Trata-se de uma pesquisa de cunho qualitativo que tem como objetivos desvelar as vivências de famílias de classe popular no cuidado a familiares idosos fragilizados, no domicílio, bem como obter subsídios para a sistematização do cuidado de enfermagem a essas famílias. O Referencial Teórico aborda temas relacionados à área temática do estudo: o cuidado de enfermagem domiciliar, a família de classe popular e a pessoa idosa fragilizada. Os sujeitos dessa investigação, intencionalmente escolhidos a partir de critérios previamente estabelecidos, são quatro famílias pertencentes à população adstrita a uma Unidade Sanitária do município de Porto Alegre. O Estudo de Caso do Tipo Etnográfico é a metodologia utilizada. Os instrumentos utilizados para a coleta de dados são a Observação Participante, a Entrevista, a Análise Documental e a Ficha Informativa. Do tratamento dos dados, através da análise de conteúdo, emergiram seis categorias: Características das famílias, Concepções das famílias, A (re)organização da família para o cuidado, A família no cotidiano do cuidado, Relação com as instituições sociais, O cuidado de enfermagem domiciliar. Foi possível perceber que as famílias são multigeracionais. Sobrevivem quase que exclusivamente das aposentadorias dos idosos e enfrentam constantemente o desemprego. Sua concepção de saúde está relacionada à capacidade de trabalho. Valorizam a família, na qual o idoso é reconhecido em sua experiência de vida. Ao necessitar de cuidado, este deve ser assumido, preferencialmente, pelos familiares. Uma pessoa envolve-se mais intensamente no cuidado, mas toda a família, auxiliada por uma rede apoio, constituída de amigos e vizinhos, interage. Nas atividades cotidianas, valem-se da criatividade para adaptar utensílios e o ambiente, bem como do saber popular, como recursos nos cuidados à saúde. As dificuldades destacadas estão relacionadas à condição socioeconômica precária, à moradia, ao vestuário e ao transporte. Percebem que o suporte social a famílias cuidadoras é restrito. Destacam que o acesso aos serviços de saúde é sofrível e ressaltam a urgência em solidificar o Sistema Único de Saúde, em busca da concretização dos seus princípios. Expressam a necessidade de implantação de programas de cuidado domiciliar, interdisciplinares, que assistam a família e o idoso de forma integral, continuada, participativa, contextualizada e humanizada. / This is a qualitative research, which aims to unveil the life experience of families from lower classes at caring for their frail elderly relatives at home, as well as to obtain subsides for creating a model of nursing care for such families. The theoretical model approaches issues related to the thematic area of caring: the family nursing home care, the lower classes families, and the frail elderly. The subjects of this investigation, intentionally chosen upon the criteria previously established, were four families from the Sanitation Unity of Porto Alegre. The design of this case study was an ethnographic type. Tools used for data collection were: participated observation, an interview, a documented analysis, and the informative report. From the analysis of data, through the content analysis, six categories were established: characteristics of the families, conceptions of the families, reorganisation of the family to the care, the family within the routine of the care, the relationship with social institutions, and the nursing home care. It was possible to perceive that families are multigeneration. They survive almost exclusively from the elderlies retirement and frequently they have to cope with unemployment. Their concept of health is related to their work skills. They value the family where the elderly is recognised for his or her life experience. When he or she needs to be cared of, it has to be performed preferably by the family. One is more involved in the care, but the whole family interacts, supported by a social net, composed of friends and neighbours. In the daily activities, they use creativity to adapt goods and the environment, as well as the popular knowledge as resources in the health care. The stressed difficulties are related to the poor social-economic condition, to dwelling, clothing, and transport. They perceive that the social support to caring families is restricted. They emphasise that access to health services is appalling and magnify the urgency in strengthening the "United Health System", aiming to establish their principles. They stress the need to introduce interdisciplinary home care programs, which could assist the family and the elderly in a holistic, permanent, participating, contextural, and humanised way. / Se trata de una investigación de tipo cualitativo que tiene como objetivos descubrir las vivencias de familias de clase popular en el cuidado a familiares ancianos fragilizados, en el domicilio, así como obtener subsidios para la sistematización del cuidado de enfermería a esas familias. El Referencial Teórico aborda temas relacionados al área temática del estudio: el cuidado de enfermería domiciliar, la familia de clase popular y la persona anciana fragilizada. Los sujetos de esa investigación, intencionalmente elegidos a partir de criterios previamente establecidos, son cuatro familias pertenecientes a la población perteneciente a una Unidad Sanitaria del municipio de Porto Alegre. El Estudio de Caso de Tipo Etnográfico es la metodología utilizada. Los instrumentos utilizados para la colecta de datos son la Observación Participante, la Entrevista, el Análisis Documental y la Ficha Informativa. Del tratamiento de los datos, a través del análisis de contenido, emergieron seis categorías: Características de las Familias, Concepciones de las Familias, La (re)Organización de la Familia para el Cuidado, La Familia en la Cotidianeidad del Cuidado, Las Relaciones con las Instituciones Sociales, El Cuidado de Enfermería Domiciliar. Fue posible percibir que las familias son multigeneracionales. Sobreviven casi exclusivamente de las jubilaciones de los ancianos y enfrentan constantemente el desempleo. Su concepción de salud está relacionada a la capacidad de trabajo. Valorizan la familia, en la cual el anciano es reconocido por su experiencia de vida. Al necesitar de cuidado, este debe ser asumido, preferencialmente, por los familiares. Una persona se envuelve mas intensamente en el cuidado, pero toda la familia, auxiliada por una red de apoyo, constituida de amigos y vecinos, interactúa. En las actividades cotidianas, se valen de la creatividad para adaptar los utensilios y el ambiente, tanto del saber popular, como en los recursos para el cuidado de la salud. Las dificultades destacadas están relacionadas a la condición socioeconómica precaria, a la vivienda, al vestuario y al transporte. Perciben que el soporte social a familias cuidadoras es restricto. Destacan que el acceso a los servicios de salud es sufrible y resaltan la urgencia en solidificar el Sistema Único de Saúde (Sistema Unico de Salud), en busca de la concretización de sus principios. Expresan la necesidad de implantación de programas de cuidado domiciliar, interdisciplinares, que asistan a la familia y al anciano de forma integral, continuada, participativa, contextualizada y humanizada.

