Introduction

Chapter 1. Basic social and psychological problems of elderly and old people

1.1 Older people as a social community

1.2 Psychological characteristics of elderly and old people

Chapter 2. Features of social work with elderly and elderly people

2.1 Legal framework for social work

2.2 Main areas of social work with elderly and elderly people

Conclusion

Bibliography

Applications

Introduction

One of the trends observed in recent decades in developed countries world - an increase in the absolute number and relative share of the population of older people. There is a steady, rather rapid process of decreasing the proportion of children and youth in the total population and increasing the proportion of the elderly.

Thus, according to the UN, in 1950 there were approximately 200 million people aged 60 years and older in the world, by 1975 their number increased to 550 million. According to forecasts, by 2025 the number of people over 60 years of age will reach 1 billion 100 million people. Compared to 1950, their numbers will increase by more than 5 times, while the planet's population will increase only 3 times (18; 36).

The main reasons for the aging of the population are a decrease in the birth rate, an increase in life expectancy for people in older age groups due to the progress of medicine, and an increase in the standard of living of the population. On average, in the countries of the Organization for Economic Cooperation and Development, the life expectancy of men has increased by 6 years over 30 years, and for women by 6.5 years. In Russia, over the past 10 years, there has been a decrease in average life expectancy.

Relevance of the study: About 23% of the country's population are elderly and old people, the trend of increasing the proportion of elderly people in the total population continues, it becomes clear that the problem of social work with older people is of national importance. The topic requires further development.

Object: social work with elderly and elderly people.

Subject: features of social work with elderly and elderly people.

Purpose of the work: To study the problems of elderly and old people and consider the main directions of social work with them.

1) Identify the main social problems of elderly and old people.

2) Consider the psychological characteristics of elderly and old people.

3) Analyze the legislative framework on which social work with elderly and elderly people is based; consider the main directions of this work.

Various sources and research were used to write the work. Among them:

Collection of normative and legal acts on the basis of which social work with elderly people is based (compiled by N. M. Lopatin) (10);

The book by E. I. Kholostova “Social work with older people” (19), which examines the social and psychological problems of elderly and old people, as well as various areas of social work with them;

The manual by V. Alperovich “Social Gerontology” (1), which examines the main problems associated with aging;

The book by the famous psychologist I. Kon “Persistence of Personality: Myth or Reality?” (7), in which he identifies and describes various types of old people and the relationships of old age”;

Article by Z.–H. M. Saralieva and S. S. Balabanov, which provides data from a sociological study on the situation of elderly and old people in modern Russia (13), etc.

Research methods:

Analytical;

Statistical.

Chapter 1. Basic social and psychological problems of elderly and old people

1.1 Older people as a social community

The socio-demographic category of older people, the analysis of their problems, theorists and practitioners of social work are determined from different points of view - chronological, sociological, biological, psychological. Functional, etc. The population of older people is characterized by significant differences, which is explained by the fact that it includes people from 60 to 100 years old. Gerontologists propose dividing this part of the population into “young” and “old” (or “very old”) people, just as in France there is the concept of the “third” or “fourth” age. The boundary of transition from the “third” to the “fourth age” is considered to be overcoming the milestone of 75-80 years. “Young” old people may experience different problems than “old” old people, for example, employment, leadership in the family, distribution of household responsibilities, etc.

According to the World Health Organization, ages 60 to 74 are considered elderly; from 75 to 89 years – senile; from 90 years and older - the age of centenarians (19; 234).

The rhythm of aging significantly depends on the lifestyle of older people, their position in the family, standard of living, working conditions, social and psychological factors. “Among older people, there are a variety of groups: vigorous, physically healthy; sick; living in families; lonely; happy with retirement; still working, but burdened by work; unhappy, despairing in life; sedentary homebodies; spending their leisure time intensively and variedly, etc. ”(1; 28).

In order to work with elderly and elderly people, you need to know their social status (past and present), mental characteristics, material and spiritual needs, and in this work rely on science, data from sociological, socio-psychological, socio-economic and other types of research. You need to have a good understanding of the social problems of older people.

For older people, serious problems are:

Deterioration of health;

Maintaining an acceptable material standard of living;

Receiving quality medical care;

Changing lifestyle and adapting to new living conditions.

Limitation of life activity.

The aging process is closely related to the constant increase in the number of patients suffering from various diseases, including those characteristic only of old age. There is a constant increase in the number of elderly people who are seriously ill and require long-term drug treatment, guardianship and care. Polish gerontologist E. Piotrovsky believes that among the population over the age of 65, about 33% are people with low functional capabilities; disabled; aged 80 years and older – 64%. V.V. Egorov writes that the incidence rate increases with age. At 60 years of age and older, it exceeds the incidence rate of persons under 40 years of age by 1.7 - 2 times. According to epidemiological studies, approximately 1/5 of the elderly population are practically healthy, the rest suffer from various diseases, and multimorbidity is characteristic, i.e. a combination of several diseases that are chronic and difficult to respond to drug treatment. Thus, at the age of 50-59 years, 36% of people have 2-3 diseases, at 60-69 years, 40.2% have 4-5 diseases, and at the age of 75 years and older, 65.9% have more than 5 diseases (1 ; 35).

Typical ailments of old age are diseases caused by changes in organs due to aging itself and associated degenerative processes.

The structure of morbidity among elderly and senile people has its own characteristics. The main form of pathology is chronic diseases: general arteriosclerosis; cardiosclerosis; hypertension, cerebral vascular damage; emphysema, diabetes mellitus; eye diseases, various neoplasms.

In old age and old age, the mobility of mental processes decreases, this manifests itself in increased mental abnormalities.

Financial situation is the only problem. Which can rival health in its importance. Elderly people are alarmed about their financial situation, the level of inflation, and the high cost of medical care.

According to Z.–H. M. Saralieva and S.S. Balabanov, every fifth family of pensioners experiences difficulties in purchasing clothes and shoes. It is in this group of families that there are those living “from hand to mouth” (!3; 29).

Many older people continue to work, and for financial reasons. According to ongoing sociological research, 60% of retirees would like to work.

In such a situation, it is impossible to talk about the continuation of a diverse, dignified life rich in spiritual and cultural values. Old people are fighting for survival (survival).

The situation of elderly and old people largely depends on the family they live in, as well as on their marital status.

The increasingly common nuclear family (consisting of spouses and their children) is changing relationships and connections with older people. A person in old age is often separated from children who have become independent, and in old age he remains alone, the reasons for which are often social in nature and caused by alienation, social injustice, and the contradictions of social progress. A lonely person can be considered as a result of weakening ties with one or another social group (family, team), a decrease in social lability, and a devaluation of social values.

The well-being of elderly and old people who live in a family is largely determined by the existing atmosphere in the family - friendly or unfriendly, normal or abnormal, by how responsibilities in the family are distributed between grandparents, their children and grandchildren. All this affects the desire of older people to live with their children and grandchildren or separately (20; 47). Conducted in different countries Research shows that some older people would prefer to live separately from their children and grandchildren, while others would prefer to live together. This should be taken into account, in particular, during urban planning and the distribution of apartments. There should be a possibility of exchanging apartments and so on.

The meaning of marriage and family varies at different stages of a person’s life. An elderly and old person needs a family primarily due to the need for communication, mutual assistance, due to the need to organize and maintain life. This is explained by old man no longer has the same strength, the same energy, cannot bear the load, often gets sick, needs special nutrition.

When it comes to older people, the main motive for marriage is similarity of views and characters, mutual interests, and the desire to get rid of loneliness (1/3 of singles in our country are people over 60 years old). Although, of course, at this age emotions and sympathies also play an important role.

According to government statistics, the increase in the number of late marriages is determined mainly by high divorce rates. As a rule, these are remarriages. In solving the problem of loneliness of older people through remarriage, social workers can play a significant role by organizing dating services for middle-aged and elderly people (12; 29).

