South Africa’s elderly grapple with lack of care service

June 28, 2023
1 min read
Ben Movenda, 76, outside a communal toilet in Alexandra, Johannesburg. The toilet is shared by about 50 people and is not wheelchair accessible. Image: Taurai Maduna/HRW

The enduring consequences of apartheid in South Africa have left the nation’s elderly with limited access to crucial care and support services, with many experiencing profound distress and fear at the prospect of institutional living.

The challenges faced by the South African elderly are also aggravated by the government policies that are intensifying the inherited burden, according to a report by the global rights body, Human Rights Watch (HRW), which has found that government does not allocate enough money to pay for the care and support services for elderly people that are covered by the Older Persons Act.

The Older Persons Act is a post-apartheid law designed to protect the rights of the elderly and provide community and home-based care and support services that enable them to remain in their own homes.

The 68-page report titled “‘This Government is Failing Me Too’: South Africa Compounds Legacy of Apartheid for Older People,” focuses on the experiences of 63 older individuals from diverse racial backgrounds across the Eastern Cape, Gauteng, and the Western Cape. Of these individuals, 61 were recipients of the Older Persons Grant.

While elderly individuals receiving the Older Persons Grant may be eligible for a social security entitlement to cover the costs of full-time home-based care and support, the Grant-in-Aid is severely insufficient, providing only 20 hours of care and support per month based on the national minimum wage for caregivers, as highlighted by HRW.

Affordable private care and support services are scarce, exacerbating existing inequalities. The cost of 24-hour live-in care for a month can amount to four years’ worth of Grant-in-Aid.

Moreover, HRW found that awareness of Grant-in-Aid is low among older people. For instance, the report cites the case of Ben Movenda, a 76-year-old wheelchair user residing in Alexandra, Johannesburg, who was unaware of the Grant-in-Aid. Instead, he relies on assistance from neighbors to access communal facilities due to the lack of ramps and inadequate infrastructure.

The absence of home-based services has detrimental effects on the physical well-being and safety of older individuals, impeding their dignity, autonomy, and independence, according to HRW. With over five and a half million people aged 60 or over in South Africa, many lack the necessary financial and other support to lead dignified lives.

HRW identifies disparities in provincial plans to increase service accessibility, insufficient numbers of social workers, and a lack of coordination among government departments responsible for upholding the rights of older people as contributing factors to the scarcity of services.

The agency also highlights that overly restrictive regulations on service range and insufficient funding hinder the capacity of non-profit organizations contracted by the government to deliver community and home-based care and support services.


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