Registro do uso de antimicrobianos em Instituições de Longa Permanência para Idosos

Challenges in long-term care facilities for older adults in Hispanic American countries

INTRODUCTION: Little is known about management and mitigation of COVID-19 in long-term care facilities (LTCF) for the aged in Latin America. OBJECTIVE: To describe how the management of LTCF in Latin American countries plan and adapt their routines for coping with COVID-19 and whether they have been able to fulfill recommendations published by the World Health Organization (WHO). METHODOLOGY: A cross-sectional study was conducted by online survey of managers of LTCF located in Hispanic American countries. A 46-item questionnaire (adopting the WHO principles) was sent to participants. Descriptive statistics were used to summarize the data. RESULTS: Twenty-three care home managers replied, responsible for a total of 874 older people (range: 5 - 270). One questionnaire was excluded because of missing responses. Fourteen LTCF (63.60%) were private, for-profit facilities. The rate of compliance with WHO recommendations exceeded 70% for the majority of items. Just over half of the institutions had developed a strategic management plan, or had identified strategies for dealing with deaths of suspected cases. Difficulty acquiring personal protective equipment (PPE) was reported by 59.10% of the LTCF surveyed. The homes’ capacity for SARS-Cov-2 testing was limited (36.36% of the institutions did not have any tests). CONCLUSIONS: The rate of compliance with recommendations published by the WHO for dealing with COVID-19 was greater than 70% at the majority of the LTCF surveyed. More than half of the institutions had strategic management plans. Availability of PPE and SARS-Cov-2 testing capacity were very unsatisfactory.

Depressive symptoms and associated factors in residents living in long-term care facilities from the metropolitan area of Belo Horizonte

OBJECTIVE: To identify the presence of depressive symptoms and its association with self-rated health among older adults living in Long-term Care Facilities. METHODS: This is a cross-sectional study in which institutionalized older adults were screened by using the Mental State Mini Exam. Standard questionnaires were used to collect the following data: 1) sociodemographic variables, 2) depressive symptoms, and 3) self-rated health. The descriptive statistical analysis by measures of central tendency and dispersion was performed to characterize the sample. The multinomial logistic regression analysis was performed to associate the variables. In all tests, the alpha value of 0.05 was considered. RESULTS: A total of 127 older adults living in 47 long-term care facilities were evaluated. Among those who presented depressive symptoms, 32.3% were classified as having mild symptoms and 13.4% had severe symptoms. Regarding self-rated health, 46.5% considered it poor/very poor. In the analysis of the association between mild and severe depressive symptoms and self-rated health, statistical significance (p = 0.004 and p = 0.001, respectively) was found. CONCLUSIONS: The results of this study suggest that more attention should be directed to institutionalized older adults who have symptoms of depression and to their impacts on the negative self-rated health.

Ações desenvolvidas por cuidadores de idosos institucionalizados no Brasil

Objetivo: analizar las acciones realizadas por cuidadores de ancianos dirigidas a residentes de instituciones de larga estancia para ancianos (ILEA) en Brasil.Metodología: estudio de naturaleza cualitativa con análisis de datos cuantitativo, clasificado como observacionaly analítico, desarrollado en 36 ILEA seleccionadas en 11 municipios brasileños de medio y gran porte, distribuidas en las 5 regiones geográficas.Se realizaron entrevistas a los cuidadores en el periodo 2008-2011. El análisis del material discursivo (corpus) fue mediado por el software de análisis cuantitativo de datos textualesAnalyse Lexicale par Contexte d’un Ensemble de Segments de Texte (ALCESTE), la versión 4.9 para Windows.Resultados: los participantes fueron 117 cuidadores de ancianos de las ILEA estudiadas. La mayoría de los cuidadores son mujeres y trabajan en ILEA sin ánimo de lucro (filantrópicas). El material textual originó 5 clases semánticas que se dividieron en dos ejes fundamentales. El primer eje se denominó “asistencia a la salud de ancianos institucionalizados” y el segundo eje “actividades habituales de cuidadores en las ILEA”.Conclusiones: los discursos evidenciaron que las principales acciones realizadas están relacionadas con el cuidado directo al anciano, como la alimentación, higiene personal –bucal y general– y administración de medicamentos. Además, la alud bucal ocupa un lugar de relevancia para los cuidadores, a pesar de que relaten dificultades para realizar esta práctica.