The transition of a person to the elderly group significantly changes his relationship with society and such value-normative concepts as purpose, meaning of life, goodness, happiness, and so on. People's lifestyles are changing significantly. Previously, they were associated with society, production, and social activities, but in old age they lost their former social roles. Retirement is especially difficult for people whose work was highly valued in the past, but is now considered useless and unnecessary. A break from work has a negative impact on people’s health, vitality, and psyche. And this is natural, since labor (as feasible) is the source of longevity, a condition for preserving good health. And many retirees would like to continue working; they are still psychologically young, educated, professionals in their field with extensive work experience; these people can still bring a lot of benefit. But, unfortunately, up to 75% of older people are unemployed or only part-time employed. For example, in 2003, 82,690 pensioners turned to employment centers in search of a job. Only 14,470 pensioners tripled to work (12; 59)..

So, the transition of a person to the group of older people changes his life, which acquires a number of new, not always favorable and desirable features. The problem of social adaptation of elderly and old people arises. Here, social gerontology can come to the aid of a social worker - the field of research into the final stage of human ontogenetic development, sociocultural attitudes and expectations in relation to a certain socio-demographic stratum - older people (4; 73). Particular attention should be paid to the psychological problems of elderly and old people.

1.2 Psychological characteristics of elderly and old people

The aging process is a genetically programmed process, accompanied by certain age-related changes in the body.

During the period of human life after maturity, a gradual weakening of the body’s activity occurs. Older people are not as strong and are not able to withstand prolonged physical or nervous stress as in their younger years; the total energy reserve becomes less and less.

At the same time, materials are accumulating that lead scientists to an understanding of aging as an extremely complex, internally contradictory process, which is characterized not only by a decrease, but also by an increase in the activity of the body.

There is a noticeable strengthening and specialization of the action of the law of heterochrony (unevenness); as a result of this, the functioning of some systems of the body is maintained for a longer period and even improved, and in parallel with this, an accelerated involution of other systems occurs at different rates, which is explained by the role and significance that they play in basic, vital processes.

The complex and contradictory nature of human aging as an individual is associated with quantitative changes and qualitative restructuring biological structures, including neoplasms. The body adapts to new conditions; in contrast to aging, adaptive functional systems develop; Various systems of the body are activated, which preserves its vital functions and allows one to overcome the destructive (destructive, negative) phenomena of aging. All this forms the conclusion that the period of late ontogenesis is a new stage in the development and specific action of the general laws of ontogenesis, heterochrony and structure formation. Scientists have proven that there are various ways to increase the biological activity of various structures of the body (polarization, redundancy, compensation, design), which ensure its overall performance after the completion of its reproductive period (2; 53).

Along with this, there is a need to strengthen conscious control and regulation of biological processes. This is done with the help of the emotional and psychomotor sphere of a person. After all, it is well known that a certain training system can improve respiratory function, blood circulation and muscle performance in older people. The central mechanism of conscious regulation is speech, the importance of which increases significantly during the period of gerontogenesis. B. G. Ananyev wrote that “speech-thinking, second-signal functions resist the general process of aging and themselves undergo involutionary shifts much later than all other psychophysiological functions. These most important acquisitions of the historical nature of man become the decisive factor in the ontogenetic evolution of man” (Quoted from: 3; 111).

Thus, various kinds of changes in a person as an individual that occur in old and senile age are aimed at updating the potential, reserve capabilities accumulated in the body during the period of growth, maturity and that are formed during the period of gerontogenesis and should be strengthened.

According to research by domestic and foreign scientists, the heterogeneous nature of the aging process is also inherent in such human psychophysiological functions as sensations, perception, thinking, memory, etc. When examining memory in people aged 70-90 years, the following was discovered: mechanical imprinting especially suffers; Logical memory is best preserved; figurative memory weakens more than semantic memory, but what is remembered is preserved better than with mechanical imprinting; the basis of strength in old age is internal and semantic connections; the leading type of memory becomes logical memory (3; 54).

Older and older people do not form a monolithic group. Further changes during gerontogenesis depend on the degree of maturity specific person as an individual and subject of activity. There is numerous data on the preservation of high vitality and performance of a person not only in old age, but also in old age. Many factors play a large positive role in this: level of education, occupation, personality maturity, etc. Of particular importance is creative activity personality as a factor opposing the involution of the person as a whole (15; 43)..

Unfortunately, typical personal manifestations of an old person are considered to be: decreased self-esteem, lack of self-confidence, dissatisfaction with oneself; fear of loneliness, helplessness, impoverishment, death; gloominess, irritability, pessimism; decreased interest in new things – hence grumbling, grumpiness; focusing one’s interests on oneself – selfishness, self-centeredness, increased attention to one’s health; uncertainty about the future - all this makes old people petty, stingy, overly cautious, pedantic, conservative, lacking initiative, etc.

Basic Research Domestic and foreign scientists, however, testify to the diverse manifestations of an old person’s positive attitude towards life, towards people, towards himself.

K.I. Chukovsky wrote in his diary: “...I never knew that it was so joyful to be an old man, that not a day later my thoughts were kinder and brighter” (Quoted from: 3; 36).

Mental aging is diverse, the range of its manifestations is wide. Therefore, psychologists distinguish different types of elderly and old people.

In F. Giese’s typology, three types of old people and old age are distinguished:

1) an old man is a negativist who denies any signs of old age;

2) old man - extroverted, recognizing the onset of old age through external influences and by observing changes;

3) introverted type, which is characterized by an acute experience of the aging process (3; 38)

I. S. Kon identifies the following socially: psychological types old age:

1) active creative old age, when veterans continue to participate in public life, in the education of youth, etc.;

2) pensioners are engaged in activities for which they previously did not have enough time: self-education, rest, entertainment, etc. This type is also characterized by good social and psychological adaptability, flexibility, adaptation, but energy is directed mainly towards oneself;

3) this group consists mainly of women who find the main application of their strength in the family, in the household; life satisfaction in this group is lower than in the first two;

4) people whose meaning in life is taking care of their own health: various forms of activity and moral satisfaction are associated with this. At the same time, there is a tendency (more often in men) to exaggerate their real and imaginary illnesses, and increased anxiety.

Along with prosperous types of old age, I. S. Kon also draws attention to negative types of development:

a) aggressive old grumps, dissatisfied with the state of the world around them,

criticizing everyone except themselves, lecturing everyone and terrorizing those around them with endless claims;

b) disappointed in themselves and their own lives, lonely and sad losers, constantly blaming themselves for real and imaginary missed opportunities, thereby making themselves deeply unhappy (7;56).

The classification proposed by D. B. Bromley is quite widely supported in the world psychological literature. She identifies five types of personality adaptation to old age (3; 39):

1) a person’s constructive attitude towards old age, in which elderly and old people are internally balanced, have a good mood, and are satisfied with emotional contacts with people around them;

2) a relationship of dependence, when an old person is financially or emotionally dependent on a marital partner or on his child;

3) a defensive attitude, which is characterized by exaggerated emotional restraint, some straightforwardness in one’s actions, and a reluctant acceptance of help from others;

4) an attitude of hostility towards others. People with this attitude are aggressive, explosive and suspicious, seek to shift the blame for their failures onto others, are hostile towards young people, withdrawn, and prone to fear;

5) an attitude of hostility towards oneself. People of this type avoid memories because they have had many failures and difficulties in their lives. They are passive, suffer from depression, and experience a feeling of loneliness and uselessness.

All classifications of types of old age and attitudes towards it are conditional, are indicative in nature, in order to create some basis for specific work with elderly and old people.

