Older Adults in Co-Residential Family Care: Circumstances Precipitating Rural Older Adults for Co-Residential Family Care Arrangements

Abstract

Using a phenomenological study design, this study attempts to investigate the factors that lead rural older adults to seek out co-residential family care arrangements. Twelve older adults from rural areas were interviewed in-depth; the data were then inductively categorized and organized into themes. The circumstances that lead older adults to give up their independent life and move in with their offspring in the research area include physical limits and health issues, separation and divorce, the loss of a spouse, economic troubles, neglect, inheritance disputes, and inaccessible places. The result recommends decision-makers and other interested parties that measures must be focused on preserving a favorable living environment for elderly people living in rural areas and addressing issues that are crucial in co-residential family care settings developing senior/adult care facilities and expanding access to health care.

1. Introduction

An increasing number of older adults are living and receiving support and care from diverse sources. Older adults can organize their living arrangements in official institutions, with other people, or by themselves, according to Li [1]. However, compared to those living alone or in institutions, the majority of older adults live with their family members [1, 2, 3, 4]. In Ethiopia, there are 3,568,810 million persons over the age of 60 or 4.8% of the country’s total population [5]. In 2022, the number is anticipated to reach 5,325,652 million. Among them, 78% of them would reside in rural areas, while 22% will do so in cities (CSA as given in Ministry of Labor and Social Affairs, [6]). In Ethiopia, the majority of senior citizens reside in their own or family houses and are supported by their families [7, 8, 9, 10]. In rural Ethiopia, older people primarily get care and support from their extended family network, which cannot be properly replaced by any other body [9].

The traditional system of care through familial ties is essential for the well-being of older adults in underdeveloped nations like Ethiopia where the system of public transfer for supporting older adults is inadequately established. However, studies frequently concentrate on older adults in residential care institutions with little attention to older adults living with their relatives [11], particularly to those who are dependent and in a co-residential living arrangement with their kin. This is despite the fact that the majority of older adults in Ethiopia receive care and support through their kinship ties [7, 8, 12]. When an elderly person can no longer handle necessary daily tasks on their own, care is required. Health, environmental, and economic changes spur support within families [13]. Many elderly people see an increase in family support as their sickness progresses [14]. Additionally, older adults may need care due to physical issues and psychological difficulties [15]. According to the vast majority of studies, physical limitations, especially those that affect ADL, increase the need for family care and the chance that older adults will live with family members [1, 16, 17]. Likewise, emotional closeness or bonding, as well as reciprocity of care [18, 19, 20], play important roles in co-residential family care [21, 22].

Widowed, divorced, and never married older people are more likely to live with and rely on their offspring than married older people [2, 16, 23, 24]. When elderly people lack the funds to cover their basic necessities and medical care, they must rely on their families [25]. On the other hand, older adults with great physical and mental health and the ability to give back appear to be prerequisites for care and support. According to a study conducted in Ethiopia, older adults who are financially independent, physically fit, and in good health are more likely to receive assistance [10].

Studies have also highlighted the socioeconomic, psychological, and spiritual requirements of older people in rural areas. Older adults deal with a variety of physical and psychological issues [26], such as joint discomfort and dependency-inducing sight impairment [27]. The context of caregiving in a co-residential care setting is determined by a variety of characteristics, including the caregiver’s relationship to the care receiver, gender, age, and socioeconomic status [28]. Older adults with little financial resources are more likely to be marginalized and have low social status [29], which can lead to isolation (neglect) and eventual loneliness. In addition, rural older adults have socioeconomic difficulty, low income, and a lack of land ownership [30, 31, 32].

Care choices for older adults are influenced by factors such as the number of children, educational level, residential area, availability of health infrastructure and care facilities, and filial piety-related values [33]. In Ethiopia, facilities offer older people essential services, health care, and recreational activities [34, 35]. Studies on the effects of institutional care and the requirements of senior citizens living in residential care facilities have also been done by Alemnesh and Adamek [36], Eskedar [37], Tigist [38], and Bruck [39]. Older adults benefit from the fundamental healthcare services offered in institutions, although they are insufficient [36, 37].

