RIO DE JANEIRO, BRAZIL – For seven years, six months and a few days, according to her count, Maria de Lourdes Silva Araújo has been living in the long-term care institution Bezerra de Menezes, in Penha, eastern São Paulo.
Since visitations were canceled to prevent the risk of contamination by Covid-19 among the almost 100 elderly home residents, the 82-year-old from Maranhão draws and paints most of the time. But she misses her relatives and 35 volunteers who would come daily to develop workshops or leisure activities, such as musical performances, and theatre or simply to keep her company.
Lourdes is part of a group that suffers even more dramatically from the effects of social isolation: the elderly in care homes. These homes have been forced to implement drastic measures. Most have suspended visitations since March. In this Penha institution, leisure activities and workshops have been reduced by 80 percent to cut down on the flow of people and reduce the risk of contagion. Today, they are carried out only by a socio-educational advisor wearing a mask and gloves.
The elderly are only in contact with essential workers. The few with autonomy for outdoor activities are no longer allowed to come and go. Two families have decided to take their elderly home temporarily. “It’s a very sad time,” says former housemaid Romilda Feliciano, who has been in the home for 14 years and has a knitting needle in her hands.
The garden has become one of the most popular areas in the institution. In addition to being bright and well cared for, the area features a glass wall that allows a wide view of Dona Vicentina Alegretti Street. In the garden, they read, walk, crochet, chat, listen to music, look at the traffic and even wave to passers-by. This wall isolates, protects, but also draws the elderly closer to the outside world. No one had direct access to the elderly. One can only see them through this glass wall. None are suspected cases of Covid-19, nor even of the common flu.
Since most elderly are aware of what is happening, as they watch and understand what is being said on TV, the pandemic has changed their internal coexistence. They replaced hugs and kisses on the staff with little hearts shaped by their hands. Distancing is cause for concern even during sunbathing. “At first, it was hard to prevent a hug and tell them they can’t”, says the service manager Cristiane Duque.
The phone is the only link with the family. Cell phones – not everyone has their own – are simple, they only make and receive calls. Most calls are made on the social service sector’s landline. At 85, Geraldo Teressani calls his two children daily. He worked as a furniture polisher for over 40 years and has been there since last year.
In addition to housing and food, the facility provides multi-professional staff assistance. The rooms are collective, with 16 beds each, divided into female and male wards. In addition to the address in Penha, the institution welcomes 53 elderly people in Itaquaquecetuba, a municipality in the metropolitan region. The pandemic had an impact on the financial situation at both addresses. The two homes rely on money or food and supplies donations. Since the onset of the pandemic, these have declined by 80 percent.
The solution was to resort to social media campaigns for help, but these have not been enough to cover monthly expenses of about R$850,000. Therefore, the institution is asking for help. “The situation is dramatic. There are still no programs defined by the federal, state or municipal government to support institutions like ours, which are in serious trouble,” Cristiane says.
Video calls
At the other end of the city, in Perdizes on São Paulo’s west side, phones have also become the main link between the 46 elderly denizens of Morada do Sol and their families. But there the devices allow video calls. The connections are mostly made with the staff’s help.
Nevertheless, the use of technology as a means of offsetting the lack of physical contact still causes strangeness. “It is common to be asked how their son ended up inside the cell phone,” says owner Armando Iaropoli Neto.
The Perdizes institution, which hosts citizens over 80 and charges between R$8,000 (US$1,600) and R$13,000, has also canceled visits, but has launched a campaign on social media to share virtual hugs. Dozens of photos of seniors with posters displaying slogans such as “In a little while we’ll kill the longing. #ItWillPass” are circulating on the internet. The institution offers 30 single, double and triple rooms, with internet and pay-TV.
The risk of contamination has reduced the flow of people and suspended activities. Employees argue that families are saddened by this distancing.
There is great concern with the isolation of the elderly because they are part of the Covid-19 risk group – among them, the mortality rate is 14.8 percent. This is a high number when compared to the death rates among young people, around 0.2 percent.
A specialist from the institution takes care of therapeutic activities at Morada do Sol. Staff receive masks to come and go to work daily and, at the start of their shift, they undergo temperature screening and a health questionnaire.
They are also provided with fuel vouchers to travel in their own cars, organize rides and use app transport. Private caregivers are included in the training and follow the same guidelines.
Long-term institutions for the elderly
Homes like Bezerra de Menezes and Morada do Sol are extended care elderly homes (ILPI), directed at people aged 60 and over, with different degrees of dependence. They may be public, philanthropic or private.
The São Paulo City Hall counts 14 ILPIs, which offer 480 places. According to the municipal government, the facilities are continuously sanitized, the windows are kept open and the beds have been relocated so that there is a distance of one meter between them.
Despite the precautions, some have identified suspected Covid-19 cases. In these situations, the elderly are isolated, and residents are relocated. More severe cases are referred to the health services.
Collective activities in most municipal institutions have been interrupted and visits canceled. “Many elderly people in our institutions do not receive visits. They have been abandoned by their families or are long-term street dwellers. Everyone is concerned. They know they are in a vulnerable situation and are more afraid than others, but we are trying to stick to the routine,” says Berenice Gianella, secretary of Assistance and Social Development.
To remember
The city of São Paulo last week recorded the first two confirmed Covid-19 deaths in extended care elderly homes. In all, there are still four suspected cases. A survey by the State Prosecutor’s Office shows that in 678 public, private and philanthropic elderly care establishments there are 29 suspected cases of the disease and 15 confirmed in 17 institutions.
Source: O Estado de S. Paulo