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SOCIOLOGY | RESEARCH ARTICLE
Care of the elderly in Nigeria: Implications for
policy
Perpetua Lum Tanyi
1
*, Pelser André
1
and Peter Mbah
2
Abstract: Nigeria has no functional national policy on the care and welfare of older
persons. Changing demographics in Nigeria, in addition to the breakdown of the
family structure and absence of a social security system, present unique challenges
to the elderly in Nigeria. This paper analyzes the current policy lacuna and future
issues concerning older persons in Nigeria. It posits that the introduction of neo-
liberal economic policies created a vacuum in policy formulation and execution in
which the older persons are not provided for within the social safety nets in the
neoliberal state. This exploratory, qualitative study is based on interviews and
narratives of interviews with government officials. The findings of the study show
that, in the face of rapid demographic change, one of the major challenges facing
Nigeria is developing policies and appointing personnel capable of understanding
and responding to the current social priorities and complex needs of an increasingly
ageing population in the country. Based on the findings, the study provides
recommendations that may assist the government to table policies that will pro-
mote the well-being of the elderly in Nigeria.
Subjects: Social Work; Education—Social Sciences; Sociology & Social Policy
Perpetua Lum Tanyi
ABOUT THE AUTHORS
Perpetua Lum Tanyi holds a PhD (Social work)
from the University of Nigeria. She is currently
a postdoctoral research fellow with the University
of the Free State, South Africa and a senior lec-
turer at the Department of Social Work at the
University of Nigeria, Nsukka. Her research inter-
ests include gerontology, care and policy for the
elderly and intergenerational relationships.
André Pelser holds a PhD (Sociology) from the
University of the Free State (Bloemfontein, South
Africa) where he is currently a professor of
Sociology. His areas of expertise include applied
social and policy research, social ecology and the
implications of changing population dynamics for
human development and the environment.
Peter Mbah holds a PhD in Political Science
from the University of Nigeria and is currently
a senior lecturer at the Department of Political
Science at the same university. He has authored
several articles on elections, political parties,
conflict, and governance in reputable local and
international journals.
PUBLIC INTEREST STATEMENT
Changing demographics in Nigeria, the break-
down of the family structure and absence of a
social security system, present unique challenges
to the elderly in Nigeria. This paper analyzes the
current policy lacuna and future issues concern-
ing older persons in Nigeria. It argues that the
introduction of neoliberal economic policies in
Nigeria created a gap in policy formulation and
execution in which older persons are not pro-
vided for within the existing social safety nets.
This study is based on interviews with govern-
ment officials in Nigeria. The findings show that,
in the face of rapid demographic change, the
major challenge facing Nigeria is developing
policies and appointing personnel capable of
understanding and responding to the current
social priorities and complex needs of an
increasingly aging population in the country. The
study provides recommendations that may
assist the Nigerian government to table policies
that will promote the well-being of the elderly in
Nigeria.
Tanyi et al., Cogent Social Sciences (2018), 4: 1555201
https://doi.org/10.1080/23311886.2018.1555201
© 2018 The Author(s). This open access article is distributed under a Creative Commons
Attribution (CC-BY) 4.0 license.
Received: 16 June 2018
Accepted: 22 November 2018
First Published: 3 December 2018
*Corresponding author: Perpetua
Lum Tanyi, Department of Sociology,
University of the Free State, PO Box
339, Bloemfontein 9300, South Africa
E-mail: PerpetuaT@ufs.ac.za;
Lum.tanyi@unn.edu.ng
Reviewing editor:
Kar-wai Tong, HongKong Baptist
University, HongKong
Additional information is available at
the end of the article
Page 1 of 14
Keywords: ageing; family support; Nigeria; neoliberal state; pension scheme; policy;
retirement
1. Introduction
The fast-growing number of older adults during the last few decades has impacted significantly on
the political, economic, and social functions of societies in both industrialized and developing
regions. According to the Population Division of the United Nations Department of Economic and
Social Affairs (United Nations Department of Economic and Social Affairs: Population Division
[UNDESA], 2015), the proportion of older persons aged 60 years and above make up 12.3% of
the global population, and by 2050 that proportion will rise to almost 22%. Sub-Saharan Africa,
which has the smallest proportion of elderly and which is ageing slower than the developed
regions, is projected to see the absolute size of its older population grows by 2.3 times between
2000 and 2030 (UNDESA, 2015). People are living longer because of better nutrition, sanitation,
health care, education, and economic well-being. An ageing population poses numerous social and
economic challenges, but the right set of policies can equip society to address these challenges in
time.
Like any other country in sub-Saharan African, Nigeria’s elderly too is increasing rapidly. In
Nigeria, those aged 65 years and above (the elderly) make up 3.1% or 5.9 million of the total
population of 191 million, which in crude numbers represents an increase of 600,000 during the
5-year period 2012–2017 (Population Reference Bureau, 2012) (National Council on Ageing 2016).
