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Growing Old in Egypt

Growing Old in Egypt: The Supply and Demand of Care for Older Persons

Thomas Boggatz
Copyright Date: 2011
Pages: 184
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  • Book Info
    Growing Old in Egypt
    Book Description:

    The Egyptian society is aging. Families have to find solutions for care-dependent older persons, while at the same time, social changes threaten the traditional system of family care. The society has to adapt to this previously unknown situation and to develop new strategies for meeting the needs of its older members. Based on eight years of research, this book investigates the cultural shifts necessitated by these developments. It introduces the reader to the nursing homes and homecare services that are currently available in Egypt’s bigger cities. It describes how younger persons face the challenges of the new profession of care-giving and how recipients adapt in different ways to the situation of receiving care by non-family members. Besides examining culturally rooted attitudes, care needs and their related factors are analyzed in order to identify requirements for the future development of professional care in Egypt.

    eISBN: 978-1-61797-381-9
    Subjects: Sociology, Population Studies

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-viii)
  3. Introduction
    (pp. 1-4)

    This book is the result of eight years of work and research in Egypt. The reader may ask why care for older persons in a developing country deserves so much interest. The common image of the demographic situation in these countries is a high fertility rate combined with low life expectancy at birth. In this context, health problems related to old age seem almost irrelevant. This idea needs to be revised. The developing world is undergoing a demographic transition, with higher life expectancy resulting in a greater number of older persons. At the same time, urbanization and industrialization produce social...

  4. 1 Demographic Transition and Its Consequences in Egypt
    (pp. 5-14)

    Health and nursing care for older persons is not a top priority in developing countries like Egypt. Health agendas typically focus on maternal and child health and the prevention of infectious diseases (El-Katsha and Watts 2002; Khattab et al. 1999). Recent investigations, however, indicate a demographic transition, with much of the developing world, from India to South America, experiencing an aging population (Feachem et al. 1992; Martin and Kinsella 1994). As a consequence, the health of older persons will demand more attention in the near future. Some authors even claim a lack of appropriate health care policy in general (Feachem...

  5. 2 Geriatric Care in Egypt
    (pp. 15-22)

    Care for older persons forms an increasing segment of the Egyptian labor market. The critical question for older persons in Egypt is whether there are enough facilities to meet the demand for care. The supply will depend both on the existence of an institutional framework and on the availability of caregivers. By ‘caregiver’ we refer in this book to any person who provides care in exchange for money. This may be a qualified nurse or an untrained helper. The qualifications of this workforce will have a strong influence on the care that older persons actually receive, and consequently on the...

  6. 3 Caring for Older Persons: The Caregivers’ Perspective
    (pp. 23-36)

    The apparent lack of caregivers raises the question of what can be done in order to increase the workforce. An answer can be found by investigating and understanding the perspective of current caregivers. What are their motives for accepting this job? What are their experiences, and how do these experiences influence their attitudes toward care for older persons? Which factors encourage them to remain in their work and which factors cause them to drop out? Two recently conducted qualitative studies provide some answers to these questions and are discussed in this chapter.

    The first study (Boggatz and Dassen 2006), conducted...

  7. 4 Care-seeking Attitudes of Older Persons
    (pp. 37-46)

    Although care facilities in Egypt seem to be limited compared to the estimated need, this is not necessarily a problem. People have to demand such services, and this demand is not necessarily a consequence of existing needs. It requires thought and effort to demand care. Older persons have to decide about the kind of service, choose a care-providing institution, and go through an application process. Whether people will expend such effort depends on their care-seeking attitude, or their motivation to accept or reject care in a particular setting.

    Some nursing theories consider the motivation to seek care. According to Dorothea...

  8. 5 Attitudes toward Care Services in the Home
    (pp. 47-62)

    The comparison of factors related to older persons’ care-seeking attitudes revealed two conflicting perspectives: a modernistic value system that appreciates the individual’s independence and self-sufficiency, and a traditional value system that adheres strongly to family integrity and filial piety. Care from professionals seems to fit into the modern way of life, whereas care from family members seems to be the acceptable solution in traditional societies. There is, however, no direct contrast between modernized cultures in the west and traditional cultures in the east. Cultures are rather fields of conflict where different values and norms compete for dominance. Cultures are not...

