Uma análise sociodemográfica dos cuidadores formais de idosos institucionalizados no município de Natal/RN, 2012

The aging population and individual have been the subject of a multitude of studies nowadays. This is probably due to the impact of this phenomenon in various sectors of society, like social security, social assistance and public health. The process of aging of the individual imply the demand for specific services, considering the limitations and vulnerabilities of the individual at that stage of life cycle. The growth of the elderly contingent in the last decades raises challenges for policymakers, the family and also for the society at large. In this scenario, long-stay institutions for the elderly (LSIEs) appear as an option to aid and support the elderly and their family, assisting in all or part in the activities of daily living and self-care. Inside these LSIEs we find the professional responsible for the direct care of the elderly, the formal caregiver. In this context, this dissertation presents two main objectives: an analysis of the phenomenon of population aging in a given brazilian municipality Natal / RN, based on the Demographic Censuses of 2000 e 2010; and a social, demographic and economic characterization of the Formal caregiver for the institutionalized elderly in the municipality, evaluating aspects of his quality of life and also analyzing the institutions where they are inserted. Furthermore, we intend to identify demographic, socioeconomic and quality of life factors that are correlated with caregivers quitting the job. The data used in the second part of this work comes from the research project named Long-Stay Institutions for Elderly: abandonment or a family need? . This survey interviewed 92 caregivers in eleven LSIEs in Natal/RN. In the data treatment logistic regressions, cluster analysis and statistical tests were used. The survey revealed that aging in Natal is more pronounced in the older, more traditional districts: Petrópolis, Lagoa Seca and Tirol. It also allowed a broad characterization of the formal caregivers in LSIEs. Most of these professionals are female. The educational level is predominantly complete high school and more. Most caregivers reported being married or in union, or have ever been in a union. Family monthly income is under three times the minimum wage. The mean age is of 37.4 years. The mean time of work as a caregiver was 5.93 years. The associations showed that being woman, not being single, having caregiving training and physical limitations (regarding quality of life) are related to wanting to quit the caregiving job. As for the characterization of the LSIEs, it was found that the philanthropic ones are older and have most (62.5%) of the institutionalized elderly. The institutions managers gave social interaction and affinity with the elderly as the main criteria with which to evaluate and hire caregivers. It is intended with this study to contribute to improving the quality of life of the elderly and their caregiver, providing information on aspects of institutionalization of elderly both in the philanthropic and particular institutions, in Natal/RN; this dissertation may also be used as a starting point for later works

O cuidador familiar do idoso com alzheimer: percepções e sentimentos

The Brazilian Constitution maintains that care for elderly people is a responsibility shared by the state, the family and the society. The politics for the elderly corroborate this understanding and treats home as a privileged place for elderly care taking. This determines the participation of the familiar as a caregiver, but highlights the lack of strategic assistance for the needs of the relative caregiver who feels helplessly and unattended in their responsibility for elderly homecare. In recent years , despite the recently pursuit for health and life quality, there is an increasing incidence of elderly patients with dementia diseases that lead to disability, the most common among then is the Alzheimer´s disease. This disease affects seriously and irreversibly cognition, memory and independence of the elderly, making it dependent on others to perform basic activities of daily life, for all his life. The present study aims to evaluate the perceptions and feelings of family caregivers of elders with Alzheimer on the role of caregiver. This is a qualitative study conducted with family caregivers of seniors with Alzheimer´s, caregivers linked to the group of the Specialized Care Center of the Elderly´s Health, located in Natal / RN. Through semi-structured interview research sought to investigate the perceptions of family caregivers on the role of caregiver, the feelings and the changes in the caregiver´s life since they assumed this role. The data were organized into categories and units of semantic analysis and analyzed using thematic content analysis by Bardin. The reports originated three categories: the perception of the role of caregiver, feelings related to the caregving and consequences of the caregiver role. Perceptions of caregivers of elderly from the requirement of dedication to the care generates losses in personal and professional life for the familiar who assumes this responsibility. The lack of family and social support, aggravates the burden of care for the dependent elderly. Public health politics for the elderly recognize the importance and needs of family caregivers, but not enough to provide support and meet the needs and assist them in supporting their limitations. The research results show the urgent need to take measures to assist the caregivers of seniors with Alzheimer, recognizing them as an action of promotion quality of life and health of the elderly and protection the health of the caregiver

