Instituições de longa permanência para idosos e condições de vida e saúde de seus trabalhadores e residentes

Abstract

This research aimed to analyze the structural conditions/services provided by Homes for the Aged (HA) of the 4th Regional Coordination of Health/RS, as well as living/health conditions of their workers and elderly. 11 HA were included in eight cities in the region, 86 of the 318 workers and 94 of the 522 dwellers found. We identified that 100% of the HA have some rooms without a restroom; 72.7% have an external area and administrative room; 54.5% have a cafeteria and a support room; 45.5% have bedrooms with more than four beds and 36.4% have an ecumenical room. Social vulnerability was the prevalent admission criterion (36.4%); most of the elderly were brought by relatives (69.2%), and death was the main cause of withdrawal (100%). The maintenance of HA is by retirement (extrapolating the 70% regulated by the law), partnerships and donations. Leisure/culture occur in 72.7%; in 27.3%, there were records of visits and 9.1% of HA work with families. In 27.3% have human resources for leisure, cleaning, food, laundry and caregivers; 63.3% have physicians and nursing technicians; 72.7% have nurses. In 63.3%, there are workers performing mixed activities, since there is a shortage of therapists found in 100% of the HA. The main difficulties for managers are financial resources/dependence of donations (81.8%) and the rigor of health surveillance/compliance with standards (63.6%). As for the HA workers, 82.6% were female, mean age 41.57 (± 9.89) years, married (47.6%), with children (76.7%), Catholics (59.3%), complete/incomplete high school (26.7%), from the Nursing area (41.9%), refresher courses (59.3%), working time greater than five years (36%), working 8 hours a day (33.7%), a day off/week (39.5%), exclusively working at HA (70.9%), 1 and 1/2 minimum wage (61.6%). Most of them have prior experience with the elderly (59.3%) and work as a team (89.5%). Concerning the quality of life (QoL) of the workers, the best domain was physical (74.3 ± 15.14) and the worst was environment (61.23 ± 13.89). Of the elderly, 58.4% were women, mean age 76.8 years; 31.1% presented a degree of dependence I, 33.9% degree II and 35% degree III. Regarding to independent elderly with preserved ambulation and cognition, the prevalence of the elderly was 70.2%, mean age 73.64 (± 8.58) years, without partners (95.7%), with children (54.3%), low schooling level (86.2%), rural occupation (36.2%), Catholics (81,3%), practicing a religion (74.5%), with chronic pathologies (69.1%), minimal/mild anxiety (84%) and no depression (62.8%). The main reason for institutionalization was being alone (37.2%). Among the dwellers with less than two years (40.4%), satisfaction with HA was “good” (57.4%), with health care provided (61.7%), with a relationship with workers (55,4%) and dwellers (56.4%). 77.7% received visits; 95.7% made friends; 57.4% performed more than three activities/day. 74.5% felt happy and 55.3% wanted to leave the place. The domain with the highest score in QoL was social and lowest, environment. The factors that interfered with QoL were: age, religion, anxiety and depression levels, institutionalization time, satisfaction with HA and health care, relationships with workers and dwellers, friendships/enmities, busy/idle time, and feelings about institutionalization (happiness, regret and the desire to leave). It is concluded that HA partially complying with the criteria of the Resolução de Diretoria Colegiada nº 283/2005. Workers and the elderly have reasonable QoL, and the environment must be a priority in their QoL promoting actions.