The rising numbers of the elderly in Nigeria are among others attributed to the crude mortality rate
that is gradually decreasing (Adebowale, Atte, & Ayeni, 2012). Ageing in Nigeria is occurring
against the background of socioeconomic hardship, widespread poverty, the HIV/AIDS epidemic,
and the rapid transformation of the traditional extended family structure (Adebanjoko & Ugwuoke,
2014). Another cause for the increase in the older segment of the Nigerian population can be
found in the declining fertility rate (although still one of the highest in Africa) that has continued to
drop since the 1980s. In 2017, the total fertility rate registered at 5.5 compared with 6.8 in 1980
(Population Reference Bureau, 2017; United Nations Population Division & United Nations
Statistical Division, 2015). Apart from the decline in fertility, improved health and sanitary condi-
tions have also contributed to the rise in life expectancy. Ageing causes people to be less active,
frail, and exposed to more risks of contracting a disease, leading to prejudice or discrimination
against the elderly, social isolation, and, sometimes, abandonment.
Despite the demographic impact of the AIDS epidemic, the Nigerian population is projected to
continue ageing over the next two decades. Current demographic projections indicate that Nigeria
will experience a doubling of the population over the age of 65 by the year 2020 (United Nations
Population Division, 2015). Furthermore, of all age groups, the group over age 85—i.e. the oldest
old—is increasing the fastest. Amidst this demographic reality and the challenges it is about to
unleash in future, Nigeria will be hard-pressed to meet the economic, health, psychological, and
material well-being challenges of the elderly, especially as traditional family support systems for
the elderly are breaking down and disappearing in the country (Okoye, 2012). This paper reports on
a study that investigated the challenges that are associated with ageing in a neoliberal state, care
of the elderly, and the views of government officials on this matter. Recommendations are also
made that may be considered to promote the well-being of the elderly in Nigeria.
1.1. Problem statement
A major challenge facing most governments in Africa is the development of policies and training of
officials capable of understanding and responding to the current social priorities and complex
needs of an increasingly ageing population. The ageing of populations across the globe is
a demographic reality of our times. By 2050, there will be more older people worldwide (aged
60 years and over) than children under 15 years for the first time in history (Pelser, 2012; UNDESA,
2013). Developing countries are now faced with an ageing revolution at a different scale than what
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is already unfolding in the industrialized nations. Statistics show that the more developed regions
have experienced the most significant extent of ageing, while many of the less and least devel-
oped countries have only just begun to experience the ageing transition in full (South African
Institute of Race Relations [SAIRR], 2012; UNDESA, 2013; Goodrick & Pelser, 2014). However, the
less and least developed regions are catching up in terms of progression through the ageing
transition. On average, the most rapid increases in older populations are occurring in the less
developed world, where it is projected that between 2006 and 2030, the number of older persons
in less developed countries will increase by 140%, as compared to an increase of 51% in the more
developed countries (Botchway, 2018; Powell, 2011). By 2012 only the more developed regions
were characterized by having “old”populations, with more than 14% of their populations aged
65 years and older (UNDESA, 2013). Comparatively, only 5.8% of the populations in the less and
least developed regions were aged 65 years and older. The less developed regions, however—
because of their overall superiority in total population numbers—have far more elderly than the
more and least developed regions.
Even though population ageing is seen as one of the great triumphs of human development
because the majority of people now expect to survive to old age, an ageing population has
implications for, among others, labor markets, health care, and social security. With relatively
low levels of social and economic development and little access to adequate health care, a country
like Nigeria will be hard-pressed to meet the challenges of large numbers of elderly people,
especially as traditional family support systems for the elderly are breaking down (Abanyam,
2013; Okoye, 2012).
In anticipation of this growth in the elderly population, employers, health, and social service
providers, as well as the general public, will increasingly turn to government for help. The govern-
ment will be expected to initiate policies that will support older people, train and empower health
and social service professionals, and supply employers with a trained workforce to take care of the
older adults. Thus, authorities at all levels of governance have a direct stake in arguably the most
significant demographic shift of the twenty-first century.
By responding to the demands of employers and health-care providers, as well as the demands
of the general public, governments in the developing regions will be faced with both new and old
challenges, including the education of the general public and the recruitment and training of
professional officials to care for older people. The government of Nigeria, therefore, has to position
itself to face and address the economic, health, social, and psychological challenges that will be
unleashed with ageing in the twenty-first century. Against this background, our paper explores the
following two questions: First, what are the challenges that come with ageing in Nigeria?
and second, what is the current state of the policy environment in Nigeria when it comes to
matters that impact the well-being of the elderly in that country?
1.2. The neoliberal state and care for the elderly in Nigeria
Nigeria, the country with the largest population in Africa (191 million), has an elderly projected
population growth rate of 3.2% (Population Reference Bureau 2012,2017)—a rate that has been
estimated to double by 2050 (Mbah, 2016). This trend calls for concern as it poses major economic,
psychological, health, and social challenges to the Nigerian state. What really heightens the
challenge is the absence of clear policy, or any functional social security service, for the elderly
people in Nigeria. Consequently, social policy for the elderly people remains turbulent, especially
with the retrenchment of the welfare system in favor of the adoption of neoliberal policies in
Nigeria. Two major distinguishing attributes of the neoliberal state are privatization, which trades
on the profit motive, and the removal of state subsidies. The latter in particular marginalized both
the elderly and the poor (Ekanade, 2014). Studies of the elderly have always emphasized the need
for Nigeria to make serious efforts to cater for the needs of this group and highlighted the fact that
the elderly needs special policy intervention for care and protection (Animasahun & Chapman,
2017). Hence, it has become imperative to explain why the poor and challenging situation of the
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elderly exists and why policy intervention aimed at the interests of the elderly has become
a pressing issue in Nigeria.
