POBRE, IDOSO E NA RUA: UMA TRAJETÓRIA DE EXCLUSÃO

Este estudo exploratório teve por objetivo investigar e descrever a população idosa em situação de rua, usuária de um abrigo exclusivo para esse segmento, na cidade de São Paulo. Os sujeitos do estudo foram 20 idosos. Os dados foram coletados por meio das técnicas da entrevista e observação de campo. Foram analisados à luz dos referenciais das áreas da Gerontologia e Saúde Coletiva. Os principais resultados mostram que a vulnerabilidade do idoso às ruas se dá tanto no nível macro, caracterizado por laços trabalhistas e habitacionais frágeis, quanto no nível micro, caracterizado pela falta de apoio familiar. Concluindo, esse estudo propocia a reflexão sobre os valores humanos no que diz respeito às desigualdades sociais e banalização da injustiça social. Aprende-se a ver o idoso de rua como sujeito e não um objeto passivo de caridade e assistencialismo.


INTRODUCTION
In October 2003, the President of Brazil passed Law number 10741, which concerns the Elderly Statute and presents other measures (1) .It should be emphasized that it took long years of procedures and discussions in the National Congress and required a broad mobilization of elderly and technicians committed to the cause of aging.Not only does it consolidate the rights ensured in other legislations, including the National Elderly Policy (2) , the National Elderly Health Policy (3) and the Single Health System (4) , but it also broadens, enhances and defines protection measures for people aged 60 years or more.
The Elderly Statute (1) considers life and aging as individual and social rights.It demands the State to guarantee elderly people with the protection of life and health through the implementation of public social policies that ensure healthy and dignified aging.
However, elderly often live in a situation of extreme poverty, deprived of such protection that would ensure the maintenance of their basic health necessities.

Moreover, it is constantly observed that the Public
Power and society lack preparation to meet the legal precepts.
This study is based on the belief that public policies, in the social domain, are instruments capable not only of assessing poverty, but, above all, of redefining access to opportunity.In this sense, the authors present the issue of aging on the streets, with a view to accentuating the difference between charity and justice in complying with legislation.
In Sao Paulo, the City Council passed Law number 1232/97, which determines on care to people on the streets.Despite being assistentialist, it aims, insofar as possible, to ensure constitutional rights that seek to guarantee equality among Brazilians.The Law determines services and programs for this population, aiming to provide them at least with care for their absolute poverty situation.carried out a census of people living on the streets in Sao Paulo, registering 10,394 people -6,186 of whom were located in the streets and 4,208 in shelters (5) .
Aging is a natural phenomenon.Hence, all being get old, since their bodies are finite.The idea of finitude in life is given by the vicissitudes of the body and should be part of human existence.However, not everyone notices and/or accepts aging.
The aging process includes, but is not limited to, the old age phase.Life and aging qualities relate with the individual's view of the world and society he or she lives in.Therefore, aging is not only a biological phenomenon, but, above all, the convergence of socially constructed factors, which assign a different status to aging people (6)   .This assertion is essential when working with elderly living on the street.
In this discussion, the authors introduce the precept that there are different forms of aging and, thus, old age.The place individuals hold in society affects the way they obtain conditions to manage their personal care.This fact suggests that social injustice affects this care relationship, and, therefore, cannot be disregarded when analyzing the object of this study.
The current social conjecture has points in common with a war situation.However, it does not refer to an armed conflict, but to an "economic war".
Its setting is the job market and world, in which people who are not ready for combat are harmed because they are not able to achieve the productivity, availability, discipline, and abnegation imposed by the economic system.People excluded from the job market comprise the reserve army -elderly who do not have the agility of younger individuals, young individuals who do not have the experience of older ones, and those without access to information and education (7) .From this perspective, the authors include in the discussion elderly living on the streets, who are doubly excluded since they are both old and poor.
Therefore, the purpose of this study is to investigate and describe the elderly population living on the streets, at a shelter exclusive for elderly in Sao Paulo.

