ILCSA aims to bridge research, education and policy in all its programmes. It carries out policy analysis and promotes advocacy under each programme, and strives to forge policy development or reform. It currently focuses on promotion of healthy and productive ageing, and the empowerment of older persons towards full participation in society. The programmes, which reflect the mission and scope of the organisation, involve scholars from diverse intellectual disciplines and stakeholders in all sectors.
Overall, researchers investigate a relationship between health, longevity, self-determination and quality of life in old age. Some studies focus on livelihoods and income security; others on living habitats and personal safety; and others on health care and human rights. Researchers generate and draw on both macro and micro data to analyse situations and to identify emerging trends; evaluate social, health and economic programmes and policy options; and offer conceptual clarification for the development of new strategies and responses.
ILCSA currently conducts three core programmes, outputs of which are aimed at informing stakeholders, creating awareness and forging policy action.
Eradicating Age Discrimination & Promoting Human Rights
Evidence shows that numerous older persons in South Africa are abused, exploited, neglected and/or marginalised. In particular, numerous social pensioners are exploited for their money and assets, and as carers to grandchildren. Building on evidence generated by the Institute of Ageing in Africa (IAA) over more than three decades, and in response to public and civil society concerns, ILCSA's programme aims to empower and foster the protection of older persons through the dissemination of information, the promotion of awareness of their human rights, and advocacy. Thus, it works to help them withstand the abuse and discrimination, and claim their rights, and to encourage the government and civil society to develop policy and create structures to eradicate discrimination and abuse.
Supporting & Empowering Older Carers to Persons Affected by HIV/AIDS
ILCSA works with national and community based organisations with a mission to support and empower older people, older women in particular, who care for persons infected with the HI virus and/or who themselves have AIDS or are affected by the disease. Its dedicated research, policy and education programme is aimed at reducing these persons' vulnerability, strengthening their capacity to cope, enhancing their well-being, and sustaining their contribution to the care management of the epidemic. A current focus of the programme is to empower older women to know their HIV status and to demand anti-retroviral therapy if diagnosed positive.
ILCSA enjoys a first-rate partnership with the NGO Grandmothers Against Poverty and AIDS (GAPA), based in Khayelitsha in the Western Cape Province, and operated in several settings in three provinces, as well as in certain neighbouring countries.
In turn, GAPA offers ILCSA investigators a participatory research site to generate evidence to inform policy and programme development, as well as to contribute to the women's empowerment and capacity building.
Expanding Geriatrics Clinical Services & Education
Geriatric Medicine in sub-Saharan Africa is in need of urgent development and expansion. A similar need exists to enhance and co-ordinate geriatric care to ill and frail older persons, and to train and support informal carers to such persons. Few resources are made available for the training and employment of specialists in geriatrics, or for the care of geriatric patients, and neither are resources available to train informal carers. A growing number of people is set to live to an advanced age, and will heighten a demand for services (particularly the management of chronic illnesses and disabilities) and put additional strain on already challenged public health systems.
The programme aims to work with the South African government, the governments of other SSA nations, African institutions and global agencies to develop a strategy to improve and expand clinical education and services in this field.
Current and Recently Completed Research Projects
Research projects recently completed or current deal broadly with a) health and social care service delivery to older clients; b) long-term care (solutions in African settings); c) promotion of age friendly communities; and d) HIV/AIDS and ageing. Selected projects are described briefly:
Testing the WHO Age-Friendly Primary Health Care Toolkit to improve care for older patients. The study aims to improve health and quality of life of older patients through improved primary health care assessments and management of medical and social conditions.
Health literacy and HIV prevention in persons aged ≥50 in South Africa and Lesotho. The study is identifying factors that promote and inhibit HIV/AIDS prevention practices in older adults in these countries.
Development of self-care management for older clients with type 2 diabetes attending Community Health Centres in Cape Town. The study examined older clients’ knowledge about living with and managing diabetes, and their social support structures, to inform the development of a self-care management programme.
An exploration of services and member profiles at senior service centres in the Western Cape, South Africa. The study examined the utilisation of specific programmes at service centres, towards the development of user and service centre profiles.
The future of long-term care for vulnerable older adults in sub-Saharan Africa. The project aims to reconcile formal long-term social and health care with informal care provision to inform intervention to mitigate the risk of unmet care. To this end several Research-Policy-Practice dialogues were convened and two Masters’ students completed their courses.
we-DELIVER. The project is aimed at delivering better services to older persons (>60 years) in rural communities in South Africa through the use of information and communication technologies (ICT). It is funded through Tirelo Bosha - a public service improvement programme and partnership between the South African Department of Public Service and Administration (DPSA) and the Belgian Development Agency.