During the oil boom era (1971–1980) in Nigeria, the period saw free medical services, including
food for hospitalized patients who were admitted to public health facilities (Alubo, 1987, p. 453). In
this sense, the government was really spending a huge amount of money on social welfare
services, not only for the elderly people who retired from the civil service but for the entire
populace. However, the drop in oil prices in the international market resulted in a deficit of
Nigeria’s balance of payment. This led to the retrenchment of the welfare system and the provision
of basic amenities and to the introduction of a neoliberal policy in 1986 (Ekanade, 2014; Mbah,
2016). In the neoliberal context, democracy was reestablished to satisfy market demands without
adequate regard to social needs. Neoliberal reforms were not concerned with social issues, but
with market efficiency, which worked against the basic tenets of human rights and constitutional
safeguards for Nigerian citizens.
2. Theoretical discourse
The study that informed this paper drew extensively on existing knowledge of public welfare in
Nigeria. Hence, our principal epistemological point of departure is a social contract theory of social
security. In this social contract, everybody surrenders to the government all their rights; the
surrender is complete (Ibeanu & Mohammed, 2005). This perspective suggests that people accept
to give up their rights to protect themselves to the state—including the right to public welfare and
security—on the understanding that the state will provide adequate physical and social security
(Ibeanu & Mohammed, 2005). As such, people transfer the realm of public welfare to the state and
its agencies and resorting to self-protection and self-care when the state fails to fulfill its part of
the social contract. This can be described as the General Will (Guillemette, 2002). People transfer
the responsibility of the provision of the welfare to government on the understanding that
government, the central agency of the state, incarnates this General Will rather than any combi-
nation of Sectional Wills that may exist in society. The concept Sectional Will refers to the sum
total of the Sectional Wills that compose society. The failure of social security and social policy in
Nigeria is a reflection of a general failure of this social contract. The citizens confer possession on
government and once this is done, it is sustained insofar as government incarnates the General
Will rather than the Sectional Will. Policies are supposed to be an expression of the General Will
and can be made only by government on behalf of the people.
Logically, the introduction of the neoliberal state has deflated the social contract and worsened
the situation of the elderly in Nigeria. The removal of state subsidies and privatization of
programs emasculate the elderly people who have no economic means of livelihood. This condi-
tion exposes the elderly to diseases and death because it has brought the elderly under the dead
weight of privatization, removal of state subsidies, and alienation from social welfare and care
(Mbah, 2014). In Nigeria, ageing is perceived as a burden, especially to family members, as the
country has failed to provide financial help or benefit from the abundance of experiences that
come with old age in the form of wise counsels in the resolution of conflicts or crises in the
community. Thus, this reminds the Nigerian government of the social policies which she is
supposed to provide to serve the citizens and justify their existence. However, the burden of care
for the elderly squarely rests on family members despite the provisions made in the 1999
Constitution. Section 14.2(b) of the Constitution states that the security and welfare of its people
shall be the primary purpose of the government, and it promises in Section 16, sub-section 2(d),
that suitable and adequate shelter and suitable and adequate food, reasonable national minimum
living wage, old age care and pensions, and unemployment, as well as sick benefits, will be
provided to all citizens (Mbah, 2014; Federal Government of Nigeria, 1999, p. 12). Unfortunately,
the Nigerian government seems not to have kept up to this social contract and has reneged on
these promises, as most elderly people are not covered by any social policy within the new planned
social security scheme, but instead has opted for the creation of employment opportunities for the
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youth. Thus, the introduction of neoliberal and neo-economic policies has brought to the front
burner the hopelessness of the poor and the elderly in Nigeria (Mbah, 2014).
3. Methods and procedures
The data for this paper emanate from an exploratory and qualitative study that was based on inter-
views conducted with and narratives derived from government officials. Interviews were conducted by
the first author with chairpersons in Nsukka local government area in the Enugu State of Nigeria who
held a degree in any discipline in the social sciences and who were knowledgeable on issues concerning
the elderly. A total of three local government chairpersons were interviewed: The chairperson of Nsukka
urban area; the chairperson of Ibagwani local government (suburban), and the chairperson of Utobolo
(rural area). The participants were all males, because at the time of this study no female was a local
government chairperson in Nsukka local government and there were only three local government
chairpersons who had a Master’s degree. The rationale for targeting only those with a degree was
because we believed they were educated and exposed to policy issues in Nigeria, especially issues
concerning the elderly, and also because they were well informed about all the transitional periods and
policies in the country. Another major reason for selecting the chosen chairpersons as our respondents
is because they can influence the local government level policies in favor of the elderly. The respon-
dents’ages ranged between 48 and 57 years, and all of them were married and had children. Nsukka
local government is located on the north-western part of Enugu state and is predominantly rural with
Nsukka town as the only urban area. The choice of Nsukka local government as the study area was,
first, because of its peculiar characteristics in attracting many academic activities. Nsukka is
a university town and has local government chairpersons who are educated, knowledgeable about
the ongoing political, social, and economic situation in Nigeria, and, more importantly, issues concern-
ing the elderly in Nigeria. Thus this gave the researchers the opportunity to elicit information from these
chairpersons. Second, the first author is familiar with the area and could get the desired information in
a relatively short period, thereby minimizing the costs of fieldwork and data gathering.
