Care and management demands of long-term care facilities for the elderly in Brazil: an integrative review (2004-2014)

Roquete, Fátima Ferreira; Batista, Carolina Campos Ricci Frá; Arantes, Rodrigo Caetano

doi:10.1590/1981-22562017020.160053

Abstract

Objective:

to analyze the care and management demands of Long-Term Care Facilities for the Elderly (LTCFs) in Brazil.

Method:

an integrative review of literature was carried out, organized into six stages: a) elaboration of a guiding question; b) online search of LILACS, SciELO, PubMed, the CAPES Portal and the Brazilian Society of Geriatrics and Gerontology databases; c) article selection, following the exclusion and inclusion criteria, with the sample composed of 17 articles; d) commented analysis of the selected articles; e) deliberation on the results obtained, formulated from the synthesis and interpretation of the selected studies; f) presentation of the results of the review.

Results:

the care demands identified are related to the process of caring and assume a working team with geriatric and gerontological knowledge, while the management demands include the means and resources needed so the care can be provided effectively. However, the LTCFs were found to rely on professionals who are unprepared to provide care or to assume an organizational management role, meaning care for the elderly is restricted to the essentials for their basic needs.

Conclusion:

the care demands were easily identified in the analyzed publications, however, there is a lack of research that evaluates management demands in a broader and more in-depth manner. It is suggested that studies aiming to broaden theoretical knowledge of the care and management demands of LTCFs are carried out, to stimulate effective and positive actions in the practices of these institutions, seeking to offer top quality care to elderly persons that live in these facilities, that responds to the real needs of their current stage of life.

Keywords:
Homes for the Aged; Health Management; Institutionalized Elderly.

[1] Correspondence Fátima Ferreira Roquete E-mail: fatimaroquete@enf.ufmg.br; fatimaroquete@gmail.com.

