Desvelando o cuidado paliativo para idosos em atenção domiciliar: interlocução com os cuidados da enfermagem

Abstract

Non-Transmissible Chronic Diseases have been considered a public health problem by contributing to approximately 72% of death and loss of life quality, especially among poor people and vulnerable group, as seniors. The offer of Palliative Care brings an approach that improve the quality of life of the elderly and their family, who face chronic and life-threatening diseases and can be developed in any care environment, including home. The general objective was to develop a substantive theory about palliative care for elderly people in home care in an interlocution with nursing care. Research was carried out in two stages with a qualitative, explanatory approach, using the Grounded Theory method, guided by the following triggering questions: How do home care nursing professionals take care for elderly people in need of palliative attention? How does nursing interlocution occur with palliative care at home for out-of-hospital elderly? The scenarios for the research were the Home Care Service of Juiz de Fora and the home of the elderly in palliative care. Ten participants were included, distributed in three sample groups: the first, with five participants (three Nurses and two Nurse Technicians); the second, with two (a doctor and a speech therapist); and the third, with three participants (an elderly person and two family caregivers). As a data source in the first stage, service records and spreadsheets were used to describe scenario and the participants’ health and demographic profile. In the second, open interviews with participants were used as a source, which were recorded and guided by a semi-structured script, realized by the main researcher in visits to the service with the professional participants and in home visits with elderly participants. In the analysis of the data in the first step descriptive statistics were used and, in the second, for textual edition after the characteristics transcription and database organization, the OpenLogos® software, version 2.0 was adopted. The analytical process, according to the orientation of the method, involved the open, axial, selective codin and the construction of the paradigmatic model. In the period from January 1st to December 31st, 2019, out of a total of 247 elderly people who were removed from hospital to home care, 45 were seniors in palliative care. The open codification axially created 232 encrypted codes with concepts that enable five categories and twelve sub-categories, according paradigmatic model conditions. The substantive theorizing process conceived the central phenomenon: Unveiling nurse care to elderly in palliative home care in a dialogue with nursing. The substantive theory that emerged from the data analysis launched a spotlight on the phenomenon of home palliative care for the elderly offered by nursing, concluding that the figure of the nursing professional is one of the pillars of this humanized and differentiated assistance, which is noticed by the patient and its family, contributing to a successful care experience away from the hospital routine. In addition, there was a confluence on both types of care (palliative and nursing), in the use of both scientific knowledge as well as affection and empathy for the suffering of the elderly person who is cared for.