Family care-giving for ageing parents in Nigeria: gender differences, cultural imperatives and the role of education
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International Journal of Education and Ageing The Association for
Education & Ageing
Vol. 2, No. 2, 139–154, May 2012
Family care-giving for
ageing parents in Nigeria:
gender differences, cultural
imperatives and the role of
education
Uzoma Odera Okoye
University of Nigeria, Nsukka, Nigeria
Abstract
Caring for an elderly relative, especially in African societies, is usually a task that
is reserved for females. This article includes an analysis of the effect of gender in
care-giving. Data was collected, using questionnaire and interviews, from 530 adult
(40 + years, mostly well-educated) respondents, residing in Nsukka town, Nigeria,
who had at least one parent alive. Comparisons were made between the responses
of the male and female adult children. The findings showed that adult daughters had
more positive general perceptions of care-giving than adult sons and were less likely
to see a personal care-giving role as a burden. To some extent the findings can be
interpreted as reflecting deep-seated gender differences which have their origins
in traditional cultural attitudes. But when considered more deeply, in the context of
economic needs and social changes in Nigeria, and the limited support available for a
growing population of older people, the findings raise questions about how likely it is
that such differences will change and whether they can be affected by lifelong learning
provision. The article concludes that developments in education and learning relating
to understanding ageing at school-level and preparing for it in later middle age, as well
as new forms of learning in later life, are important in the Nigerian context.
Introduction
Ageing comes to all in due time, if we live long enough. In Nigeria, the general
population is growing rapidly and is approaching 160 millions. The population of
older people is growing faster than the general population. The United Nations
(2006) predicts that the percentage of the Nigerian population aged 60 years and
above will increase by 26 percent by 2020 and 38 percent by 2050. This means that140 International Journal of Education and Ageing the number of elderly people to be supported and cared for will grow significantly. The needs of older people have most often been misunderstood by Nigerian society at large (Okoye, 2005). This is mainly because there are stereotypes of older people that prevent many of those younger from understanding their real needs. Kenyon (1992) and Thornton (2002) have commented on the dangers of stereotyped and negative attitudes towards older people. This article will examine these attitudes and will, in particular, explore the cultural imperatives in Nigerian society which define care-giving responsibilities in terms of gender and consider if education and learning provision can influence the situation. People do not cope successfully with ageing in isolation. Most often they will cope in the company of others who provide social, emotional and financial support and assistance in surroundings that provides security, love and understanding (Connidis, 2010). In this respect, families of older people usually provide many forms of care- giving assistance for older people. Care-giving assistance in the context of this study is taken to mean all forms of support and assistance given to an elderly parent. This could be by way of telephone calls, visits, financial support and physically caring for the parent. According to Atchley (2000), adult children generally are considered to be the first line of support when care-giving assistance is needed for their parents. He observes that the ageing relationship between elderly parents and adult children emerges through interaction between each other, usually in the process of playing their respective social roles. Abdulraheem (2005) argues that the relationship can be destroyed or diminished by permanent geographic separation or if one or both of the participant(s) are unable to perform their role, maybe as a result of health or other obligations. Sijuwade (2008) believes that such factors as feelings of superiority or inferiority, selfishness, break in trust, withdrawal by one or both participants and so on may diminish ageing relationships and so affect care-giving. Usita et al. (2004) suggest that likelihood of withdrawal from the relationship of a care- provider could be in direct proportion to the level of care needed and the physical and mental stress of providing it. Literature Review Gender has been seen as a strong factor, in the academic literature world-wide, influencing ageing relationships and care-giving. Some researchers, for example Allen (1981) and Palmore (1980) report that there is no difference between genders on attitudes towards the elderly, yet others such as McGrew (1991), Haught et al. (1999), Hawkins (1996), Steitz & Vener (1987) and Cicirelli (1993) indicate that females have more positive perceptions of the older generation than males. It is evidently possible that the way in which someone perceives an older person can influence their views on care-giving for them. McGrew (1991), in the USA, concludes that irrespective of one’s position in the family, gender is a major influencing factor on the relationship between an adult child and elderly parents. She observes that adult daughters in most cases do not appear