METHOD
This is an exploratory study, since it was developed to provide more familiarity with the study object (8) , offering an overall view regarding old age on the streets.This choice was made due to the scarcity of studies on this theme.Participants provided written consent.
Data was collected using interview and observation techniques, by administrating an instrument and keeping a field diary.Simple frequency distribution analysis was used and the data was analyzed by means of interpretative reading (8) , in the light of selected theoretical-conceptual references in Gerontology and Collective Health.

RESULTS AND DISCUSSION
The scarcity of sociodemographic studies, published over the last decades, capable of outlining a setting about the profile of the Sao Paulo street population impedes the correlation with this study's findings.However, subjective data, based on field observation and conversations with professionals working with this population, suggest that this segment has grown older.
According to a study performed by the Municipal Secretariat for Social Development (9)  Little is known about what happens with the street population after they age.In spite of the shelter -the place of research -being for people aged over 60 years, the authors did not find any elderly aged over 70.There is no explanation for this fact.
However, hypotheses may be raised.Individuals might be willing to live on the street.Most are wanderers, searching for food, shelter and protection.
Once they lose their physical ability to move around the city, survival strategies are armed.Hence the study's question: do they die, or are they welcomed by any entity, some kind of long-stay institution for instance?
Regarding origin, the SMADS detected that a small part of sheltered adults are actually from the capital; most are from the Northeast and Southeast (9) .
In the studied shelter, it was verified that nine elders are from the Northeast, ten from the Southeast, and only two were born in Sao Paulo.
Sixteen elderly have lived in this city for over 20 years.This suggests that they would have established affective attachments or some kind of social support network in the city.However, the only type of social support identified was institutional: the shelter.Throughout the lives of the street population, there is a rupture with family ties, an abandonment of roles that involve responsibilities and affectivity.This is reflected in the infirmity of the affective ties they establish on the streets.When family breakage/ rupture exists, institutional dependence is evidenced (11) .That dependence, characterized by the use of support services, could encourage this population to remain on the streets.These projects are essential for the street population's survival.
However, they could also have a negative influence on the social (re)insertion process, contributing to the lack of encouragement for them to search for autonomy.Hence, instead of preparing them and giving them the tools to recover their citizenship, they are impeded from developing the autonomy needed to break dependence ties and get off the streets (12)   .
Rev Latino-am Enfermagem 2007 setembro-outubro; 15(número especial):755-61 www.eerp.usp.br/rlaeConsidering that families are primary socialization agents and serve as a support network during crises, their absence could imply serious consequences.Family support is inexistent for the majority of the street population (13) .Therefore, breaking with family ties in addition to breaking with work ties is considered "point zero" in the process for becoming a street person.This is especially true for the Brazilian society, in which family unity is the support for the poor working-class social relationships, so, its absence can be a determining factor in this process (11) .This fact can be observed since, in this study, it was found that 12 participants had relatives in Sao Paulo, but only three kept in touch with them frequently.Eleven participants had relatives out of town, and only one kept in touch.Five participants reported that family breakage was the reason for their moving onto the streets.In addition, despite the other participants not considering lack of family support a limiting factor to move onto the streets, it was present in other statements.
Two groups of factors interact when considering the reasons for which people move onto the streets.First, there are the broad, structural tendencies at macro level; and, second, there are biographical factors, i.e., at individual level (13)   .For the study population, the individual factor was identified as the lack of family support, as mentioned before.
Regarding the macro level, it was not possible to establish a direct relationship between unemployment, fragility of work ties, and living on the streets.However, unemployment is reported in many life history statements as the reason for moving onto the streets (11,13) .From this perspective, people's vulnerability in the face of the work market becomes evident, since eight participants moved onto the streets due to financial problems, including unemployment.
The vulnerability of work ties, before moving into the streets, is also evident.It is characterized by having low or no specific qualification.This imposes fragile occupational identities on the population, characterized by activities with a high potential of replacement and with a borderline income for survival levels (11) .
Such vulnerability was identified in the present study when it was found that most participants, 18 elderly, had worked in more than one remunerated activity that did not require any specific qualification; most in the commercial and service sector, such as housekeeping and electricians.
