human development, social justice and sustainable social systems

Diocesan Caritas of Beja assisting the elderly

Even in the most developed societies, Portugal being among them, when institutional responsibilities are ignored, the duties established by law are ignored, or the ethical obligations of families are omitted, they end up causing damages that threaten the dignity of the elderly. Each of these violations, by society, by the public administration or by the families themselves, can trigger the social marginalization of the elderly, the most dramatic dimension of which is the lack of human relationship, as it causes enormous suffering to the elderly, due to abandonment, loneliness and isolation, which is exactly what we intend to combat or mitigate with our service.

For this reason, one of the first services that Diocesan Caritas of Beja, in Portugal, created and defined as a priority in its intervention was the Home Support Service that it established in 1994, in a model of assistance centred on the elderly, based on assistance, monitoring and promotion procedures at home. This model involved, at the time, a profound change in the usual way of caring for and accompanying the elderly, so that their skills were valued, and their participation was favoured and promoted. This has been our focus until today. Currently, this support reaches 76 elderly people.

The District Social Security Centre of Beja contributes with a budget for the global costs of services provided to users who are within the protocol that was designed between the two institutions (64). With the rest (12), it is Caritas that bears all costs of services provided. Whenever this is not possible, on the part of the family or user, Caritas Beja itself assumes the services, trying to ensure that no one is left behind.

This service is provided by ten direct action helpers, coordinated by a technical director and with the support of a nutritionist, who define the provision of care to families or those in the home. This includes those in a situation of physical or psychological dependence and who cannot guarantee, temporarily or permanently, the satisfaction of their basic needs or the performance of essential activities of daily living, and who may not have family support for whatever reason.

The service is adjusted to the context of each case and it is possible to offer a range of diversified services to users, also promoting socialization with other users, employees, volunteers and people in the community. They are direct action helpers who daily, one or more times a day, depending on the services registered, travel to our users’ homes, taking the requested meals, which can be lunch, snacks, and dinner, and carrying out, if necessary, hygiene assistance, housing and personal care, thereby guaranteeing their comfort and health.

The work we do is based on respect for the dignity of the elderly, respecting them in their weaknesses, acting with ethics and zeal for their safety and, whenever necessary, in conjunction with family members and the people in need themselves.

Caritas Beja in the response to COVID-19

Currently, and due to the pandemic of COVID-19, Caritas Beja, with the technical coordination  of the Home Support Service and the technical services, developed a Contingency Plan for this social response, which is monitored daily and updated whenever justified, to be able to correspond to the national measures and recommendations of the General Directorate of Health and Social Security in real time.

However, the truth is that in our interventions, the difficulties felt are the lack of means. Personal protective equipment, such as individual masks, disinfectant gel, gloves and suits, are in short supply, as are volunteers and the funding to support the new gear and expenses associated with the implementation of security measures.

We felt that no one was prepared for a situation of this seriousness and impact, precisely because we do not know when it will end. We feel the need for specialized volunteers to help us deal with the daily stress and anxiety that we are all placed in, particularly direct action helpers, who are daily on the front line, so that they can safely manage situations that may eventually arise with the elderly and their families.

Addressing the fears of the elderly in relation to COVID-19

The elderly people we monitor in the scope of the Home Support Service, as well as their families or support networks with whom we articulate the intervention, naturally express concerns that we consider legitimate, since they are the high-risk public. It has been verified that COVID-19 has a greater impact on people over 65, and on people with cardiovascular diseases (such as hypertension and heart failure), chronic respiratory disease, or diabetes.

In this sense, we try to speak regularly with our direct action teams, family members and the elderly, in order to transmit security and calm in the current context, taking the opportunity to clarify doubts about our performance procedures. At the same time, we remind teams about the recommendations of the General Health Directorate to prevent contagion and that these are part of our Contingency Plan.

We seek to assure the elderly we accompany and provide secure information. We call on them to avoid leaving the house and to use our services for any need they have. In addition to that, we raise awareness of the symptoms and characteristics of the disease, the rules of respiratory etiquette, the necessity and correct method of washing hands. We implement the recommended health advice such as distance between direct action helpers and the user, ventilation of the living spaces, cleaning surfaces regularly, and whatever else is necessary to promote good health.

This whole approach is coordinated by the Technical Director of the Home Support Service, who, in turn, with the helpers of direct action, monitors and supports the care set out above. With regard to food delivery made and distributed by Caritas, whenever possible, the lunch boxes with meals are left at the door, so that contact is as limited as possible. With regard to the personal hygiene care of the most dependent and bedridden people, to whom the existence of direct contact is essential, we have taken every step to guard against any possible outbreak of contagion, using all the protective material we have available.

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Mariana Côco

Technical Director of the Home Support Service
Caritas Beja, Portugal