An interview guide was constructed to explore the dilemmas of the elderly and the range of
resources available to them. The research purpose was explained and viewpoints sought on
questions in the interview guide. Questions addressed the major problems impacting upon the
welfare of the elderly, formal and traditional (informal) forms of support, means of income, and
access to key resources and welfare services, if any, that are available to the elderly. On average,
interviews lasted 45–60 min. Interviews were tape recorded for those who gave consent. The local
government chairpersons were approached directly at convenient venues in their offices.
Interviews, guided by the interview schedule, with framed questions ensured consistency and relia-
bility. This permitted an objective appraisal on forms and levels of support by the government if any. All
respondents were assured of confidentiality and advised that they were free to withdraw at any time.
Narratives and accounts were put together. Narratives reflect the challenges that come with
ageing and the welfare schemes in Nigeria. The narratives are teased out based on a review of
government policy response. Thematic data and subthemes, analyzed in consonance with the
research questions, captured the issues on welfare schemes and challenges faced by the elderly in
Nsukka, Enugu state of Nigeria.
4. Findings and discussion
The findings are divided into the following subheadings. Section one: Challenges that come with
ageing and care of the elderly, section two: General and social policy aimed at the elderly, section
three: Strategy for policy and advocacy on issues concerning the elderly population in Nigeria, and
section four: Recommendations.
4.1. Section one: challenges that come with ageing and care of the elderly in Nigeria
Studies carried out by Animasahun and Chapman (2017) reveal that demographic changes in
Nigeria present several challenges that may influence the modification of federal regulations,
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health policies, or social programs that may promote physical, social, and health through active
ageing. Interviews with our participants revealed that the elderly in Nigeria are faced with
challenges of retirement, ageism, and social isolation.
4.1.1. Retirement
Many people envisage the idea of retirement as a life stage of leisure, untroubled and carefree
living, relaxation, and traveling. However, this vision of retirement does not happen too often in
Nigeria. In the current economic dispensation, more and more individuals have no choice but to
work well past the age of even 80 years if they are given a chance, because going on retirement
poses several challenges in Nigeria (Odaman & Ibiezugbe, 2014; Oladeji, 2011). The abrasive reality
is that most of the elderly in Nigeria find it very difficult to adjust to life after retirement. One of the
respondents captured it this way:
Apart from money, another part of the challenge of retirement is adjusting to retired life.
Work provides many people not only with income but also with social interaction and
a sense of purpose. So, our job is often an important part of our identity. When it ends, it’s
common to struggle with the loss of that identity. Many Nigerians, especially those in the top
position in this country, when they retire you find that they find it very difficult to integrate
into society. This is because when they were working, they were driven around, they had
body guards and were living in luxury. But when they retire they lose all these and it affects
them negatively. Frustration sets in and you find them living a miserable life. (56-year-old
local government chairperson; urban dweller)
The Nigerian government has failed pensioners who had high expectations of the implementation
of pension regulation schemes existing in the country. These expectations arose from the need to
have a sustainable standard of living in retirement and their benefits paid when due. The different
pension regimes operating in Nigeria, namely a defined benefit (DB) and a contributory pension
scheme (CPS), gave rise to a varying set of problems that limited the capacity of key stakeholders
within the Nigerian pension industry to meet pensioners’expectations.
According to Apere (2015), the problems that surround pensioners in Nigeria include: (1) Delayed
or nonpayment of pension entitlements and misappropriation of existing pension funds; (2) low
standard of living (or high poverty incidence) among pensioners due to pension increases not in
line with salary inflation or no pension increase at all; (3) too frequent verification of pensioners by
pension transitional arrangements directorate (PTAD) (section 42 of PRA 2014) leading to pen-
sioners dying during verification exercises; (4) inadequate enforcement of pension regulation: After
more than 10 years of existence of the CPS, not all state governments had enacted their pension
laws to establish the CPS, which is a sign of regulatory weakness (Apere, 2015). The actuarial
valuations of the old DB schemes required by PenCoM (National Pension Commission) at the point
of implementation of the new CPS have not been carried out even for those State Governments
that have already established their CPS.
The greatest problem we have in this country is that our leaders don’t keep to their words.
The people managing the pension scheme don’t keep their word. Many elderly who depend
on pension suffer to get their pension, many even die before the pension starts coming.