The main stressors of elderly and senile people can be considered the lack of a clear rhythm of life; narrowing the scope of communication; withdrawal from active work; empty nest syndrome; a person withdrawing into himself; a feeling of discomfort from a confined space and many other life events and situations. The most powerful stressor is loneliness in old age. This concept is far from unambiguous. If you think about it, the term “loneliness” has a social meaning. A person has no relatives, peers, or friends. Loneliness in old age can also be associated with living separately from younger family members. However, psychological aspects (isolation, self-isolation) turn out to be more significant in old age, reflecting the awareness of loneliness as misunderstanding and indifference on the part of others. Loneliness becomes especially real for a person who lives a long time. The focus, thoughts, and reflections of an old person may be on an exceptional situation that has created a limited circle of communication. The heterogeneity and complexity of the feeling of loneliness is expressed in the fact that an old person, on the one hand, feels an increasing gap with others and is afraid of a lonely lifestyle; on the other hand, he strives to isolate himself from others, to protect his world and the stability in it from the invasion of outsiders. Practicing gerontologists are constantly faced with facts where complaints about loneliness come from old people living with relatives or children much more often than from old people living alone. One of the very serious reasons for the disruption of connections with others lies in the disruption of connections between old people and young people. Not the most humanistic position is being consolidated: the lack of a real life projection for the future is clear both for the oldest person and for his young environment. Moreover, it is not uncommon today to call such a relict phenomenon as gerontophobia or hostile feelings towards old people (5; 94).

Many of the stressors of elderly and old people can be prevented or relatively painlessly overcome precisely by changing attitudes towards old people and the aging process in general.

In order to work with elderly and old people, you need to have a clear understanding of the social and psychological problems of elderly and old people. In this work it is necessary to rely on such sciences as, for example, sociology, social gerontology, geriatrics, psychology; rely on data from sociological, psychological, socio-economic and other types of research.

Chapter 2. Features of social work with elderly and elderly people

2.1 Legislative framework for social work

The problem of social work with older people is of national importance. The legislative and legal basis of social work is:

1) Constitution Russian Federation

In Russia, as a social state, the right of citizens to social protection is guaranteed by the Constitution and regulated by the legislation of the Russian Federation

2) Laws: “On state pension provision in the Russian Federation” (December 2001); “On labor pensions in the Russian Federation” (November 2001); “On social protection of disabled people in the Russian Federation” (July 1995); “About Veterans” (January 1995); “On the fundamentals of social services in the Russian Federation” (December 1995); “On social services for elderly and disabled citizens” (August 1995)

3) Great importance to solve the problems of elderly and disabled people, they have decrees of the President of the Russian Federation: “On measures to create an accessible living environment for people with disabilities”; “On additional measures of state support for people with disabilities” (October 1992); “On scientific and information support for disability and disabled people” (July 1992) and a number of decrees of the Government of the Russian Federation: “On the federal list of state-guaranteed social services provided to elderly citizens and disabled people by state and municipal social service institutions”; “On the procedure and terms of payment for social services provided to elderly citizens and disabled people by state and municipal social service institutions” (April 15, 1996); “On the development of the federal target program “Older Generation” (July 18, 1996).

The above and other documents define the structure of social work, its goals and objectives, sources of financing; a social protection program for the elderly and disabled was formulated. All efforts are aimed at improving the living conditions of older people, their social services, strengthening measures of additional social support, assistance in achieving longevity, and ensuring a peaceful old age (10).

Russian state, developing and adopting relevant legislative acts, coordinates them with the starting positions of the Universal Declaration of Human Rights (1948), the Final Act of the Helsinki Conference (1975), the European Social Charter adopted in 1961. and expanded in 1996.

Basic principles of social protection: humanity, social justice, targeting, complexity, ensuring individual rights and freedoms, as well as consistency, competence and preparedness of specialists.

IN last years a mechanism has emerged for providing social services to elderly and elderly people. Elements of such a mechanism include social service centers, including departments of social assistance at home, departments of emergency social assistance, medical and social departments, and day care departments. In addition, for those who need constant medical care and cannot do without outside help, there are inpatient boarding houses for the elderly; mini-boarding schools, social hotels, hospices. Specific technologies for social work with the elderly and elderly have been developed (!9; 79).

The Department for Elderly Citizens and Disabled Persons of the Ministry of Labor of the Russian Federation has prepared a number of regulations on the creation and organization of work of stationary and non-stationary social service institutions, including resolutions of the Ministry of Labor of Russia:

From June 27, 1999 No. 28 “On approval of the Model Charter of the state (municipal) institution “Social and health center for elderly and disabled citizens”;

From July 27, 1999 No. 29(31), “On approval of the Model Charter of a state (municipal) institution”, “Comprehensive Center for Social Services for the Population”;

A lot of work is being done within the framework of the federal target program “Older Generation”. The “Older Generation” program should promote social support for older people, help create favorable conditions for the realization of their rights and full participation in the economic, social, cultural and spiritual life of the country. The program provides for measures to comprehensively resolve issues, taking into account the age characteristics and health status of all categories and groups of pensioners.

The main directions of the state’s social policy in relation to the elderly:

1) Improving the living conditions of older people, their social services, strengthening measures of additional social support, assistance in achieving longevity, ensuring a peaceful old age.

2) Further development of the legal framework for social protection and services to the population.

3) Development of a methodological, scientific basis for social work with elderly and elderly people;

4) Training of modern professional personnel.

2.2 Main areas of social work with older people

1) Social security and services

Social security and services for the elderly and elderly include pensions and various benefits; maintenance and services for the elderly and disabled in special institutions of social protection bodies; prosthetics, benefits for disabled people; providing assistance to the homeless.

Social security is carried out by government agencies, enterprises, and individuals through contributions (deductions from wages) of workers. In the latter case, payment from the funds is determined not by labor contribution and length of service, but by the size of contributions. This practice is very common in Western countries (6; 34).

One of the important areas of social security is improving pension provision. It is solved in different ways. In some countries, a pensioner receives a pension and wages completely regardless of its size and in any sector of the national economy. In other countries, so-called deferred pensions are widespread, that is, an increase in pensions by a certain percentage depending on the number of working years after retirement age. This also exists in Russia. There is also the prospect of voluntary old-age insurance (the right to an additional pension). But our pension provision continues to be insufficient, despite regular increases in pensions (16; 204).

Local authorities are also providing assistance to older people: differentiated additional payments to non-working pensioners are increasing; various categories of elderly are provided with benefits for housing, travel on suburban transport in the summer, medications are provided free of charge according to doctors' prescriptions, free vouchers to sanatoriums are provided, and so on.

Social services for the elderly and elderly are provided by Social Service Centers for Elderly Citizens.

In 2005 in the social protection system of our country there were 1,959 inpatient institutions for the elderly and disabled, more than 900 social service centers, 1,100 social assistance departments at home, as well as a number of other social assistance institutions (psychological and pedagogical, emergency psychological) (12; 75) .

The Social Service Center for Elderly Citizens usually includes several departments:

Day care department (calculated for at least 30 pensioners). Food, medical and cultural services are provided here. It is desirable to have a special workshops or subsidiary farms and feasible labor activity of pensioners in them.

Temporary stay department (for at least 15 people). It carries out medical, health and rehabilitation activities; cultural and consumer services; food in conditions of round-the-clock detention.

Department of social assistance at home (serves 120 people in the city, and 60 people in the countryside). Here, permanent or temporary (up to 6 months) social and welfare services are provided at home for pensioners who need outside help (free or on a paid basis).

The emergency social assistance service provides a wide range of services: providing those in dire need with free hot meals or food packages; provision of clothing, footwear and basic necessities; one-time provision of financial assistance; assistance in obtaining temporary housing; providing emergency psychological assistance, including by “helpline”; provision of legal assistance; provision of other types and forms of assistance determined by regional and other characteristics.

Appeared new form help - hospice. Here doctors, social workers, priests and volunteers joined their efforts. Their credo: a person should not end his life in a government hospital bed among strangers (29; 69).

Social service centers also work with elderly people living in families and provide them with paid services.

