Acoplamento estrutural das instituições de longa permanência para idosos com sistemas societais do entorno

Abstract

This study was performed in six Long-Term Care Institutions for the Elderly (LTCIEs) that helped low-income senior citizens in three regions of the country. Its aim is to examine how LTCIEs' internal organizational system maintained structural coupling with surrounding systems. The data were collected through interviews and observation. The analysis was based on concepts of Luhmann's Social Systems Theory. As a result, the rules of belonging did not encourage aid proposals that stimulated independent life and the individuality of residents. The structural couplings with the external environment generated negative resonance within LTCIEs, such as the lack of links to programmatic actions of public primary health care, inability to maintain a multiprofessional staff, inability to fully adapt the infrastructure, and inability to bring reçatives closer to the institution's daily routine. As a positive aspect, the staff was empowered by the presence of students and their professors.

The care for institutionalized elderly perceived by the nursing team

“…Moreover, these data are consistent with data from other studies on the institutionalization of elderly, which report that nursing care were provided to support illness recovery, mainly focused on biomedical actions, and not concerned with a more humanistic and holistic view (3)(4)(5)(7)(8)(9)(10) . There is urgent need to encourage the mobilization of public policies to support long stay institutions, by publishing studies on their situation and by seeking ways to solve the structural and functional problems faced by them.…”

“…Both categories were proposed based on data from Brazilian studies concerning the existence of an unwritten, systematic process of care in the institutions, and professionals in nursing and in the fi elds of gerontology and geriatrics should be aware of this process. Also, some published articles suggested further studies on the organization of the care process in long-term care nursing homes for elderly as a viable means to improve care standards (5,(7)(8)(9)(10) . The presentation of the results was organized into the two thematic categories, identifi ed by codes pre-established by the researchers, which include letter "E" and specifi c numbering for the cataloguing procedures.…”

“…It should also include leisure activities and concern with the well-being of elderly (10) . Also, the care practices adopted in the LSIs are not very much concerned with active aging.…”

Cenários de instituições de longa permanência para idosos: retratos da realidade vivenciada por equipe multiprofissional

“…10 O trabalho em equipe, ao valorizar a interface presente na multiprofissionalidade, possibilita a comprovação de uma atenção que se desloca do eixo recortado e reduzido / corporativo -centrado para o eixo -plural e complexo / usuário-centrado. 11 Alguns estudos sobre as ILPIs brasileiras, 8,12,13 em especial aqueles que abordam a questão no Sul do país, ilustram uma realidade em que predominam instituições filantrópicas destinadas a idosos de baixa renda, recursos humanos insuficientes para acolher a demanda e dificuldades de manter uma equipe multiprofissional que atenda às especificidades da legislação vigente. Nesse sentido, este estudo discute a composição das equipes de saúde, frente às dificuldades e a problemática que envolve o cuidado em saúde do idoso institucionalizado, com o objetivo de identificar os desafios e perspectivas de trabalho nas instituições de longa permanência para idosos, na interpretação da equipe multiprofissional.…”

“…O cuidado prestado ao idoso em uma ILPI, por mais significativo que seja, não substitui aquele prestado pela família, 12 sendo necessário que haja uma sensibilização da mesma, pois ela também será foco de atenção, já que a funcionalidade familiar tem papel significativo na execução do trabalho dentro da instituição. No entanto, é importante considerar que as ações que independem do núcleo de competência dos profissionais se tornam de responsabilidade de todos os membros da equipe.…”