In Ethiopia, older adults receiving institutional care are more likely to experience depression, isolation from friends and relatives, a lack of daily activities, and a lack of social engagement [36, 37, 38, 39]. Getachew [40] and Aynshet [41] each conducted a study on the conditions of elderly persons who are homeless and older adults who are beggars. The research concluded that factors contributing to bad living conditions included poverty, death, separation from immediate family, and a lack of social support.

In her investigation of the care provided to Italo-Ethiopian war veterans (1935–1941), Hosseana [42] discovered that both formal and informal care providers offer financial, material, transportation, health, and informational support. The research on older adults in rural locations in Ethiopia received little attention from Abraham [43], Noguchi [44], Fantahun et al. [45], and Kifle [8]. However, elderly people in rural areas and those who live in communities remain a population group in Ethiopia that has received little attention [8, 11, 43].

In sub-Saharan Africa, where the majority of older adults live and receive support from their informal networks, families are strong and familial ties are still present despite the strain [46]. In Ethiopia, it is a widespread family system custom to look after older parents, especially in rural areas [7, 8, 9, 12]. In addition to this, the majority of the scholarly literature focuses on urban older adults who reside in institutions. Society has the propensity to view elderly people as helpless and dependent, which opens the door to abuse such as exploitation and neglect.

Older people make up 9.1% (11,103) of Bassona Warana Woreda’s total population, according to CSA [5]. According to the Woreda Finance and Economic Development Office report from 2021, the proportion of older people aged 60 and over in the total population is predicted to be 9.5%, which is significantly higher than the national share of older people (4.8%) in the total population of the nation as measured by the 2007 Census. This project will significantly advance knowledge, practice, and policy in the field of geriatrics in general and geriatric social work in particular given the paucity of literature on family care and support for older adults in Ethiopia. It will address the knowledge gap regarding aging rural Ethiopians receiving family care, which currently exists in the literature. The study’s baseline data on geriatrics and family care was what the researcher hoped would spark more research on informal care. This study aims to explore study participants’ experiences with the conditions that lead them to co-residential family care and is motivated by the paucity of studies on elder adults living in family care arrangements in rural areas.

2. Objective of the study

The main goal of this study is to examine and explain older adults’ lived experiences in rural areas in relation to the circumstances that led them to seek family care in a co-residential family care setting. This study specifically attempts to describe the socioeconomic and health-related factors that lead rural older adults to co-residential family care arrangements.

2.1 Research questions

1. What are the physical and health-related circumstances that precipitate rural older adults for co-residential family care in the study area?

2. What are the socio-economic circumstances that precipitate rural older adults for co-residential family care in the study area?

2.2 Scope of the study

Only older adults who were receiving co-residential family care at the time the study was done are included in the study. The study also specifically focused on the conditions that lead older people in rural areas to require co-residential family care in order to represent the lived experience of older adults.

3. Methods

3.1 Study area

Although the meticulous number of older adults in Gudoberet Kebele (the smallest administrative unit in Ethiopia) is unknown, it is estimated that 438 (46,089.5%) older adults live there based on estimates from the Bassona Werrana Wereda (the third-level administrative division of Ethiopia—after zones and regional states). The choice of Gudoberet Kebele to conduct the study is influenced by the practicality of the Kebele in terms of time and expense as well as the researcher’s familiarity with the area. The population is agrarians who depend on agriculture for their living, according to the manager of the kebele. Residents who belong to the Amhara ethnic group and are Ethiopian Orthodox Christians make up more than 99% of the population.

3.2 Study design

In-depth interviews with rural older study participants were conducted by the researcher to get the data. The lived experience of older adults in rural areas was investigated and described using a descriptive phenomenology approach, with an emphasis on the factors that lead to co-residential family care. According to Sloan and Bowe [47], the researcher selected this approach to examine and explain older adults’ experiences as they actually were. In a phenomenological study, it is typical to put away thinking and prior interpretation and place more attention on the lived experiences of older adults because these experiences make more sense to those who are living them. The study’s intrinsic structural experience belongs to older adults because of their lived experiences with it (Husserl, n.d. as cited in [48]). In addition, descriptive phenomenology employs bracketing or separating the researcher’s perspective, values, and comprehension of older adults’ experiences in co-residential family care [49]. So, the researcher used language to convey their personal experience that mimics how rural older adults’ facial emotions become psychological expressions [50]. Additionally, bracketing was used for the study’s analysis and interview. The study has received approval from the Mizan-Tepi institutional review board, and informed consent and confidentiality were properly acknowledged when interview data was being gathered.

