The faces and stories of Lebanese elders: Changes in family structure, differing demographics, quality of life, and challenges faced in building capacities for care givers in social services

Advances in modern heath care have resulted in an exponential growth in the world’s elderly population. The Arab world, in particular, has experienced a fifty percent drop in mortality rate over the last twenty- five years. Concomitantly, life expectancy has increased from fifty-five years of age in 1975 to sixty seven years of age in 2000.

Lebanon, a diverse, conflict-affected country of 4.2 million people, is located on the Mediterranean Sea in the Middle East. Similar to the rest of the Arab world, its birth rate has decreased from 4.6% in 1970 to 1.9% in 2004. The mortality rate has also dropped from 9.1% to 7.1% per 1000.  Life expectancy has increased from 66 years of age in 1970 to 74 years of age in 2004 with an increase in the aging population from 4.6% in 1970 to 7.4% in 2004. Notably, recent conflicts have increased the number of widows in the country with 50.6% of women more than 65 years of age, of whom 81.5% head poor households.

Family structure has transitioned from an extended model to a nuclear format. The traditional role of ‘taking care of one’s elders’ has faded as priorities and lifestyles of younger generations change. At the same time, many women have left their gendered sphere of the home, and entered the formal economy and labor market.  With these shifting dynamics and in the absence of institutions that cater to older populations, elder care is in jeopardy. The country's high unemployment rate (8.9% in 2004) and the rising costs of healthcare exacerbates the situation for this at-risk population. 

To better understand the issues faced by elders and their caregivers in Lebanon, and to improve the capacity to meet identified needs, we conducted a 6-day capacity building workshop on Alzheimer Disease (AD) in 6 distinct demographic regions in collaboration with the Lebanese Ministry of Social Affairs and the AD Lebanon Foundation. Mixed methods data collected during the training revealed important insights into how local caregivers cope with AD; the socio-economic burden, pathophysiology, epidemiology, and cognitive and emotional wellbeing of Lebanese affected by AD (including elders and their caregivers); and the public health impact of an AD national outreach program. Understanding the needs of the growing Lebanese aging population and their caregivers is critical to inform social service programs.