Natália de Cássia Horta – Pontifícia Universidade Católica (PUC), nataliahorta21@gmail.com
Marco Aurélio Santos Pereira – PUC
Igor Filipe Nunes Vieira – PUC
Júlia das Graças Rodrigues de Almeida – PUC

March 2021.

The COVID-19 pandemic highlights the vulnerability of older people to high mortality, but due to their age and due to prevalent comorbidities such as chronic respiratory disease, cardiovascular diseases, cancer and diabetes (NUNES et al., 2020). A close look should be given to older people in Long Term Care Facilities (LTCFs), since they contains highly aged populations who often have high levels of care dependency. Regarding COVID-19 infection control, the LTCF have aggravating factors such as a community environment, with incoming and outgoing professionals from other settings (such as hospitals, other LTCFs, health services and public transport). This increases the contamination risk for residents (MORAES et al., 2020).

In this context, the PUC no Lar extension project arose to support LTCFs in the state of Minas Gerais, with a focus on the Metropolitan Region of Belo Horizonte. The project aims to share knowledge about preventive actions and precautionary measures against the coronavirus pandemic and, thus, to promote health education in LTCFs. The project relied on the use of information technology to reach potential beneficiaries in different ways: a website, videoconferences, the production of electronic booklets, telephone contacts and video production. In addition, socialization strategies were implemented among older LTCF residents, as well as with their social and family networks. The project has also advised on strategies to improve the ambience of these institutions.

The “PUC no Lar” the project team includes 20 students from biomedicine, nursing, energy engineering, physiotherapy, medicine and information system courses. Initially, extension workers were divided into two lines of action: those who stayed behind the scenes in the production of education materials and videos and on the front line, running videoconferences and live interactions. Training videos were produced to respond to general population’s questions and doubts about COVID-19. These questions were communicated through social networks and in alliance with a separate network, the Brazilian National Front for Strengthening LTCFs (https://www.frentenacionalilpi.com.br/). These questions were put into themes, such as prevention (subdivided into guidelines, PPE, sanitizers, cleaning/gowning), food, health services, mental health; testing; transmission/infection; treatment; immunization and symptoms/lethality. From 238 questions received, the project produced 142 videos that were posted on Youtube (https://www.youtube.com/channel/UCPAypBHrYMmkUeq-ZBWzw8w), Facebook, Instagram and also a dedicated website (https://pucnolar.site/).

On the front line, to promote more direct contact with professionals, residents and their families, weekly videoconferences were run through Google Meet. These addressed topics related to the pandemic and selected by the project team and the beneficiaries. Topics included: management of suspected and confirmed cases of COVID-19; the role of multi-professional teams in the management of COVID-19; impacts of social isolation on the mental health of residents and measures to minimize isolation; care in the hygiene and disinfection of food and kitchen utensils; tests available for COVID-19; expectations and progress for vaccination against COVID-19; older person-centred care;  palliative care; and “taking care of those who take care” (concerned with the mental health of social care and health professionals).

Meetings took place every week, 26 in total, and were attended by representatives of LTCFs in the cities of Betim, Belo Horizonte, Contagem, Mateus Leme, Santa Luzia, and Ouro Preto. About 42 institutions were part of the project during 2020.

On 1 October 2020, the project implemented the “Live Solidária de Afetos”, which roughly translated as “Affection Solidary Event” to mark the international day of older people. In this event, songs were chosen and sung by the residents of 8 LTCFs in a presentation broadcasted by YouTube, along with musicians from the region who joined in the virtual party. All sanitary measures were followed during the event by all participating institutions. The entire project team and the social and family networks of residents were invited to attend this live event.

Due to the suspension of visits to LTCFs during the pandemic and the reports from LTCFs regarding difficulties in sustaining the mental health of residents, “PUC no Lar” started to develop and provide booklets with interactive and educational activities to be performed by residents and with professional support. These booklets aimed to improve the atmosphere in the institutions during the pandemic period, to promote independence and self-esteem of residents and to strengthen bonds between residents and carers. The documents’ content was based on LTCF suggestions and ideas developed by the project itself. They were presented to the institutions during the weekly meetings and delivered via whatsapp and email. Each booklet has a detailed description of its objectives, proposals for execution, recommended bibliography and sanitary measures to be respected to perform the activity.

The first booklet was called “Fact or Rumor”, and aimed to provide residents with quality information about COVID-19. By deconstructing examples of fake news, residents had the opportunity to answer questions and receive information in an entertaining and engaging way. Other booklets deal with self-care, well-being and stress management, including “Relaxation therapies”, “Poems and Poetry” and “Self-Hug”. There are booklets with interactive activities promoting the participation and social interaction of residents, including such as “Bingo game”, “Photo Mural” and “Miss you, session”. These aimed to entertain residents and reduce their feelings of abandonment by strengthening links between those involved. In total, nine booklets were developed and shared with LTCFs.

Another element of the project was “Alô PUC no Lar”, which aimed to support socialization strategies to link residents with the project team and reduce social isolation. Weekly meetings or calls on specific topics were mediated by staff from the LTCFs, using Whatsapp, Google Meet and voice calls. By now, on average, there have been at least two meetings for each project team member.

In 2020, “PUC NO LAR” ran two live events, 26 videoconferences, nine booklets and 142 educational videos. The project directly reached an average of 1260 people in the video conferences, from 42 LTCFs. The evaluations of all participants were extremely positive, which has encouraged us to maintain the project during 2021.

REFERENCES:

MORAES, Edgar Nunes de et al . COVID-19 nas instituições de longa permanência para idosos: estratégias de rastreamento laboratorial e prevenção da propagação da doença. Ciênc. saúde coletiva,  Rio de Janeiro ,  v. 25, n. 9, p. 3445-3458,  Sept.  2020 .

NUNES, B., et al. Envelhecimento, multimorbidade e risco para COVID-19. ELSI-Brasil. v. 2, n. 9, p. 2-22, 2020. https://preprints.scielo.org/index.php/scielo/preprint/view/703/929