ALVAREZ, A. M. HAVING TO CARE FOR SOMEONE: THE LlVING EXPERIENCE OF THE
ELOER ANO THE CARER FAMILY lN THE CARING ANO BEING
CAREO PROCESS lN A FAMILY HOME CONTEXT.
FLORIANÓPOLlS: PEN/UFSC, 2001 .
This is a Doctorate Thesis presented i n the Graduate Degree Program i n N u rs i n g a n d H ealth at the Federal U n iversity of Santa Catarina ( U FSC). The author is a N u rse and a facu lty member at the U FS C , ded icated to the study of the geronto-geriatric n u rs i n g care. The book shows the design of an explanatory theoretical model to understand the cari ng and being cared-for process as l ived by the carer family of an aged and sick fra i l rel ative , in poor households, and urban outskirts, con nected to a Hea lth Center.
l n a present and criticai way, a picture is presented of the popu lation aging process d u ring the 20thcentury. The foundation was b u i lt from recent a n d presently accepted publications released by geronto-geriatrics scholars , as wel l as from stati sti c d ata a n d p roj ect i o n s fro m the I B G E . Publications from the U N O and O PAS o n the population aging and p u b l i c h e a l t h p o l i ci e s fo r the a g e d in B r a z i l a re commented . Two questions of concern are raised: "What has been planned to promote and protect the aged in our country" and "What kind of old age will we have in the futu re regarding human , social and hea lth aspects ".
The author places the reader i n the study, setting l i mits to and bringing the research i nto context. Aspects of the observed reality are descri bed; personal and professional sensitivity are descri bed , when the author ex poses her d istress and frustration face to rea l ity and to the lack of solution for the cases under study.
Havi ng to care , the centra l d i mension of the study, impl ies having to be cared for. A relationship and a joint story of l ife of the carer family is su pposed to exist with the elderly. Caring and being cared-for processes are described as seen by the aged who is cared for in a fam i l y home, l iving as a dependent, reacting or not to this condition , or moving towards a terminal phase. Also , as seen by the fa m i l y member who has to ca re for an aged rel ative , i n charge of and performing care with its resu lting consequences, having simultaneously his/her own needs and obligations. The author finds out, and the fam i l ies clearly spea k i n their accou nts, how sol itary, u n e n d i n g a n d l a st i n g care c a n b e , e m a scu l at i n g a s dependency evolves; how m uch ski l l , force and emotional control is requ ired . The cari n g task is seen as a n i m position
Jordelina Schier Lúcia H i sako Takase Gonçalves
to the family member carer and also for the dependent aged. Care is seen as a moral d uty shared i n the social group.
ln the Basic H ealth U n it, the Family Health Program (PSF) and the Health Commun ity Agents Program ( PACS), sti l l being implanted, are a b l e to map and detect problems, although sti l l l acki n g effectiveness. The programs, sti l l basically turned to suppot women a n d children , d o not have a systematized attention to the dependent aged , and are i n want of continued evaluation and suppot to the families. Thus, fa milies and their eld erly relatives, ater so many fruitless eforts, end up by losi ng faith in the service and goi ng to hospital emergencies, a real test of strength and confrontation. The a uthor presents a diagnosis of public health s e rv i c e s , a n d reve a l s a l s o the fe e l i n g of i m pote nce professionals have face to the l ow answering power of the system. Emphasis is given to the shortage of geronto-geriatric rehabilitation programs in these sevi ces. The poor attendance to the health of the aged popu lation is seen to be a public health problem, reason why so many actions and recovery eforts are abandoned both by the elderly and thei r families.
The reading of th is book, seemingly complex due to its items and su b-items, wh ich g rad ually u nfold , becomes i nteresting and provoking as those situations l ived by the aged and carer fa m i l i e s a re presented . Transcri ption of statements made by fam i l ies and the aged, fu l l of rea lism and feel i n g , are l i ke "Iivi ng voices" i n the text; these voices can be heard and felt with g reat i ntensity. These citations poss i b l y m a ke rea d e rs i d e ntify the i r own rea l i ty in the professional and/or fam i l y context.
Final ly, the p resented model arg ues the emerging social phenomeno n , representi ng a contribution towards the rea l ity l ived by the sick or fra i l aged, and his/her carer family member, and points to the need to have public health policies written up to look ater the s pecific needs of these clients. The book, questioning the future of those who are getting old i n our country, inquires on the contribution geronto-geri atrics health professionals are able to make so as to chang e the present state of afairs . It i s possible an answer can be found by heari ng the voices of fam i lies and their aged ones , as presented in this book.
1 Nurse. University hospital ( U niversidade Federal de Santa Catarina, Brasil )
2 P h D . Professor college o f nursing ( U niversidade Federal de Santa Catarina, Brasil)