This is, for example, how work is organized at the Miloserdie Home Social Services Center in the city of Kalinin. The center helps about 1,110 lonely elderly and disabled people. It operates departments of medical and social care, special and hospice care at home, a gerontological department with 15 beds in a local hospital, and a charity canteen. There is a day care department for the elderly. It is intended for household, medical and cultural services, and organization of recreation for pensioners. The issue of opening a branch is being considered nursing care on the basis of a local hospital (service is free). In addition, the Center provides specialized medical and social assistance to lonely, seriously ill people (17; 239).

In our turbulent, sometimes incomprehensible and cruel life, it is very difficult for an elderly person to navigate, it is difficult economically. This often leads to fatal mistakes. Now every lonely old man who has his own living space is a potential hostage of mafia-commercial structures “working” in the housing market. According to statistics from the Central Internal Affairs Directorate only for 2007. out of 37 thousand people who exchanged housing with the help of dubious companies, only 9 thousand registered for a new place of residence. A special service, Mossotsgarantiya, is now successfully operating in Moscow. She is accountable to the Moscow Government and the Committee for Social Protection of the Population. The essence of Mossotsgarantiya's activities is simple: lonely old people receive monthly monetary compensation, medical and social assistance, and in exchange for these services after death they leave their living space to the city. For this purpose, in accordance with the law and all legal norms, an agreement on lifelong maintenance with dependents is concluded. The decision is made by the commission of the Social Protection Committee (17; 203).

In a crisis situation in Russia, targeted social assistance to older people is essential. It turns out primarily to those most in need: single pensioners, disabled people, elderly people over 80 years old.

One of the new forms of serving lonely elderly people living in remote areas is the organization of so-called mercy trains. They include doctors of various specialties and social workers. They provide a variety of assistance: medical, social, household, and advisory.

2.) Social care for older people

Guardianship of older people is one of the main areas of social work with them.

Guardianship is “one of the social and legal forms of protection of personal and property rights and interests of citizens. Established over legally capable adult citizens who, for health reasons, cannot defend their rights and interests themselves. The trustee must: protect the rights and interests of the ward, live with him (in most cases) and provide the living conditions he needs, care for him and his treatment, protect him from abuse by third parties. A guardian over a legally capable person can be appointed only with the consent of the ward” (14; 143).

The forms of guardianship are very diverse. The main one is the functioning of the boarding house system.

At the beginning of 1975 in the RSFSR there were 878 homes for the elderly and disabled, in which more than 200 thousand people lived. At the beginning of 2001 in Russia there were 877 boarding houses and 261 thousand people lived in them. Now there are 959 of these houses. But the need for public boarding houses has decreased. This is explained by the fact that the practice of providing home care to disabled citizens is expanding. Nowadays, people who have completely lost the ability to move and require constant care are admitted to boarding homes.

The most common reasons why older people end up in boarding homes are: loneliness (48.8%); poor health (30%); conflict in the family and initiative of relatives (19%) (!2; 63)..

In general boarding homes, the elderly are helped to psychologically adapt to new conditions. The newcomer is informed about the services provided, the location of rooms and offices. The characteristics, needs, and interests of older people are studied in order to accommodate them in accordance with their individual psychological properties, so that they can find people close to them based on their personality, interests, and do not feel lonely. Employment needs and leisure preferences are studied.

Medical care is also provided, and a whole range of rehabilitation measures is provided (for example, occupational therapy workshops).

Among the residents of boarding houses, three groups of people can be distinguished:

1) those who came here by choice are single;

2) those who came at will and live with their families;

3) those who do not want to be in a boarding school, but are forced to come here for various reasons (financial, family climate).

It is natural that older people want to live in their own home, in a familiar environment. And expanding home care allows for this. Home-based services guaranteed by the state, in Lately are becoming more diverse. This includes catering and home delivery of food; assistance in purchasing medicines and essential goods; assistance in obtaining medical care and support in medical institutions; home cleaning assistance; assistance in the provision of funeral services and burial of lonely dead; organization of various social services (apartment renovation; delivery of firewood, water); assistance in paperwork, housing exchange.

Back in the 80s, special departments were created in some boarding homes, in which elderly people in need of constant care lived there during the absence of relatives at home (business trip, illness). Now these are temporary accommodation units.

There is a completely “new” experience. The elderly are resettled in residential buildings in which all everyday needs are taken into account. On the ground floor there is a store, a dining room, a laundry, a hairdresser, and medical offices. Residents of these houses are served by social workers. In 2003, there were 116 special residential buildings in Russia for single elderly citizens and married couples. 9 thousand people lived in them (9; 94).

3) Medical and social rehabilitation

Older people may be vigorous and active, but of course, with age, the need for medical care increases. There are a number of chronic diseases that often lead to disability. Therefore, medical and social rehabilitation, that is, a set of measures aimed at restoring, strengthening health, preventing diseases and restoring the ability to social functioning, is of particular importance. The nature of rehabilitation measures depends on the state of health and the type of pathology.

Tasks of medical and social rehabilitation of elderly and old people (20; 76):

1) coordination and coordination of work with medical institutions of the city.

2) development and testing of new non-traditional rehabilitation methods.

3) organization of specialized medical and social advisory work on the basis of city medical institutions.

4) organization and implementation of medical and social patronage for single elderly people and elderly people living in families

5) training family members in the basics of medical and psychological knowledge for caring for elderly loved ones.

6) assistance in providing disabled people with the necessary auxiliary means (crutches, Hearing Aids, glasses and so on)

7) implementation of recreational activities (massage, water procedures, physical therapy)

Old age is the age when “the expansion of death into the territory of life is especially strong.” At this age, the risk of cancer increases. When a person can no longer be cured, hospice helps him live his remaining days with dignity. Hospice is a humanistic, therapeutic institution for cancer patients in the final stages of the disease. The fundamental difference between a hospice and traditional hospitals is the creation of conditions for a full, normal life of a hopeless patient” - this is the path to getting rid of the fear of suffering that accompanies the onset of death, the path to its perception as a natural continuation of life. The experience of hospice shows that in the context of effective palliative care (when pain and other distressing symptoms can be brought under control), it is possible to come to terms with the inevitability of death, which people accept calmly and with dignity. The hospice employs social workers, doctors, priests, and volunteers (16; 276)..

The gerontological center has a lot in common with a hospice. Here such areas of knowledge as gerontology, gerontopsychology, and geriatrics interact.

4) Providing psychological assistance

As already mentioned in Chapter I, a person’s transition to a group of older people significantly changes his relationship with society and value-normative concepts (good-evil, and so on). Therefore, the main task of psychological and social assistance is social adaptation, that is, the process of an individual’s active adaptation to the conditions of the social environment. To do this, the following measures are required (1; 138):

Organization of psychological and advisory assistance (personal problems, family conflicts, stress)

Leisure activities (organization of interest clubs, studios folk art, sporting events, involvement in social activities, cultural life)

Use of information methods (various meetings, conversations, question and answer evenings)

Solving employment problems for older people

Patronage of families in which elderly people live (with the consent of the family and the elderly person);

Support for single people (interest clubs, dating clubs);

Involvement of religious organizations in the work.

The problem of social work with elderly and elderly people is of national importance. A legislative and legal framework for social work has been created, which defines the goals and objectives of social work; sources of financing; Social protection programs for the elderly and elderly have been formulated.

1) social security and social services;

2) medical and social rehabilitation;

3) social care;

Conclusion

Elderly and old people represent a special category of the population, which is extremely heterogeneous in terms of age and other characteristics. They, more than anyone, need support and participation. It is in connection with these circumstances that older people, as a special social group need increased attention from society and the state and represent a specific object of social work.

