How Covid-19 has affected older persons

Members of GAPA enjoying a song at one of their events.

Grandmothers Against Poverty and AIDS (GAPA) recently held their first monthly Health Club for members of their seniors’ clubs in Khayelitsha since lockdown.

Members reported that the Covid-19 pandemic had been a challenging time for them, as many lost close friends, family members and neighbours.

Funerals are very important in the primarily Xhosa community of Khayelitsha and those at the meeting indicated that being unable to visit their loved ones while hospitalised or attend the funerals of their loved ones were among the hardest adjustments around lockdown.

There is a belief in Xhosa culture that a person’s spirit lives on beyond death and the disruption of the typical cultural and religious process has left older persons feeling that they had not been able to grieve appropriately. Thus, the grandmothers were left with the baggage of unprocessed grief.

Family elders play an important role in Xhosa culture, including practices around death.

This put older persons in a difficult position, knowing that they are high risk, but also feeling a sense of responsibility to participate in funeral practices.

One member explained that despite the risk, as the only elder in his family, he felt obligated to travel to the Eastern Cape to bury several family members during a time when transmission levels of the virus were high. One of the GAPA grandmothers experienced multiple deaths in her family during the pandemic, but couldn’t attend the funeral of her son, aunt and brother-in-law in the Eastern Cape because she felt she had to stay at home to respect lockdown restrictions.

She felt these losses more deeply because she was unable to mourn and be with family during these hard times.

Other members indicated that they also felt tremendous guilt at not being able to visit the sick or attend the funerals of loved ones. Lockdown regulations regarding funerals also prohibited certain cultural protocols, such as seeing the body of the deceased and requirements that usually long services be kept short.

One of the elderly persons explained that “by 11am it was over – it was like there was no funeral, people were just sitting – this hit me”.

Short services left loved ones feeling like they didn’t have a funeral at all, since friends and family were denied the opportunity to reminisce about the deceased, which is part of the closure and healing process.

Usually there is a long service programme which unpacks who the deceased was; family, neighbours and friends speak and the priest comforts the family with scriptures, and the community sings.

Staff members from Ikamva Labantu and GAPA reported that most of their clients were unable to isolate, living in environments without proper hygiene and sanitation and were afraid to visit health facilities.

Gender-based violence during lockdown has received a lot of attention, but elder abuse has also been a significant issue according to Ikamva Labantu’s social workers.

Fear is a daily reality among older persons who are particularly vulnerable to Covid-19, particularly those with existing comorbidities such as hypertension, diabetes and heart disease One of the grandmothers said that as friends and family around her began to be infected, “I could see Covid-19 getting closer. I was waiting to be attacked”.

Ultimately, fear leads to anxiety and depression. The disruption of regular community and faith-based activities such as church services has also been difficult for older persons to manage and many are anxious about returning to church despite it being such a central part of their lives.

In the face of these challenges, older people have shown their resilience and Ikamva Labantu and GAPA reported only one and five Covid-19 deaths among their respective clients.

Members dealt with emotional turmoil by praying and keeping faith and trust in God.

In South Africa, older persons, particularly grandmothers, have been looking after younger generations and the sick for decades and it was no different during lockdown. Older persons found themselves in a position where they have to take care of their children and grandchildren on a fulltime basis because the schools and ECD

(early childhood development) centres were closed. This work provided them with a sense of purpose – as one woman noted: “Maybe God has spared me so I can take care of my sick daughter”.

However, it also put older people at increased risk. While older persons stayed at home and were not mobile, they were exposed to Covid-19 by young family members who come in and out of their homes.

Non-profit organisations have played a crucial role in older persons’ lives during lockdown and their important ongoing work needs to be recognised and supported.

Representatives from GAPA and Ikamva Labantu, which work in the Khayelitsha area, described lockdown as an extremely busy period because they had to take their services to older persons’ homes as seniors’ clubs were closed due to lockdown regulations. Services provided by GAPA and Ikamva Labantu include: distributing food parcels, running soup kitchens, and providing masks, sanitisers, blankets, health education and individual check-ins and follow-ups by social workers with members facing social problems such as abuse.

Ikamva Labantu has been purchasing slots on Radio Zibonele to air health messages to older persons and has set up a toll-free number for older persons experiencing social issues. GAPA also have a daily slot on radio Zibonele at 9am.

Lindeka Mrengqwa and Lulamile Mabe are with the Samson Institute for Ageing Research