Some of the elderly who are retired cannot even pay their rents. Some who retire and move
to the rural areas die immediately they get home because of suffering. (48-year-old local
government chairperson; rural dweller)
Since poverty remains a major challenge in Nigeria, elderly persons who have retired from the
economic productive phase are most vulnerable to experiencing economic hardship. Since the
statutory age of retirement in Nigeria is 60 and 70 years (depending on where you work) and is the
cut-off for being categorized as an elderly person, the majority of this group of (elderly) people are not
socially and economically secure (Oladeji, 2011). Elderly people are usually forced to cope with the
paradox of dwindling financial resources, increased health challenges, and a geometric rise in
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medical expenses. In particular, elderly people living in urban areas in Nigeria only utilized health
services and other services when they were available, accessible, and affordable (Odaman &
Ibiezugbe, 2014). The patterns of the economic lives of older persons in Nigeria vary by urban and
rural residences (Odaman & Ibiezugbe, 2014). In urban Nigeria, elders with high physical and
psychological functioning are forced to retire once they reach the statutory retirement age. They
face abrupt declines in their income and can feel less self-worth or even experience depression, since
they perceive themselves as still being fit to work. One respondent articulated the situation as follows:
The problem we have in Nigeria is lack of planning. Most of our people don’t plan for their
retirement and when it comes it takes them by surprise. Some of them immediately fall ill
because of no money. Some of them die just a few years after their retirement because of
poverty. Coupled with the fact that Nigerian government has no clear policy for the elderly it
affects the retired people so much. Some of the elderly people die even before their pension
has been processed. (56-year-old local government chairperson; urban dweller)
However, in rural Nigeria, since many older persons are not formally employed with a company or
some other form of governmental organization, they continue to engage in menial jobs and
manual work on the farms with meager earnings as long as their physical strength can afford.
The rural elderly may suffer from health disorders and physical exhaustion and often have no
retirement benefits to serve as social security. One respondent put it this way:
Poverty is the watch word in many of the rural communities in Nigeria. Most of the elderly people
residing in the rural communities have no support from the government. They get support from
faith based organizations or from their relatives. Elderly people who don’thaveanyrelatives
suffer a lot in Nigeria. (50-year-old local government chairperson; suburban dweller)
Another respondent echoed the plight of the rural elderly as follows:
In this community there are no basic amenities. For example people have to walk so many
kilometers to get drinking water, electricity is not regular. The elderly in the rural commu-
nities cannot even afford electricity bills, there are no health facilities in this community. The
elderly have to travel long distances to get medical attention. The rate of suffering is just too
much. The government has not done anything to improve the lives of the elderly in this
community. (48-year-old local government chairperson; rural dweller)
For many people, it can be unpleasant to grow older in Nigeria, especially those in the low
income sectors. Our society and culture value youth, and being old is sometimes treated like
a disease that has no cure. It’s a reality that all of us have to get old at some point, so
ageing is a huge challenge in this country. The elderly people face a lot of challenges and
there is nothing they can do about their situation. (56-year-old local government chairper-
son; urban dweller)
4.1.2. Ageism
Another challenge of ageing that seems more obvious than retirement is ageism. Although it can
target any age group, ageism generally refers to prejudice and/or discrimination against older people
(Abrams & Swift, 2012). Ageism can be either blatant or subtle. For example, it involves anything from
refusing to hire an elderly worker to assuming an older woman needs help crossing the road.
The elderly are often victims of negative stereotypes: They are perceived as slow, confused,
helpless, resistant to change, and/or generally unhappy (Abrams & Swift, 2012). Like racism and
sexism, discrimination can happen when unfair generalizations like this are made. Although the
stereotype is not true of every older individual, age-related bias, unfortunately, exists in some
settings in Nigeria. Said one respondent:
In some rural communities elderly people are called witches and wizards. This is common
amongst elderly women who don’t have children. They are being labeled in the community
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as being wicked and wizards. The incidence of abuse is common in Nigeria. At times you just
see an elderly woman with bruises all over her body. They are abused physically, emotionally
and financially. These elderly women are so ashamed to complain of any form of abuse,
because they are not sure anyone will believe them. The government of Nigeria has no laws
guarding against this act. (50-year-old local government chairperson; suburban dweller)
The authorities’neglect of the elderly was expressed in a different way by another respondent:
In Nigeria we [used to] have so much respect for the elderly. In fact, in some communities the
elderly people are celebrated every year. But this generation is a different one. They believe
that the elderly people are not useful in the society anymore. The government of Nigeria has no
respect for the elderly people. They have no policy for the care of the elderly in this country.
They are not even considered when major decisions are taken in the country. Let me give you
an example. Last year some government officials came to this town to talk about HIV /AIDS.
Many people came to the hall. When these people started they asked all the elderly people to
leave the hall, they made them understand that HIV/AIDS has nothing to do with them. We
were so angry and all of us left the hall. We know in our community that the elderly people are
the ones taking care of children orphaned by HIV/AIDS. That is how we ended up not listening
to the government officials. (56-year-old local government chairperson; urban dweller)
Let me tell you how the Nigerian government neglects the elderly. There is no special
medical care for the elderly in this country. When the elderly are sick they go to the hospital
where every other person goes. We have very few doctors who are knowledgeable about
illnesses that come with ageing. The elderly in Nigeria are really suffering. If an elderly falls
sick he/she prays to die rather than stay alive and suffer. They are not given any special
treatment in the hospital. They are expected to queue in the line and wait for their turn to
see the doctor like others. (50-year-old local government chairperson; suburban dweller)
4.1.3. Social isolation
Another major challenge the respondents identified when it comes to the elderly is that of social
isolation. Social disengagement theory argues that ageing can be thought of as a mutual with-
drawal or disengagement which inevitably takes place between the ageing person and others
(Cumming & Henri, 1961). The process leads to a relinquishment of roles since the ageing person
drops out of the working sphere and children move out of the house. In addition, older people face
a reduction of ties since peers start to die off. This process is conceived as removing the individual
from a certain amount of normative control, free to become more individualized, and less likely to
be easily assimilated into new groupings (Cumming & Henri, 1961)
While many older adults experience ageing as a positive time because they remain active and
connected to others, the majority of other elders become disconnected from family, friends, and
community. Understanding the causes of isolation can help position policymakers to help mitigate
feelings of isolation among the elderly and contribute to a much-needed societal change.
