[Ways of thinking and acting of the elderly when tackling functionality/disability issues]

[Alterity of the body of the elderly: estrangement and pain in Public Health]

In old age, the ailing patient's body becomes estranged and reveals an awareness of alterity. This paper investigates how the body of the elderly addresses the estrangement as a subject, producing its own actions in the experience of disease and practice of public health. The research, developed using the qualitative approach of an anthropological nature, is based on the assumptions of ethnography. Individual interviews with a semi-structured script in the universe of 57 elderly people were conducted. The methodology of Signs, Meanings and Actions oriented the data collection and analysis enabling the investigation of representations and concrete behaviors associated with the otherness of the body. There was the sense of production of otherness in relation to two analytical categories associated with aging and disease. A split between the active body of the memory and another experienced with limitations in the present is detected, reflecting the confrontation of self-care and adherence to treatment. The body of the elderly individual is heir to a body image that remodels constantly, depriving the elderly of their place as contemporary owners of their bodies, as they become other persons.

Elder abuse in Brazil: an integrative review

Abstract Objective: the present study aimed to carry out an integrative review of literature on the scientific knowledge relating to the occurrence of elder abuse produced in Brazil between the years of 2013 to 2017. Method: a bibliographic survey was carried out through publications indexed in the Virtual Health Library (VHL) database: the Scientific Electronic Library Online (SCIELO), Latin American Literature in Health Sciences (LILACS) and the CAPES Portal of Periodicals (CAPES). The data collection instrument, created by the authors, included characteristics such as: year of publication, main journals, research design, topics covered, main areas of knowledge, sampling and study objectives. Results: 28 publications were analyzed. The main types of violence were psychological (28%), physical (28%), unspecified (16%), financial (12%), self-abandonment (8%), neglect and verbal violence (4%). The majority of the victims were female (64%), of unspecified gender (28%) and male (8%). Conclusion: the present integrative review found that the main violence suffered was psychological together with physical, with the elderly the main victims. The main place of maltreatment was in the home. The research also found that there are gaps in information about the reasons that triggered the aggressions. It is therefore necessary to investigate this subject further and carry out new studies that seek to identify these factors.

Aging and quality of life of elderly people in rural areas

ABSTRACT Objective: To evaluate the quality of life and health of elderly in rural areas of Minas Gerais State’s center-west. Method: Cross-sectional study, in four municipalities of Minas Gerais State, by interviewing elderly people. Associations between socio-demographic and quality of life variables were tested, separated into “satisfactory”/“unsatisfactory” with values from the median of positive answers. It was used the chi-square test, Fisher’s test and regression. Results: 182 elderly answered the questions and showed a relation with the “satisfactory” quality of life - bivariate (p < 0.05): age by 69 years (61.6%), married (61.7%), living by 54 years in rural areas (68%), with no financial support (59.5%), living with someone else (61%), non-smoker (60%), presenting good health (76.7%), satisfied with life (69.6%); regression: not having financial support, living with someone else and not smoking. Conclusion: Elderly people in rural areas present good quality of life/health in the cognitive aspect, access to services, goods, habits, but awareness must be constant due to their weakness.

Social representations and normative beliefs of aging

This study adopted the theory of social representations as a theoretical framework in order to characterize similarities and differences in social representations and normative beliefs of aging for different age groups. The 638 participants responded to self-administered questionnaire and were equally distributed by sex and age. The results show that aging is characterized by positive stereotypes (knowledge and experience); however, retirement is linked to aging, but in a negative way, particularly for men, involving illness, loneliness and disability. When age was considered, it was verified that the connections with the representational elements became more complex for older groups, showing social representation functionality, largely for the elderly. Adulthood seems to be preferred and old age is disliked. There were divergences related to the perception of the beginning of life phases, especially that of old age. Work was characterized as the opposite of aging, and it revealed the need for actions intended for the elderly and retired workers, with post-retirement projects. In addition, it suggests investment in public policies that encourage intergenerational contact, with efforts to reduce intolerance and discrimination based on age of people.

Profile and prevalence of hearing complaints in the elderly

Introduction

Objective

Methods

Results

Conclusions

Disability in older adults with acute low back pain: the study Back Complaints in the Elderly - (Brazil)

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Older adults reported moderate to severe acute low back pain.

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Irrelevant association between acute pain intensity with disability was observed.

