INTEGRATIVE REVIEW
SILVA, Jânio Reis da [1], CAMARGO, Elaine de [2], SANTOS, Rodrigo Rocha dos [3], SANTOS, Sara Noemy Araújo dos [4], PIOTO, Marcela Rocha [5]
SILVA, Jânio Reis da. et al. Elderly in situation of abandonment and nursing conduct. Revista Científica Multidisciplinar Núcleo do Conhecimento. Year 04, Ed. 10, Vol. 13, pp. 166-182. October 2019. ISSN: 2448-0959, Access link: https://www.nucleodoconhecimento.com.br/health/situation-of-abandonment
ABSTRACT
Due to the aging process and the increase in people living in old age, there is an incidence of chronic diseases and, likewise, the length of care and hospitalizations. Even though it is the legal obligation of the family to take care of those who age, the moral and affective duty for different reasons, not considered, ends up causing psychic changes and increases in health problems. The elderly individual, on several occasions, finds himself in a scenario of family carelessness in the face of the complications that old age imposes. This study’s main goal is to identify and analyze the relevance of nursing activities focused on the elderly population, in circumstances of family neglect, according to the literature. Thus, an integrative review was used to explore articles published in Lilacs databases and in the Scielo library. In the hospital environment, age can be considered an indicative factor, determining support for the sick elderly, as a reliable parameter that establishes specific care criteria. The resumption of ethics in a broad view of aging generates struggles, especially in nursing that seeks to promote comprehensive and humanized care for the elderly.
Key words: Elderly, Abandonment of the elderly, Nursing care, Comprehensive care for the elderly, Nursing.
1. INTRODUCTION
Aging is a process defined by several stages: birth, development, puberty, maturity and aging, each of these stages has its specific difference and are unified throughout life (ABREU et al., 2015).
According to Brazilian Institute of Geography and Statistics (IBGE)[6] data, in 2015 there were 20.5 million elderly people in Brazil, around 39 for every 100 young people. The forecast for 2040 is almost triple, of approximately 153 elderly people for every 100 young people. It is clear that the number of elderly people is progressive, thus extending to current and future demands, which can generate an overload in the health system (MIRANDA et al., 2016).
Approximately 14% of the Brazilian population is over 60 years old. In 2060, the IBGE assumes an inversion between young and old. The information is represented in Graph 1 below (SILVA, 2016).
The aging process has been debated and surrounded by interventions that aim to castellate the elderly population, which over the years has grown. The elderly in 1970 received help mainly from non-governmental and religious organizations, similar to philanthropic activities. With regard to legislation, in the 20th century the elderly were addressed in the civil, penal and electoral code, including decrees and ordinances mainly correlated with retirement issues, in addition to having established a lifetime benefit by Law No. 6,179 of 1974 (RODRIGUES et al., 2013).
The general population has, over time, increased its life expectancy, thus making people live longer in old age. At the same time, there is a propensity for the emergence of chronic diseases, characteristic of aging and a high probability of hospitalization. Such chronic degenerations are stipulated as a commonly incurable situation, requiring a unique adaptation that intends to prevent, reduce or moderate long-term adversities (OLIVEIRA et al., 2016).
With aging, there is a reduction in the body’s metabolic activities, which have some aspects correlated with illnesses, resulting continuously in the elaboration of international and national governmental activities, aimed at health workers and essentially at the elderly. Thus, the increase in the number of elderly people in the population is verified, as a result of the decline in birth rates, life expectancy and the progress of technology, which allowed interventions to be carried out in previously unviable situations (VERAS et al., 2013).
Chronic diseases are related to increased life expectancy, resulting in various disabilities and limitations in the elderly. Thus, disease prevention and health care for the elderly population represent new challenges for nursing and public health (CARRETA et al., 2011).
When the functional capacity decreases in the elderly, it ends up causing damage to the individual and his family, affecting the health system and the life of the elderly person, as it causes greater vulnerability and dependence, and may contribute to a decrease in quality of life (VERAS; OLIVEIRA, 2016).
