HIV/AIDS and the Elderly

By Paul Andrew Bourne



The issue of HIV/AIDS is not singly limited to the infected individuals who are substantial between 15 and 24 years (UNAIDS 2004), but the elderly who will be increasingly ask to support their infected-children and other members of the family. Instead of being the socio-financially support for their children and other household members, the aged populace will be needed to absorb the stress of love ones in addition to their psychosocial and demographic challenges. According to Knodel et al's (Knodel et al. 2001, 1320) study carried out in Thailand, "59 percent of those who died of an AIDS-related disease co-resided with a parent at the terminal stage." This implies that the aged are expected to perform caretaking duties. With this social reality, the aged person's well-being will be affected in a two-fold manner. Firstly, the aged parents are expected to care for a dying love one. And, secondly, they are forced to absorb the stress of this arrangement with the biological and psychosocial conditions of their ageing organism. In order to understand the stresses of this situation on the aged, we need to analyze this within the context of the cost of care, length of care for the elderly and the AIDS patient. This can be supported by a study that revealed that longstanding ailments do reduce quality of life (Neteveli et al. 2006).

Globally, regionally and nationally, the core for the HIV/AIDS infected candidates is between 15 and 55 years, who are likely to be the children of many aged people. Therefore, the social support system that the elderly expects is highly likely to be reverted to the children. Day and Livingstone (2003) found that social support is an effective coping mechanism to deal with stress. From this established theory, the potential stressors that will be leveled against the elderly will automatically expand.

A longitudinal research that was conducted between 1991 and 1994 on households drawn from Northwestern Tanzania compared and contrasted the body weights of some elderly prior to and post the deaths of a "prime-age adult" in the household. According to Dayton and Ainsworth (2004), the findings indicated that the seniors with the lowest physical well-being (measured using body mass index, BMI) were those in poor families that had not experienced a household adult death in the survey period. The BMI for the elderly was lesser after the death of a love one than before the death of the household member. Another revelation from the study was the increased time spent by the elderly in household chores proceeding the adult death and reduction in waged employment.

In the event HIV/AIDS virus does not inflect the children of the elderly, or other household members, UNADS (2004) reported that less than five percent of them are infected by the epidemic. This social reality within the financial constraint of the family typology will become a psychosocial stress for the elderly. The issue of stress is determinant of well-being as HIV/AIDS virus. Lazarus and Folkman (1984) conceptualized stress as a "relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being" (p.19).

With the prevalence and incidence rates of HIV/AIDS, there is a demand on the aged populace to cope with such social setting. Coping embedded in an individual's cognitive, affective, and behavioral efforts to manage specific external and/or internal demands (Crocker, Kowalski, & Graham 1998; Lazarus 1999). Studies have shown the positive association between coping and well-being. Epping-Jordan, et al. (1994) did study on coping and health. They studied coping and health in a sample of 66 cancer patients diagnosed with a variety of different types of cancer including breast cancer, gynecologic cancers, hematological malignancies, brain tumors, and malignant melanoma. The findings revealed that the relationship between coping and disease progression demonstrates how the relationship between coping and health is ultimately quite complicated.

The elderly need to cope with the discrimination, the social exclusion, and the psychosocial and financial responsibility of the infected close family member in addition to a situation of personal infection within an aged body with its demands.

Rogers (1995) in a study titled "Sociodemographic Characteristics of Long-lived and Healthy Individuals" cited that many factors account for the long lives. Rogers' study was based on secondary data collected by the US Department of Health and Human Services 1988 called 1984 National Health Interview Survey. The sample size was 15,938 individuals aged 5 and older. The findings revealed that of females who walk, they are expected to live 7.5 years more than males while among females who are physically incapacitated, they are expected to live 5.5 years more when compared to males. There was association between age, sex, income, education, physical health, social network participation and emotional well-being and perceived health (Rogers 1995, 41). He wrote ". . . death is more likely to occur among those who are older, male, less educated, and with disabilities, chronic conditions, and perceived poor health" (Rogers 1995, 46).