Family care-giving for ageing parents in Nigeria 141 to go through a complex decision making process to decide whether to provide care but simply act on impulse. In this interpretation, the impulse to care for family members who need it is a predisposition in females. Kramer (1995) investigated gender differences in care-giving tasks and found that females are more likely to assist with care provision tasks than males. Horowitz (1985) in her study found that sons tend to become caregivers only in the absence of an available female sibling. And even then, they are more likely to rely on the support of their own spouses. She also found that they provide less overall assistance to their parents, especially ‘hands-on’ services. Studies have reported gender differences with regard to care-giving satisfaction. For women caregivers, a greater satisfaction in care-giving correlates with lower levels of anxiety and depression (Yee & Schulz, 2000). Walker et.al. (1990) observe in their study that daughters reporting positive effects or no change had positive evaluations of, and were satisfied with, the care-giving role. Stoller (1983) found that being employed significantly decreases the hours of assistance provided by sons but does not have a significant impact on the hours of assistance provided by daughters. Many studies have looked at the role of women and family care-giving (Long & Harris, 2000; Brewer, 2001; Dettinger & Clarkberg, 2002). Although not all have addressed gender issues and care-giving specifically, the results are still generalisable to women because they constitute the majority of informal care providers. Thus, scholars generally conclude that females in most cultures are socialised into care-giving (Brewer, 2001; Jutras & Veilleux, 1991; Long & Harris, 2000) and are more involved in care-giving roles. Cicirelli (1993) suggests that the attachment between daughters and elderly parents may be based on the impulse of females to care and may involve guilt feelings. This view had earlier been put forward by Noelker & Townsend (1987) who in their study found that guilt feeling is a major factor in the relationship between elderly parents and their adult, particularly female children. With regard to Nigerian culture, however, it is not necessarily clear how these findings drawn from across the globe, particularly from developed countries, apply. In Nigeria, cultural norms are that children are expected to provide care to their parents both materially and otherwise. In some instances, the parent/s maybe living with an adult child and in others the adult child may hire a paid care-giver to reside with the parent/s usually in the home village. In Nigeria, when people living in an urban area grow old or retire, they are usually expected to go back ‘home’ to the village. This is more so in the Eastern part of the country where the following empirical study was situated. Significantly, within traditional culture in Nigeria, there are also cross-cutting cultural imperatives which stipulate that ageing relationships such as living with elderly parents and /or providing care are seen to be the duty of the first or last son or daughter (Togonu-Bickersteth, 1989; Ogwumike and Aboderin, 2005). This, according to Sijuwade (2008), is inculcated during the process of socialisation in which the first and last of the progeny receive special care and attention and are expected to reciprocate in like terms later in life.
142 International Journal of Education and Ageing The purpose of the empirical study which follows, therefore, is to find out how the comparatively well-educated population of a reasonably affluent university town in a region of an African nation which is modernising but in which traditional values still matter, fits into the patterns outlined in the available published academic literature. Among those of the middle-aged adult population of the town who have at least one parent alive, what are the perceptions of the care-giving role towards elderly parents? In particular, are gender differences apparent in the analysis of those perceptions? If they are, what follows? It has become obvious in recent years in Nigeria that family provision of assistance for members in need is in danger of erosion by the combined impacts of the job-market, mobility and city-dwelling. Clearly cultural norms and traditional forms of behaviour will be challenged particularly with regard to the increasing number of older people in the population. After the discussion of the empirical study, the article moves on to discuss if education and learning can play a part in structuring and moulding the perceptions and assumptions that will result and, if so, what form of education and learning delivered to whom and in what manner? Methods Sample and Procedure Nsukka is a university town which contains a campus of the University of Nigeria. The population of Nsukka’s local government area is put at 147, 249 males and 160, 392 females, which makes a total of 309, 633 (NPC,2006). The university is the only major industry in the town. The empirical study was concerned with adults resident in Nsukka, aged 40-59 years, with at least one parent alive. This age bracket was chosen because, in Nigeria, the expectation is that, at 40 years, an adult is normally earning a living and his/her parent(s) will normally not be less than 60 years old. The study adopted cluster and systematic random sampling. This means that the town was first divided into clusters, then streets from where systematic random sampling was used to select only eligible respondents from sampled houses. During the sampling, care was taken to ensure equal representation of male and female respondents who had one or both parents alive and were within the required age range. Parents did not necessarily live in the same house with members of the sample. The sample size for the study was 600 adults. Questionnaires and interviews were used as the instruments of data collection. Of the 600 questionnaires distributed, 530 were returned – a response rate of 88%. There were more female (55.8%) than male respondents (44.2%). The mean age of the respondents was 41.8 (S.D. 9.215). More than half of the respondents (55.7%) were, or had been, married while the rest were single (44.3%). A good majority of the respondents (75.5%) had higher educational qualifications (Ordinary National Diploma as the minimum qualification). Half of the respondents were professionals or civil servants (50.8%) while the others were business men and women or unemployed. Slightly above half of the respondents (59.1%) had both parents alive while (76.7%) earned above the national minimum wage.
