Men's experiences delivering palliative home health care in rural South Africa: an exploratory study

Aims: The study reported here formed part of a larger study that explored the experiences of health-care workers providing palliative care in patients' homes in rural South Africa. This paper hones in on the experiences of male caregivers. Zulu culture has been strongly patriarchal and the gender of a caregiver may affect both patients' and caregivers' experiences. Methods: The study was exploratory, qualitative, and combined a visual methodology with unstructured interviews. The setting was a hospice and three home-based care organisations in rural KwaZulu-Natal, South Africa. Participants were a male Zulu nurse and two male informal home-based caregivers who have been trained in components of palliative care. Results: These male caregivers appeared to care deeply and altruistically for their patients and appeared to provide gender-appropriate care for male patients. Female patients were wary of being cared for by a man, for example having concerns that male caregivers may perpetrate physical abuse, including rape. Thus, challenges of being a male caregiver included the potential to not be appreciated by and/or to be subject to physical and verbal abuse from the community they serve. Conclusions: This study contests South African literature that presents male caregivers in a negative way. It emphasises a need to value and support male caregivers. The challenges faced by male caregivers are largely unexplored and further research is required as men could potentially play a valuable part in providing palliative care in rural homes.