Why senior citizens find comfort in nursing homes

Eva Mpirirwa sits in her wheelchair in a well-kept living room at Tick Bedside Nursing Care and Elderly Home. She wears a long dress with a yellow scarf wrapped around her neck. Kinyankore gospel music blares from a mobile phone on the table, and the 83-year-old seems to enjoy it.

Merenia Tumuhabwe, a cheerful young nurse, sings along, perhaps to uplift and comfort her elderly client.

Mpirirwa is ageing gracefully, appreciating the care she receives in her golden years at the Home in Muyenga, a suburb of Makindye Division, Kampala City.

After a few minutes, Tumuhabwe feeds her a banana, one of the many daily services essential to Mpirirwa’s happiness and well-being.

Mpirirwe’s daughter, Margret Busingye, says her mother has been unable to walk for the last 15 years. She is convinced the care she is receiving has helped to prolong her life. 

“She was diagnosed with heart disease in 2011 and in 2017, she suffered a stroke. Her doctors at Mulago National Referral Hospital told me I needed to be patient because a stroke victim recovers over a long time. I was her caretaker when she was admitted to the hospital for a long time. However, when I realised my job was a stake due to prolonged absence, I hired a nurse to look after her,” she says. 

Busingye, the executive director of Tick Bedside Nursing Care and Elderly Home, is also a senior principal administrator at the Bank of Uganda (BOU). 

“I do not think she would be alive today without proper care. Caring for her is so demanding because she is vulnerable. In 2016, in the process of caring for her, I concluded that other elderly people are in dire need of such services,” she adds. 

Today, the Home has a capacity of four beds. Most of the clients are cared for in their homes, where professionals are deployed to offer much-needed services. These include feeding, physiotherapy, massage, drug administration, and general body care, among others. 

The elderly clients in the Home pay Shs200,000 per day, while those who are cared for in their homes pay a daily fee of Shs100,000. 

Best option

Veronica Akankunda, the founder of Golden Age Elderly Homes Uganda, says care homes are the best option for old people whose family members are too busy to be with them or those who have been neglected. Both situations lead to social isolation, depression, and poor health. 

“Several families neglect their old relatives because, according to them, these old people have exhausted their time on earth. But the elderly are a treasure trove of information; an encyclopedia. They are not useless,” she states. 

Akankunda, who studied geriatric nursing in the United Kingdom (UK), says in developed countries, people must set aside some savings for their old age. She believes Uganda should emulate this policy. 

“You must have an insurance plan to cater for you in your old age. Unfortunately, most people do not save for the future because they believe their children will be there for them. They also believe in earning from their property, but in most cases, the property of the elderly is grabbed by unscrupulous people,” she explains. 

Several nursing homes in Europe and the United States of America are funded by a combination of government and public benefit programmes. The elderly who need more services only need to top up using the money they saved when they were still in active service. 

“Social workers have the authority to remove the elderly out of their family homes and take them to nursing homes if they feel those old people are in danger or have no one to take proper care of them. Isolation, poor feeding, and neglect quicken the deterioration of old people’s health,” Akankunda says. 

She adds that many of the elderly have regained their health after they began receiving professional care, giving the example of her grandmother who died at 105 years because she had received the care she needed. 

Availability

Currently, Akankunda rans several nursing homes offering elderly care in Uganda, Rwanda, and Tanzania, including the Geriatric Training Academy. The services offered include personal care, medical reminders, rehabilitation, physiotherapy, and massage. 

Since 2013, Golden Age Elderly Homes has provided care to more than 960 elderly individuals and trained more than 250 home care-based carers. Some of Akankunda’s clients lived in the homes for seven consecutive years before they were integrated into their families, upon improvement. 

“Usually, some stay with us for a long time because their relatives do not have time to check on them because they are either busy or out of the country. Not everyone can afford to fly in regularly. The old people we eventually discharge are sent home with a nurse who continues to care for them,” she explains. 

The Home in Najjera, Kira Municipality has a capacity of seven beds, and clients who are admitted are undergoing palliative care. The Home in Namugongo accommodates about four clients and targets those not so ill and weak; only those in need of bedside care such as administering medication, feeding, and companionship. 

“Last year, the majority of our clients were offered home-based care. The cost of care depends on the condition of the client because some elderly people are also battling chronic health conditions such as high blood pressure, cancer, HIV/Aids, and dementia,” Akankunda says. 

The cost of taking care of someone who can feed themselves, can eat any meal, and does not need physiotherapy is different from that of a bedridden client or one who wears diapers. 

“There is the expense of buying diapers and catheters. On average, I would say one needs about Shs1m per month for someone that is mostly bedridden,” she says. 

Government’s role

Fredrick Nyanzi, the director of Aged Family Uganda, an organisation in Nsambya that advocates for the rights of the elderly and trains caregivers, says providing home-based care is better than bringing the elderly to a home, where they may feel like they are in a rehabilitation centre.

“We have 28 caregivers deployed in different homes across the country to care for the elderly. We offer home- based care for Shs600,000 per month. We also have a rehabilitation centre in Maya, Wakiso District, where we temporarily accommodate the elderly awaiting their medical appoint- ments from major hospitals,” he says.

The rehabilitation centre helps them to cut transport costs from their distant villages to the hospitals in Kampala. The clients pay Shs200,000 per night and Shs1m per month to cater for accommodation, meals, and drug administration. Those who wish to be transported to their respective health facilities pay some extra money.

Robert Ssebunya, the presidential advisor on Buganda Affairs, says the question of elderly care in Uganda is a critical one, given the fact that life expectancy has improved over the years. According to the National Population and Housing Census 2024, life expectancy in Uganda has risen to 68.5 years from 63.7 years.

The report indicates that persons 60 years and above constitute five percent (2.3 million) of the population. However, about 86 percent of them face neglect, with caregivers failing to meet their basic needs.

“The availability of nursing homes will save the elderly from neglect and abuse. The Catholic Church, through the Mapeera Bakateyamba Home is already helping the elderly and I know that soon, the Anglican Church and the Muslims will do the same,” he says.

Ssebunya’s plea is for the government and cultural institutions to consider including nursing homes in their budgets or commit to supporting the existing ones.

“It is important to take care of the elderly because no one wants to die or age alone. There are people recorded in the Guinness World Records as having lived more than 100 years. My maternal grandfather lived for 106 years. That is something I am proud of,” he asserts.

Although the government is implementing the Social Assistance Grants for Empowerment (SAGE), a cash transfer programme that helps older people and their households, the monthly allowance of Shs25,000 is a drop in the ocean. The Ministry of Finance, Planning, and Economic Development estimates that 302,820 senior citizens benefited from the grant in the 2023/2024 financial year.

However, Prosper Muhumuza, the commissioner for Disability and Elderly Affairs at the Ministry of Gender, Labour and Social Development, says putting the elderly into nursing homes is a sign of weakening family and community care and supportive centre systems.

“Caring for the elderly should be a collective responsibility within their homesteads so that they do not need to go to these homes. For instance, in Soroti District, there is a strong community and family system, where people volunteer to dig in old people’s gardens. The men repair the leaking roofs of the elderly,” he says. Muhumuza adds that Ugandans should not reason or act like Europeans, subjecting their old relatives to commercial homes as is done in the modern world.

“I believe that Uganda’s National Social Protection Strategy (2024-2029) would help revitalise the family-centred approach of providing care to members in need,” he says.

The key focus of Uganda’s National Social Protection Strategy (2024-2029) is to increase the reach of social protection programmes, increase the provision of cash transfers and other direct income support mechanisms, enhance access to social care services, and promoting social insurance expansion