Family care-giving for ageing parents in Nigeria 143
Ten in-depth interviews comprising five males and five females were conducted.
A male and a female respondent were chosen on each street for an interview. In
order to avoid bias, respondents who were interviewed were not administered
the questionnaire. The interviews were transcribed using verbatim reporting and
thematic analysis was adopted in order to highlight the salient issues raised by the
respondents relating to particular themes.
Measures
In the questionnaire, 12 items in a Likert-scale form were used to measure a
respondent’s perceptions of the care-giving role. The items included, for example:
Adult offspring should care for elderly parents
Mean parents should be left without care
Only affluent offspring should provide care
Only first sons and daughters should provide care
Caring for adult parents should depend on what I benefited from them
Care-giving should be done by daughters.
The responses of each respondent to all the items were summated and, based on
that summation, two categories were developed: positive perception and negative
perception of care-giving role. An index of perceptions of the care-giving role was
thus constructed.
Similarly, respondents were asked to respond to a further 10 items in a Likert-scale
format. This scale was conceptualised as dealing less with general perceptions of
care-giving and more with specific actions of care-giving assistance and whether
they constituted a burden or not. Examples were:
Calling my parents on phone regularly to check on them is expensive,
I will send money to my parents only when I have no immediate need for it,
Living with my parent in the same house is not possible,
Sending my children to live with my parents will retard their development.
The responses of each respondent to the 10 items on the ‘burden of care’ were
added up and, based on the summation, two categories of respondent were
identified; those who viewed care-giving for their parent(s) to be a burden and those
who viewed it as a normal part of life.144 International Journal of Education and Ageing
Results
Table 1 presents the demographic characteristics of respondents by gender.
Table 1
Demographic Characteristics of respondents by gender (N=530)
Demographic Gender of respondents Total χx² p
Characteristics value
Male Female
Marital Status
Single 109 (46.4) 126 (53.6) 235 (100)
*Ever married 125 (42.4) 170 (57.6) 295(100)
Level of Education
Low education 84 (32.9) 171 (67.1) 282 (100) 25.045 .000
High education 150 (54.5) 125 (45.5) 248 (100)
Income level
No income 47 (42) 65 (58) 112 (100) 9.733 .008
Medium income 86 (37.9) 141 (62.1) 227 (100)
High income 101 (52.9) 90 (47.1) 191 (100)
Age
Younger 31 (37.8) 51 (62.2) 82 (100)
Middle aged 141 (43.3) 185 (56.7) 326 (100)
Older 62 (50.8) 60 (49.2) 122 (100)
Family Position
First child 108 (52.4) 98 (47.6) 206 (100)
Middle child 85 (37.6) 141 (62.4) 226 (100) 9.856 .007
Last child 41 (41.8) 57 (58.2) 98 (100)
Both Parents Alive
Yes 125 (39.9) 188 (60.1) 313 (100)
No 109 (50.2) 108 (49.8) 217 (100) 5.508 .012
*Married, Separated, Divorced and Widowed
Table 1 shows that more females were married (57.6%) and younger (62.2%) than
males. More of them were middle children (62.4%) and had both parents alive
(60.1%). More males than females had a higher level of education (54.5%), and
earned a higher income (52.9%).Family care-giving for ageing parents in Nigeria 145
Table 2
Care-giving characteristics of respondents by sex (N=530)
Gender of respondents
Dependent Variables Male Female Total χx² p value
Perception of care-giving
Positive Perception 170 (41.2) 243 (58.8) 413 (100) 6.777 .006
Negative Perception 64 (54.5) 53 (45.5) 117 (100)
Burden of care-giving
Care-giving is a burden 142 (51.4) 134 (48.6) 276 (100) 12.441 .000
Care-giving is not a burden 92 (36.2) 162 (63.8) 254 (100)
Table 2 presents respondents’ view on care-giving. It shows – on the two sub-scales
- that female respondents (58.8%) perceived care-giving more positively than males
(41.2%) while male respondents (54.5%) perceived care-giving more negatively
than females (45.5%). The differences between male and female respondents in
their perception of care-giving role were clear and were significant (X² (1, 530)
=6.777 p146 International Journal of Education and Ageing
The interviews illustrated these differences and also exemplified the range of
issues through which they could be expressed, particularly concerning the places
of residence of the grandparents on the one hand and the adult children and the
grandchildren on the other.
