Relationships are multidimensional, and we know little about how different facets of relationships affect how older patients with multimorbidity use homecare and health services. Social gerontology literature emphasizes the importance of care settings, gender inequalities, availability of health services, and affordability. However, the diversity of relationships and associated dependency in elder care remains underassessed. This qualitative study combining a demographic survey with interviews

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... xplores the relationship experiences of older women (age 60 years and over) with multimorbidity in homecare and health services utilization. Researchers contacted the Civil Surgeon of Sylhet District in Bangladesh to recruit study participants and conducted 33 interviews [11 staff members and 22 older women with multimorbidity]. Three domains of Axel Honneths theory of recognition and misrecognition [i.e. intimate, community, and legal relationships] underpin study findings. Data were analysed using critical thematic discourse analysis. Four themes, including seven relationship dimensions, emerged: the nature of caregiving; intimate affairs [marital marginalization and parent-children-in law dynamics]; alienation in peer-relationships and neighbourhood [siblings overlooking of women rights and needs, neighbourhood challenges such as ageism, and gender inequality in interactions]; and legal connections [ignorance of rights and missed communication]. Marginalization in family relationships, together with poor peer supports and a misrecognition of care needs from service providers, resulted in a lack of quality care for older women with multimorbidity. Understanding the complexities of older women relationships may assist in policy making with better attention to their health needs and deepen understanding of how gender inequality intersects with the cultural devaluation of older adults to reduce their well-being. Staff training on relationship building and counselling services for family caregivers and kin are essential to improve the quality of care for these women.