Tecnologia para banho no leito de idosos e usuários acamados: uma contribuição para o cuidar humanizado

This study aimed to validate the technology at Bed Bath System, in view of bedridden elderly and their caregivers, with a view to transforming the conventional paradigm regarding the practice of bodily hygiene held in bath chairs adapted in long-stay institutions for the elderly. This is an experimental study involving 51 (fifty one) elderly and 17 (seventeen) caregivers of three long-stay institutions for the elderly of the city of João Pessoa. For data collection, applied initially to cognitive assessment scale Mini Mental State Examination, with the aim of tracking the subject group of elderly cognitively able to participate in the study. In the second phase, to measure the percentage of agreement and disagreement about the attributes of the subjects of the shower chair and adapted the system for bed bath, used a questionnaire with closed questions, Likert scale model of four (4) points, with a good reliability index (0.728), estimated by alpha conbrach, evidenced by the Wilcoxon test a significant difference (P<0.05) between the responses of seniors and caregivers about the attributes involving technology system in bath bed and bath chair adapted, confirming the perspective of the subjects that the two systems differ significantly. However, the system bed bath got greater degree of agreement for their use, characterizing this system is a technology that makes the differential bed bath pleasurable action, quality and humanized

Abordagem da ergonomia para a análise da acessibilidade de uma instituição de longa permanência para idosos da cidade de Natal-RN

This dissertation presents and discusses the results of an applied research on the accessibility of residents in a Long Term Care Institution (LTCIs) in the city of Natal- RN. The main objective of this research is to suggest projectual improvements that maximize the accessibility in a LTCIs of Natal-RN, considering the aspects of mobility, safety, comfort and independence of elderly residents. Moreover, one should consider the specific characteristics of the user population, capabilities and limitations of the biological process of aging, which causes damage to the neurological system, musculoskeletal and cardiovascular and progressively affects on visual acuity, balance and locomotion of elderly people. This research has a qualitative approach and divided into four phases: exploratory, bibliographical and documentary research, mapping of the LTCIs of Natal-RN, case study. The phase of the mapping presented an overview of accessibility on LTCIs of Natal-RN. The institution of the case study was defined based on the overall assessment of accessibility and ergonomics criteria, preceded by an application of an Ergonomic Work Analysis to understand the accessibility of the elderly people. Interactional and observational methods were used to collect field data. To this end, an intense process of social construction was conducted, involving the elderly residents, caregivers, health professionals and general servants and LTCIs´ managers. It was found that the NBR 9050 is not comprehensive to solve the diversity of accessibility problems found in LTCIs. All LTCIs investigated were in disconformity to the NBR 9050. In the case study, it was found that the inappropriate design hinders the daily activities of the elderly people and is a source of risk of accidents. The environment, facilities and lack of assistive technologies hinder the autonomy of the elderly people, and this LTCI requires ergonomic intervention to improve the accessibility, autonomy and security of the elderly people

Saúde física e emocional de cuidadores da cidade de Santa Cruz-RN: perfil epidemiológico e fatores associados

Taking care for an impaired elderly is a hard and costly task that could affect directly the caregiver health. The purpose of this study was to evaluate the physical and mental health of elderly caregivers from the city of Santa Cruz-RN and analyze the potential correlated factors through an observational analytic design of a crosssectional. A multidimensional questionnaire was used to evaluation of the social demographics characteristics and those related to the care activity, as well as the caregivers´ physical and mental health. It was realized a descriptive analyze using frequency distribution and measures of the central tendency and dispersion to description of the caregivers. To verify the magnitude of the association between the variables was used the bivariate analysis through the Pearson and Spearman correlations and qui-square test. To evaluation of the association of the correlated factors to the adverse outcome with the caregivers´ physical and mental health was made a multivariate analysis by logistic binary regression and multiple linear regression models. The final sample was constituted by 304 persons, mostly women with a mean age of 50.3 ±16.8 years. The principal factors related to the physical health were age, stress and life satisfaction. Be a male caregiver, caring for a little while the elderly with cognitive deficit and not been spouse were related to worse mental health. Have worse physical health, high stress, depressive symptomatology, burden and low levels of satisfaction were also related to the mental health. After adjust through multiple linear regression was observed R2 values of R2=0,21 for Stress, R2 =0,17 for Depressive Symptomatology, R2 =0,21 for Burden and R2 =0,16 for Satisfaction. The attainment of the factors associated with caregiver´s health can help in the elaboration of specifics politics witch the goal is the integral attention to the elderly and his caregiver. The inability of continuous taking care could result in adverse outcomes such as institutionalization, impairment and death