Trata-se de uma pesquisa de cunho qualitativo que tem como objetivos desvelar as vivências de famílias de classe popular no cuidado a familiares idosos fragilizados, no domicílio, bem como obter subsídios para a sistematização do cuidado de enfermagem a essas famílias. O Referencial Teórico aborda temas relacionados à área temática do estudo: o cuidado de enfermagem domiciliar, a família de classe popular e a pessoa idosa fragilizada. Os sujeitos dessa investigação, intencionalmente escolhidos a partir de critérios previamente estabelecidos, são quatro famílias pertencentes à população adstrita a uma Unidade Sanitária do município de Porto Alegre. O Estudo de Caso do Tipo Etnográfico é a metodologia utilizada. Os instrumentos utilizados para a coleta de dados são a Observação Participante, a Entrevista, a Análise Documental e a Ficha Informativa. Do tratamento dos dados, através da análise de conteúdo, emergiram seis categorias: Características das famílias, Concepções das famílias, A (re)organização da família para o cuidado, A família no cotidiano do cuidado, Relação com as instituições sociais, O cuidado de enfermagem domiciliar. Foi possível perceber que as famílias são multigeracionais. Sobrevivem quase que exclusivamente das aposentadorias dos idosos e enfrentam constantemente o desemprego. Sua concepção de saúde está relacionada à capacidade de trabalho. Valorizam a família, na qual o idoso é reconhecido em sua experiência de vida. Ao necessitar de cuidado, este deve ser assumido, preferencialmente, pelos familiares. Uma pessoa envolve-se mais intensamente no cuidado, mas toda a família, auxiliada por uma rede apoio, constituída de amigos e vizinhos, interage. Nas atividades cotidianas, valem-se da criatividade para adaptar utensílios e o ambiente, bem como do saber popular, como recursos nos cuidados à saúde. As dificuldades destacadas estão relacionadas à condição socioeconômica precária, à moradia, ao vestuário e ao transporte. Percebem que o suporte social a famílias cuidadoras é restrito. Destacam que o acesso aos serviços de saúde é sofrível e ressaltam a urgência em solidificar o Sistema Único de Saúde, em busca da concretização dos seus princípios. Expressam a necessidade de implantação de programas de cuidado domiciliar, interdisciplinares, que assistam a família e o idoso de forma integral, continuada, participativa, contextualizada e humanizada. / This is a qualitative research, which aims to unveil the life experience of families from lower classes at caring for their frail elderly relatives at home, as well as to obtain subsides for creating a model of nursing care for such families. The theoretical model approaches issues related to the thematic area of caring: the family nursing home care, the lower classes families, and the frail elderly. The subjects of this investigation, intentionally chosen upon the criteria previously established, were four families from the Sanitation Unity of Porto Alegre. The design of this case study was an ethnographic type. Tools used for data collection were: participated observation, an interview, a documented analysis, and the informative report. From the analysis of data, through the content analysis, six categories were established: characteristics of the families, conceptions of the families, reorganisation of the family to the care, the family within the routine of the care, the relationship with social institutions, and the nursing home care. It was possible to perceive that families are multigeneration. They survive almost exclusively from the elderlies retirement and frequently they have to cope with unemployment. Their concept of health is related to their work skills. They value the family where the elderly is recognised for his or her life experience. When he or she needs to be cared of, it has to be performed preferably by the family. One is more involved in the care, but the whole family interacts, supported by a social net, composed of friends and neighbours. In the daily activities, they use creativity to adapt goods and the environment, as well as the popular knowledge as resources in the health care. The stressed difficulties are related to the poor social-economic condition, to dwelling, clothing, and transport. They perceive that the social support to caring families is restricted. They emphasise that access to health services is appalling and magnify the urgency in strengthening the "United Health System", aiming to establish their principles. They stress the need to introduce interdisciplinary home care programs, which could assist the family and the elderly in a holistic, permanent, participating, contextural, and humanised way. / Se trata de una investigación de tipo cualitativo que tiene como objetivos descubrir las vivencias de familias de clase popular en el cuidado a familiares ancianos fragilizados, en el domicilio, así como obtener subsidios para la sistematización del cuidado de enfermería a esas familias. El Referencial Teórico aborda temas relacionados al área temática del estudio: el cuidado de enfermería domiciliar, la familia de clase popular y la persona anciana fragilizada. Los sujetos de esa investigación, intencionalmente elegidos a partir de criterios previamente establecidos, son cuatro familias pertenecientes a la población perteneciente a una Unidad Sanitaria del municipio de Porto Alegre. El Estudio de Caso de Tipo Etnográfico es la metodología utilizada. Los instrumentos utilizados para la colecta de datos son la Observación Participante, la Entrevista, el Análisis Documental y la Ficha Informativa. Del tratamiento de los datos, a través del análisis de contenido, emergieron seis categorías: Características de las Familias, Concepciones de las Familias, La (re)Organización de la Familia para el Cuidado, La Familia en la Cotidianeidad del Cuidado, Las Relaciones con las Instituciones Sociales, El Cuidado de Enfermería Domiciliar. Fue posible percibir que las familias son multigeneracionales. Sobreviven casi exclusivamente de las jubilaciones de los ancianos y enfrentan constantemente el desempleo. Su concepción de salud está relacionada a la capacidad de trabajo. Valorizan la familia, en la cual el anciano es reconocido por su experiencia de vida. Al necesitar de cuidado, este debe ser asumido, preferencialmente, por los familiares. Una persona se envuelve mas intensamente en el cuidado, pero toda la familia, auxiliada por una red de apoyo, constituida de amigos y vecinos, interactúa. En las actividades cotidianas, se valen de la creatividad para adaptar los utensilios y el ambiente, tanto del saber popular, como en los recursos para el cuidado de la salud. Las dificultades destacadas están relacionadas a la condición socioeconómica precaria, a la vivienda, al vestuario y al transporte. Perciben que el soporte social a familias cuidadoras es restricto. Destacan que el acceso a los servicios de salud es sufrible y resaltan la urgencia en solidificar el Sistema Único de Saúde (Sistema Unico de Salud), en busca de la concretización de sus principios. Expresan la necesidad de implantación de programas de cuidado domiciliar, interdisciplinares, que asistan a la familia y al anciano de forma integral, continuada, participativa, contextualizada y humanizada.