Articles and Authors	Publication and Year	Objective and Participants/Study Sample	Care and/or management demands identified and type of LTCF.
Degree of dependence of elderly persons resident in Long Term Care Facilities. Marinho et al.⁷7 Marinho LM, Vieira MA, Costa SM, Andrade JMO. Grau de dependência de idosos residentes em instituições de longa permanência. Rev Gaúch Enferm. 2013;34(1):104-10.	Revista Gaúcha de Enfermagem (Gaúcha Nursing Journal) 2013	Identify the degree of dependence of institutionalized elderly persons. 125 elderly persons resident in three LTCFs /Montes Claros, Minas Gerais.	Care. Non-profit LTCF*.
Satisfaction of elderly persons and nursing professionals with care provided in a LTCF. Castro et al.⁸8 Castro VC, Derhun FM, Carreira L. Satisfação de idosos e profissionais de enfermagem com o cuidado prestado em uma instituição asilar. J Res Fundam Care [Internet]. 2013 [acesso em 28 jul. 2014];5(4):493-502. Disponível em: http://www.seer.unirio.br/index.php/cuidadofundamental/article/view/2282/pdf_912 http://www.seer.unirio.br/index.php/cuid...	Journal of Research Fundamental Care (On-line) 2013	Identify the level of satisfaction of elderly persons with the quality of health care provided by nursing professionals and the level of satisfaction of these professionals with the activities they perform. 23 elderly persons and eight nursing professionals from an LTCF/Maringá, Paraná.	Care and management. Type of LTCF not described.
Indicators of institutionalization of elderly persons: study of cases and controls. Del Duca et al.⁹9 Del Duca GF, Silva SG, Thumé E, Santos IS, Hallal PC. Indicadores de institucionalização de idosos: estudo de casos e controles. Rev Saúde Pública. 2012;46(1):147-53.	Revista de Saúde Pública (Public Health Journal) 2012	Identify the indicators and causes of the institutionalization of elderly persons. 991 elderly persons, 393 of whom were institutionalized in 24 LTCFs and 598 non-institutionalized elderly persons /Pelotas, Rio Grande do Sul.	Care. LTCFs registered with Sanitary Surveillance. Type not described.
Perception of health professionals regarding the care of institutionalized elderly people. Piexak et al.¹⁰10 Piexak DR, Freitas PH, Backes DS, Moreschi C, Ferreira CLL, Souza MHT. Percepção de profissionais de saúde em relação ao cuidado a pessoas idosas institucionalizadas. Rev Bras Geriatr Gerontol. 2012;15(2):201-8.	Revista Brasileira de Geriatria e Gerontologia (Brazilian Journal of Geriatrics and Gerontology) 2012	Identify the meaning that health professionals attribute to the care of institutionalized elderly people. 14 health professionals: nurses, pharmacist, physiotherapist, physician, nutritionist and nursing technicians of an LTCF/in the central region of the state of Rio Grande do Sul.	Care. Type of LTCF not described.
Evaluation of Long Term Care Facilities for elderly persons in the city of Olinda, Pernambuco. Angelo et al.¹¹11 Angelo BHB, Silva DIB, Lima MAS. Avaliação das instituições de longa permanência para idosos do município de Olinda-PE. Rev Bras Geriatr Gerontol. 2011;14(4):663-73.	Revista Brasileira de Geriatria e Gerontologia (Brazilian Journal of Geriatrics and Gerontology) 2011	To analyze the organization and functioning of an LTCF, through the application of a specific instrument of Sanitary Surveillance, prepared in 2007, verifying that the institutions comply with the regulations of the Ministry of Health. Seven private, public and charitable LTCFs /Olinda, Pernambuco.	Management. Charitable, public and private LTCFs.
Structural linkages of Long Term Care Facilities for the Elderly with surrounding societal systems. Creutzberg et al.¹²12 Creutzberg M, Gonçalves LHT, Santos BL, Santos SSC, Pelzer MT, Portella MR, et al. Acoplamento estrutural das instituições de longa permanência para idosos com sistemas societais do entorno. Rev Gaúch Enferm. 2011;32(2):19-25.	Revista Gaúcha de Enfermagem (Gaúcha Nursing Journal) (Online) 2011	Analyze how the internal organizational system of the LTCF maintained structural linkages with surrounding societal systems. Six LTCFs from three regions of Brazil (South, Southeast and Northeast).	Management. LTCFs serving low income elderly persons. Type of LTCFs not described.
Structural alterations in a Long Term Care Facility for the Elderly aimed at the prevention of falls. Santos et al.¹³13 Santos SCS, Vidal DAS, Gautério DP, Silva ME, Rosales RA, Pelzer MT. Alterações estruturais numa ILPIs visando prevenção de quedas. Rev Rene. 2011;12(4):790-7.	Revista Rene de Fortaleza (Northeast Network Nursing Journal) 2011	Propose alterations to the physical structure of the LTCF, with the aim of preventing falls among elderly residents. One LTCF / Rio Grande do Sul.	Care and Management. Charitable LTCF.
Research in LTCF: necessary and possible contributions. Creutzberg and Gonçalves¹⁴14 Creutzberg M, Gonçalves LHT. Pesquisa em instituições de longa permanência para idosos: contribuições necessárias e possíveis. Rev Bras Geriatr Gerontol. 2010;13(3):361-7.	Revista Brasileira de Geriatria e Gerontologia (Brazilian Journal of Geriatrics and Gerontology) 2010	To identify the structural linkages of the LTCF with the scientific system, through the perception of directors on research in these settings, observing the communication and the resonances in the institution. Seven directors of three LTCFs /Porto Alegre, Rio Grande do Sul.	Management. Public and private non-profit LTCFs.
