Mr. Dimba has been living alone since the wife passed but over the past few months, he has found it more difficult to look after himself and the house as well. During the monthly visits that his children pay him, one of the sons noticed that the father is not himself. As a first step, he may have called his siblings to tell them about the father’s current status and express his concerns over the same. From there, they may recommend that the son (unpaid carer) stay at home to help the father with his activities of daily living for a couple of days before he goes back to the city as they organize for a carer who is likely to be male since male Africans prefer fellow males to care for them especially with the personal care activities like bathing and dressing. This may take longer than expected because finding a male carer willing to take up care giving is quite difficult because males consider care giving a ‘feminine’ job. In turn, if the son overstays at home, he may lose his job back in the city. If there is no close male family member willing to care for Mr. Dimba, then they are likely to get a paid male carer for Mr. Dimba. This is a possible solution because Mr. Dimba’s children work in the city and assuming they earn decent incomes, they may be able to afford a paid carer for Mr. Dimba.

Soon after, during the monthly visits to Mr. Dimba, one of the children may take their father to a public health centre in the town. However, this may be a challenge at the facility especially if one of the visiting sons is not cognizant of the daily issues affecting the father and the clinician may not be able to have a clear picture of the situation to assess progress. Being a peri-urban town, it’s likely Mr. Dimba will be assessed by a general physician or a psychiatric nurse (if any) who may be on duty. Now, since most healthcare professionals lack the basic knowledge on dementia diagnosis and support, they may not give a diagnosis but instead prescribe medication for physical symptoms, if any. The health care services are likely to be paid out of pocket. With time, the family may start to limit Mr. Dimba’s movements out of the house because they are worried people will see the father with the ‘most dangerous disease in the community’. In an attempt to better the condition of their father, they may invite traditional healers to treat Mr. Dimba with traditional medicine as well as faith healers from church to pray for him in case they think that Mr. Dimba has been cursed or bewitched and this may further strain the family’s finances because these services require payment as well except those that involve spiritual care from faith healers. Once follow up is done by these healers and no progress has been made, they may refer Mr. Dimba to a specialist in the nearest city where they are likely to get one while they continue receiving prayers. If the family can afford services of a specialist (psychiatrist), they may take Mr. Dimba to stay with one of his children in the city during the treatment period when he is seeing specialist, who is likely to be a public health provider in a government hospital. The children can contribute the money to see the specialist though this can get quite costly since most mental health conditions are not publicly insured.  Some private insurance companies also charge extra fees for mental health conditions.