Demographic and epidemiological change has resulted globally in changes in population and individual health, which, in turn, have resulted in changing care needs. Demographic change in South Africa, mainly through a confluence of declining fertility rates and pre-AIDS increases in life expectancy, has produced an ageing population that is expected to continue ageing for at least the next 10 to 15 years. Currently, South Africa’s older population (60 years+) has a much higher annual average percent growth rate than the total population. Having more older persons than ever before implies increased prevalence of frailty, chronic disease and disability through a tendency of declining physical, mental and cognitive functional capacities—hence meaning a larger demand for care. The changing age structure of a population is commonly associated with changes in health, disease and cause of death patterns. Recent research indicates an intensive, quadruple burden of disease, with the major addition of HIV/AIDS to persistent pre-transitional conditions, non-communicable conditions, and high rates of injuries—implying an extensive and diverse need for care. While demographic and epidemiological change have led to an increased demand for care, health system change, shortages in formal public health care delivery, and the spiralling costs of private care have led to decreased availability of formal care. Care-requiring persons therefore may need to rely increasingly on ‘informal care’, defined here as ‘care provided at home to another person who, because of frailty disability or ill-health, cannot manage on his/her own’. Research on informal care in developed nations is well-established and extensive, but has received very little attention in South Africa where it is not clear how many and who it is that are informal carers. The thesis study has hence been conducted to contribute to the limited research in the field of informal care, aiming to establish the national extent of informal care, and to present a demographic and socio-economic profile of informal carers. A multi-stage stratified area cluster probability sample of 2704 persons was drawn from free-living adults in a nationally-representative household survey in 2000. Field data were collected during 2611 individual face-to-face interviews. Basic univariate and logistic regression analyses were conducted. Of the adult population, 27% were found to be informal carers. Significant prevalence differences were found regarding sex, population group, geographic residence, education, employment status, and income. Adjusting for selected demographic characteristics, the significance status and levels of some relationships changed. It is concluded that informal caregiving is widespread in South Africa. While demographic and epidemiological evidence suggest that the reliance on informal carers is expected to increase, many informal carers are struggling to shoulder the physical, mental and financial burden. A national strategy to focus on informal carers is recommended, to raise awareness about their essential role and value in the health care system; to recognize their contributions to population and individual health; to comprehensively support them; and to assess their needs and concerns through ongoing research. / Dissertation (MA (Demography))--University of Pretoria, 2006. / Sociology / unrestricted