In order to work with elderly and old people, you need to have a clear understanding of the social and psychological problems of elderly and old people. In this work it is necessary to rely on such sciences as, for example, sociology, social gerontology, geriatrics, psychology; rely on data from sociological, psychological, socio-economic and other types of research. The problem of social work with elderly and elderly people is of national importance. A legislative and legal framework for social work has been created, which defines the goals and objectives of social work; sources of financing; Social protection programs for the elderly and elderly have been formulated.

The main areas of social work with the elderly and elderly are:

4) social security and social services;

5) medical and social rehabilitation;

6) social care;

4) provision of psychological assistance.

The need for social services, social care, medical, social and socio-psychological rehabilitation of elderly people arises as a result of limited life activity; changes in a person’s social status; poor financial situation. All areas of social work are closely interconnected with each other and serve one goal: the restoration of broken or weakened, lost social connections and relationships, the loss of which occurred as a result of age, serious illness, or disability.

Further necessary:

To contribute to the restoration of an atmosphere of mercy and humanism towards elderly and elderly people. The efforts of the state and the church should be combined; revive centuries-old experience in this field.

Develop a legislative framework for social work with this age category;

Prepare personnel; develop social technologies.

In connection with the increasing importance of the work of social service centers, develop standard projects for the construction of centers; allocate modern technology for these centers;

To solve the problem of employment of older people, to do this, improve the legislation on the labor of older people.

Create a data bank of elderly and elderly people in need of specific types of assistance;

Improve the quality of medical, social care and psychological care.

Bibliography

1) Alperovich V. Social gerontology. Rostov n/d, 1997.

2) Amosov N. M. Overcoming old age. M., 1996.

3) Gamezo M.V., Gerasimova V.S., Gorelova G.G. Age-related psychology: personality from youth to old age. M., 1999.

4) Dementyeva N.F., Ustinova E.V. The role and place of social workers in serving the disabled and elderly. Tyumen, 1995.

5) Dmitriev A.V. Social problems of older people. M., 2004.

6) Dolotin B. “For people of the older generation” // Social Security No. 7, 1999.

7) Kon I.S. Personality constancy: myth or reality? M., 1987.

8) Constitution (Basic Law) of the Russian Federation. M., 1993

9) Kravchenko A.I. Social work. M., 2008.

10) Lopatin N. M. Social protection of elderly and elderly citizens. Collection of normative acts. M., 2006.

11) Elderly: Dictionary-reference book for social work. M., 1997.

12) Pochinyuk A. Social work for older people: professionalism, partnership, responsibility // AiF Long-Liver 2003. No. 1 (13).

13) Saralieva Z.-Kh. M., Balabanov S.S. An elderly person in central Russia // Sociological research. 1999. No. 12. P.23 – 46.

14) Dictionary-reference book for social work /Edited by E.I. Single. M., 2001.

15) Smith E.D. You can age gracefully: A guide for the elderly, the elderly and those who care for the elderly. M., 1995.

16) Social work with older people. Handbook for a social work specialist. M., 1996.

17) Old age: A popular reference book / Ed. L. I. Petrovskaya. M., 1996.

18) Population aging in the European Region as an important aspect modern development: materials of consultation of the international seminar. M., 1995.

19) Kholostova E.I. Social work with older people M., 2003.

20) Yatsemirskaya R.S., Belenkaya I.G. Social gerontology. M., 1999.

Working

Not working

	Working pensioners	Non-working pensioners

1. Result: tEmp = 1.9

Critical values

p≤0.05 p≤0.01

The obtained empirical value t (1.9) is in the zone of insignificance.

2. The obtained empirical value t (2.9) is in the zone of significance.

3aThe obtained empirical value t (2.2) is in the zone of uncertainty.

3bThe obtained empirical value t (3.6) is in the zone of significance.

4aThe obtained empirical value t (2.6) is in the zone of uncertainty.

4bThe obtained empirical value t (3.8) is in the zone of significance.

5aThe obtained empirical value t (2.6) is in the zone of uncertainty.

5bThe obtained empirical value t (1.6) is in the zone of insignificance.

6aThe obtained empirical value t (1.5) is in the zone of insignificance.

6bThe obtained empirical value t (2.9) is in the zone of significance.

7aThe obtained empirical value t (1.9) is in the zone of insignificance.

7bThe obtained empirical value t (2.4) is in the zone of uncertainty.

8The obtained empirical value t (3.5) is in the zone of significance.

Ka The obtained empirical value t (3.9) is in the zone of significance.

Samots. the obtained empirical value t (1.9) is in the zone of insignificance.

(Yatsemirskaya R.S., Belenkaya I.G. Social gerontology. - M.: Vlados, 1999. - 213 p.)

Deontological problems arise especially acutely when communicating with seriously ill old people who have lost the ability to self-care.

It is common knowledge that people are most successful in caring for the elderly. patient and balanced People. Of course, moral support is the most valuable, therefore a social worker who does not limit his activities to formal services, has also managed to become a friendly and attentive interlocutor, assistant and adviser, will prove to be an ideal comforter for an old man. Those who are too harsh, domineering, and work mainly for money or for the sake of a career cannot cope with this type of activity. In turn, old people with their life experience very easily understand and perceive falsehood and insincerity in attitude towards them. A hasty person who does not know how to listen and is preoccupied with his own problems will never gain the trust of old people.

The social worker needs Special attention pay attention to your appearance and form of communication with old clients. Too fashionable clothes, an abundance of cosmetics and jewelry are not conducive to establishing contacts between old people and social workers. Old people are especially distrustful of frivolous, superficial people who make promises but do not keep them. Lack of composure, sloppiness, restlessness, and verbosity also cause caution from the old person to the social worker and do not contribute to the establishment of trusting contacts.

When caring for old patients who have lost the ability to self-care, the social worker with all his behavior and actions should support and awaken the desire to maintain maximum mobility for as long as possible and perform at least the most basic self-care activities. In any case it is necessary respect dignity and a sense of independence old people. The old person must become a subject for the social worker individual approach. Feeling of respect for an old person, interest in his life path and experience usually increase confidence in the social worker and his authority as a specialist. We must never forget that when talking with an old person, you should try to maintain an expression of interest, sympathy and goodwill on your face.. All this will allow you to get acquainted with the old person’s social history, place and living conditions, understand intra-family relationships, their significance for the old person, understand interpersonal relationships between young family members and the old person, and help resolve their internal disagreements and grievances.

The role of rehabilitation of elderly and old people in this case should be assessed from both a social and moral point of view. It also provides a significant economic effect, since restoring the ability to self-care frees a large number of medical personnel from caring for sick elderly people, if they are admitted to a hospital, as well as relatives, relieving them of the need to leave their professional activities.

DEONTOLOGY IN SOCIAL WORK WITH ELDERLY AND OLD PEOPLE

Parameter name	Meaning
Article topic:	DEONTOLOGY IN SOCIAL WORK WITH ELDERLY AND OLD PEOPLE
Rubric (thematic category)	Medicine

(Yatsemirskaya R.S., Belenkaya I.G. Social gerontology. - M.: Vlados, 1999. - 213 p.)

Deontological problems arise especially acutely when communicating with seriously ill old people who have lost the ability to self-care.

It is common knowledge that people are most successful in caring for the elderly. patient and balanced People. Of course, moral support is the most valuable, in this regard, a social worker who does not limit his activities to formal services, who has also managed to become a friendly and attentive interlocutor, assistant and adviser, will turn out to be an ideal comforter for an old man. Those who are too harsh, domineering, and work mainly for money or for the sake of a career cannot cope with this type of activity. In turn, old people with their life experience very easily understand and perceive falsehood and insincerity in attitude towards them. A hasty person who does not know how to listen and is preoccupied with his own problems will never gain the trust of old people.

The social worker needs pay special attention to your appearance and the form of communication with old clients. Too fashionable clothes, an abundance of cosmetics and jewelry are not conducive to establishing contacts between old people and social workers. Old people are especially distrustful of frivolous, superficial people who make promises but do not keep them. Lack of composure, sloppiness, restlessness, and verbosity also cause caution from the old person to the social worker and do not contribute to the establishment of trusting contacts.

