Care that Transforms: From Institutionalization to Community Care

Background: Over the past 3 years, the Leão XIII Foundation, a state government agency in Rio de Janeiro that develops social protection programs in the state, has been promoting the repoliticization of care through its Long-Term Care Facilities for the Elderly. By reconfiguring its institutional role, the Leão XIII Foundation seeks to transform LTCF from mere spaces of shelter into political and pedagogical spaces of care, recognizing it as a social right and essential work.

 

Approach: The aging of the Brazilian population poses the challenge of reorganizing care practices, traditionally centered on the family. The increase in longevity, which will raise the number of elderly people from approximately 33 million in 2025 to approximately 68 million in 2050, coupled with the feminization of care and the fragility of family networks, demands an integrated care model that articulates community and specialized environments in a logic of shared and long-term care. The care of elderly people, especially those who require greater support, needs to be conceived as a web of interdependent relationships. Specialized services—which guarantee social protection and technical care—and community and family spaces, where belonging, coexistence, and meaning of life are built, are intertwined within it. The power of integrated care emerges precisely when these spaces connect, creating continuity of bonds and care practices.

 

The Sepetiba Senior Residential Village, a public long-term care facility managed by the Leão XIII Foundation, has a structure integrated into the community, without walls separating its 28 houses from other homes in the area. However, symbolic barriers persisted, reinforcing institutional isolation and loss of community ties. To overcome these and enable an open-door long-term care facility model as an extension of the community, integration strategies are being implemented that articulate intergenerational projects aligned with the WHO Decade of Healthy Ageing.

 

Among the initiatives, the following stand out: the Giroteca, a community reading room and space for interaction and learning with a physical and digital collection accessible to the community, guaranteeing the democratization of access to information and technological knowledge, promoting digital inclusion; the Integrated Care Plans, instruments agreed upon between services and the socio-family network for joint monitoring; and partnerships with universities and caregiver training centers.

 

Results: The Village experience aims to serve as a pilot project for a long-term care facility model that transitions from institutional care to socially shared care, recognizing that caring for older people is a collective task. It thus approaches the idea of a compassionate society, founded on co-responsibility and empathy. The objective of this replicable model is to build innovative and inclusive caregiving communities, combating prejudices such as ageism, familism, and long-term care facility bias.

 

Implications: The hope is that Village and other LTCF will be recognized as a living part of the territory and not as a rupture from it. That they can promote a symbolic reform in the way society understands aging: institutions that care, educate, articulate and transform. This may be the path to transforming LTCF into living spaces and the territory into a community of care.