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RESUMO: Introdução: A funcionalidade no envelhecimento está associada à autonomia e independência das pessoas idosas. Objetivo: Identificar e hierarquizar as dificuldades referidas no desempenho das atividades de vida diária de idosos. Método: Estudo transversal e descritivo, de base domiciliar, que utilizou a base de dados do Estudo SABE (Saúde, Bem-Estar e Envelhecimento) nos anos de 2000, 2006 e 2010. A funcionalidade foi avaliada por meio do relato de dificuldade no desempenho das atividades básicas (ABVD) e instrumentais de vida diária (AIVD). A hierarquização do comprometimento funcional foi avaliada pelo escalonamento de Guttman. Resultados: A prevalência de dificuldade referida no desempenho de uma ou mais AIVDs foi de 35,4; 45,8 e 41,0% e para as ABVDs foi de 16,3; 13,3 e 17,5%; respectivamente nos anos de 2000, 2006 e 2010. Em dez anos de acompanhamento observa-se, entre as mulheres, variabilidade na prevalência de 42,3 a 54,6% de comprometimento nas AIVDs e de 17,0 a 20,4% nas ABVDs e, entre os homens, de 25,6 a 33,1% em AIVDs e de 8,0 a 13,7% em ABVDs. Nas três ondas, as atividades com maior relato de dificuldade foram utilizar transporte, realizar tarefas pesadas e cuidar das finanças, enquanto o ato de comer foi a menos prevalente. Conclusão: Houve aumento na prevalência de comprometimento funcional no período de dez anos, com maior variabilidade entre as mulheres e com o avançar da idade. Esses resultados contribuem para o planejamento dos serviços e a distribuição adequada dos recursos existentes por desvelar as necessidades e os cuidados necessários.

ABSTRACT OBJECTIVE To investigate the prevalence of demand and provision of care for the Brazilian population with functional disabilities in activities of daily living. METHODS This is a quantitative and descriptive study using baseline data from ELSI-Brazil (Brazilian Longitudinal Study of Aging), a cohort study with a representative sample of the Brazilian population aged 50 years or older (n = 9,412). We considered the demand for care from the self-report of having some difficulty to perform at least one activity of daily life (eating, bathing, going to the toilet, dressing, moving in a room [ambulation], and transferring from chair [transfer]). Care supply was measured by having some help to perform the activity of daily living. RESULTS Approximately a quarter of the individuals evaluated (23.2%) reported difficulty in at least one activity of daily living, especially regarding transfer and dressing. Age, schooling, and number of chronic diseases were significantly associated with the difficulty in activities of daily living. Among those who reported difficulty, 35.1% received help of others and 11.8% did not receive (lack of care). The activities with greater lack of care were bathing (13.3%) and transfer (11.7%), which reveals an undignified survival condition. Care remains a family (94.1%) and female (72.1%) issue; despite the important changes that have taken place in society, there is still a lack of care policies. Of the total caregivers, 25.8% reported stopping working or studying to perform this role and only 9.2% were paid (hired ones or family members). CONCLUSIONS The ELSI-Brazil results reveal the expressive care demand of the Brazilian population aged 50 years or older with functional disabilities on activities of daily living and the lack of care policies aimed at this public.

OBJECTIVE To analyze the perception of and motivation for the chronic use of benzodiazepine among older adults. METHODS A qualitative study was conducted on 22 older adults living in Bambuí, MG, Southeastern Brazil, who were taking benzodiazepines and had the clinical and cognitive ability to respond to interview questions. The collected data were analyzed on the basis of the “signs, meanings, and actions” model. RESULTS The main reasons pointed out for the use of benzodiazepines were “nervousness”, “sleep problems”, and “worry” due to family and financial problems, everyday problems, and existential difficulties. None of the interviewees said that they used benzodiazepines in a dose higher than that recommended or had been warned by health professionals about any risks of their continuous use. Different strategies were used to obtain the prescription for the medication, and any physician would prescribe it, indicating that a bond was established with the drug and not with the health professional or healthcare service. Obtaining and consuming the medication turned into a crucial issue because benzodiazepine assumes the status of an essential food, which leads users to not think but sleep. It causes a feeling of relief from their problems such as awareness of human finitude and fragility, existential difficulties, and family problems. CONCLUSIONS Benzodiazepine assumes the characteristics of polyvalence among older adults, which extrapolate specific clinical indications, and of essentiality to deal with life’s problems in old age. Although it relieves the “nerves”, the chronic use of benzodiazepines buffers suffering and prevents older adults from going through the suffering. This shows important difficulties in the organization and planning of strategies that are necessary for minimizing the chronic use in this population.

