Programa Melhor em Casa e velhice dependente : os cuidados no domicílio na cena contemporânea

Abstract

Population aging and the extension of old age are achievements that occur worldwide, in different dimensions, under a context of advancement of the neoliberal ideology that alters the role of the State in investing in public social policies. In Brazil, according to data from the Brazilian Institute of Geography and Statistics, in 2018 the general population had 15.4% people aged 60 years or older (IBGE, 2019) with projections of a 30% increase by 2050 (IBGE, 2022). Other researches pointed out that 30.1 % of elderly people in Brazil presented some difficulty in performing activities of daily living (AVDs) configuring dependent old age which, due to the presence of functional limitations, requires care (BRASIL, 2018). Despite the regulation of various policies of care for the elderly in the country, it was only after 2006, with the National Policy on Health of the Elderly, that emphasis began to be given to the care of dependent old age. In this direction, in 2016 Ordinance No. 825 of April 25, 2016, was created, which redefined Home Care through the Better at Home Program. This is a program inserted in the Unified Health System and funded by the Federal Government, which has been placed as an important strategy for support, guidance, and monitoring of elderly people with functional dependence in their homes. Considering this, the present study aims to analyze the State's responses in relation to dependent old age, based on the Better at Home Program, developed within the scope of Health Policy in Brazil. Thus, the social problematic of aging with dependence in the capital society will be analyzed, emphasizing the relations between care and social protection, as well as the social policies aimed at the elderly as responses to the expressions of the social issue. In methodological terms, the exploratory research conjugated elements of the quantitative and qualitative approaches with the joint appropriation of elements from bibliographic and documental research in order to gather a greater amount of information about the studied object. Thus, it was possible to make approximations about the state responses regarding the services and programs aimed at dependent old age in Brazilian public health. With fragile responses, due to the absence of effective investments in the materialization of the Health Policy for the Elderly and social control, the home care services provided by the Better at Home Program teams have shown themselves to be essentially orienting, with emphasis on the premise of reducing state costs and directing responsibilities to the families. With this, the State inserts itself in the homes, but the care continues, to a great extent, with the family caregivers. This has happened in the midst of the growing aging population and the increasing demand and crisis of care. Thus, the regulation of a care policy with broad responses to the demands and needs of dependent elderly people and their families becomes essential.