Prevalência de incontinência urinária e fatores associados em idosos institucionalizados

Urinary incontinence (UI) is a geriatric syndrome that is especially prevalent in institutionalized individuals, and that causes economic and social impacts derived from treatment costs and overload of caregiver. UI also entails physical consequences to the health of the elderly, such as urinary tract infections or pressure ulcers, among other health problems. However, the existing national research on this condition is still scarce and comprises serious methodological biases. Therefore, the objective of this study is to determine the prevalence of urinary incontinence and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted between October and December, 2013 and carried out in 10 nursing homes in the city of Natal (Northeast Brazil). UI was verified through the program Minimum Data Set version 3.0, which was also used to assess fecal incontinence, urinary devices and UI control programs. Data collection included sociodemographic information, UI characterization, as well as variables related to the institution itself and to health conditions (comorbidities, medication, pelvic floor surgery, Barthel Index for functional capacity and Pfeiffer test for cognitive status). Bivariate analysis was performed using the Chi-Square Test (or Fisher‟s Exact Test) and the Linear Chi-Square Test, calculating the prevalence ratio with 95% confidence interval. Variables with p value under 0.20 were included in the multivariate analysis, which was performed using the Stepwise Forward logistic regression. The inclusion of variables in the final model depended on the likelihood ratio test, absence of multicollinearity and on the Hosmer-Lemeshow test. A statistical significance level of 0.05 was considered. Six (1.8%) hospitalized elderly, one individual in palliative care (0.3%) and one (0.3%) individual under the age of 60 were excluded from the study. The final sample consisted of 321 elderly, mostly females, with a mean age of 81.5 years. The prevalence of UI was 59.43% and the final model revealed statistically a significant association between UI and white race, physical inactivity, stroke, mobility constraints and cognitive decline. The most frequent UI type was functional UI due to physical or cognitive disability, and incontinence control measures were applied only to a minority of residents (approximately 8%). It is concluded that UI is a health issue that affects more than half of the institutionalized elderly, and is associated with white race, physical inactivity, stroke and other geriatric syndromes such as immobility and cognitive disability. Most of these associated factors are modifiable and therefore the findings of this study highlight the importance of UI prevention and treatment in nursing homes, which include general measures, such as physical and psychosocial activities, and specific measures, such as prompted voiding

Formação profissional do cuidador de idosos em instituições de longa permanência

The old caretaker's work seeks to minimize suffering and morbidity resulting from physical, cognitive and emotional limitations of these individuals, being a practice permeated by the uniqueness of the subjects involved, therefore, a process in constant construction. In this notion, the caregiver's role is crucial to assist the elderly in everyday life, aiming at improving their quality of life. This study has descriptive and analytical character with quantitative and qualitative approach aimed to investigate the professional training of active caregivers in long-term stay institutions for the Elderly (ILPIs) in Natal/RN in the year 2014. For this, semi-structured interviews were conducted with 63 caregivers employed in nine ILPIs, representing 75% of the professionals performing activities in these institutions. The interviews captured data on the socioeconomic profile, the perception about the profession and training of caregivers. Data were analyzed by observation of absolute and relative measures of central tendency of the numeric variables frequencies. It was found that most caregivers had poor socioeconomic status and had no specific training course to practice caregiver role. However, among those who carried out courses, most reported that the content covered during the training gave security to perform the practice, although they have shown a contradiction when referred to the need to build capacity. The perception of care is mainly related to love and care for the other while the choice of profession is associated with care practice itself. The results also indicate the presence of a low level of formal training for the exercise of the occupation, also revealing the weaknesses ranging from the absence of a core curriculum that can guide the formation, compounded by the low educational professionals in focus.