The same standard was observed in activities currently performed by the street population, when they do work.Among the currently and formerly working adults and elderly, 96% do not have any formal work register (9) .In the study, five of the 20 participants worked in the informal market, with no formal register.However, 14 participants reported the need and desire to work.Besides providing physical subsistence, working assigns professional identity, which is part of one's personal identity.In the current society, in the capitalist system, professional identity is overestimated.Individuals are recognized by their profession.Therefore, lacking such a profession or any other drawback to the individual's insertion in the work market poses stigmatizations and feelings of guilt, which is quite common among the street population (15) .
The capitalist culture is also observed in the the cooperative.This shows the recognition of employment as the only desired form of work (12) .
In this study, the studied population is extremely vulnerable financially and depends on governmental support.Social security/promotion support is the income source for eight participants, other eight do not have any income, and count exclusively on the shelter for their physiological, welcoming and protection needs.
In addition to the difficulty of insertion in the work market, there is the housing vulnerability that affects society as a whole, particularly poorer Brazilians.This problem is aggravated in the case of underqualified populations with fragile ties with the work market, increasing the possibility of moving onto the streets.In this perspective, this study found five elderly who reported eviction as the cause for their moving onto the streets.
Early insertion in the work market and low education level are factors that influence vulnerability in terms work and/or housing ties (14) .Regarding the studied population, two participants were illiterate,  (9) .
It was observed that elderly with less time in the shelter are more critical about their situation.
The authors believe that there is a direct relationship between the satisfaction that individuals assign to their life condition and their expectations in this respect.In other words, the closer one gets to his or her expectations, the more satisfied one gets.
Knowledge increases and multiplies people's desires, and the less they desire, the easier it is to have their needs fulfilled.
As far as health is concerned, the shelter is part of the Community Street Health Agents Program at the Sao Paulo Municipal Health Secretariat.
Therefore, elderly living at the shelter have access to Basic Health Units (BHU), without any trouble to schedule appointments.Six participants have high blood pressure and three have diabetes mellitus, all of whom are periodically followed-up at the BHU.
When asked about health problems, none of the participants reported having any chronic disease.Some acute factors were reported, including flu, headache; pneumonia, and other health problems, such as two cases of run-over.It was observed that, for participants, health problems refer to something that makes them immediately seek health services -Emergency Room and/or the BHU.This suggests that chronic diseases do not make participants feel ill.
Considering that being healthy and becoming ill are exclusive, individual experiences, as well as forms of life expressions (16) , it becomes easier to understand the answers obtained.These answers cannot be analyzed by means of the WHO definitioncomplete biopsychosocial wellbeing -since it would be noticed that no one is healthy; it would become an utopia.If health were not considered as the mere absence of illness, nor as complete wellbeing or total normality, but as a moderate amount of suffering, with prevalence of wellbeing feeling, it would become an ideal, but also a reality (17)   .
Disease is not the mere disappearance of a physiologic function, but the appearance of a new vital order.Health is a state of functional harmony and balance, both physical and psychological, considering one's natural and social environment.This balance and harmony are capable of adapting the organism when submitted to new environmental conditions, either natural or social (18) .
Considering that the organism has norms that permits it to adapt to the environment, being healthy is not only being normal in a certain situation, but in various.On the other hand, disease cannot be considered as the absence of a norm.Actually, it is a life norm that is not capable of adapting the organism to the environmental conditions which it is inserted in (18) .Human beings do not feel wellbeing because it is the conscience of living, it is the impediment to spend the life that is felt and recognized.Hypertensive and diabetic street people do not consider themselves ill, since they have adapted to the new norm imposed by their bodies, and do not feel their wellbeing.
Another category that emerged during data analysis concerns the time living on the streets.In this respect, the referenced used was a typology founded on street people, approaching categories such as the "newly-dislocated", characterized by people who are afraid of street company, do not know who to trust and if they will survive.The newlydislocated usually turn to care institutions where they receive food and shelter.They recall their memories with happiness and a strong desire to return to the statements of street population involved in work founded on solidary economy.Cooperativism was difficult to implement and not well accepted among the street population of a non-governmental organization (NGO) in Sao Paulo.Street people perceive work and income generation through cooperative as temporary activities, from which they would move away as soon as they got a job.The perspective of being employed, selling their work power, was greater than generating income through Old, poor and out on the streets... Fernandes FSL, Raizer MV, Brêtas ACP.