3.3 The sample

The researcher has taken into consideration several phenomenologically recommended concerns when determining sample size. As Dukes [48] pointed out, the researcher placed a lot of emphasis on avoiding making assumptions about what they wanted to observe and paying attention to what was actually visible. Furthermore, samplings were also taken into account based on the research topics [51]. These factors guided the interviewing of 12 rural older adults receiving co-residence care who were available during the data collection.

Older adults who live with their families in a rural Kebele of Gudoberet and receive care from them are the study’s participants. The inclusion criteria for choosing participants older adults are developed in accordance with the study’s goal. The criteria utilized to identify participants are (1) older adults aged 60 and above based on the UN definition, (2) older adults who are co-residing with their family carers receiving care, and (3) older adults who are willing and capable of supplying information with consent.

3.4 Data collection procedure

This study employed in-depth interviews to get data from rural older adults by creating an interview guide. After the interviewer establishes a casual, engaging relationship with rural older adults, the phenomenology design calls for a lengthy interview in which data are gathered through open-ended questions [52]. The Mizan-Tepi University Institutional Review Board granted the study’s ethical approval (IRB). Additionally, the researcher adhered to [53] Ethical and Safety Recommendations when investigating delicate subjects. In addition, this study followed the Declaration of Helsinki’s guidelines. The older adults in rural areas were scheduled for interviews at a time that worked best for them. They were made aware of their ability to decline to take part in or not reply to particular interview questions.

Likewise, older adults were made aware of their right to privacy and secrecy, and they were advised that neither their names nor the information they provided would be utilized in any other way. About 40–75 minutes were allotted for the interviews. The participants’ native language of Amharic was used for all of the interviews. With the elder people’s permission, the interviews were audio recorded.

3.5 Data analysis

The first step in the data analysis method was arranging the older adult interview data and phenomenologically transcribing the audio recordings. The researcher has horizonalized the interview data by assuming that each statement is pertinent to the study. Listing the meaning or meaning units was done after the horizonalized sentences. After that, meanings were grouped into common themes (a group of related data arranged in the same location) and categories, resulting in a meaningful “essence” that permeates the data. This was accomplished by eliminating overlapping and repeating statements [54]. The textural descriptions of rural older adults in a co-residential family care setting were then developed using these grouped themes and categories. Construction of the circumstances for co-residential family care is based on the textural descriptions, structural descriptions, and integration of textures and structures into the meanings and essences of rural older adults’ lived experiences [52]. This study’s goal is not to theorize using previous interpretation, as was discussed in the study design. So, information gathered from older people in rural areas is inductively coded.

The researcher has carefully listened to the audio recordings of all of the participants older adults in order to improve the quality of the data. Peer debriefing involved disclosing part of the data and analysis to coworkers in order to solicit their helpful feedback. In order to confirm that the analysis accurately reflects the lived experiences of the study’s rural older adult participants, the researcher also presented the analysis to them.

4. Findings

The study participants who are older adults move out of their own homes or locations and into co-residential family care. For a variety of reasons, they moved away from their initial residence, and they spent between about 2 months to 23 years living in the houses of their offspring. The older adult participants’ socio-demographic characteristics (Table 1) are listed below for a better understanding of their background. Additionally, the studies use pseudonyms to characterize the experiences of older adults.

