“But … we are Africans!”: Family life cycle structuring and functioning in southern Angola

Protocol: the complexity of informal caregiving for Alzheimer's disease and related dementias in rural South Africa

BACKGROUND

 With aging, many people develop Alzheimer's disease or related dementias (ADRD) as well as chronic physical health problems. The consequent care needs can be complicated, with heavy demands on families, households and communities, especially in resource-constrained settings with limited formal care services. However, research on ADRD caregiving is largely limited to primary caregivers and high-income countries. Our objectives are to analyse in a rural setting in South Africa: (1) how extended households provide care to people with ADRD; and (2) how the health and wellbeing of all caregivers are affected by care roles.

METHODS

 The study will take place at the Agincourt health and socio-demographic surveillance system site of the MRC/Wits Rural Public Health and Health Transitions Research Unit in Mpumalanga Province, northeast South Africa. We will recruit 100 index individuals predicted to currently have ADRD or cognitive impairment using data from a recent dementia survey. Quantitative surveys will be conducted with each index person's nominated primary caregiver, all other household members aged over 12, and caregiving non-resident kin and non-kin to determine how care and health are patterned across household networks. Qualitative data will be generated through participant observation and in-depth interviews with caregivers, select community health workers and key informants. Combining epidemiological, demographic and anthropological methods, we will build a rich picture of households of people with ADRD, focused on caregiving demands and capacity, and of caregiving's effects on health.

DISCUSSION

 Our goal is to identify ways to mitigate the negative impacts of long-term informal caregiving for ADRD when formal supports are largely absent. We expect our findings to inform the development of locally relevant and community-oriented interventions to improve the health of caregivers and recipients, with implications for other resource-constrained settings in both higher- and lower-income countries.

“Our Family’s Path:” Couples’ Perspectives on the Developmental Trajectories of Families in Urban Southern Angola

The aim of the present study was to explore and to understand how 36 urban Southern Angolan couples perceived their family’s development across the lifetime. The study sought to compare those results with three systemic approaches of family development, two Western and another indigenous. Through semi-structured interviews, the existence of two trajectories of family life, with similar life events, were identified. The life events of these two trajectories were organized in a different chronological order, based on the religious commitment of the individuals. The results showed discrepancies with the Western models on the composition of the household (i.e., big backyard families and families with a third element) as well as the type of events considered to be important milestones within the family trajectory (e.g., the inexistence of the empty nest). This study provides support for the indigenous framework proposed by Simões and Alberto (2015) and contributes to a better comprehension of the family functioning of the urban Southern Angolan families.

Family Rituals and Routines in the Developmental Trajectory of Urban Southern Angolan Families

Rituals and routines are fundamental parts of the family dynamic and contribute to its organization across generations. However, studies on these variables in the context of urban Southern Angolan families are scarce. Thus, this article aims to identify the rituals and routines that organize the development of families in urban Southern Angola through different life stages, using semistructured interviews with 20 professionals from various social fields and 25 couples. Despite some discrepancies between the views of the two groups, they both reported a set of rituals and routines relevant to the organization of the families’ life trajectories.