to earn a livelihood; and there are those who are economically secure and only require opportunities to continue to provide value and be recognized as a valuable member of the society. In the same vein, there are groups of older persons who by virtue of their circumstances are dependent and require long term care. The right policy framework will recognize this diversity and put in place measures to address the issues.
Addressing ageing issues will require an increased awareness of challenges of ageing among policymakers, the younger generations and older persons themselves. It will also require a shift from approaching support to older person as a charity and more as an economically viable sector worthy of investments from the government and private sector. The older person care industry in the UK, US, and Canada is a multi-billion-dollar industry and encompasses various sectors, including nursing homes, assisted living facilities, homes, healthcare services, and other forms of elderly care. Nigeria has over 14 million people above the age of 60 and is projected to double by 2030. This represents a potentially viable ageing industry capable of contributing to economic development and reducing unemployment. However, this sector will continue to remain untapped until we make the right mental shift. Building an economically ageing industry will include creating enabling environment for the private sector to invest in areas such as the establishment and operation of older persons’ homes, and geriatric healthcare centers. It will require a strong regulatory framework to ensure that older persons are well-catered for and are not open to abuse. With the increasing number of older persons, Nigeria can also turn this sector into a multi-billion-dollar industry with the right investments and policies.
As a result of the number of people living in poverty in Nigeria, older persons’ care cannot be left entirely in the hands of individuals or the private sector. The government needs to invest in social protection programmes for older persons, while also ensuring that healthcare centers are properly equipped to offer specialized care to older persons. In addition, the older person care industry must be supported to thrive by investing in training of caregivers to reduce older person abuse and stress of family caregivers. If done properly, this can generate employment for thousands of unemployed young people.
As one age, there is an increased need for inclusive environments that allow them to function independently. Public buildings are almost inaccessible to older persons and they find it difficult to go about their business unaided. If buildings are made more accessible, older persons will live more independently, this will in turn reduce the burden of care on younger family members forced to provide voluntary unpaid care to their older relatives.
By institutionalizing ageing through the signing of the National Senior Citizens Center Act into law, approval of the National Policy on Ageing and Establishment of a functional National Senior Citizens Center, The Muhammadu Buhari administration has laid a solid foundation for President Bola Ahmed Tinubu to change the face of ageing and ensure that older persons have the enabling environment to live a life of dignity and thrive in a society where they can deploy their skills and experience to shape the life of future leaders.
Saheed Mustafa writes from Abuja. He can be reached on firstname.lastname@example.org