Hospitalization and associated factors among residents of Long Term Care Facilities for the Elderly. Del Duca et al.¹⁵15 Del Duca GF, Nader GA, Santos IS, Hallal PC. Hospitalização e fatores associados entre residentes de instituições de longa permanência para idosos. Cad Saúde Pública. 2010;26(7):1403-10.	Caderno de Saúde Pública (Public Health Notebook) 2010	To assess the prevalence of hospital admissions in a one-year period and associated factors based on a census among LTCF residents. 466 elderly persons from 24 LTCF/ Pelotas, Rio Grande do Sul.	Care and Management. LTCFs registered with Sanitary Surveillance. Type of LTCF not described.
Process of care in Long Term Care Facilities: view of formal caregivers of elderly persons. Ribeiro et al.¹⁶16 Ribeiro MTF, Ferreira RC, Magalhães CS, Moreira AN, Ferreira EF. Processo de cuidar nas instituições de longa permanência: visão dos cuidadores formais de idosos. Rev Bras Enferm. 2009;62(6):870-5.	Revista Brasileira de Enfermagem (Journal of Brazilian Nursing) 2009	Evaluate the care provided in charitable and private LTCFs, according to the elderly person/caregiver relationship, their training, satisfaction, difficulties with the role and activities performed. 181 caregivers of elderly persons/Belo Horizonte, Minas Gerais.	Care. Charitable and private LTCFs.
Residences for older adults: basic criteria for suitable choices. Vergara RS.¹⁷17 Vergara RS. Residencias para adultos mayores: criterios básicos para su adecuada selección. Rev Hosp Clín Univ Chile. 2008;19:356-60.	Revista do Hospital das Clínicas da Universidade do Chile (Journal of Clinical Hospital of University of Chile) 2008	Indicate basic factors to be considered in the selection and choice of LTCFS. Carried out with official data from the Ministry of Health of Chile, relating to LTCFs in that country.	Care. Type of LTCF not described.
Long Term Care Facilities for the Elderly: the image that remains. Creutzberg et al.¹⁸18 Creutzberg M, Gonçalves LHT, Sobottka EA. Instituição de longa permanência para Idosos: a imagem que permanece. Texto & Contexto Enferm. 2008;17(2):273-9.	Texto e Contexto Enfermagem (Nursing Text and Context) 2008	Identify the structural linkages of the LTCFs with the societal system, observing the communication and the resonances in the institution. Seven directors and 52 LTCFs (South, Southeast and Northeast)	Management. Public and private LTCFs.
The mechanisms of health in the elderly: a study with institutionalized elderly persons. Pestana and Espírito Santo¹⁹19 Pestana LC, Santo FHE. As engrenagens da saúde na terceira idade: um estudo com idosos asilados. Rev Esc Enferm USP. 2008;42(2):268-75.	Revista da Escola de Enfermagem da Universidade de São Paulo (USP) (The Journal of the Nursing School of the University of São Paulo) 2008	Describe the health situation of the elderly in an institutionalized context and identify how they perceive their health. 17 elderly persons from a LTCF/Rio de Janeiro.	Care. Charitable LTCF.
Profile of caregivers of elderly persons in Long Term Care Facilities in Belo Horizonte, Minas Gerais. Ribeiro et al.²⁰20 Ribeiro MTF, Ferreira RC, Ferreira EF, Magalhães CS, Moreira AN. Perfil dos cuidadores de idosos nas instituições de longa permanência de Belo Horizonte, MG. Ciênc Saúde Coletiva. 2008;13(4):1285-92.	Ciência de Saúde Coletiva 2008 (Public Health Science)	Evaluate the profile of caregivers of elderly persons from charitable and private LTCFs. 181 caregivers of elderly persons/Belo Horizonte, Minas Gerais.	Care and Management. Charitable and private LTCFs.
The quality of life of the institutionalized elderly person in homes. Almeida and Rodrigues²¹21 Almeida AJPS, Rodrigues VMCP. A qualidade de vida da pessoa idosa institucionalizada em lares. Rev Latinoam Enferm. 2008;16(6):1025-31.	Revista Latino-Americana de Enfermagem (Latin-American Nursing Journal) 2008	To describe the quality of life and factors that influence it and to identify the degree of dependence in basic activities of daily living of institutionalized elderly persons. 93 elderly persons from four LTCFs/ City of Lamego, Portugal.	Care. Type of LTCF not described.
The meaning attributed to 'being elderly' by workers from Long-Term Care Facilities. Reis and Ceolim²²22 Reis PO, Ceolim MF. O significado atribuído a 'ser idoso' por trabalhadores de instituições de longa permanência. Rev Esc Enferm USP. 2007;41(1):57-64..	Revista da Escola de Enfermagem da Universidade de São Paulo (USP) (The Journal of the Nursing School of the University of São Paulo) 2007	Identify the meaning attributed to "being elderly" by workers who provide direct nursing care to institutionalized elderly persons. 50 professionals from five LTCFs/Campinas, Sao Paulo.	Care. LTCF registered with the city council.
The economic survival of Long Term Care Facilities for Poor Elderly Persons. Creutzberg et al.²³23 Creutzberg M, Gonçalves LHT, Sobottka EA. A sobrevivência econômica de instituições de longa permanência para idosos empobrecidos. Rev Latinoam Enferm. 2007;15(n. esp.):147-54. 15...	Revista Latino-Americana de Enfermagem (Latin-American Nursing Journal) 2007	Identify structural linkages of LTCFs with the economic system, to maintain institutions that provide accommodation to poor Brazilian elderly persons. Seven directors, eight elderly persons and 52 LTCFs, Brazil.	Management. Public and private non-profit LTCFs.