Antalet anhörigvårdare av personer med demens förväntas öka under de nästkommande tio åren i samband med att antalet personer som drabbas av demenssjukdom ökar, samtidigt som den offentliga omsorgen minskar. Anhörigvårdare av personer med demens har flera stödbehov som inte är uppfyllda på grund av en bristande förståelse av deras livssituation. Syftet med denna litteraturstudie är att skapa förståelse och belysa livssituationen för anhöriga som vårdar en närstående med en demenssjukdom. För att besvara syftet har en litteratursökning gjorts i tre databaser som har resulterat i identifieringen av 15 kvalitativa studier. Tematisk analys har tillämpats på studiernas resultatavsnitt. Tre huvudteman och fem underteman har identifierats. Teman belyser anhörigvårdarna av personer med demens, deras upplevelse samt de strategierna de använder för att klara av vardagen. Livssituationen för anhörigvårdare av personer med demens ser olika ut och stödbehoven är individualiserad och beror på deras livssituation innan insjuknandet samt på sjukdomens symtom. / Family caregiving of people with dementia is expected to increase due to a declining public care and a growing number of people suffering from dementia. There is a need for better understanding of the life situation of family caregivers in order to give them the right support. The aim of this literature study is to emphasize the life situation of relatives caring for persons with dementia disease.  The methodological approach is thematic analysis av 15 qualitative studies that have been identified after a literature search conducted in three databases. The results are presented in three main themes and five sub-themes. The themes highlight the family caregivers, their experience and the strategies they use to cope with everyday life. The study concludes that the life situation of the family caregivers is individualized. Their support needs are varying according to the development of the dementia disease and the circumstances before the illness.

The main topic of this diploma thesis is support of informal caregivers taking care for dying loved ones or loved ones with life-threatening illness in the home environment. The theoretical partis focused on informal carers, the quality of life of informal carers, the quality of life of dying people and quality of life of people with life-threatening diseases, death and the stages of coping with death. It also deals with hospice and palliative care, their forms, methods and uses. The practical part is focused on the analysis and evaluation of questionnaires filled out by informal carers. The aim of my diploma thesis is to point out the need to help informally caring for dying loved ones or loved ones with life-threatening illnesses. Within the practical part of this thesis, it was intended to map helpful and, conversely, deficit types and ways of support. These outputs can then be the basis for improving the quality of support and services for informal carers caring for a loved one in the home environment. Keywords Informal care, formal care, hospice care, palliative care, quality of life, death.

This dissertation focuses on shared care of elderly in their homes in the municipal district of Prague 7. The goal was an understanding of the context and organization of the care, as well as how the informal care providers perceive their current situation and what is their idea of the optimal form of the care. Data for the analysis were gathered through means of semi-structured surveys with answers from twenty respondents who are informal care providers. Results are indicating that at the moment, the state of home shared care for the elderly is not fully satisfactory. Therefore, the conclusion includes recommendations which could contribute to the improvement of the current situation.

