Paper short abstract:

This qualitative paper explores the interplay between urban and rural migration in South Africa and older adults’ receipt of and attitudes towards long term care. I discuss the implications of their experiences for the expected increase in unmet need for care and the development of care systems.

Paper long abstract:

For South Africa's older black population, internal migration and dispersal of families between rural and urban areas is not a new phenomenon. Restrictive legislation constrained where many lived in their youth, often forcing urban to rural migration, while the late 1980s saw rapid unplanned urbanisation around formerly White towns and cities. With unemployment now at 40% among younger black adults, economic migration is also common among their children and grandchildren. As more people grow old in both urban and rural South Africa than ever before, with and without co-resident family, increasing policy attention is being given to how need for care in older age will be met.

This paper considers the influence of migration on receipt of long term care for older adults with functional disability. It draws on data from two focus group and 70 in-depth interviews with a diverse sample of black older men and women and their families in urban, peri-urban and rural South Africa. Participants include older adults receiving formal (home-based, day-, residential) care and family care, as well as those called on to provide care. The paper explores who provides care - and who is expected to provide care - when family are employed elsewhere, and when they are not. It additionally explores the role of formal support and older adults' preferences for care. A key finding is that discourses around migration and older adults 'left behind', the inappropriateness of 'Western' formal care and the quality of family care do not accurate represent older South Africans' experiences.