“When someone becomes old then every part of the body too becomes old”: Experiences of living with dementia in Kintampo, rural Ghana

Abstract

Studies have suggested that in African countries, symptoms of cognitive decline are commonly seen as part of “normal ageing” or attributed to supernatural causes. The impact of folk beliefs about causality upon help-seeking is unclear. Likewise, there is a lack of evidence relating to how families cope with living with an older resident with dementia. Our study's aim was to explore the sociocultural beliefs, understandings, perceptions and behaviours relating to living with dementia in Kintampo, Ghana. We conducted in-depth interviews with a total of 28 people, using a series of case studies among 10 older people living with dementia and their families. Results revealed that symptoms of cognitive impairment were generally linked to inexorable bodily decline understood to be characteristic of “normal” ageing. Stigma was therefore perceived to be non-existent. Whilst managing the costs of care was often a challenge, care-giving was largely accepted as a filial duty, commonly shared among female residents of large compound households. Families experimented with biomedical and traditional medicine for chronic conditions they perceived to be treatable. Our findings suggest that whilst families offer a holistic approach to the needs of older people living with chronic conditions including dementia, health and social policies offer inadequate scaffolding to support this work. In the future, it will be important to develop policy frameworks that acknowledge the continued social and economic potential of older people and strengthen the existing approach of families, optimising the management of non-communicable diseases within primary care.

Psychosocial supports utilized by caregivers of patients with dementia in South western Uganda: A qualitative investigation

“…These findings are consistent with other studies from sub-Saharan Africa finding that caregiver support and patient care for dementia is often obtained outside of the formal medical care system, such as religious and traditional healers and community supports, though caregivers are eager to gain more biomedical guidance (30)(31)(32). These findings differ from treatment recommendation from high-income countries, that promote the delivery of dementia caregiver support interventions targeting dementia education, behaviour management strategies, communication skills, and caregiver coping skills within the biomedical care system (20,33).…”

“…Ideally, members of a lineage are expected to provide each other with instrumental and material resources and expect to receive emotional, economic, and social security. Though families offer a holistic approach to the needs of older people living with dementia, health and social policies offer inadequate scaffolding to support their work (34). With families becoming smaller, communities and society in general are important source of emotional and instrumental support for caregivers (35).…”

Dementia research needs in Ghana: a perspective

“…Results from the KDI showed an overall prevalence of 5.0% (95% confidence interval, CI=3.6-6.8) and a standardised prevalence of 6.6% (95% CI=3.6-6.8), for all ages. 18 In addition, the kinsfolk in the study area ascribed the symptoms of dementia to normal aging and linked them to other comorbidities of aging. 18 Table 2 shows a breakdown and the characteristics of the publications found in our search, highlighting the research needs, which can be grouped into three main thematic areas: diagnosis and prevalence; studies on the prevention of dementia; and other interventions to improve the quality of life of older persons (Box 1).…”

“…The results of the ground-breaking epidemiological study conducted within the Kintampo North and Kintampo South Districts revealed dementia is prevalent. 18 There is, therefore, an urgent need to replicate more of such epidemiological studies nationally. An example of such large studies is one conducted by the 10/66 Dementia Research Group (DRG), across 11 LMIC in 2003.…”

Exploring Pathways to Hospital Care for Patients with Alzheimer’s Disease and Related Dementias in Rural South Western Uganda

“…Like in other countries such as Ghana, South Africa and Tanzania women tend to be pro-active caregivers for people with dementia (Agyeman et al, 2019, Deist and Greeff, 2017, Mushi et al, 2014, with men providing finances and the role of decision-making about the care (Agyeman et al, 2019). Studies from Ghana and Tanzania have also shown that children and grand-children also take up different components of the responsibility (Agyeman et al, 2019;Mushi et al, 2014).…”