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There is interaction between age groups and marital status with disability.

Background

The increase in the older adult and oldest old population in Brazil is growing. This phenomenon may be accompanied by an increase in musculoskeletal symptoms such as low back pain. This condition is usually associated with disability.

Objective

To verify the association between pain intensity and disability in older adults with acute low back pain and assess whether these variables differ depending on the age group and marital status.

Methods

This is a cross-sectional study conducted with 532 older adults with acute low back pain episodes. Pain intensity was assessed through the Numeric Pain Scale and disability through the Late Life Function and Disability Instrument, which shows two dimensions: “frequency” and “limitation” in performing activities. The association between pain and disability was analyzed.

Results

For the interaction effect between age groups and marital status, we found that the oldest old living with a partner performed activities of the personal domain less often compared to the oldest old living alone. The oldest old group living with a partner had a lower frequency of performing activities, but did not report feeling limited. The association of pain with disability was minimal (rho < 0.20) and thus considered irrelevant.

Conclusion

Disability in older adults with acute low back pain was influenced by the interaction between age groups and marital status and is not associated with pain intensity.

Upper and lower limb functionality and body mass index in physically active older adults

Abstract Introduction: Aging leads to sarcopenia and functional capacity decline, compromising upper (UL) and lower limb (LL) performance of activities. Body mass index (BMI) is an important parameter for the assessment of health conditions in older adults, especially with regard to obesity, since it leads to functional limitations in terms of mobility and task performance. Objective: To investigate the potential association between UL and LL functionality and BMI in physically active older adults; and to characterize this population with regard to BMI and UL and LL functionality. Methods: The data were collected between August 2013 and April 2014. The sample comprised 371 physically active older adults. This study used secondary data from the program “PET Saúde IPA/SMS”. The program interviewed older adults living in areas comprised by the Third Family Health Unit of a neighborhood in Porto Alegre/RS. This paper used questions from the “Instrumento de Avaliação Multidimensional Rápida da Pessoa Idosa” (Instrument for Rapid Multidimensional Assessment of Elderly People, in English) that had to do with UL and LL functionality, weight, height and BMI. Results and Conclusion: There was no association between UL and LL functionality and BMI in physically active older adults. More than half of the sample was overweight. Most participants had functional UL and LL. While occupation, self-perception of health as “good” and “very good”, and physical activity were found to be associated with LL functionality; regular physical exercise was found to be associated with UL and LL functionality.

[The association between cognition and handgrip strength among the elderly: an integrative review]

The objective of this study is to identify researches that associated cognition and handgrip strength among the elderly. This is a bibliographic review, based on an integrative approach of articles published in the last five years, indexed in the PubMed, Lilacs and Scopus databases. Inclusion criteria were: observational or experimental studies with a sample of elderly people (aged 60 years or more); assessment of muscular strength using a manual dynamometer; seniors who had at least one cognitive assessment instrument. At the end of the search 10 articles were selected to examine cognitive function and statistical results in the sample. It was observed that most of the research was conducted among the elderly aged over 75 and the Mini Mental State Examination (MMSE) was identified as the scale most commonly used for global cognitive assessment. A significant association was identified between alterations in cognition and reduction of handgrip strength (HGS) in 90% of the articles included in this study. Results of this review suggest the influence of cognitive impairment on the muscular strength of the elderly, which can affect aspects of their functional capacity and consequent dependence.

O cuidado em saúde na velhice: a visão do homem

Resumo A cultura condiciona as representações de velhice e de gênero com reflexos nas percepções sobre a saúde, a doença e o cuidado. A interface entre esses fenômenos é objeto deste estudo, fundamentado na perspectiva da antropologia médica, que pretende investigar como os homens idosos da comunidade expressam e percebem a relação entre saúde, doença, masculinidade e envelhecimento, e como esses construtos se relacionam com os subsistemas de cuidado informal e profissional. Foram entrevistados 27 homens com 60 anos ou mais, residentes em Bambuí (MG) e assistidos pela Estratégia Saúde da Família, acerca de suas atividades cotidianas, sua saúde e suas formas de cuidado. O modelo de signos, significados e ações, utilizado na coleta e análise dos dados, permitiu reconhecer as maneiras típicas de pensar e agir de homens idosos em relação ao processo saúde-doença-cuidado, bem como suas interações e contradições junto aos setores profissional e informal do sistema de cuidado em saúde. A produção material e simbólica dos entrevistados demonstra a identidade masculina ligada ao conceito de saúde, o qual se vincula às relações sociais, que fundamentam o cuidado informal à saúde. Contrapondo-se a essa percepção está a visão de envelhecimento inexoravelmente relacionada à doença, em que se ancora o sistema profissional de cuidado. Assim, homens idosos restringem a procura por cuidados em saúde em parte pela própria construção sociocultural da masculinidade que renega a fragilidade, mas também porque as ações e os profissionais de saúde desconsideram as especificidades de gênero e o valor dado pelos homens idosos à independência funcional.

