Botswana, a country in sub-Saharan Africa, has been in the midst of an
HIV/AIDs pandemic that has halted its previously lengthening life expectancy
trend. However, one group to escape immediate effects on falling life
span is the oldest old age group (> 80 years). Their roles in the community
due to the pandemic, however, have changed. Place of death is an important
consideration in end-of-life care for older adults, and one which has been
well studied in the Global North. The purpose of this article is to determine
where Botswana’s oldest old die (home or hospital), and to see whether cause
of death, gender, or residence in a city, town, or rural area is associated
with place of death. We use death certificate data from 2005 and 2006 to
describe where the oldest old Batswana (the name for the people of Botswana)
died, home or hospital. Two-thirds died at home. The mean age at death
was 88.46 (± 6.21) years; more were female (56.9%); and of known causes
of death, cardiovascular disease was the leading cause (16.8%). Most stated
causes of death (62.4%) were listed as “unknown.” Most oldest-old Batswana
died in rural areas (70.1%), and in rural areas, proportionally more oldest old
died at home compared to cities and towns. On multivariate analysis, being
a woman > 80 years of age at death predicted home death. Future longitudinal
study needs to determine preferences of place of death and the quality
of death of Batswana > 80 years, especially women.