Representação da queda em ambiente doméstico: um enfoque na autonomia do idoso

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Data
2011-04-27
Autores
Renó, Lívia Pimenta [UNIFESP]
Orientadores
Santos, José Francisco Quirino dos [UNIFESP]
Tipo
Dissertação de mestrado
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Background. Domestic accidents involving falls, as a common episode in the elderly households, can reach the point of physical incapacitation, with consequent loss of independence at old age. Research has pointed out schemes for accident avoidance, including rearranging home spaces and furniture in safer ways. Based on observation and generalization, treatment often deal with old people as if forming a homogeneous group, thus establishing a single pattern of intervention upon the elders` home wandering habits, and life style, with little or no regard, to individual differences. To effectively protect the aging person, such practical aid should adapt to each case, beginning by knowing what he/she thinks and says about his/her aging condition. Object: to establish which perceptions and behavioral categories were employed by elders when describing their own physical ability and intellectual condition as related to a past episode of fall. Method: a qualitative research was done, consisting of semi-structured interviews about motives given by aging individuals, their reasons, their spontaneous opinions about both their health condition, and causes of falls in the home. Results: 15 subjects (11 men, 4 women, mean age= 74.8) were interviewed at home, of a lower medium class neighborhood of Sao Paulo, all under medical attention of a geriatric program, (epidoso) by Unifesp`s Department of Preventive Medicine. Data was transcribed and grouped into cultural concepts and categories, revealing modes of thinking, thus condensed: a) subjects blame falls at home to “distraction”, “lack of attention” and “fail”, that is, for them the fall is due to a momentary absence of awareness, but in-depth analysis reveals underlying lack of perception of obstacles` true place in the room, that end up in stumbling and fall. This is aggravated by the supposed familiarity with a notion of the labyrinth of home, its paths being no longer true, following itineraries no longer precise. In other words, judgment becomes definitely impaired, and yet continues to orient actions, which are now wrong; b) objectivity, in self-evaluation, can be disfigured by a warped interpretation of reality, due to magical or pseudo-scientific beliefs, that commonly carry a serious outcome, the non-compliance with existing medical programs. Conclusion. Programs vowed to raise the aging people`s awareness of dangers of falling in the home should consider close inclusion of cultural traits of subjects as well as an appraisal of the state of self awareness. In addition, individual diversity, behavioral and social, should be taken into account when the issue is preventive counseling.
O aumento da população de idosos no mundo direciona pesquisas a buscar maneiras de controle das enfermidades crônicas decorrentes do envelhecimento. A queda é um dos agravos que fragiliza e impede a manutenção da capacidade funcional do idoso. Objetivo: Compreender a representatividade social da queda para o idoso que a sofreu e, através da analise do cotidiano das tarefas domésticas, definir quais foram as atitudes tomadas diante do evento. Método: Análise qualitativa, utilizando entrevista semi-estruturada, partindo do tema da influência da queda na vida diária. As falas são transcritas codificadas e posteriormente categorizadas expressando as idéias encontradas no pensamento do idoso. Resultados: Identificou-se que para o idoso que sofre queda, esta passa a ser fator de preocupação e cuidados quando interfere na autonomia para os afazeres do cotidiano. A queda trouxe ao indivíduo distintas percepções segundo o impacto físico provocado. Para aqueles que tiveram a rotina alterada pela incapacidade de realizar tarefas, a queda retomou a percepção do envelhecimento decadente. Aos que mantiveram as atividades rotineiras, a queda reafirmou a percepção de autonomia nesses indivíduos ao sentirem-se livres das decadências provenientes da idade. Conclusão: Para incentivar a conscientização dos riscos de queda em idosos, profissionais de saúde devem mostrar que a queda interfere nas atividades rotineiras destes indivíduos e, portanto, além de promover incapacidades físicas, o evento impede a continuidade de tarefas tão valorizadas no cotidiano de idosos. Estas tarefas não devem ser restringidas, mas readaptadas.
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Citação
RENÓ, Lívia Pimenta. Representação da queda em ambiente doméstico: um enfoque na autonomia do idoso. 2011. 92 f. Dissertação (Mestrado) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2011.