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Health promotion in long term care institution: proposal for the establishment of an "Age-friendly Long Term care institution"

Grant number: 10/10015-7
Support Opportunities:Regular Research Grants
Duration: September 01, 2010 - August 31, 2012
Field of knowledge:Health Sciences - Collective Health - Public Health
Principal Investigator:Helena Akemi Wada Watanabe
Grantee:Helena Akemi Wada Watanabe
Host Institution: Faculdade de Saúde Pública (FSP). Universidade de São Paulo (USP). São Paulo , SP, Brazil


Caring for frail elderly throughout history has occurred within the family. Due to changes in family's composition and conformation in Brazil, availability of family caregivers has declined, although the number of elderly has grown significantly. Long-term-care institutions have become an option for the care of dependent older people since support programs to care giving for the elderly at home are insufficient. The World Health Organization initiative known as Age Friendly Cities Global Project, based on Active Aging and its pillars: health, security and participation, is being developed with the support from the Health Department of São Paulo state in some counties and districts and in some services lique hospitals and primary health care centers. This study will introduce long-term institutions for elderly in the Age Friendly Cities Global Project and the authors intended that its actions will be extend to elderly's families and to the communities in which they operate. For the evaluation of Long-term-care services, several state and municipal departments of health produced tools for sanitary inspection of such establishments. However, unlike general hospitals and hospices, the Long-term-care institutions are considered place of residence for the elderly, where they are assisted on their daily life needs, receive some basic health care as well as disability prevention and rehabilitation actions as well as occupation of their free time. Thus, there is need to establish standards for an "Age-friendly Long-term care institution" as regards to the following topics: physical structure and accessibility, respect and social inclusion, communication, participation and care management. Based on the principles of Health Promotion, Active Ageing and the concepts of Age Friendly Cities Global Project The authors intend to identify and analyze the perceptions, expectations, difficulties, facilities and demands of elderly residents in long term care institutions (LTCI), their families and friends, LTCI workers, volunteers and the surrounding community about LTCI's physical structure and accessibility, respect and social inclusion, communication, participation and management of care. Method: LTCI's managers and residents will be interviewed and focus groups will be performed with families, workers, volunteers and the community of two LTCI located in the southern area of the city of Sao Paulo. Speeches will be recorded, transcribed and analyzed according to thematic content analysis proposed by Bardin. To learn about the institutions daily life, participant observation will be performed. The authors intend that results will give basis to elaborate a diagnosis in relation to physical structure and accessibility, care management, participation and inclusion and communication of both LTCI, indicating what is to be improved or should be maintained and strengthened. The authors also aims to elaborate an action plan with LTCI managers in order to make the LTCI more friendly. It is hoped that this study will also subsidize the development of criteria for the definition of an age-friendly LTCI, in accordance with the theoretical and legal bases for the operation of such institution in Brazil and the expectations of the subjects of this research; they also intend that this research gives fundamentals to elaborate a checklist with essential features for the establishment of a age-friendly LYCI and to the elaboration of a manual for the implementation of such LTCI. (AU)

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