Negative repercussions can arise in the life of the elderly person, when beyond the physical limits, the emotional ones reach the daily life of this individual, which is caused by the loss of occupational and economic status, continued physical decline, higher frequency of physical illnesses and disability, which in periods onwards, displays the rigid engagement of cognitive levels close to absolute submission (SANTANTA NETO, 2013; NASCIMENTO, 2019).
The absence of tenderness for another individual is capable of happening, regardless of the type of relationship exercised, mutual respect is a must. The family has the responsibility to protect and comfort the elderly (VIEGAS; BARROS, 2016).
In the legal field, the Brazilian Constitution of 1988 declares that children, when of legal age, have an obligation to protect and support their parents in a condition of senility, need or weakness. The commitment to care for the elderly is, therefore, a duty. However, the fact that it is an obligation for children to look after their parents, there is even an ethical and devoted obligation, which sometimes has not been respected, causing psychological disorders and aggravation of diseases (VIEGAS; BARROS, 2016).
Even though it is a legal obligation for children to take care of their elderly parents, what is observed is exactly the opposite, in the social and health area, it is increasingly common for these people to be abandoned to their fate. Therefore, it emerges as a research problem: how is nursing assistance and care given to the elderly, especially with regard to screening for abandonment of this population?
The elderly, for several moments, are faced with a state of family abandonment in the face of the complications that old age imposes. The rise of indulgent aging requires changes in goals and tasks, integrating comfort in life.
The elderly population corresponds to a large percentage of users of health systems, relying particularly on nursing activities. This whole process requires specific attention from health programs for the elderly everywhere, highlighting the importance of training professionals, offering them greater autonomy in order to improve humanized care for the elderly in a situation of abandonment.
2. OBJECTIVE
Identify, in the literature, elderly people in a situation of abandonment mentioned by members of the nursing team and analyze the relevance of nursing advice to this population, according to the literature.
3. METHOD
This was an integrative review, which is characterized by an extensive analysis of the literature on a particular topic, with the purpose of designing a composition of studies carried out in isolation, investigating the same or equivalent problems (LAKATOS; MARCONI, 2011).
The following guiding question was used: how is the nursing team’s assistance to the elderly in a situation of abandonment?
The search was carried out in the Virtual Health Library, Scientific Electronic Library Online (SciELO), BIREME library, and in the Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) databases, which brings together scientific publications in the area of Health of Latin America and the Caribbean; National Library of Medicine (MEDLINE) and Portal de Evidências, which offers integrated access to health information sources with the best level of scientific evidence.
The keywords for data collection were selected from the Health Sciences Descriptors (Decs), as follows: Elderly; Abandonment of the Elderly; Nursing care; Comprehensive Care for the Elderly; Nursing. From these words, the Boolean AND linker was used.
The insertion parameters of the articles were determined in this way: to be an investigative article disseminated in national journals, listed in databases and published between 2010 and 2019.
The elimination criteria were articles released outside the range of 2010 to 2019, which only the abstract is available, published in a language other than Portuguese.
During the research and study of the articles, 359 articles were found and 17 publications were designated, which considered the proposed designs, excluding those that in the reading of the theme were not related to the research theme.
For the synopsis and evaluation of the articles, the immediate processes were undertaken: exploratory, selective, critical and reflective reading.
For the selection of scientific articles, articles that address the proposed descriptors were considered, where we observed whether they have a relationship of interest in the title (screening of elderly people in abandonment situations and nursing conduct).
Short texts that do not allow access in full, articles that do not meet the proposed objective and year of publication greater than 9 years that are not available in full were discarded.
4. RESULTS
Tracking the study of the references and content examined in the articles, these were ordered according to year, database, title, methods and main results.
Through the descriptors used, 45 articles were detected in the VHL, 15 of the articles are located in the LILACS database, the others in CAPES and SCIELO. After precisely examining and complying with the insertion and elimination parameters, already specified in the methodology, 20 articles published between 2010 and 2019 on abandonment of the elderly were designated.
The representation of the articles designated for the present study is in table 1 below.
