Práticas cotidianas dos cuidadores formais de idosos

Abstract

This work is a qualitative approach based on the theoretical reference of Michel de Certeau. This study had the objective of analyzing the day-to-day practices of formal elder caregivers. The participants were 18 formal caregivers, initially indicated by the Minas Gerais Elder Caregivers Association (Associação de Cuidadores de Idosos de Minas Gerais) and, posterior to that, chosen by the "Snowball" technique. The criteria to select these participants was the remunerated exercise of elder care, with at least one year of field experience, not taking in consideration age or gender, and that the caregivers were hired by the elders family, by the elders themselves or by long-term care institutions. Besides the interviews realized with these participants, a documental research on the newspapers Folha de São Paulo and O Globo was carried by this study. Pieces of the last 10 years that contained the expression "elder caregiver" were selected. The final sample had 69 pieces from both newspapers. The collected data, by means of semi-structured interviews and newspaper pieces, was submitted to content analysis. In all phases of this study, the resolution nº 466/2012, from the National Board of Health (Conselho Nacional de Saúde) was taken in consideration. First, this study focused on documental research of Brazilian newspapers, after that, we conducted the interviews that composed the analysis corpus. From the data analysis, 4 categories were identified: in the analysis of the newspapers, 1) Qualification, regulation of the elder caregiver as a profession and labor issues and 2) The job of the caregiver: from the needs of the job market to the needs of the professionals labor; and in the interviews, 3) Who are the elder caregivers - ways of being, and 4) The everyday jobs of the formal elder caregiver - ways of doing. The newspapers presented the demand of these professionals in the job market, the large offer of classes and jobs directed for the elder caregiver, as well as discussions about the job's regulation and labor issues. We could also observe that the newspapers' pieces traced the caregiver's profile that was requested by the market, being: specialized professionals, with proactivity, good will and affection. Data from the newspapers corroborate the caregiver's reports, mainly about their need of qualification and the job market's demand. In this study, the formal elderly caregiver did not have any kind of kinship with the person that received care, being predominantly women, with an average age of 50, married, with children, resident in Belo Horizonte-MG, even if most of them were from Minas Gerais' countryside. They have been caring for the same elders for about 2 years, and these elders are, in average, 78, and dependents. These professionals were hired by professional reference, have completed high school and have done elderly caregiver classes. A significant amount of caregivers work in the elders' houses, their work regime being RPA. They earn between one (1) and two (2) minimum wages to fulfill a workload of 24 non-stop hours, at day and at night. The weekly working hours of the caregivers in question reach extremes such as more than seventy-two (72) hours of work in a week and less than forty-four (44) hours for work in a week. They are skilled, have been working in the field for eight (8) years and are exclusively dedicated to the occupation of caring for the elderly. The caregivers' self-perception about being a caregiver is related to charity, and they establish comparisons between their profession and others, such as nurses, as a possibility of professional development; or teaching, as they question themselves about what is demanded of them and the lack of professional recognition. The caregivers everyday job is comprehended as a game, in which the spaces (vocational/illegitimate care) are built by subtle tactics, used by the caregivers, by the elderlys relatives and by the health professionals, that play with the order and the hegemonies, being permeated by strategies (manuals, guides and laws) that determine the caregiver's place (professional care). Among the strategies used, the vision of the caregiver as a provider of charity and not of professional care stands out, based on the guides and manuals, that reinforce the charity imagery of this professional. Such strategy contributes to the construction and maintenance of the marginal space of the caregiver, making it difficult for the caregiver to reach a place in professional care, with consequent professional appreciation and regulation of the profession. About the tactics of the caregivers, the organization of activities register instruments and the use of uniforms, with the purpose of legitimizing their profession, stand out. In this context, the formal elder care is given by women, married and with children, average age of 50 and with low schooling, and this job shows them the possibility of reintegration into the labor market. These professionals have a more altruistic and charity-related view of what they do than a technical-professional view. The day-to-day practices are influenced by where they take place and by the people/professionals that participate in them. It is full of arts of making, ways of being and power relations among caregivers, health professionals, the elders family and in some cases even the elders themselves. This comprehension has allowed the thought on the caregivers job and the future perspectives for the occupation, among them the formulation of guidelines that standardize and regulate the caregivers qualification and, therefore, the reach of the professions legalization. We hope that the results of this research will add new knowledge and possible advances to this occupation, that still goes through so many uncertainties.