When caring for old patients who have lost the ability to self-care, the social worker with all his behavior and actions should support and awaken the desire to maintain maximum mobility for as long as possible and perform at least the most basic self-care activities. In any case, it is extremely important respect dignity and a sense of independence old people. An old person should become the subject of an individual approach for a social worker. Feeling of respect for an old person, interest in his life path and experience usually increase confidence in the social worker and his authority as a specialist. We must never forget that when talking with an old person, you should try to maintain an expression of interest, sympathy and goodwill on your face.. All this will allow you to get acquainted with the old person’s social history, place and living conditions, understand intra-family relationships, their significance for the old person, understand interpersonal relationships between young family members and the old person, and help resolve their internal disagreements and grievances.

The role of rehabilitation of elderly and old people in in this case should be assessed from both a social and moral point of view. It also has a significant economic effect, since restoring the ability to self-care frees a large number of medical personnel from caring for sick elderly people, if they are admitted to a hospital, as well as relatives, relieving them of the critical need to leave their professional activities.

DEONTOLOGY IN SOCIAL WORK WITH ELDERLY AND OLD PEOPLE - concept and types. Classification and features of the category "DEONTOLOGY IN SOCIAL WORK WITH ELDERLY AND OLD PEOPLE" 2017, 2018.

1. The relevance and significance of social work with the elderly and

old people. 4

2. Differential characteristics of elderly and old people. 7

3. Main tasks and professional responsibilities of social

employee. 10

4. Ethical principles of communication for a social worker 13

5. Ethical responsibility to the profession. 17 6. Skills and abilities that a social worker should have. 17 7. Requirements for the professionalism of social workers serving elderly and old people 18 8. Deontology in social work with elderly and old people. 9. Medical and social work with elderly people. 10. Changes in the social status of an elderly person and related psychological problems. 11. Social protection of older people, social service models: social service centers; social services at home; day care departments; emergency social assistance service; inpatient facilities; special residential buildings for the elderly targeted social protection 12. Experience in social services and medical and social work with the elderly in some regions of the country 13. Experience in social work with the elderly in foreign countries. 14. Literature used

RELEVANCE AND IMPORTANCE OF SOCIAL WORK WITH

SENIOR AND OLD PEOPLE

In demography, the quantitative and qualitative composition of the population is usually depicted in the form of a pyramid, the base of which is newborns and children; then there is a gradual narrowing of the pyramid, taking into account mortality in each age period; its top are people aged 90 years and older.

Until now, it has been thought that this group of older people is of little importance to health and social services in population health research.

By the end of the 20th century, the demographic situation had changed radically:

The age structure of the population of most countries of the world, including Russia, no longer resembles a pyramid, but rather a column, characterized by a relatively small number of children, young and mature people and a relatively high number of people in older age groups.

Even more surprising is the fact that the proportion of centenarians who live to be 90 - 100 years or more is constantly increasing. The number of centenarians aged 85 years and older in a number of countries, according to the population censuses of recent years, varies from 12 to 68, and at the age of 100 years and more - from 0.5 to 1.1 per 10,000 people.

It is expected that in 2018 average age will be 85.6 years old at death. It would seem that the dream of mankind is coming true, “man has always longed to live for centuries, and his fantasy in this direction was unbridled” (I.V. Davydovsky), if not for the negative aspects of the senile period of life.

It is completely natural and logical that an increase in the absolute and relative number of older people and long-livers leads to an increasing likelihood of the appearance of multiple pathologies in them. According to D.F. Chebotarev, the pathology of sick old people can be compared to an iceberg, in which 1/2 of its volume is hidden under water. Complaints from old people direct the doctor’s attention to the tip of this iceberg, while for proper treatment and care it is necessary to know the entire pathology, i.e.

“see the whole iceberg.”

For the social sphere, the main thing is the fact that among old people there is a tendency towards slowly growing painful pathological processes that take a chronic course and are difficult to treat. If we take into account that from the age of 40 to 45 there is already an “accumulation” of diseases, then it is understandable why there are so many very old people who are incapable of even the most basic self-care.

Interestingly, older people with impairments in daily functioning account for approximately 60% of all those who report having any illness; only half of them are able to identify any underlying disease. According to Polish gerontologists, only 24% of people over 60 years of age living in comfortable conditions can be considered practically healthy; among those living in unsatisfactory conditions, only 9% of such old people; 10% of people over 60 years of age cannot leave home independently and need constant family, social or medical assistance.

The results of clinical and epidemiological studies of the mental health of the elderly and senile population also turned out to be depressing. With increasing life expectancy, the number of mentally ill old people, mainly with dementia, is steadily growing. According to demographic predictions, the number of elderly people with dementia will increase in beginning of XXI century by 50%. Some gerontopsychiatrists express the opinion that the spread of dementia and other intellectual and mental disorders in old people in recent years has become epidemic, a “silent epidemic,” and senile dementia in the near future will become the “disease of the century.”

As life expectancy increases, the period of helpless existence of old people with various chronic and mental illnesses also increases. The progression of the consequences of chronic pathological processes cannot always be stopped with the help of the latest pharmacological agents.

The vast majority of old people need the most wide range services and assistance provided to them by strangers, be they family members, neighbors, medical, social or charitable organizations. In relation to Russia, the majority of families are unable to take upon themselves all the worries about old and helpless relatives. The entire burden of caring for old people will fall primarily on the shoulders of state social services, as well as health authorities.

Problems of social work with old people are currently the focus of attention of many social institutions, social and research programs aimed at ensuring an acceptable standard of living for elderly and old people.

Among labor pensioners, the absolute majority belongs to old-age pensioners. There is reason to believe that in the near future this figure will fluctuate within 88 of the number of labor pensioners. However, 75% of pensioners still remain outside the scope of attention and activities of the social protection system. It is these elderly and old people who cannot realize their needs for the social assistance they need, and the fact that they need it, especially when solving material and everyday difficulties, is beyond doubt.

It is also alarming that about 50% of old people, after the first contact with officials of the social protection system, do not come for social assistance again, as they are left with a feeling of bitterness and resentment. One of the reasons for this feeling is the state’s insufficient funding of social services and benefits for low-income segments of the population and the lack of strict consideration of the targeting of social protection.

Social work with elderly people, in the form in which it has developed in economically developed countries, began to develop in the Russian Federation from the early 90s of the 20th century, when our society was closely faced with the problems of establishing new socio-economic relations. And, nevertheless, Russia has accumulated some experience in social work with low-income and socially disadvantaged categories of elderly and old people.

According to social gerontologists in Western countries, the main task of social work is to connect the individual, family or community with external and internal sources of those resources that are necessary to correct, improve or maintain a certain situation.

More and more important place The activities of social services will involve training professionals who carry out programs to provide social services to the elderly population. This is exactly what V.D. is convinced. Shapiro, is the true understanding and application of social gerontology. The still prevailing opinion among social workers that life experience and their own observations of their grandparents are enough for them does not stand up to criticism. For social workers, it is necessary, first of all, to understand the many psychological, psychopathological, somatic, moral and ethical problems that arise among elderly and old people, to master methods and technologies that would help and facilitate their efforts in everyday life. practical work and communication with populations served. In this regard, the primary task at this stage is to expand the training of specialists in practical social work with old people.

It is well known that the interweaving of somatic, psychogenic, psychological problems of old people is so complex that often without sufficient knowledge and special training it is impossible to establish what determines the condition of an old person - a somatic or mental illness. Social workers are required to be efficient, proactive, and quick-witted in solving the specific needs of each old person.

To solve the priority problems of serving older people, it is necessary to have qualified social workers at all levels.