Table 1 – Description of articles according to year, article title, method, main results. Sao Paulo, 2019
| Nº | Author, year | Title | Method | Main results |
| 1 | LINO et al., 2019 | Prevalência e fatores associados ao abuso de cuidadores contra idosos dependentes: a face oculta da violência familiar | Cross-sectional study | The high prevalence of negligence practiced by caregivers, which indicate high overload and stress, and misfortunes associated with alcohol, which require family support. |
| 2 | NASCIMENTO HG, FIGUEIREDO AE. 2019 | Demência, familiares cuidadores e serviços de saúde: o cuidado de si e do outro | Analytical-descriptive qualitative research | For family caregivers, what exacerbates the difficulties in care is the state of neglect they experience. |
| 3 | NUNES, PACHECO. 2018 | O processo saúde doença da pessoa idosa em situação de abandono | Qualitative social research | The study exposes the profile of the elderly population in a state of violence that shows social fragility, abandonment stood out as the negligence most experienced by this population. |
| 4 | SANGUINO, G.Z. 2018. | O trabalho de enfermagem ao idoso hospitalizado | Descriptive exploratory research | The attention given by nursing to the hospitalized elderly requires caution, as it is easily elaborated aiming at the agility of professionals. |
| 5 | LIKES, S.A. et al. 2018 | Estatuto do idoso e sua aplicabilidade: o cuidado de enfermagem em uma Estratégia Saúde da Família | Qualitative study | The nurses’ concern was witnessed in stimulating and exercising the support network, emphasizing the Statute of the Elderly. |
| 6 | LOPES, E.D.S. et al.2018 | Maus tratos a idosos no Brasil | Integrative Review | The aggressions that stood out were the psychological ones, together with the physical ones, and these occurred mostly in women. |
| 7 | VIEGAS LM, FERNANDES AA, VEIGA MAPL 2018 | Intervenção de enfermagem no estresse do cuidador familiar do idoso com dependência: estudo piloto | pilot study | There were improvements in coping, comfort and overwork. |
| 8 | ARAÚJO NETO, A.H et al. 2017 | Quedas em idoso institucionalizados: riscos, consequências e antecedentes. | Literature review | It portrayed occurrences of falls and contributed to a focused and humanized treatment for the elderly. |
| 9 | PERSEGUINO MG, HORTA ALM, RIBEIRO CA. | A família frente a realidade do idoso de morar sozinho | Qualitative approach, with theoretical framework | Nursing, tasked with preparing methods of how to care, has the duty to carry out its work related to families and assist them in outlining comprehensive plans. |
| 10 | MENEZES JUNIOR et al. 2016. | Caracterização do Abandono Afetivo do idoso e as ações em Anápolis de apoio ao dever da proteção integral: proposta de construção de cartilha informativa à terceira idade | Observational theoretical study | It is essential to maintain the necessary commitment to guarantee the benefits of the elderly, thus establishing norms that seek to contribute and reduce the inequalities endured by this population. |
| 11 | CAMACHO, A.C.L.F.; ALVES, R.R. 2015. | Maus tratos contra os idosos na perspectiva | Integrative Review | The bibliography shows that there are several workers in the health area who are unprepared for assisting elderly victims of abandonment/neglect |
| 12 | GASPAROTTO, L. P. R. et al. 2014. | As quedas no cenário da velhice: conceitos básicos e atualidades da pesquisa em saúde | Literature review | The multidisciplinary support is based on the prevention of falls and lacks the specialized knowledge of professionals who care for the elderly. |
| 13 | SOUSA, L. RIBEIRO, A.P.2013. | Prestar cuidados de enfermagem a pessoas idosas: experiências e impactos | Exploratory study | The disease and dependence of elderly people bring reflection on nurses about their professional practice, increasing their compassion. |
Source: Own authorship.
4.1 DISCUSSION
Aging is an event integrated into life, considered today as a global factor, commonly caused by improved living conditions, evolution of medicine and technology, physical exercise and a balanced diet, consequently leading to an increase in life expectancy. (GASPAROTTO and SANTOS, 2013).
