Aging and Institutionalization: Challenges for a Comprehensive and Integrated Approach

Focusing on the characterization of elderly individuals and the routines developed in Residential Facilities for Elderly People (ERPI), we identify the needs and challenges involved in providing care for this population. 

Through intentional conversations, participant observation, and documentary research, we gain a clearer understanding of institutional realities and the daily lives of elderly residents. These techniques allow us to gather information on sociodemographic characteristics, professional history, personal preferences, interests, motivations, daily routines within ERPI, and activities undertaken. 

Special attention is given to the health condition of the elderly population, which includes an assessment of their physical, mental, emotional, and functional status. This evaluation is conducted using the Barthel Index, the Mini-Mental State Examination (MMSE), and the Geriatric Depression Scale. The information obtained allows us to prioritize intervention strategies in areas such as physiotherapy, occupational therapy, sociocultural animation, nursing, general medicine, neurology, psychology, psychomotricity, psychiatry, and nutrition.

The lack of cognitive stimulation and the insufficient integration of elderly individuals into institutional activities can negatively impact their well-being. At Vida Maior, we strive to meet the needs of individuals and their families as they navigate the aging process. Here, social intervention involves identifying and interpreting these needs to implement appropriate measures. This work aims to understand the aging process of elderly individuals in ERPI, diagnosing their needs, challenges, and potential, in order to ensure an effective and precise intervention.

Aging also carries a social dynamic, bringing changes in an individual's status and interpersonal relationships. The loss of socially valued roles can lead to a decline in self-esteem, often due to shifts in family, work, and societal roles, losses, and reduced social interactions.

Elderly individuals also experience psychological transformations, including difficulties in adapting to new roles, lack of motivation, challenges in planning for the future, emotional struggles with loss, psychiatric conditions requiring treatment, depression, paranoia, suicidal tendencies, and low self-esteem and self-image. It is therefore essential to intervene and design activities that promote active aging, helping to mitigate these factors. This requires a thorough understanding of each person's characteristics, functional abilities, customs, and interests. Within the Vida Maior intervention model, this is a priority and a fundamental part of daily practice.

The transition to institutional care and the adaptation process can be challenging for both the individual and their family. This transition often involves disruptions, including leaving behind a familiar physical space, personal belongings, and established social networks of family and neighbors within the local community. Institutions sometimes tend to become closed-off environments, and the pandemic only reinforced this isolation.

At Vida Maior, social intervention focuses on minimizing this isolation, recognizing that it often results from personal choice and is symbolized by a barrier to social interaction with the outside world. Institutionalization means moving to a new place, whether temporarily or permanently, which requires a multidimensional and active integration effort involving multiple stakeholders—ERPI staff, families, physical space, new peers and friends, and activities—through a dynamic and systemic family-centered intervention.

Community participation, maintaining family traditions and relationships, are essential factors in the success of social intervention for individuals in ERPI. It is a holistic process that enables social intervention to achieve positive results for the elderly. The socio-emotional sphere is inseparable from elderly care—it is much easier to support someone with only physical limitations than someone with psychosocial challenges.

It is necessary to stimulate positive thinking, joy, hope, and creativity. When this happens, individuals gain self-esteem, increase their participation, and become more engaged in their surroundings.

In summary, we know that the best way to ensure a healthy aging process is to remain active, in any capacity. Engaging in meaningful activities, whether operational or social, enhances well-being for both the individual and their family. At Vida Maior, communication with families and their feedback is essential to harmonizing social intervention and ensuring a well-structured aging process.

By Elisabete Feio Baltazar

Technical Director, Vida Maior Atlântico