"Taking care of my own blood": older women's relationships to their households in rural South Africa.
OBJECTIVE
This paper examines financial, emotional, and physical responsibilities elderly women are being asked to take on due to the incapacity of their adult children to care for the next generation; such incapacity is likely to increase as the HIV/AIDS epidemic worsens.


METHODS
This paper combines quantitative and qualitative data. Census data from the Agincourt health and demographic surveillance system (AHDSS) describe the presence of the elderly (specifically women over the age of 60 and men over the age of 65) in households in the Agincourt study site. Semi-structured interviews with 30 female residents aged 60-75 complement the census data by exploring the roles that older women, in particular, are playing in their households.


RESULTS
An elderly man and/or woman lives in 27.6% of households; 86% of elders live with non-elders. Households with a woman over the age of 60 resident (as opposed to those without) are twice as likely to have a fostered child living in the household and three times as likely to have an orphaned child in the household. Elderly women face financial, physical, and emotional burdens related to the morbidity and mortality of their adult children, and to caring for grandchildren left behind due to adult children's mortality, migration, (re)marriage, and unemployment.


CONCLUSIONS
Older women provide crucial financial, physical, and emotional support for ill adult children and fostered and orphaned grandchildren in their households. As more prime-aged adults suffer from HIV/AIDS-related morbidity and mortality, these obligations are likely to increase.
University of Missouri-Columbia, University of Colorado-Boulder, USA & MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of Witwatersrand, South Africa. schatzej@health.missouri.edu
Enid J
EJ
Schatz
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000401:mortality / Q000523:psychology; D000328:Adult; D032721:Adult Children; D000375:Aging; D017028:Caregivers / Q000523:psychology; D002648:Child; D017281:Cost of Illness; D004196:Disease Outbreaks; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000401:mortality / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D012424:Rural Population; D012737:Sex Factors; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D014930:Women / Q000523:psychology