One male (50 years) exclaimed:
If my mother come to stay with me, she and my wife will be quarrelling
and I don’t want to die young so she is in the village and we see
her when we go home for something or during Christmas, but if it
becomes necessary for her to live with someone, I am sure any of my
sisters will bring her to their house and I will be visiting her there too.
Females took a contrary position. One (46 years) called regularly:
Although it is a bit expensive but I must call my mother every two days
to check on her. You know they like hearing our (their children) voices
and it will make her happy.
Another (41 years) looked ahead:
Why not, when my children are of age I can send them to live with my
parents. That way I don’t have to get house helps that even maltreat
them and disrespect them.
However a male (45 years) said that he would not send his children to his parents’
home:
My children’s education is very important to me and I can’t afford to
send them to the village to live my parents because the schools in the
village are not up to standard (Male, 45 years).
Discussion
These findings imply that with regard to gender and care-giving, female respondents
were more likely to render care-giving assistance than their male counterparts, were
more likely to have positive perceptions of the provision of care-giving and less likely
to admit to regarding the care-giving role as a burden. Of course, Nigerian adult
daughters may be unwilling to complain openly about their feelings. They may go
through hardship in providing effective care-giving for an elderly parent but, out of a
sense of duty, not be willing to admit to it. Elsewhere, indeed, Pinquart & Sorensen
(2006) reported high levels of burden and depression, and lower levels of subjective
well-being and physical health, in women who were caring for older people.
Nevertheless, the majority of Nigerian adult daughters did not discuss the burdens
of care-giving negatively in terms of guilt avoidance but rather, positively, as the
result of the impulse to care, their obligations and empathy as mothers themselves.Family care-giving for ageing parents in Nigeria 147 However, in the Nigeria, with its ageing population and the contrasting pressures of modernisation, economic growth and mobility of education, location and employment as against traditional cultural imperatives and local and customary values, it may be that the empathetic impulses to care for elderly parents by busy adult daughters will not be enough, especially if they have restricted budgets and/or if they live at a distance. It is a multi-dimensional problem. Some of the dimensions are not found, or are found to a lesser degree, in developed countries. Elderly parents in developed countries may receive a pension, may have access to social and recreational facilities and medical care – in some cases free of charge. In turn, these reduce the burden of care-giving for their adult children (Lassey & Lassey, 2001). In Nigeria, large numbers of older people do not receive any pension and do not have access to comparable facilities and services. During interviews in the empirical study, most of the respondents confirmed that difficulties in care-giving arise when the adult child does not have enough money and/or when either the parent or adult child has ill-health. In effect, some of the respondents, including females, felt that they had had to abandon their elderly parents in the home village where they would die, sooner rather than later, due to lack of money and good medical treatment. The financial environment seems to be key. There is plenty of material in this study to show that it is imperative, as soon as economic and political factors allow, for the Nigerian state to develop a comprehensive policy for older people which incorporates pensions and social services and facilities such as free medical treatment, recreational facilities and institutional and adult day care centres. All of these will help adult care–givers, especially the females. There is also a clear need for the Nigerian state to move ahead with full implementation of the Pension Reform Act of 2004, which has a broad range of provisions for older people that the state has not yet introduced. Nevertheless, it needs to be considered whether there are less resource-intensive provisions which could be put into place now in Nigeria, if the political will is present. Some will argue that since Nigerian males do not perceive the importance of care- giving to elderly parents in the positive manner that women do, then what really matters is that social and public policy, in particular educational policy, focuses attention on changing the attitudes of males. Given the rapid growth of its older population, Nigeria cannot afford attitudinal barriers and women cannot cope with the necessary care-giving unaided. It is, indeed, possible to argue that developments in schooling and education and in learning in later life are among the reforms that are more immediately possible. This article now suggests a four-fold approach to considering the role of education; i) at school; ii) while caring for an elderly parent as an adult; iii) preparatory to later life; iv) during later life. i) In order to accelerate a move away the stereotyping of old age and gender - imbalanced cultural assumptions about care-giving for older people, one can argue that there is a need to introduce programmes even into the early years of Nigerian schools that will encourage young people both female, but particularly male, to
148 International Journal of Education and Ageing
start interacting with older people early so that care-giving will come naturally to
them when the time comes. Such programmes could be embedded in the school
curriculum at both the primary and secondary school level. There is evidence
elsewhere that educational programmes can have a positive effect on attitudes
of young people towards ageing and older people (Knapp & Stubblefield, 2000;
Puentes & Cayer, 2001; Funderburk et al. 2006; Cottle & Glover, 2007; Hall & Batey,
2008; Dunhama & Casadonteb, 2009). The Canadian Network for the Prevention of
Elder Abuse (CNPEA 2010), reports that most prevention strategies view education
as one of the best means of countering elder abuse, while Davidovic et al. (2007),
showed convincingly that intergenerational programmes are an effective way to
influence and improve perceptions of older people and of ageing.
