3110objn902azevedoetal Online braz j nurs

Teaching to take care: The nurse and caregiver familiar in home care elderly.

Author: Neusa Maria de Azevedo, RN, Hospital Geral de Nova Iguaçu, National Health Departament, Rio de Janeiro, Brazil

Advisor: Fatima Helena do Espírito Santo, RN. PhD. Teacher at Professional and Academic Master Degree in Nursing School of Fluminense Federal University. Rio de Janeiro, Brazil

Bibliografic reference: Azevedo NM. Teaching to take care: The nurse and caregiver familiar in home care elderly. [Dissertation]. Niteroi (RJ), Brazil: Nursing School Aurora de Afonso Costa, Federal Fluminense University; 2010. 

Problem: In the context home, the caregivers familiar of elderly experience situations who he did not feel ready to make the home care demanding of nurses the need to establish guidelines to provide support to caregiver family and contribute to the improvement of health conditions of elderly in the own family that need to readjust your daily routine to meet the needs of the home care elderly.

Objective: these study aims: 1- discuss the possibilities of guiding and support to the family caregiver of elderly people; 2- describe the domiciliary environment of the elderly; 3- characterize the family caregiver; 4- identify the elderly people in situation of home care; 5- identify family caregivers' needs.

 Method: Study case by qualitative aproach developed with 20 elderly in situation of domiciliary. The caregivers familiar are recruited at Programa de Internação Domiciliar of Hospital Geral de Nova Iguaçu (PID-HGNI). in data collection used participant observation, and interviews with caregiver familiar of elderly  with support one instrument to data collection to characterization the research participants.

Results: The information analyzing unveiled three thematic categories: "Realizing the care of to elderly", "Realizing the feelings of the caregiver familiar" and "The  nurses guidelines to elderly's to family caregivers". The first one enables the view that all subjects had limitations in performing both survival and instrumental activities of daily living, that making them highly dependent on the family caregiver. This dependence causes changes in family daily living, leading the changes in their lives, expressed as follows: care burden, absence from work, physical exhaustion, self-care deficit, especially when this care is lonely with no cooperation from other family members. Next, the second category has on everyday care feelings evidenced by the experience/coexistence of family caregivers and the elderly. the results show feelings of duty and obligation by marriage or others commitments; taking into account the care received in the past; mixed feelings in the coordinating care and other activities, uncertainties related to the future; and support religious. All these feelings mobilize the family caregivers to perform the activity of caring of their elderly relatives, regardless of the possible damage they may suffer. However, there are reports of improvements in their own health and personal plans for the future as a result of the activity done. At last "The  nurses guidelines to elderly's caregivers familiar" reveals itself in his everyday life, in disease situation and lack of knowledge and skills to take care of the elderly. In this context, the nurse focuses on observation of how the family caregiver faces the care to the home care elderly, which occurs in a daily and progressive way, identifying the available resources. The implementation of educational interventions enables the caregiver to achieve independence to carry out the necessary care, reducing stress on everyday life, opening up further possibilities for redemption of selfcare.

Conclusion: We conclude that it is up to the nurse getting to know the home environment, its dynamics, to identify the elderly and their caregivers familiar profiles before establishing one orientation program. Because in the daily care of elderly at homecare situations arise up that required orientation, to listen and look attentive to the needs of the elderly, as well as the caregiver familiar, who needs support to learn to how take care of the elderly and of himself within the disturbing context that surrounds them during the process of homecare. 

Keywords: nursing, domiciliary assistance, family, elderly

Main bibliography:

Cattani RB, Girardon-Perlini NMO. Cuidar do idoso doente no domicílio na voz de cuidadores familiares. Rev Eletrônica de Enfermagem,2004 6(2): 254-71.

Martins JJ, Silva RM, Nascimento ERP, Coelho FL, Schweitzer G, Silva RDM, Erdmann AL. Idosos com necessidades de cuidado domiciliar. Rev. Enferm. Uerj, Rio de Janeiro, 2008 jul/set; 16(3): 319-25. 

Paes PFA, Espírito-Santo FH. Limites e Possibilidades no cotidiano do familiar que cuida do idoso com Alzheimer no ambiente domiciliar. Rev. E. Anna Nery Enferm, 2005, ago; 9(2): 192 – 8. 

Caldas, CP Envelhecimento com dependência: responsabilidades e demandas da família. Cad Saúde Pública, mai-jun, 2003; 19(3): 773-81. 

Lacerda MR, Giacomozzi CM, Oliniski SR, Truppel TC. Atenção à Saúde no Domicílio: modalidades que fundamentam sua prática. Saúde e Sociedade, 2006 maio-ago; 15(2): 88-95.  

Gomes IM, Kalinowski LC, Lacerda MR, Ferreira RM. The domiciliary health care and its state of art: a bibliographic study. Online Braz J Nurs. 2008; 7(3). Available at www.objnursing.uff.br/index.php/nursing/article/view/j.1676-4285.2008.1781/411

 

Address for correspondence: Neusa Maria de Azevedo, Rua Dr. Mario Guimarães 293 aptº 1102, centro,Nova Iguaçu. Rio de Janeiro (RJ), Brazil. CEP: 26255-230. Telefone: (21) 9584-7484. Email: enfnazevedo@hotmail.com.   

Date of examination: august 26, 2010. Nursing School Aurora de Afonso Costa, Federal Fluminense University. Examiners: Fátima Helena do Espírito Santo, Jaqueline Da Silva, Rosimere Ferreira Santana, Ana Maria Domingos, Patrícia dos Santos Claro Fuly.