The representation that society spreads, regarding the elderly, still carries marks of the physical decline of disability, which magnifies the mental and social decay of some time ago, the extension of longevity entails several difficulties for the care of the elderly patient (GASPAROTTO and SANTOS, 2013).
Aging is a process defined by several stages that are consolidated throughout life. From its fertilization, the human being passes through several cycles in its development. After birth, the individual grows, reaches puberty, matures and reaches old age. It seems like a simple division, but each of these phases has significant differences (ILHA et al., 2015).
Brazil currently has 13.55% of its population over 60 years old. The IBGE projections for 42 years from now, is an inversion in the population picture between young and elderly, in 2060 Brazil will have a quarter of the set of inhabitants over 65 years old and 32.6% will be over 60 years old, while while individuals under the age of 25 will consist of only 25.34%. The data are represented in Graph 1 below (LEAL, 2018).
Graph 1 – Elderly population in Brazil
The assumption for 2020 is that 15% of the population in Brazil will be composed of elderly people, which will grow 16 times by 2025, ranking sixth in the world ranking regarding the elderly population (CARRETA et al., 2013 and ARAUJO NETO et al., 2017).
Faced with the Brazilian reality, that the elderly are living longer, it is extremely important that the family offers the necessary support for this population to have a dignified life.
It is necessary to agree with Bertolin and Viecili (2014), when they state that the family members are the only ones with whom the person can count, from their birth, referencing, socializing and effecting strong bonds, these bonds are responsible for the physical, psychic stability and affective and in the lack or breakage of these links, a vague feeling of lack of protection, fragility and abjuration arises.
Abandonment is defined as the lack of fundamental zeal for the victim, practiced by the person responsible for providing care or guardianship. However, this type of aggression towards the elderly is not exclusively about the use of brute force, but about abandonment, use of words and actions that generate pain and various sequelae, either by the action of a family member or people who have created ties with the elderly victim (MENEZES JUNIOR et al., 2016).
The family is marked by the essential factors of affection, commitment, solidarity, and support during life, in addition to the extension of affective, intellectual and social ties and the security of being protected, appreciated, which probably explains the differences given by the elderly about relatives and family (PERSEGUINO et al., 2017).
The affective ties and the social obligation of family members to support each other are aspects expected by the elderly, who believe that the entire population maintains this tradition. Family support is a fundamental condition for healthy aging, which is present in elderly people kept in care with added humanization.
Family helplessness also occurs by the caregiver, regardless of whether he is not a family member. Birth; Figueiredo (2019), points out that the abandonment of family members gives the family caregiver a loss of freedom in the face of distancing and family disagreements due to illness and weakness of the elderly. In addition, the emergence of possible conflicts between family members is observed, which makes the caregiver’s work difficult.
4.1.1 ACTION OF THE NURSE BEFORE THE ELDERLY IN A SITUATION OF ABANDONMENT
It is essential that the nurse, the professional closest to the patient, has technical-scientific knowledge about gerontology and the care needs of the elderly, who need specific hospital care. It is up to the nursing team to appreciate the relevance of companions during the hospitalization and procedures performed on the elderly, providing improvements in the affective condition of the elderly (SANGUINO et al. 2018).
Campos (2016), when the elderly reach the age of 80, the many who do not have a specific caregiver, makes it difficult to find healthy elderly in our country, even considering the autonomy of the elderly in their daily activities.
In a study carried out by Nunes; Pacheco (2018) sought to understand how aggressions against the elderly can harm the state of health or illness, highlighting the elderly in social vulnerability, they were the ones who suffered the most abandonment and neglect and even so, these individuals did not feel aggrieved. The elderly studied had at least two diseases, one being chronic, resulting from physical aggression or due to abandonment and others due to lack of continued care.
In the literature, studies point to family abandonment as an aggregate of negligence for the elderly. Therefore, identifying this type of violence provides a favorable opportunity to improve the act of caring. However, this is not an easy task, since one of the obstacles to facing this problem is the limited inclusion between health and palladium systems for the elderly. In view of this, it is essential to train nursing teams to detect, help and warn of occurrences of aggression that occur in the Health Unic System (SUS)[7], in order to obtain the necessary resources to protect the elderly (LINO et al., 2019).