Participants (pseudonym)	Sex	Age (years)	Education	Religion	Marital status	Source of livelihood	Number of children alive	Relationship with current caregiver	Number of years lived in their current living arrangement
Almaz	F	89	No education	Orthodox	Divorced	Agriculture	1	Mother	23
Emebet	F	65	Read and write	Orthodox	Widow	Agriculture	3	Mother	14
Asegedech	F	67	No education	Orthodox	Divorced	Agriculture	1	Mother	Since married
Abebe	M	69	No education	Orthodox	Remarried	Collecting fire woods	2	Father	5
Mulu	F	61	No education	Orthodox	Remarried	Local liquor sale	2	Mother	20
Bogale	M	88	No education	Orthodox	Widow	Agriculture	4	Father	5
Mekonen	M	89	Fourth grade and church education	Orthodox	Widow	Agriculture and pension	5 (adoptees)	Father (not biological)	Since married
Haile	M	92	Church education	Orthodox	Widow	Agriculture and pension	8	Father	Since married
Desta	M	82	No education	Orthodox	Married	Agriculture	5	Father	Since married
Gizachew	M	75	Read and write	Orthodox	Separated	Agriculture	1	Father	3
Yeshemebet	F	73	No education	Orthodox	Widow	Agriculture	7	Mother	2 months
Gete	F	70	No education	Orthodox	Widow	Agriculture	8	Mother	5

Table 1.

Socio-demographic characteristics of older adult participants.

4.1 Physical limitations and health problems

The functional limitations of older adults to carry out tasks is one of the justifications for shared living. Among the participants, Bogale, Haile, Mekonen, Desta, and Yeshemebet claimed that their choice to live with their adult children was motivated by a physical inability to manage daily tasks on their own. Their primary means of subsistence is agriculture, which involves hard physical labor. However, when they grew older, they found it difficult to handle the demands of agricultural labor. They, therefore, made the decision to leave all of their assets, including their land, to their children who lived close by in the hope that they would manage them and take good care of them.

I started to lose my strength as I grew older. I was unable to tend to the animals while also cultivating the stony farmlands. I then made the decision to sell the cattle and give one of my daughters the farmland in exchange. I also let my two girls use the empty space in my compound. They built their own home and share residence with us. (Desta, 13 April 2021)

Nevertheless, due to temporary and bedridden health issues, some older adults are unable to maintain their independent living. Even though they were physically fit when it started, their condition forces them to depend on their children. Before they begin to cohabit with their children, Emebet, Abebe, Bogale, and Yeshemebet each give a brief description of their health.

I plunged into a little gorge twelve years ago. Then my hand and one part of my leg went numb. My kids drove me to the hospital and got me some holy water. I am unable to regain my health, though, because nothing is possible apart from God’s approval. I therefore stay here and sleep in the midst of my kids as I wait for God to either heal me or take my life. (Emebet, 24 March 2021).

Due to an eye condition that made it difficult for me to cook, fetch water, and perform other household tasks, I was unable to work. Consequently, two months before to the date of this interview, I made the decision to move in with my married daughter. I do not have a female child living with me who helps with household duties. (Yeshemebet, 18 April, 2021)

According to interview data from older adults in the study area, their physical health and strength are decreasing, forcing them to look for co-residential family care.

4.2 Inaccessible location

The decision of older adults to relocate their living arrangements to their offspring, who are located in a relatively accessible location, is influenced by the location of their home or neighborhood being inaccessible. Their inability to access the institutions they deemed essential for the old age period is a result of the remoteness of their former location as well as their physical deterioration. Some older adults find it difficult to complete their old age activity because of the distance to a church and the rough terrain.

The environment made it difficult for me to move into the location I wanted when I was at home. I find it challenging to consistently travel to church due to the slick roads. When I get older, that’s when I need to connect with God. I therefore require a convenient place where I may locate a church close by. Because it’s convenient for me to attend church and is closer to town, this is where I’ve chosen to live. (Bogale, 29 March 2021)

Gete also notes the terrain and how to get to the church, but she also stresses out how the weather and lack of medical facilities have an impact on her health and force her to change her living situation.

I formerly resided in a warm, sunny lowland area. I struggle with hypertension. Additionally, there isn’t a clinic where people can get examinations and medical care. My children warned me that the warm, sunny weather might make my condition worse. I made the decision to come here because it is a highland location and is close to health centers. (Gete, 15 April 2021)

As a result, the necessity for co-residential family care in rural older adults is influenced by external circumstances. Regardless of the quality of family caregiving, older adults are encouraged to live with their families in co-residence by the neighborhood’s generally favorable physical environment, which allows them access to religious and medical institutions.

