Reflections on the development of an integrated continuum of long-term care for older adults in Brazil

Abstract

To catalyze the discussion and implementation of state policies for an integrated continuum of long-term care (LTC), it is imperative to assemble strategic actions involving the public and private sectors, civil society, international agencies, professionals, academia, and the media, considering clear objectives for improving the lives of older adults, their families, and the communities where they live. Care may be provided at home, in the community, or at LTC facilities (LTCFs) for older adults. In this essay, we focused on institutional care. Tensions between advocates of different models of care for older people should include space for dialogue, convergence, and intersectoral actions, regardless of where LTC is provided. Conditions for LTCFs not to be perceived as the “last and undesirable alternative” should exist or be created so that these institutions are seen instead as welcoming, productive, and inclusive environments that are integrated to the community and its social, recreational, and health systems. The aim of this essay was to reflect on the urgency of developing an integrated continuum of LTC for older adults in Brazil that considers care as a right along with its modalities of delivery, flow, services, and activities, as well as sustainable financing alternatives and legal and governance directives. This work was divided into four sections: (1) aging as a social achievement and care as a right; (2) models of LTC and panorama of the sector in Brazil; (3) change in paradigms for conceiving LTCFs and LTC; and (4) framework for achieving an integrated continuum of LTC.

Institutional care in four Latin American countries: the importance of fostering public information and evaluation strategies

“…In many Brazilian municipalities, facilities must also be registered with the Municipal Councils of Older Adults (Conselhos Municipais da Pessoa Idosa), and in some states, public prosecutors also exercise supervisory authority. Where these types of supervision exist, facilities are registered, and most indicators are based on deficits and diseases (26). LTC facilities are defined as "governmental or nongovernmental institutions, of a residential nature, intended for the collective residence of older persons" (27).…”