The nursing experience that works with the elderly population is essential and should be expanded, as they are specialists in elderly care. Illness and dependence of elderly people lead nurses to reflect on their professional practice and increase their compassion. Thus, it is understood that nurses need to be increasingly trained to face the individuality and plot in elderly care (SOUSA; RIBEIRO, 2013).
Sousa; Ribeiro (2013) states that among the specificity in elderly care, it ensures that nurses are widely qualified to deal with complicated situations, whether abuse, urgency, emergency or psychosocial problems.
The care provided by the nursing team to the hospitalized elderly faces several problems and obstacles, as they follow interventions focused only on the distinct characteristics of senility; and care aimed at facilitated practicality. Advice focused on the particularity of the elderly is needed, providing effective multidisciplinary care to this population (SANGUINO et al., 2018).
Nursing professionals must offer differentiated assistance to the hospitalized elderly population, guided by the principles of humanization, thus observing their expectations, quality and humanization of care (SANGUINO et al., 2018).
A study was carried out with the aim of evaluating the effectiveness of a nursing intercession, supported by stress management programming and overwork of the provider of services to the elderly. It was proven that the tool helped them in the agility of care and especially in learning new ways of caring. As for the nurses, the program allowed them to become aware of the caregiver’s obstacles and to visualize possible improvements in comprehensive care interventions for the elderly (VIEGAS et al., 2018).
4.1.2 POSITIONING OF THE FHS NURSE IN FRONT OF ELDERLY VULNERABILITY
On September 21, 2017, an Ordinance was approved by the Ministry of Health, which establishes the revision of guidelines for the organization of primary care, within the scope of the public health system, ORDINANCE N 2.436 (BRASIL, 2017).
A public policy of care for the elderly needs broad interventions relevant to aging. For WHO, this is a matter of extreme importance, something vital that is capable of being carried out under any circumstances (MUROSINI, 2018).
It is expected that the nursing team and other competent professionals will emphasize the integral and constant advice of all families connected to the public service network, without leaving aside the family and societal scope (ARAÚJO NETO, 2017).
The health team must pay attention to variations in the housing contour of its coverage region, with an emphasis and focus on the elderly population and maintain an action that aims at welcoming, progress in the life and health of the elderly, restoration of affective ties, insertion collective and family (DENNINGER, 2015).
The nursing professional must act based on welcoming, as they work in the cohesive planning of existential solidarity, favorable to the population. Thus, it is important to have a social policy that benefits the elderly during the execution of laws to probable negligence exercised by family members (CAMACHO et al., 2015).
All health teams have a duty to provide an interaction between family, caregiver and society in the socio-educational process, to reduce the negligence faced by the elderly population.
Likes et al. (2018) sought to learn the application of defense laws to the elderly in public health and the understanding of employees, especially nurses, whose role is to act and guide the rights and duties of this population. They develop actions in order to enhance the perception of both, avoiding possible future problems and resulting in significant improvements throughout the life of the elderly person.
In this way, the Family Health Strategy (FHS) professionals seek a bond with the elderly that respects their life history, their real situation and that gives extreme importance to the feelings and pain resulting from negligence or family abandonment. This type of bond tends to boost health (CAMACHO et al., 2015).
It is essential to prepare nursing professionals with courses, classes and lectures, making them able to host elderly people in vulnerable situations, resulting from abandonment and family aggression. Care for the elderly should be humanized and it becomes necessary to educate society about the rights of the elderly.
For Camacho et al. (2015), it is important to remember that the experience of gerontological care of nurses in their activities in the Family Health Strategy Units begs for funds worthy of qualified human resources through continuing education, including the provision of minimum infrastructure for the proper execution of tasks.
Public policies act in the fight against violence, treating this inconvenience as a public health problem, leading this charge preferably to nursing and later to other professionals and specialized institutions (CAMACHO et al., 2015).