The environment can play a big role in isolation among the elderly. Many community settings
are not ageing-friendly. The vast majority of older adults prefer to age in place. As reported by
Partners for Livable Communities (2007), a design that makes it difficult to walk may contribute to
older adults’isolation and therefore may negatively impact their quality of life.
Research has shown that rural areas have higher incidences of poverty and less access to
community resources, such as activity centers, grocery stores, pharmacies, and town halls
(Fochingong, 2014; Hartman & Weierbach, 2013; Snedeka, 2017). For older adults in rural areas,
lack of access to these services is often the greatest challenge faced. Without them, it is difficult to
continue to live independently and meaningfully. But regardless of whether isolation is imposed by
one’s environment or chosen by the individual, its effects are of significant concern for the growing
ageing population and require more attention.
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There may be an assumption that urban areas, which offer public transportation, are more
supportive to older adults. However, what many do not realize is that the physical problems that
can make driving difficult for older individuals can also make using public transportation difficult.
For example, individuals with physical disabilities may have trouble crossing wide streets to reach
bus stops or may have difficulty climbing the high stairs of a bus or train. Or, perhaps, an individual
has always driven but now has to rely on public transit and needs assistance with navigating the
route or timetable. Customer service may not always be willing or able to respond to those needs
(Burkhardt, McGavok, & Nelson, 2002).
All the roads in Nigeria are so bad…so bad that even some people with cars find it very
difficult to drive their cars in some parts of the town. Many elderly people stay isolated
because they are afraid to fall or to be knocked down by a car. There is nothing in Nigeria like
an age-friendly environment. (56-year-old local government chairperson; urban dweller)
Stigma also contributes to both voluntary and involuntary isolations of the ageing population.
Many people make assumptions about ageing and focus on ageing stereotypes, i.e. of what an
individual cannot do, without knowing an individual’s capabilities. Statements such as “You’re too
old for that,”are uttered so often that perhaps they are perpetuating a self-fulfilling prophecy.
Ageism has long been present in society and is a form of discrimination. It is important not only to
do away with these stereotypes but also to avoid paternalistic tendencies. Older adults affected by
HIV/AIDS may also isolate themselves:
In this community I find so many older people who are so withdrawn, they stay indoors,
they don’t even go to the market or church, and this is because they don’t want to be called
names. Elderly people who have lost children to HIV/AIDS or who have children suffering
from HIV/AIDS are not comfortable. Some elderly people who are HIV/AIDS positive don’t
even go anywhere. They stay in their homes alone because they don’t want to be called
names or be abused by others. (48-year-old local government chairperson; rural dweller)
Retirement for many older adults can symbolize a significant life transition. People may have
different attitudes toward this new phase of life based on their circumstances. Some may look
forward to traveling and exploring other activities, some may be wondering what they will do to
occupy their time, and still others may be forced to retire due to age. Undoubtedly, retirement can
cause a decrease in the amount of social contact an individual experiences throughout the day.
Retirement not only impacts social connectedness but also can cause a shift in income and social
roles (Kaplan & Berkman, 2016). For some, retirement can be symbolic of an end. In as much as
Nigerians live a communal type of life, the issue of social isolation is becoming an issue now,
especially among the elderly people.
The local government chairperson in the urban area had this to say:
Many of the elderly who retire from the civil service now don’t go to their village homes. They
retire and stay in the city center. At times they live alone in their apartments. Their children
have their own apartments. Some of the parents will not want to even stay with their
children because of either their lifestyle or because they want their own space. There is
nothing in Nigeria like an adult day care center where they can go and relax with their
friends and come back to their homes. They stay alone in their homes and become isolated.
4.2. Section two: general and social policy aimed at the elderly
Provision of social services such as income, security, health care, housing, and legal assistance can
positively influence the well-being and health of the elderly (Oladeji, 2011). However, in Nigeria,
there is no national social security system to provide an economic buffer in old age. In 1989, the
Nigerian government developed the national social development policy which aimed to provide
a framework for protecting elderly persons from moral and material neglect and provide public
assistance when necessary. Despite the development of the national social development policy to
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care for the elderly, there has been no effective execution of this policy by any federal agency
(Abdulkadir, 2016; Oladeji, 2011). For older adults in rural areas, lack of there are indications of
policy frameworks for the elderly to be carried out in Africa, policy changes have not been observed
in Nigeria (Mudiare, 2013). The failure of the Nigerian federal institutions to regularly disburse
pension funds to retirees and provide adequate social services for the aged poses a significant
threat to food security, social security, and national security (Ajomale, 2007).
