Ghana’s population is gradually ageing, creating new long-term care (LTC) needs. The number of older people in Ghana (commonly defined as age 60+) has increased rapidly-from about 213,000 in 1960 to over 1.6 million by 2010 (aarpinternational.org)-and continues to grow. More than half of Ghanaians aged 65–75 are estimated to require some assistance with daily activities. However, formal long-term care services, such as nursing homes or home health aides, are very limited. As a result, care for the elderly in Ghana is predominantly provided by informal caregiving networks, including family members and community or religious groups.
This article examines Ghana’s current long-term care landscape, highlighting the heavy reliance on family care, the scarcity of institutional support, differences between urban and rural settings, and the cultural expectations shaping elder care. A brief comparison with the United States' LTC model is also provided to contextualise Ghana’s approach.
The Bedrock of Care: Informal Caregiving Networks
In Ghana, informal caregivers- especially adult children and other family members- are the primary source of support for older adults. It is traditionally expected that children will care for their ageing parents as a reciprocal duty. An oft-cited Ghanaian adage proclaims, “Because you [the parent] have taken care of me to grow teeth, I will take care of you until your teeth fall out,” underscoring the cultural norm of filial responsibility. Across Africa, family members have long been “primarily responsible for providing care and support to older adults.”
This strong family caregiving culture means that elder care usually takes place within the home. Adult children (often daughters or daughters-in-law) tend to the daily needs of frail parents- cooking, cleaning, helping with bathing or dressing, managing medications, and so on. Extended family networks commonly pitch in as well; for example, a niece, nephew, or grandchild may assist an elderly relative.
In rural villages, neighbours and kin often form a close-knit safety net, ensuring that an isolated elder has food and company. In urban settings, an elder might live with one of their grown children, becoming part of the household.
Religious and community organisations also play a supportive role in Ghana’s informal eldercare network. Churches, mosques, and other faith-based groups frequently consider it part of their mission to look after vulnerable seniors. For instance, local churches have been known to organise social gatherings or visitation programs for the elderly, providing companionship and basic assistance. The NGO HelpAge Ghana operates day centres where seniors can come during the daytime for meals, health check-ups, recreation, and fellowship. These community-driven efforts-often volunteer-led-help fill some gaps, especially for elders who have no immediate family nearby.
Tradition Under Strain: The Challenges of Informal Care
Despite the strength of family ties, heavy reliance on family caregiving is becoming more challenging. Economic and social changes are straining the traditional system. Many younger Ghanaians have migrated from villages to cities (or abroad) for work, leaving behind elderly parents in rural areas with fewer caregivers. In urban families, modern work schedules and school commitments mean that “Grandma will wake up to an empty house” all day and only see family late at night. As one gerontologist observed, “the state assumes the family will take care of older people, “but families have changed. This can result in what has been termed “benign neglect”-not intentional harm, but elders being alone or socially isolated for long stretches. Such isolation can harm seniors’ mental and physical health, contributing to depression or uncontrolled chronic conditions.
The burden on family caregivers is significant. Most caregiving is done with little formal training or support, and often by women who may also be juggling jobs or other duties. Caregivers can face economic strain, as they may have to cut back on paid work or spend their own money on their elder’s needs. Studies in Ghana confirm that this strain is real: caregivers frequently report financial difficulties, stress, and health impacts from their responsibilities.
Without outside help, quality of care can suffer-for instance, family caregivers might not know how to properly handle dementia behaviours or may inadvertently neglect aspects of care due to exhaustion. In the worst cases, overwhelmed caregivers may even become abusive or exploitative, though data on elder abuse in Ghana are limited.
In summary, informal family networks remain the cornerstone of elder care in Ghana. Children and relatives are expected to look after ageing family members, and community or religious groups provide additional support where they can. This culturally rooted system provides care for the vast majority of older Ghanaians. However, it is coming under pressure as traditional family structures evolve and as the needs of the elderly (for healthcare, supervision, etc.) grow.
