Occupational therapy with bedfast disabled: communitary actions based on problems identification

Abstract

In the context of the brazilian health sector reform, the criticism on the institutionalization of the elderly, of those affected by cronical diseases and the disabled persons led to the formulation about the health care with the view on maintaining these people in their home and in their communities, therefore, particularly avoiding their hospitalization. The Program for the Bedfast, of the Vila Floresta Health Unit of the Conceição Hospital Group in Porto Alegre - RS, has been adopting these references and also implementing community actions - at home - for selected groups of patients. So, a study with the objective of identifying their problems has been developed, with the purpose of discussing it under the Occupational Therapy perspective. The data collection was held at homes, through structured interviews and also by the unsystematic observation done with the patients or their aide. The points approached were the health and life conditions of the disabled persons with emphasis being put on social-economical, environmental and psychosocial elements, as well as the difficulties on activity of daily living. The results have demonstrated that the group is primarily made of elderly people, with low autonomy and self-determination conditions, who are also in a situation of social isolation, facing risks to their mental and physical health. Therefore, it has been related that the action with these pacients requires the construction of the independent living as such while, at the same time, social interactions take place. The study shows that the objectives of the program need to be treated by a multidisciplinary team, that the informal resources of the home, neighborhood and community have to be activated and that the occupational therapist has to act in the direction of building spaces that permit the social interactions based on the respect for the differences. From this perspective, it is understood that the maintenance of the quality of life is strongly related to the way of acting with autonomy, even if with some necessary help, as well as with the effective participation on the family and community life.