  9. 6 Attitudes toward Nursing Homes
    (pp. 63-78)

    A recurring theme in our interviews about home care services was the rejection of nursing homes. This attitude has been previously reported (Azer and Afifi 1992), and statistics on the utilization of nursing homes confirm these observations, as they report numbers slightly under capacity, contradicting the estimated need for care. In 1999 there were only 2,359 residents in contrast to 2,388 available places, according to the Central Agency for Public Mobilization and Statistics (CAPMAS).

    One explanation we found for the rejection of nursing homes was the traditional value of family integrity and filial piety. At the same time, the cost...

  10. 7 Main Aspects of Care Seeking: A Study in Greater Cairo
    (pp. 79-100)

    The critical question with regard to the demand for care in Egypt is what percentage of older Egyptians would accept home care service or a nursing home. A simple figure, however, would provide a rather superficial answer. What must be known is the background of such acceptance or rejection, in order to avoid premature conclusions. The previous chapters provided some insight into the complexity of care-seeking attitudes and the factors involved in decision making. A variety of factors may influence the acceptance of care from non-family members. A combination of these factors reflected several types of attitudes. Some of these...

  11. 8 Care Needs and Care Dependency
    (pp. 101-110)

    In order to supply adequate and appropriate services for older persons it is useful to identify their needs. Need is commonly distinguished from demand in that demand refers to what people want, whether they need it or not (Stevens and Gabbay 1991). In the previous chapters we analyzed care-seeking attitudes of older Egyptians. These determine thedemandfor care, since only care accepters are likely to ask for home care service or nursing homes. Care consumers may even expect services, such as help with housework or entertainment, which are not considered to be tasks for caregivers. Care rejecters, on the...

  12. 9 Care Dependency in the Egyptian Context
    (pp. 111-122)

    Care is a response to basic human needs, which are universal. The quantification of such needs, however, depends on how caregivers and care service recipients define the nature of required support through a process of social negotiations embedded in a cultural value system shared by both sides. Care dependency is related to universal needs, but at the same time it is culture-specific. Consequently, an instrument designed to assess care dependency must be appropriate for the cultural environment where it is used. The Care Dependency Scale (CDS) was developed for a European context. To apply this instrument in a developing country...

  13. 10 Care Dependency and Unmet Needs: Prevalence and Contributing Factors
    (pp. 123-136)

    Care dependency is a perceived need for help with regard to self-care activities. The Care Dependency Scale, described in the previous chapter, was designed to assess these needs. The final chapter of this book will explore care needs among older Egyptians as measured by the Arabic CDS. It will describe at first the prevalence of the different aspects of care dependency in order to determine which kind of support is most needed. The result will be different for care service recipients and non-care-service recipients. As care service recipients are composed of home care service recipients and nursing-home residents, a further...

  14. 11 Conclusion
    (pp. 137-139)

    Two years have passed since I left Egypt. Our project to establish a training center for geriatric care and a home care service suffered several setbacks. A major problem was finding caregivers willing to participate in the training before starting work. The main challenge for the employment agency was to reconcile the expectations of care service recipients with the expectations of caregivers. Although the project did not achieve all of the originally planned goals, the home-caregiver system continues to work well because demand remains high. Nevertheless, the number of home care service providers in Egypt is still low. Care for...

  15. Appendix 1 The Care Dependency Scale (Arabic Version)
    (pp. 140-144)
  16. Appendix 2 CDS: Factor analysis
    (pp. 145-145)
  17. Appendix 3 Factors related to functional limitations and care dependency: Non-care recipients
    (pp. 146-147)
  18. Appendix 4 Factors related to functional limitations and care dependency: Care service recipients
    (pp. 148-150)
  19. Bibliography
    (pp. 151-162)
  20. Index
    (pp. 163-176)