Demographic Characteristics Associated with the Likelihood to Use Paid Home Care for People with Dementia among South African Muslims

Abstract

Background: In societies where the value of filial piety is observed, a preference for caregiving to take place at home exists. In fact, institutional and paid home care for people with dementia (PWD) are still taboo in some Muslim societies. However, economic development and globalisation have resulted in intergenerational separation, thus impacting the ability by young adults to provide care for the elderly at home. Objective: We establish the demographic characteristics most likely to be associated with the use of paid home care – age, gender, education level, marital status, family structure, experience with dementia care in the family, and number of dependents – for PWD among South African Muslims. Methods: A survey, administered in the form of an online questionnaire, of Muslim families across each of the 9 provinces of South Africa was conducted. Multiple logistic regression was used to test the effects of the demographic variables on the type of care choice arrangement (family as primary caregiver vs. paid home caregiving). Results: 422 responses were analysed, 28% of which indicated the respondents’ desire to use paid home caregivers. The multiple logistic regression results indicate that South African Muslim families are more likely to use paid home care if they are older (that is, over 40 years; OR = 1.972, 95% CI: 1.445–2.695), are female (OR = 1.637, 95% CI: 1.089–2.457), and have high levels of education (OR = 1.828, 95% CI: 1.070–3.125). Conclusion: Home-based care is touted as the next dementia care model. Given that intergenerational mobility is likely to increase as future generations continue to participate more in the labour market, minority groups with a disposition to the same familial social values will require appropriate support in order to cope with the demands of caring for PWD. Suitable interventions for Muslim families who are not open to using external assistance, as well as those who are, need to be administered to enable the caregiver and care recipient to thrive at home.