The influence of social change on informal care among older spouses in rural Ghana

BACKGROUND AND OBJECTIVES: Informal care is essential for older people living in low- and middle-income countries, where there is less public funding aimed at promoting well-being in later life. In Ghana, however, the emergence of economic modernization has led to the decline of informal care from adult children, resulting in increasing reliance on spousal care. Despite this shift, gaps remain in our understanding of older spouses' care for one another in rural Ghana, such as the influence of individualism, patriarchy, and the caregiver's own mental and physical health. This study sought to address these gaps by exploring the ways that economic modernization has changed older spouses' experiences of caregiving. RESEARCH DESIGN AND METHODS: Semi-structured interviews were conducted with 10 married couples from three rural towns in Ghana. RESULTS: Spouses perceived economic modernization as influencing a shift in their children's values from interdependent to independent, which motivated their children's migration to urban areas in pursuit of their individual socioeconomic advancement. This contrasts with children's traditional obligations rooted in collectivism, including providing informal care for their aging parents. The relative absence of adult children in rural Ghana thus compels an increasing reliance on spousal care, leading to challenges including exhaustion, gender incongruence with the traditional caregiving role, depression, and loneliness. DISCUSSION AND IMPLICATIONS: Declining filial care in low- and middle-income countries highlights the need for government policies that ease older spouses' care burdens, such as implementing non-contributory pension schemes, expanding community-based formal care, and developing rural infrastructure.