Nascimento and Figueiredo (2019) carried out a study to find out the opinion of the family caregiver of the elderly in a weakened mental state, regarding the care offered to the patient. The content emphasizes that the family health team receives and supports both, however it is not indicated as a reference in quality of care. For family caregivers, what increases obstacles is the condition of helplessness experienced. Until then, the family health team has basic knowledge related to the adversities encountered by the elderly, family and caregiver.
Another aspect that should be considered by the professional is the mental health of the caregiver. Most of the time, the caregiver is overloaded, or does not have relevant information and knowledge of the act of caring. The caregiver must be informed about the relevance of rest, rest and entertainment, and the variation with other professionals, avoiding overloads and stress. In this way, it highlights the importance of applying educational management measures aimed at the whole family, including caregivers.
5. FINAL CONSIDERATIONS
It is important to remember that not only children abandon the elderly, but anyone who has established an affective bond with the person in a senile state, we emphasize the seriousness of the commitment to care for the elderly, which needs to be exercised with love and empathy. Nursing care for the elderly is essential, whether in a hospital or residential environment, as it aims to meet the basic and crucial care needs of this group, granting them a better quality of life.
These professionals, through nursing care, are able to promote to the elderly the concept of freedom, duty of action, participation and empowerment of deliberation regarding their impositions of health and zeal.
The resumption of ethics from the point of view of dignified senility goes through numerous debates in the aging population and, mainly, among health teams. Nursing, in particular, has an obligation to provide humanized advice to the elderly population, offering comprehensive and comprehensive care.
It is necessary to reflect on the support in the care aimed at the person in old age. The elderly need to have the possibility that their family members also have a structure that guarantees their care without putting their own survival at risk. In summary, it appears that the person in a senile state does not go through a situation of abandonment exclusively out of malice, or for the convenience of their relatives, but because everyone, in their social realities, depends on their own means to ensure not only their own survival, but also the survival of the elderly.
REFERENCES
ABREU, H.C.A. et al. Incidência e fatores preditores de quedas de idosos hospitalizados. Rev. Saúde Pública. v.49, n.37. 2015.
ARAÚJO NETO, A.H.; PATRÍCIO, A.C.F.; FERREIRA, M.A.C. et al. Quedas em idoso institucionalizados: riscos, consequências e antecedentes. Rev.Bras.Enferm. v.70, n.4, 2017.
BRASIL. Lei nº 13.466, de 12 de julho de 2017. Altera os arts. 3o, 15 e 71 da Lei no 10.741, de 1o de outubro de 2003, que dispõe sobre o Estatuto do Idoso e dá outras providências. Diário Oficial da República Federativa do Brasil. Brasília, DF.2017.
BERTOLIN, G.; VIECILI, M. Abandono Afetivo do Idoso: Reparação Civil ao Ato de (nã0) Amar? Revista Eletrônica de Iniciação Científica. Itajaí, Centro de Ciências Sociais e Jurídicas da UNIVALI. v. 5, n.1, p. 338-360, 2014.
CAMACHO, A.C.L.F.; ALVES, R.R. Maus tratos contra os idosos na perspectiva. Rev. enferm UFPE. Recife. V. 9, n.supl. 2, p. 927-935. 2015.
CARRETTA, M.B.; BETTINELLI, L.A.; ERDMANN, A.L. Reflexões sobre o cuidado de enfermagem e a autonomia do ser humano na condição de idoso hospitalizado. Rev. bras. enferm. v.64, n.5, p.25-29. 2011.
GASPAROTTO, L. P. R.; FALSARELLA, G. R.; COIMBRA, A. M. V. As quedas no cenário da velhice: conceitos básicos e atualidades da pesquisa em saúde. Revista Brasileira de Geriatria e Gerontologia, v.17, n.1, p. 201-209, 2014.
LEAL, P. População idosa cresce, enquanto a d jovens encolhe no Jaraguá do Sul. OCP News. 2018.
LIKES, S.A. et al. Estatuto do idoso e sua aplicabilidade: o cuidado de enfermagem em uma Estratégia Saúde da Família. Destaques Acadêmicos, Lajeado, v. 10, n. 3, p. 115-127, 2018.