Repercussões do tempo operatório em pulmões de ratos idosos

A duração das operações pode representar um fator importante para uma série de complicações pós-operatórias, especialmente para os indivíduos idosos. Objetivo: estudar a repercussão nos pulmões, de operações de diferentes tempos de duração. Métodos: Vinte ratos idosos (18 meses) e 20 jovens (3 meses) foram separados aleatoriamente em grupos A e B respectivamente. Os grupos foram divididos em A1, A2, A3, A4, B1, B2, B3 and B4, com cinco ratos cada. Os animais foram anestesiados com pentobarbital (20mg/Kg) intraperitoneal. No subgrupo A1 e B1 foi feita operação com duração de 30 minutos, nos grupos A2 and B2 60 minutos, em A3 and B3 a operação foi feita em 120 minuto e os animais A4 e B4 (controle) não foram operados. O procedimento consistiu de laparotomia xifopubiana que foi aberta e fechada tantas vezes quanto necessário para atingir os tempos estipulados. Após o quinto dia pós-operatório os animais foram mortos com superdose de anestésico e biópsias de ambos os pulmões foram realizadas. Os achados histopatológicos foram transformados em escores. Resultados: os grupos de ratos jovens atingiram os escores: A1= escore 6, A2=11; A3=28; A4=5. Os ratos idosos tiveram os escores: B1=12; B2=34; B3=51 e B4=6. A análise estatística revelou diferenças significantes entre os escores dos grupos A e B. Conclusões: O tempo prolongado nas operações realizadas em ratos idosos contribuiu para o aparecimento de alterações pulmonares de modo significante. Quanto maior o tempo operatório, mais intensas e mais freqüentes as complicações pulmonares

Repercussões do tempo operatório em pulmões de ratos idosos

A duração das operações pode representar um fator importante para uma série de complicações pós-operatórias, especialmente para os indivíduos idosos. Objetivo: estudar a repercussão nos pulmões, de operações de diferentes tempos de duração. Métodos: Vinte ratos idosos (18 meses) e 20 jovens (3 meses) foram separados aleatoriamente em grupos A e B respectivamente. Os grupos foram divididos em A1, A2, A3, A4, B1, B2, B3 and B4, com cinco ratos cada. Os animais foram anestesiados com pentobarbital (20mg/Kg) intraperitoneal. No subgrupo A1 e B1 foi feita operação com duração de 30 minutos, nos grupos A2 and B2 60 minutos, em A3 and B3 a operação foi feita em 120 minuto e os animais A4 e B4 (controle) não foram operados. O procedimento consistiu de laparotomia xifopubiana que foi aberta e fechada tantas vezes quanto necessário para atingir os tempos estipulados. Após o quinto dia pós-operatório os animais foram mortos com superdose de anestésico e biópsias de ambos os pulmões foram realizadas. Os achados histopatológicos foram transformados em escores. Resultados: os grupos de ratos jovens atingiram os escores: A1= escore 6, A2=11; A3=28; A4=5. Os ratos idosos tiveram os escores: B1=12; B2=34; B3=51 e B4=6. A análise estatística revelou diferenças significantes entre os escores dos grupos A e B. Conclusões: O tempo prolongado nas operações realizadas em ratos idosos contribuiu para o aparecimento de alterações pulmonares de modo significante. Quanto maior o tempo operatório, mais intensas e mais freqüentes as complicações pulmonares

Vacinação: o fazer da enfermagem e o saber das mães e/ou cuidadores

Observa-se na prática das unidades de saúde, ainda hoje, o pouco conhecimento das mães sobre o processo de vacinação e pouco envolvimento do enfermeiro nesse processo, principalmente na área de educação em saúde. O objetivo é identificar as ações de enfermagem na sala de vacina e descrever o conhecimento das mães/cuidadores acerca da vacinação infantil. Estudo exploratório-descritivo com abordagem quantitativa. A população foi composta por 43 mães e/ou cuidadores e 10 profissionais de enfermagem. Ocorreu em duas Unidades de Saúde da Família, na Zona Oeste de Natal/RN, em novembro e dezembro/2008. A maioria das mães (88,4%) conhece a importância de vacinar a crianças, embora não saibam quais as vacinas estão sendo dadas e para quais doenças são destinadas. A maioria dos profissionais prioriza mais a técnica do que a atividade educativa. Percebe-se, portanto, que há lacunas no saber das mães/cuidadores e nas ações de enfermagem que visem um trabalho promocional na sala de vacinação

