Institutionalized elderly: vulnerabilities and strategies to cope with Covid-19 in Brazil

Abstract

This article presents a systematized reflection and discussion around two guiding axes: the first discusses aging and vulnerabilities to biological, physical, cognitive, social and affective losses that require specific attention, as well as vulnerabilities to COVID-19 to which institutionalized elderly people are exposed; the second, we reflect on the adoption of restrictive and protective measures to prevent the spread of the virus, aiming to keep the elder health and mitigate the effects of the pandemic. The conclusion is that the pandemic has increased the many vulnerabilities to which institutionalized older people were already exposed, adding vulnerability to a new disease, such as COVID-19, due to its high lethality and comorbidity, aggravated by precariousness of long-term Brazilian institutions due to the negligence of public authorities, civil society, the management of the institution and the families of the patients. The post-pandemic scenario will require collective efforts to protect and ensure the survival of the elderly living in those residences.

Effects of SARS-CoV-2 infection on health and functional capacity in institutionalized older adults

“…The sociodemographic and lifestyle profile of older adults residents in NHs found by other researchers (20,21) is similar to that observed in this research, where almost half of older adults were 80 years old or older, with most of them being female and with low education. Notably, in Brazil, this profile is expected for older adult residents in these institutions, since these people tend to arrive at NHs older, with some physical and/or cognitive limitations (20,21) .…”

Fear of the COVID-19 and medical liability. Insights from a series of 130 consecutives medico-legal claims evaluated in a single institution during SARS-CoV-2-related pandemic

“…Caregivers were unable to support people who are not self-sufficient. Furthermore, individuals with unique needs (e.g., women in childbirth, the institutionalized elderly, or psychiatric patients) need support [31][32][33][34][35][36][37]. Interestingly, one patient with depression committed suicide [38][39][40].…”

Did managers of long-term care facilities neglect the functionality of older adults? A survey during the COVID-19 pandemic

“…Poor attention to functionality reflects the biomedical model that persists in Brazil and other countries, where older adults living in LTCF receive minimal person-centered care and disease is overvalued. 36 …”