We also tried to understand if there were any cultural practices that contribute to the care of the
elderly or stopping the government from taking care of the elderly. All the local government
chairpersons made us understand that there is no cultural practice stopping the government
from taking care of the elderly in Nigeria.
Culturally, we respect the elderly in our communities. We take care of them when we have
the resources. In our culture, we consider the elderly people first in everything we are doing,
so if there were any policy from the government they would have been considered first.
However, the respect is supposed to be incorporated that, the oldest should be catered for
first. The elderly are not supposed to be undermined. However, the reverse is the case in
Nigeria. You will notice that the government has all kinds of policies for children and
reproductive health, but they don’t have any functional policy for the older people. (56-year-
old local government chairperson; urban dweller)
On the question of whose responsibility it was to take care of the elderly people in Nigeria, one
respondent replied as follows:
The first group that is supposed to care of the elderly people are the immediate family
members. It is culturally acceptable across the communities that family members should
care for the elderly people. Secondly, the committee of concerned citizens may decide to
take care of the elderly people in our community, or faith based organizations who usually
visit the elderly. For instance, in the Catholic Church, they have a donation for the poor.
These faith based organizations will make donations and take it to the elderly people in the
villages and towns. (50-year-old local government chairperson; suburban dweller)
Asking whether the care given to the elderly by the family members and the faith-based organiza-
tions was adequate or not, the following responses were received:
It depends on the wellbeing of the family taking care of the elderly one. If it’swithinarich
family you will notice that the elderly person will be properly taken care of. The person will
even have a special person assigned to her to wash her dress, cook food, even wash her body
for her. She will even have a personal doctor who visits her in the home to care for her health
needs. But if the person is poor and from a poor family you will see that the level of care will
be limited. In the community individuals try their best to provide the elderly who are poor with
feeding, medical attention, clothing and affection. (56-year-old local government chairperson;
urban dweller)
In Nigeria there are few geriatric departments in teaching hospitals. It is not like what they
have in other developed countries and some parts of Africa. We have the generalist method
of treatment in this country. We do not even have doctors who specialize for the care of the
elderly like they do for children (pediatrics) and for women (gynecologists). We do not have
doctors who specialize for the care of elderly people. Most of the elderly people from poor
families go to the government hospitals because they cannot afford the bills in the private
and teaching hospitals. Even the government hospitals at times do not have medications or
even the equipment to take care of the older people, so at times they just die out of
carelessness. (48-year-old local government chair person; rural dweller)
Compared to the early 1970s, 1980s and 1990s a lot has changed in the present dispensation.
In Nigeria back then there were free medical facilities to people, including the elderly people.
In the 1970s in Nigeria there was the oil boom. We had free medical services not only to the
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elderly, but to all Nigerians, free feeding in public health facilities and in universities. However,
with the introduction of the structural adjustment programme in 1986 and onwards, privati-
zation came and all the luxury disappeared. This structural adjustment programme introduced
in Nigeria brought poverty and suffering on the masses. (56-year-old local government
chairperson; urban dweller)
4.3. Section three: strategy for policy and advocacy on issues concerning the elderly
population in Nigeria
An ageing population in Nigeria poses several challenges to both the policymakers and the elderly
themselves. One such challenge, for instance, is the dysfunctional public and private pension
regulatory schemes which affect the elderly (Olukorede, 2013; Odo & Igbeka, 2011; Ubhenin,
2012). Some observers also mention that the family structure and traditional care for the elderly
in Nigeria are also collapsing (Okoye & Asa, 2011). One respondent summarizes these challenges
as follows:
In terms of policy for the elderly the three arms of government should take care of the
elderly: local, state and federal level of government. They should have a data base for the
elderly in each community to avoid double bended or corrupt practices that will infiltrate the
funds kept for care of the elderly. This data base will help the people managing it to know
those who will benefit from the program initiated by the government. Secondly, homes for
old people should be established in every local government area where elderly people who
do not have anyone to care for them, or any elderly person who wishes to stay there, can go
and stay. Next, in each local government area the government should partner with NGOs to
run the homes. Why they should partner with NGOs is because people in Nigeria do not value
or take government establishment serious. But if there is a partnership the government will
have people who will be on the ground to monitor the workers. Another reason for the
government to partner with an independent body is to avoid corruption and embezzlement
of funds. The Government should do something urgently to cater for the older people in
society. (50-year-old local government chairperson; sub-urban dweller)
4.4. Section four: recommendations
The results of this study have implications for stakeholders such as public social service agencies
(governments), private social service agencies (NGOs), family service agencies, social workers,
medical assistance, and other professional institutions in meeting the needs of the elderly. With
this in mind, the recommendations are tailored toward these agencies.
The growth in the ageing population is an opportunity for the Nigerian government not only to train
more social workers, nurses, and medical doctors to offer the much needed services but also for
individuals in different professions to come together and contribute to a positive and healthy societal
change that will benefit the elderly. The many social and economic challenges triggered by ageing are
an emerging issue and the government needs to table policies that will incorporate the elderly—
policies that need to ensure that the elderly will feel valued and connected in their old age.
It is imperative that all government sectors design innovative policies specifically targeted to
meet the emerging issues that come with ageing as indicated in the findings of this study. These
emerging issues should be categorized accordingly: (1) The common challenges that prevail
among the elderly in both urban and rural areas; (2) planning for retirement and management
of pension schemes; and (3) issues surrounding social isolation.
