Atenção Domiciliar: custos da família com o cuidado de idosos com feridas

Abstract

The objective of this research was the costs to the family in the care of the elderly with wounds during home care with emphasis on the role assumed by family caregivers, within the scope of the care production proposed by the Home Care Policy in the Unified Health System. When Increasing aging process, there is a relative increase of the chronic conditions, being cardiovascular, respiratory and metabolic diseases that contribute to the appearance of wounds. In addition, aging brings with it some changes, related to the skin and, as a consequence, the appearance of wounds. The elderly with wounds can significantly reduce autonomy, functional capacity, and increase length of hospitalization. Home Care is a preferable alternative to provide continuity to the services started in other points of the Health Care Network. In home care, there is a transfer of costs to families, in which there is an increase in direct costs, water, electricity and food; Indirect costs, which come from the burden of care; And the intangibles, referring to suffering, loss of well-being and anxiety. A qualitative, two stages research was conducted using the Data Based Theory method. The first was performed at the Home Care Service of the city of Juiz de Fora. The second stage occurred from May 2016 to August 2017, including ten participants. The data were collected through a semi-structured interview, participant observation with records in the field diary, through a home visit. The second, by theoretical sampling, began with an eighth interview, consisting of three users. The criterion of sampling and theoretical saturation was followed. For the organization, codification and interpretation of the empirical data, the OpenLogos® program was used. Data analysis was performed using three types of coding: open, axial and selective. The following categories emerged from the data: Understanding the home care of an elderly person with wounds for the family; Having the domicile as place of care; Realizing the factors that interfere with the costs of wound care; Seeking strategies to take care of the wound; Assuming the different costs with the wound; And Experiencing the costs of the home care of a wounded elderly, this last one being the central phenomenon of the research. The participants experience different types of costs arising from the process of caring for an elderly person with a wound at home, because even if there are contributions from other family members and the support of the Home Care Service, the caregiver assumes the care. This is because, in the absence of material provided by the service, absence of family support, the caregiver responsible faces the need to provide care, or the elderly would be left without treatment. Thus, nurses' performance is determinant in the care process of a wounded elderly person in Home Care, emphasizing the importance of turning their attention to family members, in order to minimize the costs of this care.