forma Psiquiátrica. Concluiu-se que uma proposta ampliada e resolutiva requer novas possibilidades políticas e organizacionais, ancoradas em práticas assistenciais que priorizem o fortalecimento da autonomia e o empoderamento dos sujeitos. Palavras-chave: Família; Cuidado; Serviços Comunitários de Saúde Mental. AbstractThis study aims to understand the family role in the care and deinstitutionalisation processes, and how the family has been experiencing the forward--looking and anti-asylum proposal for the substitute services provision as a public policy. This is a qualitative and hermeneutical critical study conducted in two Psychosocial Care Centers (CAPS), each in a different city in the state of Ceará, northeastern Brazil. The study had as volunteers 29 employees, 13 users and 16 caregivers, who participated in the groups to the users of CAPS and his/her family members. The research was approved by the Research Ethics Committee of the State University of Ceará and complied with the ethical principles set out in Resolution 196/96. The semi-structured interview and thematic focus group methods were used to collect the data. The results show that the caregivers relate their practice to zeal actions, involvement, concern and responsibility. The caregivers' participation and empowerment in the dialogue with users address the search for autonomy, for emancipatory projects, for an effective relational improvement and critical user vision for the organization of health services and of social reality. The resolution of attention is presented as inefficient and discriminatory, threatening the care management and the caregivers' hopes in the psychiatric reform assumptions. It was concluded that a problem-solving proposal requires new policies and organizational possibilities, anchored in care practices which prioritize the autonomy strengthening and individuals' empowerment.

The success of antiretroviral therapy has led to an increase in the number of older people living with human immunodeficiency virus worldwide. This study analyzed the epidemiological patterns and time trends of acquired immunodeficiency syndrome (AIDS) related mortality in people aged 60 and older in Brazil from 2000 to 2011. Secondary mortality data from the Brazilian Mortality Information System was used to perform a nationwide population-based study, which included all AIDS-related deaths among people aged 60 years and older in Brazil from 2000 to 2011. Crude and age-adjusted mortality rates (per 100,000 inhabitants) were calculated by sex, age group and place of residence. Trends over time were assessed using joinpoint regression analysis. In the 12-year study period, 12,491,280 deaths were recorded in Brazil, of which 144,175 were AIDS-related deaths. A total of 8194 AIDS-related deaths was identified in people aged 60 years and older (0.12% of all deaths and 5.7% of AIDS-related deaths). The overall age-adjusted mortality rate for the period was 4.30 deaths/100,000 inhabitants (95% confidence interval: 3.99-4.64). Males (6.45 deaths/100,000 inhabitants), aged 60-64 years (6.63 deaths/100,000 inhabitants) and residing in the South region (5.94 deaths/100,000 inhabitants) had the highest mortality rates. We observed a significant increase in mortality at the national level and in all the Brazilian regions, with a sharper increase in the most socioeconomically disadvantaged regions of the country, such as the North and Northeast. The findings show that AIDS in older people is an increasing public health problem in Brazil, and reinforce the need to establish public policies for the prevention, early diagnosis and appropriate clinical treatment of this age group.