4.3 Separation and divorce

One of the circumstances that lead to co-residential family care is conflict with a spouse that results in legal separation or divorce. Some of their reasons for divorcing their spouse and choosing a new living situation for their children include behavioral issues with their spouse, complications with their husband and adoptee, and disputes over children born outside of marriage.

We shared a home for 35 years. We are currently residing in different locations due to our inconsistent behavior. I moved to Addis Abeba and stayed there for eighteen years as a result of her behavior. I built a house once I got home. I imagined that we would cohabitate. But she walked away from me. I became sick because I was upset. Then, when I arrived here, my sister assisted me in obtaining medication and recovering from my sickness. She warned me not to go back to my house again, so I made this my home. (Gizachewu, 12 April 2021)

Due to tension between her husband and the adoptee, Almaz, 89, and her husband split 23 years ago. Her husband planned to give the adopted child ownership of their farmland.

We had one adopted child and my spouse had been sterile. My husband wished to give the adoptee the farmland. He intended to take the farmland, according to my adoptee. I informed him that since he is not a member of my blood family, he cannot take my land. Our argument became very heated. He gave me some little barley. I instructed him to consume the barley. I divorced at that point. I eventually got to my biological child. (Almaz, 23 March 2021)

Asegedech also says that she made the decision to live with her child because her spouse had an extramarital child. She was angry and made the decision to move in with her married daughter.

4.4 Death of spouse

Emebet, Yeshemebet, Gete, Bogale, Mekonen, and Haile are among the older participants who are widowed. All of them, with the exception of Emebet, lost their spouses when they turned 60. If their spouses were still alive, some of the participants who switched to co-residential family care said they would prefer to live alone. They must relocate their living situation with their children due to the loss of their partner, their ensuing isolation, and the difficulties they face at work.

Upon the death of my wife, I encountered difficulties in living because there is no one with me to cook and do other domestic work. Then, I decided to live with my child after the 7th year of my wife’s death. (Bogale, 25 April, 2021)

After turning 80, Mekonen and Haile lost their wife. They could not support themselves on their own. They made the decision to welcome their married son and daughter into their own house as a result. When their spouse passed away, they moved in with their children.

4.5 Economic problem

Because they lack the resources to live alone, some older adults must rely on and live with their children in order to be healthy. They have no other option for living but sharing a home with their children, especially if they lack farmland. Abebe, Mulu, and Asegedech spoke about a financial issue that led to co-residence with their children.

During the Derg regime, the local administration took my farm. After that, I got a job renting land from nearby farms. However, when my physical fitness declined, I was unable to continue, and the cost of renting land increased such that I could no longer compete with other farmers. These made me dependent on my son, then I had to switch to my daughter. (Abebe, 20 May, 2021)

The main cause of my daughter’s dependence on me is the financial situation. I have no source of income and have instead spent the majority of my life working for others. I moved in with my daughter because I was having financial trouble. (Mulu, 26 April, 2021)

Asegedech further notes that her reliance on her daughter is a result of the financial difficulties she encountered following her divorce from her husband.

I didn’t receive a portion of the land or any other property when my spouse and I got divorced. After that, I ran into financial problems. My daughter was my final hope. I arrived here because I lack any sources of support. If I had a source of income, like farmland, I believe I am capable of surviving on my own. (Asegedech, 27 April, 2021)

Men are the primary breadwinners in the study area, and if a husband dies, the wife will find it difficult to maintain her usual lifestyle on her alone, forcing her to move for co-residential family care.

4.6 Neglect and inheritance dispute

Among the various factors that lead older adults to leave their house and move in with another child is neglect by nearby children and possible abuse threats. Participants who are older adults who have moved away from their former homes note that they may be threatened and neglected by their children if they share a house or live in the same area. When there is a conflict of interest, children who are supposed to be a source of protection can end up being a threat to older people. Children and the surviving parent clash when one of the parents pass away about who will inherit what. Sometimes the argument is intensified to make older people fear their children and leave or move in with another child who can take care of them and protect them.

