Caring for the elderly in their own home, in a rural context

Abstract

Knowing who the rural populations are and how they live, particularly how they have experienced the issues of health status, was the reason for this study that addressed three main concepts, namely the rural community, the elderly population and social determinants of health.

The progressive increase of longevity, observed across the board in all societies, accompanied by a sharp drop in general fertility and mortality, has been leading to a significant change in the population’s age pyramid, with a substantial increase of the citizens over 65 years of age.

This is an exploratory and descriptive study. We took a convenience sample of 777 inhabitants, of whom 64,1% are elderly, who met the following inclusion criteria: living in the rural area of a municipality in the northern region (NUT’s III); consenting to participate in the research; and having resorted to the mobile unit during the study period, i.e. January to September 2010. We consider this the most appropriate classification for the objectives of this study, since it seeks to understand the health profile of the elderly population in a given geographical area and find out some of the factors that influence that health profile. All ethical procedures arising from research on humans have been taken into account, with favorable opinion from the Ethics Committee for Health, the ARS North (opinion n. º 35/2009).

To collect data, we used the survey questionnaire and participant observation.

Results show that the interior will become a huge “retirement home” and that care for the elderly in domestic context is a task in support of neighborhood networks. It was found that 62,9% did not have adequate self-health monitoring; 62,3% had an adherence to the prescribed treatment regimen not shown; and 65,5% had an ineffective management of therapeutic regimen. Regarding the health situation, it was found that 25,1% of respondents suffer from cardiovascular disease, 20,7% have an osteoarticular pathology and 16,2% suffer concurrently from cardiovascular and metabolic disease. In what concerns to access to medical consultations, 62,2% of the subjects of our sample had between 0 and 5 appointments in their family doctor in the year prior to the questionnaire.

The study contributes to give visibility to this part of the population, it reflects the cultural influence of the health of rural populations and helps to rethink the suitability of public policies and the importance of using proximity strategies in the preparation of health plans, in order to provide proper and equal care. The local care will be those that effectively minimize the difficulties encountered as a result of geo-demographic isolation and access to health care derived from knowledge deficit and a reduced social and familiar support network.