This study was undertaken to identify the biographical characteristics, attitudes and perceptions of informal family care-givers caring for patients with mental illness in Dennilton. Data were gathered from 48 care-givers by using a cross-sectional survey approach in which structured questionnaires were completed. The results revealed that a sizeable proportion of the care-givers were 60 years and older. Only 10% were employed and a quarter married, suggesting that the care burden influenced their life choices. Many care-givers were mothers or female family members. Half of the patients cared for suffered from depression. Violent, aggressive behaviour was reported as a symptom that care-givers found difficult to deal with. Less than half of the care-givers reported that the patients accepted their health situation. / Sociology / M.A. Soc.

This thesis deals with the security system care services and other related services, including informal care for seniors in the Czech Republic. The aim of the work is to evaluate, describe and offer a closer understanding of nursing as a basic social care service in connection with the principle of shared care in a natural home environment for seniors as the ideal form of care for the elderly at present and due to the demographic development in the future. The thesis is divided into a theoretical and a practical part. The theoretical part covers three main topics: day care service system in the Czech Republic, seniors as a target group of caring and sharing and municipalities and their role in caring for the elderly. The practical part is devoted to the research, which focuses on the relationship of care services and communities from the perspective of potential service users, ie. the elderly. A combination of qualitative and quantitative research methods is used in the research and interprets the results of the survey conducted among the elderly in three senior clubs in Prague 17. The research complements the findings mentioned in the theoretical part.

The aim of the diploma thesis themed Long-term care and the informal persons caring for clients is to identify both positive and negative aspects of the long-term care and its influence on physical and mental condition of persons taking care and their closest relatives. At first, the thesis deals with the issue of long-term care in the Czech republic and its division into two categories, formal and informal. Furthermore, the thesis presents the situation of the informal caregivers who have to face various obstacles arising from the nature of long-term care, such as their complicated relation with the formal institutions, lack of financial support, worsening of their lives' qualities and also lack of social recognition of their status. In order to retrieve the relevant information within the scope of the research question, the method using half-structured interviews was used. The research sample consisted of 7 female respondents from České Budějovice and its surroundings who were taking care of persons between the age of 5 and 71 years. The pesons suffered either physical or mental disorders. Some of them suffered both physical and mental disorder. At the beginning of the research the caregivers received two main questions. The first question was focusing on their perception of the current system of rules for informal caregivers, whether they support it or not. The second question aimed on describing the biggest positives and also the setbacks related to the care of person with some kind of disorder. The outcome of the interviews was that if a person decides to care of a close person with disorder there is a wide network of social services provided for him, even though it could be definitely improved. The issues which could be improved are primarily financial income of caregivers, accessibility and afffordability of relief services, providing more information and education for the informal caregivers, and last but not least the opportunity for caregivers' self-realization and their position at the labour market.

Since the 1980s, practically all of the western welfare states have developed social policies, which aim at shifting the responsibilities for welfare services from the state to the family, the civil society or to the market. In Sweden, this political transformation has particularly hit the public eldercare. In the last twenty years, the percentage of the population 65 years and older receiving public home help services in Sweden has decreased from 23 to 8 per cent at the same time as the number of beds in hospitalized eldercare has been heavily reduced. Moreover, during the course of the 2000s, the majority of the Swedish municipalities have reintroduced means testing of the eldercare based on whether the elderly have relatives or not that can perform the services. Parallel with these downsizes in the publicly financed and organized eldercare; privately produced eldercare services have increased, carried out by large and internationally own business corporations. Based on an theoretical framework, which combines the historical approach within the neo-institutional research tradition with a discursive method of analysis, this thesis explores if the period from the 1980s and onwards has been a formative moment in Swedish eldercare during which new ideas have become embedded in the institutional frameworks regulating the division of responsibility for eldercare services between the state, the family and the market. To examine if and how the municipalities, which are principally responsible for organizing and financing the public eldercare in Sweden, have implemented the change in ideas that have emerged in national politics since the 1980s, the thesis also examines how the eldercare has developed in two of Sweden’s municipalities since the 1980s. The results of the thesis demonstrates that the period from the 1980s and onwards has been a formative moment in the Swedish eldercare during which new ideas regarding the public responsibility for eldercare service have emerged and become institutionalized. Since the 1980s, senior citizens’ need for care has increasingly been re-interpreted from a public to a private issue with the consequence that today, their need for certain services, in particular those related to housework, are no longer regarded to be a public responsibility but a private matter that the elderly will have to solve, either by buying the services on the market, or, by asking relatives for help and assistance. The main problem connected with this reprivatization of senior citizens’ need for care is, however, that as the state has withdrawn its responsibility, women, in their role of being wives, daughters, or daughters-in-laws, have been forced to step in as informal and unpaid providers of care. Therefore, regardless of political reigns and modes of production, women have been forced to taken on an increasingly larger responsibility for their elderly relatives.