Violência contra as pessoas idosas: perspectivas e desafios de profissionais e gestores da saúde e da assistência social

Abstract

Violence against elderly is a public health problem, with a major impact on the victim's quality of life. Healthcare and social assistance professionals working in the area around the houses have a prominent role in tackling the problem. This study has the general objective of identifying the perspectives and challenges of professionals and healthcare managers and social assistants in facing violence against elderly. A qualitative, descriptive study was carried out in two Basic Health Units (UBS) and a Reference Center for Social Assistance (CRAS) of one district of Belo Horizonte, Minas Gerais. The 18 participants analyzed in the study were family healthcare professionals and support team from the UBS, from a CRAS and its managers. Data were collected via interviews with a semi-structured script from June to December 2020. The interviews were submitted to Thematic Content Analysis and organized into four categories: “Violence against elderly: understanding of the participants”; “Strategies for identifying violence against elderly”; “Situation of violence against elderly: what now?”; and “Intersectoral articulation to face violence against elderly”. The first category addresses the participants' understanding of the topic, correlating it with the typology often found in professional practice. Risk factors of violence against elderly and the need for professional training to face the problem were revealed. The second category shows the main strategies for identifying violence, including the work of Community Health Agents and Agents trained to Combat Endemic Diseases, routine service activities, complaints and suspicion coming from other services of the Health Care Network or other sectors. As complicating aspects, the veiling of cases by the elderly, family members or caregivers and the professional difficulty in dealing with the issue of violence were listed. The third category describes the actions taken after the evidence of violence, including the discussion and notification of cases and make the informal support network more sensitive in what concerns to elderly care. Among the difficult points, the lack of knowledge on the flow and support bodies; the slowness and the low rate of resolution in obtaining answers; the insufficiency of public policies; the overload of demands for Primary Healthcare; and the fragility of the affective bonds with elderly were mentioned. The fourth category presents the analysis of the intersectoral articulation to face the problem, with emphasis on joint actions between UBS and CRAS; the need to expand the Protection and Specialized Care Service for Families and Individuals (PAEFI); the performance of Greater Care Program, More Life Center and the Elderly Council; and referring victims to institutionalization. It is possible to conclude that to confront violence against elderly represents a challenge for professionals and managers of health and social assistance inserted in the territory, being essential to encourage discussions for identification and action, prioritizing intersectoral interventions.