ILCSA publications (selected)
Adebusoye LA, Kalula SZ. 2019. Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, South Africa, 2010 – 2013.South African Medical Journal, 109(2):116-121. doi: 10.7196/SMJ>2019.v109i2.13275
Hoffman J. 2018. Second parenthood realities, Third Age ideals: (grand)parenthood in the context of poverty and HIV/AIDS. In: Timonen, V. (Ed.) Grandparenting practices around the world. Bristol: Policy Press.
Hoffman J. 2018. Parenthood between generations: Transforming reproductive cultures. Journal of Population Ageing, 11(2): 209–212. 10.1007/s12062-017-9189-z#citeas
Hoffman J. 2018. Age(ing) on the youngest continent: Challenges and (imagined) prospects. In: Pawlik A (Ed.) Grey is the new pink: Moments of ageing. Kerber, Germany, pp 78 - 85.
Kaplan M, Thang LL, Sanchez M, Hoffman J. (Eds.) Intergenerational contact zones: Foundations and applications. Routledge [In press]
Kelly G, Mrenggwa L, Geffen L. 2019. “They don’t care about us”: older people’s experiences of primary healthcare in Cape Town, South Africa. BMC Geriatrics, 19(1): 98.
Mapira L, Kelly G, Geffen LN. 2019. A qualitative examination of policy and structural factors driving care workers’ adverse experience in long-term residential care facilities for the older adults in Cape Town. BMC Geriatrics, 19(1): 97.
Policy and advocacy activities (2018-2019)
ILCSA contributes to policy debate on older persons nationally, regionally and globally. All ILCSA research projects are aimed at policy development. At both sites, Kalula and Hoffman engaged in advocacy for service improvement and innovation. Hoffman convened an international multidisciplinary research-policy-practice dialogue on developing a “Long-term Care Economy in Gauteng (province), South Africa: Expanding Opportunities for Work and Equality,” (hyperlink) outcomes to promote employment and enterprise creation, and to advance gender equality. Hoffman convened a seminar series on “’Leave no one behind’ – Sustainable Goals, Ageing Global Development” towards forging the universal 2030 Agenda for Sustainable Development, at the University of Oxford (hyperlink). Hoffman participated in a panel discussion in the CommonAge Forum alongside the Commonwealth Heads of Government Meeting in the UK. He participated in a forum at The Rockefeller Centre at Bellagio, Italy on “New Partnerships to Improve Social Health and Economic Reinvestment in Low-Income Neighbourhoods: The Role of Anchor Institutions,” focused on broad health and wellness issues, and forging new partnerships including with financial institutions. With photographer Osborne Macharia in Kenya, he contributed to a photographic exhibition on “Age(ing): Grey is the New Pink” at the Weltkulturen Museum in Frankfurt, Germany, focused on facing the “challenge of ageing” optimistically and tapping potential in older persons (hyperlink). He gave a plenary address in the IAGG Africa Region conference on “Long-Term Care Systems for Africa: Setting Agendas,” in Nairobi, Kenya.
Kalula presented a paper in the “Family Summit in Celebration of the International Day for Families,” in Johannesburg; and participated in a South African “Theory of Change” workshop in Johannesburg to map a research project on “Strengthening Responses to Dementia in Developing Countries (STRiDE), towards developing a National Dementia Plan. She is a member of a group to identify indicators to assist clinicians with palliative care needs. She gave a video link talk on making Cape Town an age-friendly city, in the IAGG’s14th Global Conference on Ageing in Toronto, Canada.
Education and training activities (2018-2019)
At both ILCSA sites, undergraduate and postgraduate training on health and ageing, and in Gerontology per se has a strong emphasis on research, as part of degree studies, as well as on public education through seminars, guest lectures, etc. Selected activities during the review period include: Kalula participated in a Diploma in Palliative Care course under the Department of Public Health and Family Medicine for patients with dementia. She gave a presentation on management of falls in older persons in workshops of the South African Geriatrics Society and a preparatory course for candidates for the Diploma in Geriatric Medicine examination. She gave a presentation on clinical geriatric symptoms in a pre-conference master class for the IAGG Global Social Initiative on Ageing (GSIA), convened by Hoffman, Nairobi, Kenya. Hoffman, with the UN International Institute on Ageing (INIA), Malta, convened an introductory course in Social Gerontology attended by 20 policy makers and practitioners.