Limited Institutional Support and Formal Care Services
Ghana’s formal long-term care infrastructure is very limited, and institutional support for elders is scarce. There are no government-run nursing homes or state residential care facilities for the elderly in Ghana. The expectation has historically been that the family will provide care at home, so public investment in long-term care facilities has been negligible.
A National Ageing Policy was drafted in 2010 to provide a framework for elder care development, but it has largely stalled and remains “sitting on ice” with little implementation.
Because the public sector does not provide elder care homes, the gap has started to be filled by a few private entrepreneurs and NGOs in recent years. As of 2020, only a handful of private care homes existed, mostly around Accra, and they served a very small clientele.
For example, Comfort For The Aged-one of the first private elder care homes in Accra-opened in 2016 but initially struggled to find clients, as the concept of a “care home” was unfamiliar and somewhat stigmatised. By 2020, it had only 7 residents (capacity 10), each paying roughly $250 (≈GH₵1,400) per month for full care. Another facility, Mercy Mission, and a few others have opened in Accra/Tema, with fees generally ranging from GH₵500 to GH₵1,500 per month (about $100–$300). These costs are prohibitive for most Ghanaians, meaning such homes cater primarily to the affluent.
The nascent private care homes in Ghana provide services similar to assisted living or nursing facilities-residents receive housing, meals, help with daily activities, medication management, and some medical attention from nurses on staff. Family visits are usually allowed (often on weekends) so relatives stay involved. Operators of these homes report that some elders improve socially and medically after moving in, as they are no longer isolated. One client who had barely spoken while living alone “started talking” again when engaged daily in the group home setting.
Nevertheless, these facilities remain few. As of 2020, only three private elder care homes were in operation, and two more were under construction in the Accra region. By 2024, the sector had grown modestly, with several organisations and companies (e.g. Comfort for the Aged, AnsMed Home, Ark Lifestyle, Royal Olive Court, Tabitha Ghana) offering either residential care or nursing services on a small scale in Greater Accra. Still, coverage is extremely limited relative to the need, and outside the capital, such services are virtually non-existent.
Beyond residential facilities, formal home-care services (paid caregivers visiting elders at home) are also rare but slowly emerging. A few agencies (such as Imperial Home Care Services or Nanny Ghana Service) have appeared in urban centres, providing nurses or caregivers that families can hire. However, this too is accessible mainly to middle- and upper-income families, given the costs. The vast majority of Ghanaian elders and their families do not have any formal long-term care services available or affordable to them.
The Ghanaian government’s role in direct elder care provision is currently minimal, but some government initiatives and institutions are addressing elder well-being. The Ministry of Gender, Children and Social Protection (MoGCSP) is the lead government body responsible for older persons’ policy. It oversaw the creation of the National Ageing Policy (titled “Ageing with Security and Dignity” in 2010) and has drafted an Aged Persons Bill to strengthen legal protections for seniors. As of the mid-2020s, advocacy to pass this bill into law is ongoing, with calls for a National Council on Ageing to be established.
Although direct care services are lacking, some public social support programs help older Ghanaians indirectly. One example is the Livelihood Empowerment Against Poverty (LEAP) cash transfer program, which provides small bimonthly stipends to extremely poor households, including those headed by or containing an elderly person with no support. Another initiative is the EBAN Elderly Welfare Card, launched in 2015, which gives adults 65+ benefits like priority access to services (e.g. skipping queues at banks and hospitals) and a 50% discount on public transportation fares. In healthcare, Ghana’s National Health Insurance Scheme (NHIS) has since 2008 waived the insurance premiums for adults aged 70 and above. This means elders 70+ can enrol in NHIS free of charge (though they still must pay for some services and medications not covered). These measures, while not substitutes for long-term care services, do acknowledge the needs of the elderly and aim to reduce their financial barriers.
