Abstract
Population ageing is accompanied by a higher prevalence of chronic-degenerative diseases that require palliative care, particularly dementia. Elderly people with dementia need the help of formal or informal carers. These carers require a variety of guidelines to provide care. In this sense, the multidisciplinary team, which includes the occupational therapist, needs to be prepared in order to provide care. The occupational therapist works to support carers, mainly focusing on occupation and considering the cognitive, psychological and social factors involved in caring for patients with dementia. Strategies for training carers include psychoeducational, psychotherapeutic and psychosocial interventions such as support, education and therapeutic groups. Against this backdrop, this study aimed to understand and discuss the interventions of Brazilian Occupational Therapists with formal and informal carers of elderly people with dementia in palliative care. This is a qualitative study that collected data through focus groups and analyzed the results using the Reflective Thematic Analysis technique. Two focus groups were held. The participants were 13 occupational therapists living in the city of Belo Horizonte, Minas Gerais, Brazil, aged 25-62, with professional experience ranging from 2.5 to 37 years. Of those interviewed, 53.8% worked at home; 46.2% in long-term care institutions for the elderly; 38.5% in hospitals; 23.1% in outpatient clinics and 15.4% in primary care. After a thorough analysis of the data collected, two themes were developed: ‘Occupational therapy interventions for carers of people with dementia in palliative care’ and ‘Carer care strategies. In the first theme, the interviewees pointed to interventions such as providing guidance and training for carrying out activities, supporting the implementation of adaptations and positioning, and drawing up a care plan: ‘providing guidance to help the carer carry out daily activities in a safe way, without infantilizing the elderly person’ (Focus Group 1); ‘supporting the carer to help the elderly person carry out important and necessary activities’ (Focus Group 2). Support for carers was provided through verbal guidance, reports and booklets. In the second theme, the occupational therapists reported the promotion of interventions aimed at caring for the carers themselves, with a focus on overload and routines: ‘In order to support the carer and prevent them from becoming ill, we need to know: How is that carer's life? How is their routine organized? They are usually overloaded and neglect several important things (...) how is their performance?’ (Focus Group 2). The results revealed strategies for training carers to promote the active participation of older people in meaningful daily activities, as well as attention directed at the carers themselves to mitigate their overload. This study illustrates interventions that can support the practice of occupational therapists with carers of elderly people with dementia in palliative care. Moreover, it highlights the need to address such conditions in developing countries like Brazil.