DIFFERENTIAL CHARACTERISTICS OF ELDERLY AND

OLD PEOPLE

A differentiated approach should become mandatory in social work with elderly and old people as individuals, members of society, family, residents of a communal apartment, nursing home, etc. Thus, according to the WHO definition, “old old” differs significantly from “new old” ”, those who have recently retired. What is important for social workers, first of all, is comprehensive information about the population of elderly and elderly people they serve. In geriatrics and gerontopsychiatry it has become an axiom that physical and psychological characteristics people differ significantly over 5-year periods: 60 - 64 years, 65 - 69 years, 70 - 74 years, etc., therefore, in order to obtain social information and create a data bank about elderly and old people, it is important to know not only the demographic features of that or another area, but also a picture of demographic changes in this population group.

In many countries, the proportion of people reaching retirement age is already close to its maximum and is unlikely to increase in the future. However, important changes may occur among the elderly and old population, for example, the number of “old old” will increase, and the number of people aging no more than 15 years after retirement will decrease. It is important not to mix all groups of people of the third age, but to consider each group with a gap of no more than 5-10 years. Only then can we obtain objective data characterizing old people, which can be used to plan social work in the future. Of course, it is impossible to predict whether the current population aged 60 - 64 years in 10 years will be similar to the group that is now 70 - 74 years old. However, it can be assumed with a high degree of probability that changes in the organization of social services and the economy are inevitable, which will affect these age groups. First of all, these data are of particular importance for planning the activities of local social services and health care institutions. So, for example, if the state of health or financial and economic security in any sample of surveyed old people turns out to be worse than in other areas, it is of direct significance for this particular area, district, region. Other, less immediate problems may be identified: demographic projections in most areas indicate that the proportion of older people in the elderly population will increase over the next decade. Thus, if modern system social assistance and social work meets the needs of this contingent and such services are now used to the maximum extent, then in the future this system may turn out to be inadequate to the new conditions if its expansion is not planned in accordance with the growth in the size of this population group. Even more urgent is the need to obtain objective information for intelligent planning and immediate reorganization of social services in areas or regions where the needs of the rapidly growing number of elderly people dependent on these services are not being fully met. To forecast the needs for social services and social work, it is important to determine the dynamics of the growth in the number of people aged 75 years and over, and not the general increase in the number of people aged 55 years and over. According to G. Stoinev, 80% of people over 75 years of age are the most helpless people and they need full outside help and service.

The attitude of elderly and old people themselves to the assistance provided to them by social workers also deserves special attention. Practical experience and specially conducted research allow us to identify several specific behavioral stereotypes of elderly and old people:

1. sometimes rejection of social assistance in Everyday life, distrust of social workers, reluctance to be dependent on strangers, strangers;

2. obvious rental attitudes, desire and persistence in receiving as many services as possible from social workers, entrusting the latter with all household duties;

3. dissatisfaction and dissatisfaction with one’s living conditions is transferred to social workers with whom they communicate directly;

4. a social worker is perceived as an object who is responsible for their physical health, moral and financial condition. Of course, the majority of the older population, with whom social work is carried out in various forms, expresses their sincere gratitude to social workers and highly appreciates their work. However, hostility, suspicion, and dissatisfaction with the services provided are also common.

Sometimes they resort to excessive admiration and praise of a social worker in order to obtain from him those services that are not included in the list of duties performed.

Working with old people in all countries is considered one of the most difficult in all respects: there is great frustration among those caring for them; To avoid it, high professional training, understanding and knowledge are required psychological characteristics elderly and senile age.

Social workers need to prepare from the very beginning for the fact that in their work there will be much less gratitude than suspicion, unfounded accusations, and often undeserved insults. Social workers must be prepared to be patient and caring towards anyone, even a very capricious and annoying old person.

You cannot perceive an old person in isolation, outside of his life path. On the contrary, what he is now is a reflection of the multidimensional and multi-layered development of personality. The biography of every old person is a reflection of a successful or failed fate, perhaps a broken or ruined life.

The most important thing is that every old person is a person and as a person has intrinsic value. Personality is the core of human existence, his feelings, experiences and actions. Personality also determines a person’s behavior during the aging process. Each person is unique in his “I” and cannot in any way be replaced by another person, and in this form another person does not exist.

A person’s self-worth must be fully preserved, it must be indivisible, “individual” in Latin means “indivisible.”

characterological feature - sociability, i.e. the opportunity to open yourself to contacts with other people. A person comes into contact with the people around him, creates long-term or short-term connections with them, supports them or rejects them; in the course of these contacts, like or dislike, trust or distrust arises.

the people around him and the world around him, builds his own individual world on the basis of his own “I”, and this largely determines whether he will succeed in his plans.

From the standpoint of psychoanalysis, childhood is the period when a person begins to exist and leads a way of life in which the external and internal, earth and sky, “I” and “WORLD” are united, mutually intertwined in living integrity.

IN mature age these poles are separated, the formed consciousness allows one to distinguish between one’s individuality and the world, spirit and carnal motives. In the constant rushing between your own “I” and the outside world, there is a danger of leaving your essence and being swallowed by this world, to which you give yourself as a sacrifice.

At the third stage, i.e. in old age, a person has a chance, if he correctly overcomes this age threshold, to regain lost harmony, and at a higher level.

This brief introduction to the essence of the principles of psychoanalysis related to the issue of mental aging of the individual allows us to get an idea of ​​​​the complexity and psychological difficulty of the work of social workers.

MAIN TASKS AND PROFESSIONAL RESPONSIBILITIES

SOCIAL WORKER

If we proceed from a generalized system of fundamental provisions on the content of the activities of a social worker, then it turns out to be possible to determine the range of main tasks assigned to workers social sphere, in the process of direct communication with people.

This is, first of all:

assist individuals and groups to recognize and address personal, social, environmental and spiritual difficulties that adversely affect them;

help people cope with these difficulties through supportive, rehabilitative, protective or corrective interventions;

protect the helpless according to the law by resorting to the use of power;

promote the wider use by each client of their own opportunities for social use of all means and sources for the social protection of people in need, etc.

The range of tasks under consideration clearly shows that they include the widest range of skills and abilities that social workers will need to perform them.

If we consider in the context of the tasks of social work, the range of main responsibilities that a social worker as a professional must perform, then basically it looks like this:

create and maintain a work environment and atmosphere;

identify and overcome negative feelings that affect people and himself;

recognize and overcome aggression and hostility in relationships with people;

promote the provision of physical care to the needy and elderly;

observe, understand and interpret behavior and relationships between people;

communicate verbally and in writing;

organize and conduct conversations in various circumstances;

conduct negotiations, speak on the radio, etc.

The field of activity of a social worker is very wide:

a. in neighborhoods and enterprises, he identifies people in need of socio-medical, legal, psychological, and material assistance;

b. promotes the integration of activities of various government organizations and institutions for providing socio-economic assistance to the population;

c. helps in family education;

d. works with pensioners, disabled people, children;

e. participates in the creation of centers for social assistance and social rehabilitation;

f. works with juvenile offenders and people returning from prison, etc.

A social worker today is not only a person who provides assistance to certain disadvantaged people and families, but also, to a certain extent, a politician and public figure involved in reforming social policies and laws aimed at achieving the well-being of the entire society.

To perform this multifaceted activity, a social worker must be ready to act in different capacities and play many roles.

According to Teare and McPheeters (ref. text, 1993), a social worker must perform at least 11 roles:

Field worker;

Mobilizer;

Behavior corrector;

Information Manager;

Administrator;

Although this list is by no means complete, it gives some idea of ​​the variety of roles of a social worker and the wide scope of his work.

The considered tasks of social work, the roles, functions and responsibilities of a social worker do not exhaust all of his activities, but they allow us to trace and identify the main, core idea, as if uniting all the other components of the difficult and extremely necessary profession of a social worker today, namely the ability and desire to go to people, to find forms of communication with them in order to help them.

