Gestão do cuidado domiciliar pelo cuidador de um familiar dependente para o autocuidado

Abstract

This study aims at the management of home care by the caregiver of a family member partially or totally dependent for self care. The focus is on the needs and demands of the family caregiver of SUS users, in home care. The objective of this study was to: develop a substantive theory about the management of home care by the family caregiver of adults and the elderly, partially or totally dependent for self-care; describe how the caregiver manages the care of his family member, at home; understand the needs and demands of the user, under the eyes of the family caregiver; to analyze the financial, social and emotional costs emanating from home care, from the point of view of the family caregiver. A qualitative research was carried out using the methodological framework of Grounded Theory developed in two stages; in both the participant observation technique was executed. In the first one, an ambience and data collection in medical records for the evaluation of the sociodemographic and health profile was carried out, applied to all users of the Interdisciplinary Home Care Program, totaling 46 participants. In the second, nineteen family caregivers were interviewed, applying four instruments to assess the user's self-care capacity; evaluation of the sociodemographic and health profile of the family caregiver; family economic classification; caregiver overload assessment. In addition, to conducting a recorded interview with semistructured questions. Participants were divided into four sample groups. The first group consisted of six caregivers of family members totally dependent on self-care, who did not have the help of paid caregivers. The second group consisted of five caregivers of family members totally dependent on self-care, who had the help of paid caregivers. The third group comprised three caregivers of partially dependent relatives for self-care, without the assistance of the paid caregiver. The fourth, made up of five participants, allowed the validation of the theoretical model, based on the findings of this research. The data analysis was carried out concomitantly with data collection and was conducted using the three types of coding: open, axial and selective. The following categories emerged from the data: becoming caring for your loved one, sick and dependent on care; managing care in the home context: understanding and meeting the needs and demands of the family caregiver; weaving the network of relationships: the family and health services as a locus of care; receiving the assistance of the multiprofessional team of the Interdisciplinary Home Care Program and understanding the family budget: conditions that influence home care; seeking services and distributing functions: strategies for the management of home care by the family; caring for your family member: feeling the physical, emotional, financial and social overload. The family member assumes the role of caregiver, in an integral way, executing procedures, planning and organizing resources, seeking services, supervising, and finally managing home care. In this range of roles and responsibilities, they feel overwhelmed. Therefore, the work of the multiprofessional team of the Home Care Service is essential for the maintenance of home care through the development of the support-education system, assistance or even the implementation of more complex procedures.