Additionally, a few non-governmental organisations focus on elderly welfare. HelpAge Ghana (affiliated with the global HelpAge network) is a prominent NGO that advocates for older people’s rights and runs community-based programs such as health screening, day care centres, and social activities for seniors. The Association of Ghana’s Elders (AGE) is another group, essentially a social network for older adults, founded to provide peer support and combat loneliness among seniors. Organisations tied to specific groups-for example, the Veterans Association of Ghana-also provide some support for their members. These institutions, however, reach relatively few people and often rely on donations or volunteer efforts.
In summary, formal long-term care in Ghana is in its infancy. The state has no established LTC services and relies on family care as the default. A few private and nonprofit initiatives are emerging (particularly in cities) to offer nursing home or day-care options, but these serve only a tiny fraction of the elderly and are often too costly for the average family. Government efforts so far have focused more on policies, laws, and modest social supports (health insurance exemptions, pension schemes, etc.) rather than building an institutional care infrastructure. The net effect is that older Ghanaians who cannot be fully cared for by family have very limited alternatives for long-term care.
Urban vs. Rural Caregiving: Contrasts and Challenges
Ghana’s diverse geography and settlement patterns influence how elder care is delivered. There are notable differences between urban and rural caregiving contexts:
Family Structure and Proximity
In rural areas, elders traditionally lived in multi-generational households or close to relatives, which made caregiving a shared family responsibility. Even today, an elder in a village may have multiple extended family members around- nieces, nephews, cousins- who can check in on them. By contrast, in urban centres like Accra or Kumasi, families tend to be more nuclear. Adult children often live in smaller households with their spouse and kids, sometimes in apartments, and may only have one elderly parent living with them (if at all). Many urban elders reside alone or with just their spouse, as their children might have moved elsewhere for work.
Migration has created a rural-urban divide: it’s common for older parents to remain in rural hometowns while adult children are in the city or overseas. These elders in rural areas may lack day-to-day support and instead receive material support (remittances) from children far away. Urban elders, on the other hand, might have family physically present but those family members are busy outside the home for most of the day.
Community Support
Rural communities often exhibit stronger communal ties and informal surveillance of the elderly. Neighbours in a village are more likely to notice if an old person hasn’t been seen and will offer help or inform relatives. Traditional norms in rural Ghana encourage respecting and consulting elders (e.g. village elders often have roles in advising or mediating local matters). Thus, an older person in a rural area may feel a sense of belonging and purpose, providing informal “social care” that mitigates loneliness. In urban settings, however, community cohesion is weaker; people may not even know their neighbours well in a big city. Urban elders can experience greater social isolation, confined to their homes, especially if mobility problems limit them from venturing out into the bustling city environment.
Caregiver Burden and Resources
Research indicates that caregiver burden tends to be higher in urban areas than in rural areas. Urban informal caregivers report more stress, possibly because they are often sole caregivers juggling employment with caregiving, and formal services to ease their load are scarce or unaffordable. Rural caregivers, by contrast, sometimes share responsibilities among family and may have a slower pace of life that better accommodates caregiving tasks. One 2024 study found that rural caregivers in Ghana had significantly lower overall burden scores compared to urban caregivers.
This could be due to rural caregivers having more extended family support or lower expectations for intensive medical care (since advanced care facilities are far away anyway). However, rural caregivers face other challenges: they often have less access to healthcare facilities and trained professionals. If a rural elder develops a serious condition, the family might struggle to get them proper medical attention due to distance and cost, whereas an urban family can more easily access hospitals and clinics.
Ghana’s approach to long-term care is deeply rooted in tradition, with families and communities forming the backbone of elder support. However, demographic shifts, migration, and economic pressures are testing the limits of this model. The country’s formal LTC infrastructure is embryonic, serving only a privileged few, while most elders and their families must navigate care with limited resources and support.
As Ghana’s elderly population continues to grow, the need for a more robust, accessible, and culturally sensitive long-term care system becomes ever more urgent. Policymakers, civil society, and communities must work together to ensure that older Ghanaians can age with dignity, security, and the support they deserve.