Acidentes por quedas em um grupo específico de idosos

Este estudo objetivou conhecer a incidência do evento queda e identificar a presença de seus principais fatores de risco. Estudo exploratório, realizado de março a novembro/2009, com aplicação de um formulário sobre quedas em um grupo de idosos. Os dados foram analisados por cálculo de frequências, média e desvio-padrão. Participaram 62 idosos, 41,9% relataram queda nos últimos seis meses, a maioria mulheres. Identificou-se ocorrência de agravos concomitantes: visão regular, audição boa, polifarmácia, IMC normal, forte força de preensão palmar e condições dos pés adequadas. Na maioria dos que caiu, o desequilíbrio foi apontado como principal motivo. A queda ocorreu mais no período da manhã, em local de piso áspero e seco, sem degraus, rampas ou tapetes, iluminação adequada e o tipo de calçado mais utilizado foi chinelo de borracha. Percebe-se a alta ocorrência das quedas na população idosa, fato que fundamenta a necessidade de avaliação das condições de risco envolvidas

Integridade da pele em idosos: revisão da literatura segundo as cartas de promoção da saúde

Trata-se de uma revisão bibliográfica que objetivou relacionar as medidas educativas para a promoção da integridade da pele em idosos com as Cartas de Promoção da Saúde. Realizou-se a busca nas bases de dados CINAHL, SCOPUS, LILACS e COCHRANE, nos portais CAPES e BVS e na biblioteca PUBMED, mediante a aplicação dos descritores Health Education; Skin e Aged. Os resultados dos 7 artigos analisados apontaram como principais medidas educativas: inspeção diária da pele, cuidados com calçados e com os pés, uso regular de protetor solar e mudanças de decúbito. Essas medidas estavam relacionadas com as seguintes Cartas de Promoção da Saúde: Ottawa, Declaração de Santafé de Bogotá e Declaração de Jacarta. Conclui-se que as medidas educativas, baseadas nas Cartas, são de grande relevância para a criação de uma cultura de saúde, com enfoque na população e no indivíduo como agentes executores imprescindíveis para o alcance da promoção da saúde

Visitabilidade-vivenciabilidade em assentamentos informais : um estudo da acessibilidade de percursos urbanos no Conjunto Santa Terezinha em Fortaleza-CE

This research approaches the issue of accessibility in informal settlements, seeking for the challenges and limits defined by informal urban settings, about the application of accessibility parameters. Take the empirical universe as the Conjunto Santa Terezinha, located in Fortaleza- Ce. Initially, the study presents a reflection about the housing issue in Brazil and the informal settlementes in view of the Right to the City. In this sense, the main references are, the works of Suzanne Pasternak (2008), Nabil Bonduki (1998) and Erminia Maricato (1996-97), among others. Follows with the discussion of the concepts and classifications of this type of settlement, making a content analysis of legislation and regulations relating to accessibility and proposed the discussion of the accessible route as the right strategy for the city. In another step, the methodology of 'walking together' created by Dischinger (2000) was applied in a passage previously chosen, which the researcher follows the disabled person during the journey through city making records like photos and video. The comments and perceptions are compared to the spatial analysis of urban morphology, made from the method of Del Rio (1990) and Panerai (2006), and the parameters of NBR 9050. Knowledge of the area is enriched by the methodology of the production of space made by Henri Lefebvre in his book 'The production of space' (1974) with these categories: space conceived, perceived and lived. Another key reference of this author it s the book 'The Right to the City' (991), which allowed in-depth reflections on the social function of town. In conclusion, the study finds that to guarantee a minimum access conditions in informal sittlements it´s necessary to know the specifics of their morphology, their relations and urban practices in view of the visitability- experiencebility, describing it as complementary concepts

Influência de fatores biopsicossociais sobre a mortalidade de idosos no município de Santa Cruz/RN: um estudo prospectivo