LINO, V.T.S. et al. Prevalência e fatores associados ao abuso de cuidadores contra idosos dependentes: a face oculta da violência familiar. Ciência & Saúde Coletiva, v.24, n.1, p.87-96, 2019.
LOPES, E.D.S. et al. Maus tratos a idosos. Rev. Bras. Geriatr. Gerontol., Rio de Janeiro. v. 21, n.5, p. 652-662. 2018.
MENEZES JUNIOR, E.E. et al. Caracterização do Abandono Afetivo do idoso e as ações em Anápolis de apoio ao dever da proteção integral: proposta de construção de cartilha informativa à terceira idade. Revista Eletrônica do Curso de Direito – PUC Minas Serro – n.14. p. 84-99. 2016.
MIRANDA, L.C.V.; SOARES, S.M.; SILVA, P.A.B. Qualidade de vida e fatores associados em idosos de um Centro de Referência à Pessoa Idosa. Ciênc. saúde coletiva. v.21, n.11, p.3533-3544. 2016.
MUROSINI, M.V.G.C. Política Nacional de Atenção Básica 2017: retrocessos e riscos para o Sistema Único de Saúde. Saúde debate. v. 42, n. 116, p. 11-24, 2018.
NASCIMENTO, H.G.; FIGUEIREDO, A.E. Demência, familiares cuidadores e serviços de saúde: o cuidado de si e do outro. Ciência & Saúde Coletiva. v. 24, n.4, p.1381-1392, 2019
OLIVEIRA, M.R.; VERAS, R.P.; CORDEIRO, H.A.; PASINATO, M.T. A mudança de modelo assistencial de cuidado ao idoso na Saúde Suplementar: identificação de seus pontos chave e obstáculos para implementação. Physis v.26, n.4, p.1383-1394. 2016.
PERSEGUINO MG, HORTA ALM, RIBEIRO CA. A família frente a realidade do idoso de morar sozinho. Rev Bras Enferm. v.70, n.2, p.235-241. 2017.
SANTANA NETO, J. Diagnóstico de enfermagem memória prejudicada em idosos hospitalizados. Acta paul enferm. v.24, n.1, p.:36-42. 2013.
SANGUINO, G.Z.; PREVIATO, G.F.; SILVA, A.F. et al. O trabalho de enfermagem ao idoso hospitalizado. J. res.: fundam. care. v. 10, n.1, p. 160-166. 2018.
SILVA, M.R.F. Envelhecimento e proteção social: aproximações entre Brasil, América Latina e Portugal. Serv. Soc. Soc. N.126, p.215-234. 2016.
SOUSA, L. RIBEIRO, A.P. Prestar cuidados de enfermagem a pessoas idosas: experiências e impactos. Saúde Soc. São Paulo, v.22, n.3, p.866-877, 2013
VERAS, R.P. et al. Desenvolvimento de uma linha de cuidados para o idoso: hierarquização da atenção baseada na capacidade funcional. Revista Brasileira de Geriatria e Gerontologia 2013; 16(2):385-392.
VERAS RP, OLIVEIRA MR. Linha de cuidado para o idoso: detalhando o modelo. Rev. bras. geriatr. gerontol.v. 19, n.6, p.887-905. 2016.
VIEGAS LM, FERNANDES AA, VEIGA MAPL. Intervenção de enfermagem no estresse do cuidador familiar do idoso com dependência: estudo piloto. Rev baiana enferm. v.32, n.:e25244. 2018.
APPENDIX – FOOTNOTE
6. Instituto Brasileiro de Geografia e Estatistica (IBGE).
7. Sistema Único de Saúde (SUS).
[1] Nursing graduate.
[2] Nursing graduate.
[3] Nursing graduate.
[4] Nursing graduate.
[5] Master’s in progress in Health Sciences. Specialization in Training of Nursing Teachers at Technical Level. Specialization in Nursing in Urgency and Emergency. Graduation in Nursing.
Submitted: October, 2019.
Approved: October, 2019.