O presente trabalho tem por objetivo investigar as características do processo de cuidar e a experiência de mulheres que cuidam de seus maridos idosos em Bambuí, Minas Gerais, Brasil. Entre os participantes do Projeto Bambuí, selecionaram-se dez idosos que necessitavam de cuidador e disseram ser cuidados por suas esposas. As dez esposas foram entrevistadas, utilizando-se de um roteiro de questões, com os grandes eixos temáticos sugeridos pela literatura. A análise dos dados inspirou-se na corrente interpretativa da antropologia e nos remete a uma cultura que define o papel, as responsabilidades e as obrigações da mulher, determina as regras que regem as relações conjugais, dita normas e modelos de comportamento e estabelece que cuidar de um idoso dependente é uma obrigação "natural" da mulher. Apesar de todas as evidências, as mulheres têm dificuldade em dissociar o cuidado de seu papel de esposas e em admitir o fardo. Cuidador e necessitados de cuidados vivem a dura realidade da incapacidade funcional, de modo integral, intuitivo e improvisado. Essa reflexão reforça a responsabilidade pela sistematização do cuidado domiciliário no nosso meio.This paper investigates the characteristics of caregiving and the experience of women that care for their elderly husbands in Bambuí, Minas Gerais, Brazil. Among the elderly population in this community, the authors interviewed ten wives, using a survey exploring the main themes on the subject of caregiving. The data were interpreted based on an anthropological model of analysis. This model places the interaction between the individual and the context in the center of the interpretative process, underlying the construction and expression of diverse forms of human experience. The results of the survey highlighted the role, responsibilities, and obligations of women in Brazilian society with respect to caregiving for dependent elders. Women are seen as "natural" caregivers, whereby it is their given obligation to take care of their husbands, providing all kinds of support. Both the individual in need of care and the caregiver live the reality of functional disability in a society lacking the proper mechanisms to provide for the elderly population. The current study clearly shows the need to systematize home caregiving in Brazilian society.

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Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

RESUMO INTRODUÇÃO: O aumento da expectativa de vida é uma realidade mundial e determina maior prevalência de doenças crônicas e maior demanda pelos serviços de saúde, incluindo os hospitalares. Atualmente, estudos têm focalizado o declínio funcional e suas consequências - demanda por recursos materiais e humanos, institucionalização e hospitalização. O objetivo foi a revisão crítica da literatura disponível sobre os fatores de risco associados ao declínio funcional em idosos hospitalizados. METODOLOGIA: Pesquisa nas bases de dados MEDLINE, LILACS e SCIELO, nos idiomas inglês e português, entre 2000 e 2007, utilizando as palavras-chave hospital, elderly, functional status, aged e functional decline e referências bibliográficas dos artigos selecionados. RESULTADOS: Satisfizeram os critérios de inclusão 31 publicações. Após leitura crítica do ABSTRACT, os 15 artigos mais relevantes foram selecionados. CONCLUSÃO: O declínio funcional pode ocorrer antes, durante e/ou após a hospitalização. Idade avançada, comprometimento funcional prévio, déficit cognitivo, iatrogenias, gravidade da condição clínica e histórico de quedas foram os fatores de risco mais citados. A capacidade funcional, como marcador de saúde desse grupo, merece maior investigação.

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)