The aging process if characterizes for a complex events network, from multidimensional nature, that encloses biological, social, psychic and functional aspects. The alteration of one or more aspects can speed up the aging process, anticipating limitations and until the death in the aged. For an adjusted confrontation of this question is necessary an interdisciplinary vision, in which the some areas of the knowledge can interact and with this to intervenes of the best possible form. Then, information derived from studies of aspects related to incidence, morbidity-mortality and transition patterns, involved in the health-illness process can more accurately identify risk groups thereby establishing links between social factors, illness, incapacity and death. Thus, this study aimed to identify, by a multidimensional vision, the risk factors of mortality in a coorth of elderly in a city in the interior of the state of Rio Grande do Norte (RN), Brazil. A prospective study carried out in Santa Cruz RN, where 310 elderly were randomly selected to form a baseline. The follow-up was 53 months. The predictive variables were divided into sociodemographic, physical health, neuropsychiatric and functional capacity. The statistical analysis carried out by bivariate analysis, survival analysis, followed by binary logistic regression and Cox regression, in the multivariate analysis, considering significant levels p < 0.05 and confidence interval (CI) of 95%. A total of 60 (19.3%) elderly died during the follow-up, where cardiovascular disease was the main cause. The survival was approximately 24.8 months. The study of general survival showed, at 12, 24, 36, and 48 months of observation, a survival rate of 97%, 54%, 31%, and 5% respectively, with a statistical difference in survival only observed for the variables of cognitive function and Basic Activities of Daily Living. In the logistic regression analysis, the risk factors identified were cognitive deficits (OR = 8.74), poor perception of health (OR = 3.89) and dependence for Basic Activities of Daily Living (OR = 3.96). In the Cox analysis, as well as dependence for Basic Activities of Daily Living (HR = 3.17), cognitive deficit (HR = 4.30) and stroke (CVA) (HR = 3.49) continued as independent risk factors for death. The risk factors found in the study can be interpreted as the primary predictors for death among elderly members of the community. Therefore, improvements in health conditions, with actions towards sustaining an autonomous life with special attention for elderly with cognitive impairment, could mean additional healthy quality of life, resulting in the reduction of premature mortality in this population

Corpo e Velhice: um estudo da qualidade de vida de idosos da Vila Vicentina Júlia Freire em João Pessoa

The aim of this study was to follow the daily routine of elderly individuals residing at the Vila Vicentina Júlia Freire (VVJF) nursing home in João Pessoa, Brazil, observing and analyzing as much as possible, the way in which they live in a group and how they deal, through personal experiences, with their own body image and with that of others. The results were obtained from information considered relevant, according to the perspectives of the residents themselves, contained in narratives of their history and related to their quality of life. Our interest lays in how they coped with changes in their bodies at old age and adapted to the challenges of this new phase. To obtain this information, with significant expressions, we used the Narrative Interview (NI) as a research tool in order to redeem their life experience and develop an understanding of their impressions about the life experience at the current nursing home. We selected, among the housed, ten subjects - actors - to appear as a sample of the group together. The design of our sample had a hybrid model, combining two types: random sample (probability) and an intentional sample (not probability). After recording transcripts and ensuring that all the subjects showed common interests that were relevant to the group, we chose three categories for analysis as follows: a. the elderly as seen by themselves and by others; b. religiosity as a moral factor; c. intimacy and relationships. Our choice was based on the importance of the theme as a multidisciplinary topic in the quality of life of populations. The subjects, chosen as spokespersons for the VVJF, spoke, among other things, about the way in which they viewed the world, their own body and how they experienced the environment and their fellow residents, in an attitude of reflection and criticism that confirms the lucidity of an old age conditioned to an elderly institution. The method allowed us to investigate our subjects from a multidisciplinary point of view. We suggest other studies in assorted areas of the human sciences, having as principle, man at the center of all our scientific questionings. The paradigm that the elder is, necessarily, unhappy in his sheltered has been, in this job, broken through the testimonies collected, establishing multiple perspectives of the analyzed subjects by their respective narrative records. Involving the participation of researchers with major in Administration, Communication and Law, this study filled, in this aspect, the requirements of the multidisciplinarity of the Program of Pos-Graduation in Health Science