Dynamics of institutionalization of older adults in Belo Horizonte, Brazil

Introduction Epidemiological and social changes related to population aging in Brazil will probably increase the need for nursing homes (NH). The stud y analyses the dynamics ofinstitutionalization in Belo Horizonte, a 3 milli on inhabitant city of whom 8.0% are aged 60 or more. Methods Age and length of stay of 1,128 NH residents (92.5% of the estimate d population) was registered and occupancy and institutionalization rates w ere determined. Results Among women aged 65+ in Belo Horizonte, 0.88% were living in NH; am ong men, 0.26%. Occupancy rates were 92%. Women (81 %) were older than men (76.4 x 70.4 years; two-railed t test = 6.4; p=0.00) and lived there for a longer period (56 x 4.5 years; two-tailed t test = 2.6; p=0.01). Almost 1/3 of the men were aged < 65. Conclusions High occupancy rates, long waiting lists and hard criteria for admission (half reject demented or dependent individuals) insinuates that t hese low institutionalization rates are related to scarcity of beds. The pr eponderance of women reflects the proportion of those widowed or separated in the community (66% of those aged 65+, versus 76% of married man). The hi gh frequency of institutionalized men aged <65 suggests lower capacity of m aintaining themselves after widowhood. High death rates (24% during a 20 mo nth follow-up of a 263 random sample) determines the small median length of stay (3 years). These data unveil the anachronism of a system which is not directed towards the maintenance of the Brazilian older people among their families and homes.