Impact of Cardiovascular Interventions on the Quality of Life in the Elderly

INTRODUCTION

The elderly population is growing rapidly. Political and socio-economic changes led to the demographic transition in this population with the highest number of surgeries and as well as many comorbidities.

OBJECTIVE

To evaluate the impact of cardiovascular intervention on quality of life of elderly patients after three and six months.

METHODS

Analytical prospective cohort study with elderly between 60 and 80 years of age, of both sexes, with a diagnosis of coronary artery disease and underwent cardiovascular intervention during the period June 2010 to June 2011. Data were collected by individual interviews in the pre and postoperative periods (after three and six months) by telephone. We used the SF-36 to analyse quality of life in order to assess the physical and mental health of the study population.

RESULTS

Of the 44 individuals evaluated, 59.1% were men, 75% in the range of 65 to 74 years, 38.6% were white and 38.6% were black, 31.8% were uneducated, 43.2% were married and 68.2% had less than a minimum wage. Prevailed patients: non-diabetics (68.2%), non-obese (81.8%), hypertensive (84.1%), non-alcoholic and non-smokers (68.2% and 61.4%, respectively). A significant increase in the average of the SF-36 scores between pre and post-surgical periods (three and six months) for the domains: functional capacity, pain, general health, vitality and emotional aspect.

CONCLUSION

The elderly population undergoing intervention may have cardiovascular benefits and improvements of quality of life. Physical fitness improvement measures can be taken to resume that capability.

[Home visits by community health agents to families with frail elderly individuals]

The scope of this study was to understand the significance that community health agents attribute to the home visit conducted with families with frail elderly individuals and if the technique has served as a tool for care for this group. Semi-structured interviews were conducted with community health agents in the city of Bambui in the State of Minas Gerais. They were all recorded, transcribed and analyzed. The Signs, Meanings and Actions model was used in the collection and analysis of data. In their ways of thinking and acting, seeing aging as being inexorably associated with disability, the agents "try to help" people who have a sociocultural context similar to theirs to get access to health services. As they do not receive guidelines for working with families with elderly individuals, they intuitively establish "equitable" criteria that ensure they visit more risk groups (the elderly, needy, sick and poor). The visits are in response to immediate demands from these groups, but the focus of attention is based on sickness and the provision of medication and procedures. The need for reorientation of the care model, implementation of the National Health Policy for the Elderly and specific actions of care to families with frail elderly individuals are not perceived.

Velhice, incapacidade e cuidado na saúde pública

Resumo O envelhecimento populacional modifica profundamente o escopo de atuação da saúde coletiva, altera o perfil de morbimortalidade e aumenta a demanda por cuidados crônicos. Na população idosa, a incapacidade serve como indicador de saúde e balizador de ações e políticas. Esta pesquisa de abordagem qualitativa, fundamentada na antropologia interpretativa e na perspectiva êmica, tem por objetivo compreender a forma de pensar e agir dos idosos diante da “velhice com incapacidade” e suas relações com a saúde pública. Foram realizadas entrevistas individuais no domicílio, com roteiro semiestruturado, junto a 57 idosos residentes na cidade, inclusive participantes da coorte de Bambuí. A metodologia de Signos, Significados e Ações orientou a coleta e a análise dos dados, possibilitando a investigação antropológica das representações e comportamentos concretos associados à incapacidade na velhice na cultura local. Emergiram da análise duas categorias acerca das relações entre velhice, incapacidade e cuidado na saúde pública: experiências de cuidado na velhice com incapacidade; o medo da falta de cuidados. Os resultados revelam que a saúde pública precisa rever seus conceitos sobre incapacidade na velhice e incorporar a dimensão funcional da saúde e o cuidado à velhice com incapacidade na agenda.