Thabisile Gumede
6 June 2026
The first signs came after loss. Two weeks after his mother died, Nduduzo Kheswa noticed his grandmother was not the same. The woman who had raised him, who had been his mother in every way that mattered, was beginning to forget. She forgot things. She forgot people. She forgot him.
“I felt that she was losing her mind when I saw her in that state,” he recalls. “My grandmother was a strong person, but she started feeling like a small child.”
What Nduduzo was witnessing was dementia, a condition that robs a person of their memory, their sense of time and place, and eventually their ability to recognise the faces of those they love. But in the community where he and his grandmother lived, the explanation was far more sinister. When she began leaving the house at night wearing only a petticoat, neighbours did not think of illness. They thought of witchcraft.
Dementia is not a single disease but an umbrella term for a range of symptoms caused by damage to brain cells. The most common form is Alzheimer’s disease. South Africa is facing a dementia crisis that most of its citizens do not know is coming. In 2024, there were an estimated 6.1 million South Africans aged 60 and older. Researchers project that more than one million South Africans could be living with dementia in the coming decades, and according to the Global Burden of Disease study, prevalence is forecast to increase by 181 percent between 2019 and 2050. By 2050, more than 70 percent of all people living with dementia worldwide will be in low and middle-income countries like South Africa.
It was a community nurse who first used the word dementia. Before that, Nduduzo had no framework for what he was seeing. “I thought she was losing her mind. I thought she was crazy. At first I thought she had depression,” he says.
His family fractured under the weight of not knowing. Some believed his grandmother had an ancestral calling. Some believed she was bewitched. Almost all of them left Nduduzo to care for her alone.
Across South Africa, particularly in rural communities, older women with dementia face a danger that goes beyond the illness itself. A study conducted in Soweto found that caregivers described community members labelling elderly women with dementia as witches, with some being stoned, killed, or banished. One caregiver in the study recounted that older women who went out at night were branded witches and either killed or banned from the community. A 2024 study published in The Lancet Global Health shows that dementia prevalence among people over 60 in rural South Africa can be higher than in urban areas, yet rural communities remain the least served by health education and specialist care.
Nduduzo’s grandmother was fortunate. People in her community eventually came around. “When they knew she had dementia, they supported her and spent time with her,” he says. Some people had advised him to take her to a sangoma. He refused. “I wanted to take her to the doctor to do proper tests,” he says.
Nobody prepared Nduduzo for what caregiving would cost him. He gave up his social life. His business stalled. His marriage did not survive. “I didn’t have a personal life. I had to be there 24/7,” he says. “It took a lot of me emotionally and deprived me of many things.” He was eventually put on antidepressants. “It was too much for me as her caregiver.”
Research on dementia caregivers in South African townships found that Black African caregivers are overwhelmingly family members, often women and young people, who receive very little education about the disease and almost no practical skills training to manage its progression. Nduduzo wishes someone had told him what was coming. “I wish I knew that as time passes they get worse. I wish I was told about the tantrums, the mood swings.”
Even as dementia hollowed out his grandmother’s memory, something persisted. She still knew how to love. “She would come to my room and put a blanket on me. She would come in the morning to check on me and offer me tea even though she couldn’t make it,” he says. She called him by her late husband’s name. She asked for her daughter, not knowing she was gone. In her confusion, she was still reaching for the people she loved. “She still had love,” he says.
She was, to the end, his grandmother. Strict. Watchful. A woman of faith who prayed with her neighbours and made sure no visitor left her home hungry. “I want her to be remembered by the love she showed to her family and community,” he says. Before his grandmother’s death, Nduduzo began sharing her story on social media. His videos and posts were widely shared, and something unexpected happened: strangers fell in love with her. People who had never met her began to follow her journey, to root for her, to grieve with him.
Through a phone screen, his grandmother became somebody’s gogo too. In telling her story, Nduduzo did two things at once: he gave South Africans a window into a condition most of them had never heard of, and he made sure that the woman behind the illness would never be forgotten.
Nduduzo believes communities and the health system must do more. “Health workers must teach people about dementia and do campaigns. There are posters in public hospitals but they can do more to reach out to communities in townships and rural areas.”
His advice to anyone who recognises these signs in an elderly relative is simple. “Go to the doctor as soon as possible to get a diagnosis.” And to young caregivers watching someone they love change before their eyes: “Treat them as you did before. They are still the same person inside.”
His grandmother was not mad. She was not bewitched. She was a woman whose brain was failing her, slowly and cruelly, and she needed care, not fear. She needed the people who loved her to stay. Nduduzo stayed.
If you or someone you know needs support with dementia, contact Dementia South Africa on 0860 636 679 or visit www.dementiasa.org