Yet, it is important to be realistic about the difficulties in the case of Nigeria. As
the study in this article has confirmed, in traditional Nigerian culture gender-role
socialisation is strong and may constitute a major obstacle to the success of
school-based educational programmes. In many Nigerian households, female
children are still socialised into traditionsl roles, from generation to generation,
according to the dictates of culture. Public enlightenment/education campaigns
geared towards parents on the desirability of socialising male children into
care-giving roles would be needed as an accompaniment to changes in the
school curriculum. Cultural imperatives and traditional values do not shift
easily. Programmes of curriculum change in schools and public enlightenment
campaigns would need to be both sophisticated and well-resourced.
ii) There must be a place for the development of learning opportunities for the adult
children and others who have to provide care for elderly parents. The goals of such
programmes would include the development of caring skills, the acquisition of
new knowledge relevant to caring (including understanding the ageing process)
and the sharing of good practice and learning from the experience of others.
Varying forms of learning delivery methods seem relevant – not only face-to-face
teaching and learning and facilitated group-work but also distance learning and
self-programming support and sharing groups.
iii) The concept of ‘pre-retirement education’ does not easily fit Nigerian society
at present but the area of preparation for ‘being older’, on which there is a
considerable world literature, may do. Weierich et al. (2010), for example, in
the USA, write of education in financial planning decisions - in such matters as
moving home, managing healthcare costs and budgeting as being fundamentally
important. Translating this approach to the Nigerian context, one suggestion has
been that resource persons should be trained to help older people to understand
their financial and health needs. Findings by Okoye and Aghedo ( 2011) show
that one of the key reasons why the 2004 Act is not being embraced by Nigerian
workers is lack of knowledge of the benefits. Older people who develop through
training a broader knowledge of their range of financial options in later life are
more likely to be able to minimise their dependence on care-givers, than are
those whose knowledge of options is limited.Family care-giving for ageing parents in Nigeria 149
iv) There are currently suggestions in Nigeria that provision of learning opportunities
in later life will help older people to cope with the changing environment as their
numbers grow. Elsewhere, Ahjin and Sharan (2004) have argued that educational
provision can open up to older adults possibilities of continuing involvement in
their communities while Field (2009) has documented the extent to which it has
been shown that participation in education has a positive impact on well-being
of older adults. Kumpa and Krašovec (2007) from Slovenia think that educating
older adults is becoming an increasingly important activity because it empowers
them, while at the same time reducing their social exclusion. This is because
educational programmes can suggest solutions to, or provide ways of coping
with, many of the problems which cluster round the realities of ageing. Translating
all of these ideas to the Nigerian context – in which many older people may be
expected to return to the home village and fend for themselves at a long distance
from their adult children - is, of course, problematic. It may be that educational
programmes for older people of an indigenous kind could be developed that
celebrate traditional skills and emphasise communal interaction and mutual
caring. It may be that programmes of later life learning can be created that, while
drawing on experiential knowledge and the life-time values which older Nigerian
people have, help them to identify what they want, and what they need, from
the emerging new Nigeria. Skilled teaching and facilitating techniques would be
required to engage the older learners in this context. One can certainly argue
that Nigeria and other African states cannot simply import forms of later life
learning from western developed countries. It will have to re-think them.
This article has shown that issues and difficulties around care-giving for elderly
parents by their adult children, and the limitations imposed by gender differences in
that care-giving, are part of a growing crisis in Nigeria occasioned by the increase
of the older population. Social policy, as well as economic responses are required.
It has been proposed that among those responses, developments in education and
learning relating to understanding and preparing for ageing as well as provision of
possibly new forms of learning in later life, merit immediate consideration.
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Key Words
Gender. Care-giving. Older people. Nigeria. Learning. EducationFamily care-giving for ageing parents in Nigeria 153 Correspondence Dr. Uzoma O. Okoye, Department of Social Work, University of Nigeria, Nsukka, Enugu State. Nigeria. uzokoye@yahoo.co.uk
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