Care and management demands of long-term care facilities for the elderly in Brazil: an integrative review (2004-2014)

Abstract

Objective: to analyze the care and management demands of Long-Term Care Facilities for the Elderly (LTCFs) in Brazil. Method: an integrative review of literature was carried out, organized into six stages: a) elaboration of a guiding question; b) online search of LILACS, SciELO, PubMed, the CAPES Portal and the Brazilian Society of Geriatrics and Gerontology databases; c) article selection, following the exclusion and inclusion criteria, with the sample composed of 17 articles; d) commented analysis of the selected articles; e) deliberation on the results obtained, formulated from the synthesis and interpretation of the selected studies; f) presentation of the results of the review. Results: the care demands identified are related to the process of caring and assume a working team with geriatric and gerontological knowledge, while the management demands include the means and resources needed so the care can be provided effectively. However, the LTCFs were found to rely on professionals who are unprepared to provide care or to assume an organizational management role, meaning care for the elderly is restricted to the essentials for their basic needs. Conclusion: the care demands were easily identified in the analyzed publications, however, there is a lack of research that evaluates management demands in a broader and more in-depth manner. It is suggested that studies aiming to broaden theoretical knowledge of the care and management demands of LTCFs are carried out, to stimulate effective and positive actions in the practices of these institutions, seeking to offer top quality care to elderly persons that live in these facilities, that responds to the real needs of their current stage of life.

Caring for institutionalized elderly: representations of managers and professionals

“…Thus, managers often, instead of carrying out activities related to the administrative issues of the institution, use their available time to raise other sources of financial resources, finding it difficult to comply with what determines the legislation. 8,14 Similar to what was found in interviews with managers, the concept of care to professionals is also related to the philanthropic character of the institution, reinforcing the concepts of benevolence, charity and love. Thus, the social representation of care related not only to the historical inheritance of the insertion of the institutions in the country, but also to the changes in the conceptions of care and the work process in health itself.…”

“…By having the philanthropic character, for the most part, only identifies the "willingness" to donate their time in favor of the management of inputs, to organize the professionals to do the care. 8,14 It was also identified that they do not consider that this care carried out by the professionals needs training aimed to the specific needs of these elderly people, although they have an expanded degree of actions that require their own knowledge, skills and attitudes for this age group.…”

“…Unfortunately, in the social context to which these institutions are inserted, prevails the administration by managers, and although they have a "good will", do not have a specific qualification for the functions for which they are allocated. 14 In the study conducted by Damaceno and Chirelli, it was observed that there are still difficulties to implement the National Policy on the Health of the Elderly Person (PNSPI) in Brazilian municipalities. 22 There are few specific actions given to the elderly, unprepared professionals to take care of these specificities of the elderly, requiring the expansion of intersectoral actions to address health problems.…”

Dimensions assigned to Long Term Care Facilities by managers and health professionals: interfaces and contradictions

“…Studies of the elderly have indicated that abandonment can be one of the reasons that result in the elderly living in LTCFs 13,14 , in tandem with the way in which the family and the institution conduct themselves and the institutionalization is handled. This, therefore, contributes to the strengthening of stigma, meaning the institution must dismantle this negative stereotype and become a place where the rights of the elderly are guaranteed by the State, the family, the community and the staff.…”

The practice of care in long-term care facilities for the elderly: a challenge for the training of professionals

“…Most Brazilian LTCFs face problems, however. They do not prioritize the hiring of professionals trained in gerontological care and possess limited resources, making it difficult for the elderly to participate in the management of their own care 7,8 .…”