If not old people’s homes, we do need support for the elderly

Wednesday January 23 2019

An elderly Ugandan. Unlike Europe, the elderly in Africa usually either live with their grown-up children or grandchildren or even relatives of some kind or other. FILE PHOTO | NMG


One of the things that struck me rather hard as a youngster arriving in Europe for the first time nearly 30 years ago, was the way many elderly people lived.

In almost every neighbourhood I lived in over the years, there were old and frail people living on their own. There were also those who lived in old people’s homes.

There was something very odd about all this. I would wonder if the old people who lived on their own and rarely received visitors had any children or relatives.

If so, how come they did not visit or even live with them? I would ask myself the same questions about those who lived in old people’s homes.

The reason I wondered about all this was because back in Africa where I had come from, I had never seen old people living on their own.

Old people’s homes were entirely new to me, and the thought of an old person being taken and left there by their relatives was staggering.


Back home, the elderly usually either lived with their grown-up children or grandchildren or even relatives of some kind or other.

Where they lived with grandchildren and relatives, these would have been sent to live with them for company, and to also help them with errands at home.

Their children or relatives would then send financial or other assistance on a regular basis. Or at least that was the theory.

As it turned out, my problem was mainly ignorance. I had no idea and had not even considered the kinds of forces that drove all this.

Later on, it dawned on me that these were some of the consequences of societal evolution into modernity.

For all sorts of reasons linked to changes in social and economic circumstances, Western families were simply not able to relate to the elderly in the same way we did back in Uganda.

According to scientific studies, these same forces are now already acting on African societies, rendering the old ways of looking after the elderly extremely difficult, if not impossible in many cases.

These days it is not unusual to find elderly people living on their own, without any support, including in rural contexts where traditional practices tend to be more resilient than in towns where various factors degrade them rather quickly.

There are also large numbers of young people who are unable to look after their own children in urban areas where they have migrated to find work.

So they send them to the village to live with grandparents who are barely able to look after themselves, and who subsequently receive little or no support from the town-based parents, many of whom are usually also struggling.

This societal evolution has thrown up some new questions, including what to do about elderly people living in destitution.

Interestingly, the one serious response came from the donor community who not too long ago began to push African governments into embracing the idea of social protection.

In broad terms, the idea is to provide financial or some other support to the elderly poor to help them maintain a reasonably dignified existence.

Different governments have responded differently to this pressure. Most have either put up resistance or agreed to do something and then done very little. The most commonly advanced reason has been, “We cannot afford it.”

In Uganda, the government’s initial response was pretty much similar. After several donor manoeuvres and counter-manoeuvres by the government, eventually the latter embraced the idea, forced to do so partly by vocal potential recipients and Members of Parliament, who were driven by the desire to be seen to champion the wellbeing of their constituents.

There is no shortage of opponents of “handing out free money” in a poor country with many far more pressing needs.

However, the level of support has grown tremendously. One reason is that in areas where the initiative has been piloted for some years, there is evidence of a positive impact on the lives of recipients.

Because of this evidence, recently the government announced the rolling out of a “senior citizens’ grant” to be paid monthly to elders aged 80 and above across the entire country. Questions about affordability loom large.

There is also much debate about whether doling out cash indiscriminately to all who qualify by virtue of age, including those who are not poor, makes sense, given there are more deserving younger elders.

Both questions are valid, no doubt, and could be used as grounds to argue for further fine-tuning of eligibility criteria. Fortunately, there is politics.

Besides donor pressure, one of the key drivers of the government’s conversion to the idea of financial support for the elderly and determination to roll it out quickly has been pressure from Members of Parliament.

They are also reacting to pressure from potential recipients among the elderly, supported by civil society activists.

Although pressure for state-provided social protection came from external actors, it is now clear that our own society must begin to prepare for a future when individual families simply won’t be able to care directly for their elderly relatives, even if they wanted to.

Frederick Golooba-Mutebi is a Kampala- and Kigali-based researcher and writer on politics and public affairs. E-mail: [email protected]