We are the ones who have to adapt to other people

In Perafita, Matosinhos, there is an association that was set up because 300 elderly people were living alone and someone felt that this had to change. Today, almost 30 years later, the Associação de Apoio Social de Perafita runs three social services, employs 66 staff and has a waiting list for its care home. Celestina Silva and Ângela Ferreira explain how they are taking this mission forward into the future.

The association’s Day Centre is located on the ground floor of a building in a residential neighbourhood in the parish of Perafita, in the municipality of Matosinhos. On a typical weekday, the 30 current users start the day with breakfast and then move on to their preferred activity: socialising and relaxing in a lounge, playing games or chatting about the day’s events, or even enjoying the company of the television. For many of these men and women, aged between 70 and 90, this is the place that gives structure to their day, replacing isolation at home and providing care that their families can no longer manage on their own.

“By eight in the morning we’re already welcoming people, many of them brought in by their families, and we don’t close until six in the evening,” explains Ângela Ferreira, the association’s technical director. The opening hours, which we might consider extended, arose from the need to help families manage their own lives. “It’s not just the service users we need to help. It’s also those who look after them.”

Inside, there is a place for every user. At the entrance, the staff know their names, their habits, their stories. Some prefer to have lunch later, some need help eating, and some come here for their only conversation of the day. Every day, the minibuses adapted for people with reduced mobility travel the streets of Perafita, Leça and Santa Cruz do Bispo. “We were one of the first institutions to have adapted transport. We are the ones who have to adapt to the people. Otherwise, it’s very difficult”, explains Ângela.

A story that begins with a realisation

The Perafita Association is about to celebrate its 30th anniversary. The story begins in 1997, when Celestina Silva, the current chair, was on the Executive Committee of the Perafita Parish Council. The realisation was clear. There were many people living alone in the parish: elderly people without children, or with children in Lisbon or abroad, and without a support network. But realisation alone was not enough.

“We took two social work trainees and went to the Perafita Health Centre to see the reality for ourselves,” says Celestina. The young women went around the parish, door to door, and the conclusion was unequivocal: more than 300 people living in isolation, with the forecast that many more would join this number in the coming years.

After analysing the data, a group of people got together for lunch and decided to launch a project to support the elderly population: “We mobilised whatever resources we had at our disposal, the Perafita Lions and some local businesses. We sat everyone down for lunch and said: ‘This is it. We want to get stuck in, let’s do this.’”

The Association currently runs three social services: home care, serving 90 users; the Day Centre, serving 30; and a care home for the severely dependent in Leça da Palmeira, serving 32 users. It is at this last facility that the demands are greatest and where the association’s mission is most evident.

“These are the users that nobody usually wants to take on,” says Ângela Ferreira bluntly. We are talking about advanced dementia: stroke, Parkinson’s, complex conditions that require 24-hour nursing care, trained staff and, above all, the right attitude. “We have even taken in residents from other care homes who wrote to their families asking them to leave, because they were causing too much trouble for the staff.”

The manager also highlights the close relationship with Pedro Hispano Hospital and the health centres in Perafita and Leça da Palmeira. “We take in people who are already highly dependent. By the time these cases reach us, we’re already talking about people who need help right then and there.”

Celestina Silva, the head of the centre, recalls a recent incident: a lady with dementia who was insulting the staff with words she would never use in her right mind. “If you don’t realise that the person isn’t trying to upset anyone – they’re causing trouble because their mind isn’t working properly – it’s very difficult to cope,” she explains. There have been situations where a resident has physically assaulted a staff member. “We have to explain to people that this is an illness. And be there for them during the most difficult hours of their shift, so that they understand that their carer is also present here.”

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Putting ourselves in someone else's shoes

There is a principle that Ângela Ferreira keeps repeating throughout our conversation, in various ways: it is not the service user who has to adapt to the service. It is the service that has to adapt to the service user.

"I once had a gentleman here who was used to having lunch at half past one. He’d arrive at noon and tell me that was his time to read the paper. The staff were in an uproar. I said: ‘You’re independent. We’ll have lunch at half past twelve and then he’ll have lunch with me.’ And so it was. At the care home, the same logic applied: a resident who wanted to watch TV series until three in the morning and get up at noon. A carer would keep watch. “What would I gain by putting up a fight? I’d make the people working with him feel uncomfortable; I’d end up annoyed and disillusioned.”

“I always try to put myself in the other person’s shoes,” he sums up. “This exercise is the most difficult and the simplest at the same time.”

Solar panels and what they represent

It was through the Colmeia Project, a partnership between Galp and Matosinhos Municipal Council, that the Galp Foundation provided its first tangible support: the installation of solar panels at the care home in Leça da Palmeira. The process began with a Galp employee who had a relative living in the care home and who redirected an application for the project to the institution.

“We completed the installation of the panels last year and are now starting to see the savings on our energy bill,” explains Celestina. Rising energy prices have, however, offset some of the effect, but the expectation is that savings will stand at 25% in the medium term, according to the Association. “Which is very good for us.”

To understand what that means, you only need to hear how day-to-day management works. “If we need sheets, ideally we’d buy 50. But we only buy 30. There are beds to wash every day. In winter things don’t dry; we have our own laundry but it’s not enough,” explains Celestina. Or the adjustable beds that are over 15 years old: “We ask for help from anyone who can get them working, because a new remote control costs a lot.” And, with 10 vehicles in operation, a single day on potholed roads is enough to get flat tyres.

Saving on energy doesn’t free up extra money, but it does free up time. And time, in this house, is the difference between having a stock of supplies or not.

What supports all this

The association has 66 staff members. Social Security contributes through agreements totalling 52,000 euros a month, but salaries are around or exceed that amount. “These organisations are doing the work that the state should be doing. And the welfare state isn’t paying for the work we do.”

The answer, in part, comes from corporate sponsorship. When the care home opened, each room was funded by a local company: “The name is still there, on the wall,” says Celestina. Now, the organisation wants to build a new facility 800 metres from the centre, which will bring together the three social services and double the number of places in the care home to 60 residents. The new project will be funded by the Programme for the Expansion of the Social Services Network (PARES) and the private sector. The architectural design is already in place, with support from the council. The rest will take years of work.

“There are companies here with a huge impact on the local area. They all have staff who will grow old. Become members so you can benefit later,” she says, without irony.

At the AASP Day Centre, Care Home and Home Care Service, the impact is measured in ways that cannot be quantified. But it is also measured in the realisation that, as Ângela Ferreira says, the worst thing that can happen is having to depend on others. “What we do here is try to make that a little less difficult.”

It is this work, carried out every day, step by step, that the support provided through IRS donation helps to ensure.

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"We are the ones who have to adapt to other people"

Putting ourselves in someone else's shoes

Solar panels and what they represent

What supports all this