Some of the challenges that are common among the elderly in both urban and rural areas are
the diseases that come with old age and the lack of well-trained doctors to care for the elderly. The
Nigerian government should make sure that there are trained geriatric doctors incorporated into
the health-care system to take care of the health needs of the elderly. The government should
either establish geriatric hospitals or have geriatric sections incorporated in all the teaching
hospitals across the country to care for the elderly. There should be a framework for supportive
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and protective care that comprises those services provided to frail, ill, or disabled older people to
support them and their caretakers while maintaining their capacity to live in the community.
Apart from geriatric doctors, Nigeria needs more trained social workers and nurses to care for the
elderly. The educational system should recognize the challenges of an ageing Nigeria and incorpo-
rate gerontology content into the curriculum. By doing so, these professionals will be taught about
the process of ageing and how to care for the elderly. Another challenge common among the elderly
in the urban and rural areas relates to the geographical environment. The rural areas have very bad
road networks and so this makes it very difficult for the elderly to move around. Meanwhile, in the
city centers, the roads are good but too congested for the urban elderly dwellers to move around.
The government should create suitable transportation services in both urban and rural local govern-
ment areas for the elderly to facilitate access to shops or marketplaces, attend church services, keep
appointments with doctors, visit friends, and maintain contact with the family members. This is
important for those who can no longer drive or use public transportation.
While many people in the developed countries view retirement as a period to travel around the
world and spend time with friends/relatives, take trips to places they cherish, carry out home
projects, tackle new hobbies, the majority of people in Nigeria want to stay at work because of the
agony that comes with retirement. The Government of Nigeria needs to create awareness among
all citizens about the importance of preparing and planning for retirement. The country could do
this by organizing workshops where people will be taught how to prepare themselves for retire-
ment. The planning component may include identifying sources of income, estimating expenses,
implementing a savings program, and managing assets.
The pension scheme in Nigeria is not functional and because this affects the retired older
population, the government needs to incorporate new ideas into the scheme so that pensioners,
who are mostly the elderly, would not struggle to get their benefits when they retire from service. In
this regard, the study recommends for the Nigerian government to consider the following steps: (1)
Adopt a pragmatic approach to the pensioners’biometric verification process (a system of self-
verification by pensioners capable of automatically updating the pensioners’database) consisting of
an initial face-to-face verification in order to minimize the frequency of subsequent face-to-face
verification exercises. (2) Pensioners’biometrics is to be included in a database that is suitable for
future actuarial valuation, demographic and financial projections, which would also eliminate ghost
pensioners. (3) An automation of pension/gratuity calculations and the pension payment system to
ensure that pension increases are implemented on a timely basis relative to increases in workers’
salaries, thus allowing pensioners to receive their pensions/gratuities as and when due. The
Integrated Personnel and Payroll Information System for the federal public service should be
emulated at the state and local government levels. (4) A periodic actuarial valuation of the old DB
pension scheme as required by law needs to be carried out in order to ascertain the value of the
pensioners’liabilities at a given date as the scheme runs off. This will enable a realistic annual
pension budget estimate to be made for government(s) which will reduce the insufficient funds
being allocated for pension payment. This would help in the administration of the PTAD in minimiz-
ing the delays and arrears in pension payment. (5) The PTAD should set up a realistic pension
stabilization fund with the primary aim to stabilize the pension/gratuity payment system which is
always in arrears. This will ensure that money is readily available to pay the arrears of pension
liabilities.
5. Conclusion
In the face of rapid demographic change, the major challenge facing Nigeria is developing policies
and appointing qualified personnel capable of understanding and responding to the current social
priorities and complex needs of an increasingly ageing population. More fundamentally, Nigeria is
passing through a phase of rapid socioeconomic and political transformation as well as unsustain-
able economic development that has a negative impact on the care of the elderly. Thus, old people
have to count on either financial support from their children or other relatives or are otherwise left
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to die in a depressed economy. However, the analysis shown in this study has revealed that the
traditional emphasis on family-centered care is collapsing rapidly and is not a reliable financial
safety net for elderly people. Therefore, to improve the living conditions of elderly persons in
Nigeria, there is a need for an urgent policy engineering and refocus on the issues of older persons.
This can be done by restructuring the pension scheme and other social policies in Nigeria to favor
the elderly people, including those who never worked in any government establishments.
Funding
The authors received no direct funding for this research.
Author details
Perpetua Lum Tanyi
1
E-mail: PerpetuaT@ufs.ac.za
E-mail: Lum.tanyi@unn.edu.ng
Pelser André
1
E-mail: pelseraj@ufs.ac.za
Peter Mbah
2
E-mail: peter.mbah@unn.edu.ng
1
Department of Sociology, University of the Free State, PO
Box 339, Bloemfontein 9300, South Africa.
2
Department of Political Science, University of Nigeria,
Nsukka, Nigeria.
Citation information
Cite this article as: Care of the elderly in Nigeria:
Implications for policy, Perpetua Lum Tanyi, Pelser André
& Peter Mbah, Cogent Social Sciences (2018), 4: 1555201.
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