One of my children begged me to give her a half of her father’s property after my spouse passed away. I complied with her request and collected my village’s elders and youngsters. I instructed my kids to split up their father’s assets evenly. Then, one of my daughters steadfastly refused to split the acreage because she wanted to take all of her father’s land by herself. We argue over this as a result, and I filed a lawsuit. I was permitted to use the land by the court. I gave her permission to take her share even after the court’s ruling, but she persisted in pestering me. She intended to murder me. Due to the fact that I was living alone, I began to fear for my life. I left my house as a result and moved here to be with my children. (Gete, 15 April 2021)

Some of the older adults were compelled to move out of their home and live with another child or relative due to abuse by a son who shared a residence with them. Bogale and Yeshemebet emphasize how frustrating it is that their sons have been neglecting them at home. They complained about how their married son, who lived in the same compound, was treated.

My child displays challenging conduct and lives with me in one compound. I gave her a blessing because his wife is a lovely person. But my kid treated me badly. He ignored me for the first three and a half years after the loss of my wife. He never encourages me to approach close to the fire, even when I start to get cold, while he relaxes there. I become upset as a result, and I ask my other son to take me to him. (Bogale, 29 March 2021)

Although older adults in this study want their children to provide them with care and safety, there are occasions when difficult relationships arise as a result of financial considerations and caregivers’ abusive behavior toward older people. By escaping this toxic and violent relationship, the older adult’s decision to move to a new co-residential family care setting is mediated by the presence of an adult child with a stronger emotional attachment.

5. Discussion

The likelihood of co-residence is determined by the parents’ financial dependence on their children, their marital status, and their capacity to perform activities of daily living (ADL) independently [17]. The move to co-residence is linked to older adults who are widowed having declining health [55]. As older adults with health issues are more likely to depend on others for a living, their physical and mental state affects whether they choose co-residential family care. Changes in functional health status result in a requirement for additional family support and an increase in the possibility that older adults will live with children [1, 16, 17].

This study also shows that independent living is impossible for older adults due to their physical limitations in doing daily tasks. As a result, they are compelled to live together with their adult children since they require help with daily tasks.

The co-residence of older adults with their children was also found to be influenced by their marital status. Ruggles and Heggeness [24] observed that changes in older adults’ marital status owing to separation, divorce, and widowhood enhance older people’s need to co-reside with their offspring. This conclusion is consistent with the study’s findings. The likelihood of co-residential living with children grows as a result of the change in marital status experienced during a period of widowhood [16]. The results also showed that the requirement for co-residence is not solely caused by a change in marital status, as older adults’ decisions to do so may also be influenced by financial pressures and physical limitations that prevent them from living alone. Accordingly, a study by Audinaryana et al. [2] found that socioeconomically disadvantaged women, widows without jobs, and those who have had physical disabilities are more likely to live with their adult children.

Challenges arise for older adults who want to keep their independence due to economic issues. Due to their financial struggles, they are forced to change their living situation to co-residential care. According to earlier research [17], economic factors influence informal family care, and indicators of older adults living situations include their degree of education, occupation, and pension [1, 2, 17]. Owning material goods and working in the economy helps older adults keep their independence, but economic hardship makes it more necessary for them to live with children. While older people with high occupational levels and pension coverage live alone, shared living is more likely to occur when one’s financial capacity is lower [1, 2]. In this study, agriculture is the main source of income for older adults, who also have lower literacy rates. Age-related financial pressures force them to rely on co-residential family care.

Older adults in the study area are vulnerable to challenges with their ability to support themselves due to the lack of social security programs. For people without access to farms, the economic burden is too great. The choice of older adults will be influenced by a variety of factors, therefore having financial resources does not ensure independent living. This study demonstrated that, despite having adequate financial resources, older adults often need to live with their adult children due to physical restrictions and inaccessibility of their residence. Some senior citizens who are unable to manage their property and live independently move their married adult children into their own homes.

