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Abordagem Integrada em Cuidados Paliativos Domiciliários na Demência
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Nas sociedades atuais, verifica-se um aumento da esperança de vida, resultando num crescimento do número de pessoas com demência. Este fenómeno coloca desafios adicionais aos sistemas de saúde e apoio social, especialmente na prestação de cuidados paliativos no domicílio. A prestação de cuidados às pessoas com demência no domicílio é frequentemente garantida por cuidadores informais, geralmente familiares, que enfrentam dificuldades na gestão das necessidades complexas destes doentes. Os cuidados paliativos assumem um papel fundamental ao proporcionar um acompanhamento integrado, focado no alívio do sofrimento e na melhoria da qualidade de vida das pessoas com demência e dos seus cuidadores. Contudo, a implementação desta abordagem integrada continua a enfrentar desafios significativos, como a insuficiência de recursos e o encaminhamento tardio para serviços especializados. Este estudo de caso teve como objetivo compreender os desafios enfrentados pelos profissionais da área social e da saúde na implementação de cuidados paliativos domiciliários para pessoas com demência, usando o modelo integrado de cuidados. Foi analisada legislação que define funções desempenhadas por estas equipas, as necessidades biopsicossociais dos doentes e cuidadores informais, assim como artigos que analisam o modelo integrado de cuidados. O estudo de caso centrou-se em perceber, do ponto de vista dos profissionais, a intervenção realizada assim como o modelo integrado de cuidados integrados. Para concretizar esse objetivo foram realizadas entrevistas semiestruturadas aos profissionais de uma equipa de cuidados paliativos domiciliários, incluindo médicos, enfermeiros, psicólogos e assistentes sociais de um determinado concelho da região de Lisboa. Esses dados foram analisados através da análise de conteúdo, do tipo categorial, permitindo assim definir categorias explicativas do modelo de cuidados desenvolvido por esta equipa. Os resultados demonstram que a abordagem integrada melhora a prestação de cuidados, a qualidade dos cuidados com potencial para melhorar a qualidade de vida das pessoas com demência e seus cuidadores. No entanto, persistem desafios como a escassez de recursos, o encaminhamento tardio e a sobrecarga dos cuidadores informais. A investigação conclui que, para fortalecer a abordagem integrada nos cuidados paliativos domiciliários, é essencial reforçar as redes de suporte aos cuidadores informais, aumentar os recursos das equipas especializadas, sendo necessário promover políticas públicas que garantam um acesso equitativo e atempado aos cuidados paliativos.
In contemporary societies, increasing life expectancy has led to a rise in the number of people living with dementia. This phenomenon presents additional challenges to health and social care systems, particularly in the provision of palliative care at home. Informal carers, usually family members, who face considerable difficulties in managing the complex needs of these individuals, often provide home-based care for people with dementia. Palliative care plays a crucial role by offering integrated support focused on relieving suffering and improving the quality of life of people with dementia and their careers. However, the implementation of this integrated approach continues to face significant obstacles, such as insufficient resources and delayed referral to specialist services. This case study aimed to understand the challenges faced by professionals in the social and healthcare sectors in implementing home-based palliative care for people with dementia, using the integrated care model. The research involved the analysis of legislation outlining the roles performed by these teams, the biopsychosocial needs of patients and informal carers, as well as academic articles examining the integrated care model. The case study focused on exploring, from the professionals' perspective, the interventions carried out and the application of the integrated care model. To achieve this, semi-structured interviews were conducted with professionals from a home-based palliative care team, including doctors, nurses, psychologists, and social workers in a specific municipality in the Lisbon region. The data were analysed using categorical content analysis, enabling the definition of explanatory categories related to the care model developed by this team. The findings indicate that the integrated approach enhances care delivery and quality, with the potential to improve the quality of life of people with dementia and their careers. Nonetheless, challenges remain, such as limited resources, delayed referrals, and the burden on informal carers. The research concludes that, in order to strengthen the integrated approach in home-based palliative care, it is essential to reinforce support networks for informal carers, increase resources for specialised teams, and promote public policies that ensure equitable and timely access to palliative care.
In contemporary societies, increasing life expectancy has led to a rise in the number of people living with dementia. This phenomenon presents additional challenges to health and social care systems, particularly in the provision of palliative care at home. Informal carers, usually family members, who face considerable difficulties in managing the complex needs of these individuals, often provide home-based care for people with dementia. Palliative care plays a crucial role by offering integrated support focused on relieving suffering and improving the quality of life of people with dementia and their careers. However, the implementation of this integrated approach continues to face significant obstacles, such as insufficient resources and delayed referral to specialist services. This case study aimed to understand the challenges faced by professionals in the social and healthcare sectors in implementing home-based palliative care for people with dementia, using the integrated care model. The research involved the analysis of legislation outlining the roles performed by these teams, the biopsychosocial needs of patients and informal carers, as well as academic articles examining the integrated care model. The case study focused on exploring, from the professionals' perspective, the interventions carried out and the application of the integrated care model. To achieve this, semi-structured interviews were conducted with professionals from a home-based palliative care team, including doctors, nurses, psychologists, and social workers in a specific municipality in the Lisbon region. The data were analysed using categorical content analysis, enabling the definition of explanatory categories related to the care model developed by this team. The findings indicate that the integrated approach enhances care delivery and quality, with the potential to improve the quality of life of people with dementia and their careers. Nonetheless, challenges remain, such as limited resources, delayed referrals, and the burden on informal carers. The research concludes that, in order to strengthen the integrated approach in home-based palliative care, it is essential to reinforce support networks for informal carers, increase resources for specialised teams, and promote public policies that ensure equitable and timely access to palliative care.
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Demência cuidados paliativos abordagem integrada cuidados domiciliários Necessidades biopsicossociais Dementia palliative care integrated approach home-based care biopsychosocial needs