Sobrecarga e estratégias de coping dos cuidadores de idosos no contexto da atenção domiciliar.

Abstract

Global demographic transition predicts a significant increase in the elderly population by 2050. In Brazil, changes since the 1930s have led to a demographic transition with impacts across various sectors. Scientific advances have contributed to an epidemiological transition, marked by the prevalence of non-communicable chronic diseases (NCDs) such as diabetes and hypertension, posing significant challenges to public health and reflecting in escalating costs in the country's healthcare system. The implementation of Health Care Networks (RAS) is one specific model addressing NCDs in Brazil. Home Care Services (SAD), also known as the "Better at Home Program," emerges as a promising alternative. SAD provides specialized care at the patient's residence, particularly catering to those with reduced mobility, promoting health, and offering post-hospitalization support. In the home setting, the caregiver's role is crucial, enabling the elderly patient to receive assistance and guidance for their chronic condition. Often a family member assumes this role, altering family dynamics, responsibilities, and financial provision, leading to a restructuring of family life. It is noteworthy that the caregiver's activities, often familial, are frequently combined with additional household maintenance tasks. Given this context, this study aimed to investigate the burdens faced by caregivers in the caregiving process and the coping resources they employ. It is an observational qualitative field study conducted in the Home Care Service of Fortaleza, Brazil. Data were collected through home visits coordinated by SAD professionals between November and December 2023. A sociodemographic questionnaire, semi-structured interviews, and the Zarit Scale (1987) adapted for Brazil (Scazufca, 2002) were employed. Results revealed the significant burden on elderly caregivers, with multiple responsibilities ranging from basic care to household management, significantly limiting time for self-care management and coping strategy development. Urgent dialogue promotion with caregivers is emphasized, as expressed by complaints of physical and psychological burdens in interviews. It is highlighted that time allocated for prioritizing mental and physical health is insufficient, and coping strategies primarily focus on emotional management and social support. This research contributes to existing scientific knowledge, but there is a suggestion for the implementation of more effective support strategies, including non-family caregivers. Recognizing the social transformations resulting from population aging and preparing for potentially more challenging future scenarios is paramount. Keywords: Coping Strategies. Demographic Transition. Non-Communicable Chronic Diseases (NCDs). Home Care. Informal Caregivers