This study also identifies other factors that lead rural older adults to change their living arrangements, including inheritance conflicts, abuse, and neglect by their shared child. However, earlier research has shown that older adults who experience violence or family conflict tend to live alone or stop sharing housing, contradicting this conclusion [56]. It is advantageous for older adults who have been mistreated or neglected to move to other co-residential care when other children are available who have stronger emotional bonds with them. Older adults move in with their adult children for emotional connection and a healthier parent–child bond [17]. The results showed that older adults who experience abuse usually arrange their living situation with a caring, close-knit adult child.

5.1 Conclusion and implication for practice

Older adults decide to co-reside for family care for a variety of reasons, including physical limitations and health issues, an inaccessible location, separation and divorce, the loss of a spouse, economic difficulties, neglect, and disputes over inheritance. Future policy initiatives for the care of older people in rural areas should think about making local infrastructure development accessible, bolstering the family system, and extending support services. Physical, psychological, and social difficulties are forcing older adults in the research region to relocate for co-residential family care.

In Ethiopia, social work is still a relatively new profession. Higher education institutions should seek to open and expand gerontology social work education by developing faculty, curriculum, attracting a large number of students, and disseminating research findings in order to satisfy the requirements of older adults [57]. To offer care for this population group that is becoming more and more demanding, social work education generally and geriatrics social work training in particular should be increased.

Addressing older adults’ social and psychological needs is just as important as meeting their bodily requirements. Interdisciplinary education must be prioritized if gerontological social workers are to be qualified. Geriatric social work interventions should include a biopsychosocial approach and interdisciplinary teamwork, especially with health experts, to address the complex needs of older adults and their family caregivers [58].

Senior centers should be built because they provide a number of advantages, including opportunities for older people to make new friends and find joy in life [59]. Additionally, the establishment of senior centers in rural areas would encourage self-care and health management among older people living there [60]. Senior centers also encourage older people’s involvement in the community through social interaction and friendships with other older people, both of which have been found to be important in other studies [61].

The creation of daycare facilities helped older adults live better lives by addressing their loneliness and sense of isolation [62– 64]. Additionally, because older adults in nuclear families are more likely to suffer from depression than those in joint families, the importance of family caregivers for older adults should not be minimized [65]. Besides that, it is important to recognize the role that family support plays in reducing loneliness in old age, especially for people who do not get enough family time [63]. It is also important to offer assistance to rural older adults’ family caregivers in order to lessen their burden of caregiving. Training in caregiving [66], financial assistance and reimbursement for the care given to senior citizens [67], and provision of farmlands for family caregivers are significant.

The creation and implementation of home care for senior citizens, which is currently a favored style of care, should involve social workers significantly [28]. It is essential to increase older adults’ access to healthcare. Additionally, daycare and family care arrangements could be combined with services like health education and entertainment programs.

It is important to provide material assistance and expand community health insurance programs. The quality of life for older people in rural areas will improve thanks to gerotechnology or the provision of assistive gadgets for incapacitating medical issues. To support older people in rural areas and lessen the strain on family caregivers, it is crucial that all stakeholders—including governmental and non-governmental organizations, religious institutions, and human service professionals—play their part.

5.2 Limitations of the study

“Why do older adults in rural areas in the research region seek co-residential family care?” is the topic that this study seeks to address. A co-residential family care arrangement’s sorts of services, older adults’ needs, interactions, and problems are not examined in this study. Furthermore, conclusions from the study should not be extrapolated to apply to other older adults receiving co-residential family care outside the study area.

Acknowledgments

I would want to show my gratitude to all the respectable senior citizens who took part and shared their expertise, opinions, and experience by sparing their time and energy. Without their gracious attitude and active participation, the study may not have been able to be completed. They were incredibly cooperative and supportive. Because of them, my time in the field was really intriguing and enlightening. Fourthly, I would like to express my gratitude for the assistance and collaboration of the Gudoberet Kebele Administration, the Bassona Werrana Woreda Administration Office, and the North Shoa Zone Labor and Social Affairs Office during the data collection process.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

Declaration of conflicting interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval and consent to participate

Ethical clearance was obtained from Mizan-Tepi University research directorate. The aim and potential benefits of the study were discussed with all older adult participants. Written informed consent was taken before involved with participants.