Across South Africa, a growing number of families are quietly facing a reality few are prepared for: the emotional, physical, and financial cost of caring for elderly parents who can no longer care for themselves. At Pensioners Forum, we hear daily from people overwhelmed by this responsibility. We’ve come to call it the “Elder Tax” — the cost of stepping in when systems of support fall short.
What is the Elder Tax?
The Elder Tax isn’t a government levy — it’s a term we use to describe the unpaid burden placed on adult children or family members when their ageing parents can no longer live independently. This includes everything from covering medical expenses to giving up employment to provide full-time care.
SASSA and Private Pensions: Not Enough
While the SASSA Older Person’s Grant provides important support, it is limited in value and cannot cover full-time care, frail care facilities, or home nursing services. Private pensions, when available, are often modest and do not account for escalating health costs or inflation. For many, even basic necessities stretch their resources thin.
Limited Access to Elderly Caregiver Support
There is a SASSA Elderly Caregiver Grant, but it is means-tested and based on strict criteria — including proving disability or dependency and meeting household income thresholds. For those who do qualify, the process of applying can be complex and lengthy. Many are unaware of the grant, and others fall just outside eligibility despite facing real financial strain.
Affordable Elder Care Remains Out of Reach
Government-subsidised old age homes are few and highly oversubscribed. Waiting lists can stretch for years. Meanwhile, private frail care or assisted living costs often range from R15,000 to R30,000+ per month, well beyond the means of the average South African family. In-home care options, while sometimes more flexible, still come at a cost of R6,000 to R15,000 or more per month — and that’s before medical supplies, food, or rent.
The Bridge Family Reality
Many middle-generation households today are what we call “bridge families” — supporting elderly parents while also raising children or assisting unemployed adult dependents. In some cases, this means multiple generations living under one roof, sharing one income, and trying to meet everyone’s needs. Often, someone in the household must give up their job to provide care, which compounds financial pressure.
Emotional and Mental Strain
Aside from the financial demands, the emotional toll of caregiving can be immense. Families managing dementia, frailty, or chronic illness without proper training or support often report exhaustion, depression, and feelings of isolation. Access to mental health resources for carers is also extremely limited.
Government Support Structures: Present, But Inaccessible for Many
While South Africa does have elder care policies and some provincial programmes, they are often overstretched and under-resourced. Public frail-care facilities cannot meet growing demand, and even where home support services exist, access can be inconsistent across regions.
Families who try to access these services often encounter red tape, long waiting periods, and insufficient guidance. The system, though not entirely absent, is not built to handle the scale of need that now exists.
Conclusion
The Elder Tax reflects a growing pressure on ordinary South African families — one that is rarely discussed, but increasingly common. While some public support is available, it often falls short or remains inaccessible to many who need it most.
There is no quick solution, but greater awareness of the reality many are facing is a necessary first step. By sharing these experiences and understanding the current gaps, families can better prepare and explore support options — even if limited — and begin broader conversations about elder care in South Africa.
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