Those. communication is one of the main roles of a social worker. In this case, communication occurs at different levels:

social worker as a representative of the state providing assistance to members of society; social worker-group, and finally, social worker and client. The latter is the most significant, because Ultimately, the most important thing is the individual.

Therefore, mastering communication skills is considered very important and significant in the training of social workers.

These include:

Ability to listen to others with understanding and purpose.

Ability to identify information and collect facts necessary to analyze and assess a situation.

Ability to create and develop relationships.

Ability to observe and interpret verbal and nonverbal behavior, apply knowledge of personality theory and diagnostic methods.

Ability to gain the trust of clients.

emotional mood.

Ability to conduct research or interpret findings.

The ability to mediate and resolve relationships between conflicting individuals and groups.

Ability to establish inter-institutional relationships.

Ability to interpret social needs and report them to relevant services and institutions.

The ability to intensify the efforts of students to solve their own problems.

an individual approach to people based not only on an in-depth study of personal and professional and business qualities, but also on identifying interests and needs, creating conditions for the full development of creative abilities and maximum labor productivity.

The performance of social services staff should also be assessed. At the same time, it is very important that it be objective because this will help to avoid mistakes and rationally use each employee.

It should be based on the following principles:

Objectivity and independence.

Linking assessment results with professional growth, financial situation and social status In order for certification to take place at a high organizational and methodological level, it is advisable to use methods of expert assessments and testing.

It is very important that in social management the following areas are developed:

formalization of methods and systems for selection of social workers; development of a scientific approach to the analysis of needs for managerial personnel;

selection and training of capable workers.

ETHICAL PRINCIPLES OF SOCIAL COMMUNICATION

EMPLOYEE

How should communication between a social worker and a client be structured?

In order to comprehend the process of communication, it is important to determine its direction, the values ​​in accordance with which it should be built. The values ​​of social work are formed in accordance with the humanistic ethics of communication, and its highest value is a person.

Interpersonal ethics are extremely complex.

It is based on the main principles of trust and goodwill, respect for another person.

Recognition of the value of another person can be expressed in specific assessments and even if this positive assessment ahead of a person’s actual merits, he will try to justify it, i.e. fulfill the social role that is prescribed to him from the outside.

testifying to the culture of communication, the moral credo of a social worker. Tolerance helps to humanize interpersonal relationships, make them more humane and friendly.

In addition, the humanistic ethics of communication is focused on such moral universal values ​​as: trust, frankness, unselfishness, mercy, kindness, care, truthfulness, fulfillment of duty and faithfulness to the word. Communication also presupposes such feelings as camaraderie, empathy, guilt, shame, repentance.

Ideal communication is inseparable from such values ​​as freedom, justice, equality, love. In communication, you need to value not only your own freedom, but also the freedom of the other, respect for the inner world of the other.

The level of communication culture and communication ethics are close concepts.

They are determined not only by the perfection of individual sides or aspects of communication, they presuppose a harmonious combination and development of elements of a communication culture.

Summarizing all of the above, I would like to highlight the basic ethical standards of a social worker, which can serve as a help to everyone involved in social work.

Western social workers have code of ethics, developed by NASR. Its main provisions include:

be guided primarily by the interests of clients;

customer independence;

Respect the client's privacy and keep confidential all information obtained in the course of working with him;

Be friendly in your relationship with colleagues, - in the process of work, act in accordance with the values, moral standards and purpose of your profession;

Serve your profession for the benefit of others.

The ethical standards for professional communication of a social worker include the following:

1. A social worker should not participate in cases involving lies, deception, or forgery.

2. A social worker must clearly distinguish between his statements and actions as a private person and as a social worker. 3. A social worker must strive to improve his professional knowledge and practical experience, and put his official duty above all else.

4. The social worker must direct efforts to prevent inhumane or discriminatory actions directed against one person or groups of professional relationships to achieve personal 6. A social worker engaged in scientific or research work must analyze and provide for it possible consequences for people, make sure that research participants voluntarily participate in it, inform about this in advance and do not put pressure on them / while maintaining confidentiality and respecting the dignity of participants 7. A social worker must protect his clients from discomfort, harm, threats, deprivation of any or right.

8. A social worker analyzing a variety of cases can discuss them only for professional purposes and only with people professionally associated with 9. Information obtained in the process research work must be considered confidential. As for the immediate ethical circumstances of the social worker in front of the client, then:

10. The client's interests should always come first.

11. A social worker must work with a client kindly, loyally, persistently, using maximum professional skills.

12. Never use a relationship with a client to achieve personal gain.

13. Never exhibit, contribute to, or participate in position, political opinion, mental or physical disability, or any other characteristic or personal characteristic, 14. The social worker must inform the client about possible risks, rights, opportunities and responsibilities, presented to him by the social service.

15. You should consult with colleagues and managers if this may be useful for the client.

16. A social worker may interrupt work with a client only in special cases, while taking measures to cause the least possible harm to the client.

17. The social worker should try to give the client the opportunity to self-determinate as much as possible, i.e.

make decisions about their problems, methods 18. A social worker should not participate on behalf of a client in an action that violates or undermines civil or legal rights client.

Regarding such an important ethical issue as confidentiality, the social worker must:

confidentiality of all information received;

Inform the client about the boundaries of her confidentiality in each specific situation, the purposes of obtaining information - to obtain the client's consent to print, record conversations - in relations with colleagues must be respectful, fair, honest, correct.

You should collaborate with colleagues to effectively pursue professional interests. Respect the opinions, qualifications, and achievements of colleagues and use appropriate channels to express judgments in this regard.

If a social worker replaces a colleague, he or she must act with due regard to the interests, character and reputation of that colleague.

A social worker who supervises his colleagues must carry out his duties in a fair, balanced manner, formulated by criteria.

ETHICAL RESPONSIBILITY TO THE PROFESSION.

A social worker must adhere to and enhance the integrity, ethics, knowledge and mission of social work.

The social worker should protect the dignity and integrity of the profession.

The social worker must be critical and at the forefront of knowledge relevant to social work.

A social worker must participate in the accumulation of social work knowledge, share research results and practical experience with colleagues.

Social work, like any branch of knowledge, is in the process of constant development and enrichment with new knowledge and new experience.

The above ethical standards are not the only or comprehensive ones, but they can provide some assistance to social workers in their daily work, the main goal of which is to help people, strive to make society more prosperous and perfect.

SKILLS AND ABILITIES YOU SHOULD HAVE

SOCIAL WORKER

Psychologists from Rostov State University, commissioned by the regional Department of Social Protection, conducted a socio-psychological study in order to improve the activities of the Rostov City Center in providing assistance to the elderly and disabled. When asked what qualities a social worker should have, the activity of older people was maximum. They listed 35 qualities and skills, repeating them a total of 446 times. Such interest from clients indicates the importance they attach to the personality of the social worker. The most frequently repeated were 20 “qualities” with varying levels of generalization. All of them can be divided into 3 groups:

1. Personal characteristics: kindness, caring, honesty, responsiveness, friendliness, tolerance, humanity, balance.

2. Communication skills: attention to others, ability to listen, courtesy, polite attitude towards people.

3. Attitude to work: conscientiousness, diligence, responsibility, demanding of oneself.

The following 32 qualities, indicated 437 times, are considered unacceptable by social workers. All of them can be divided into 3 conditional groups:

Personality traits: nervousness, self-interest, callousness, arrogance, dishonesty, cruelty.

Communication skills: rudeness, disrespect for old people, disgust, anger, impoliteness, insolence.

Attitude to work: indifference to wards, constant haste, irresponsibility, laziness, dishonesty, unwillingness to help, frivolity, lack of concentration, extortion.

Using T. Leary's methodology, the respondents compiled a generalized psychological portrait of a real (serving each of them) and an ideal social worker. In general, clients would like to see more generous, understanding, and compassionate people in social workers. Elderly people, thus, state their need for more attention, selfless help and proactive active care from a social worker.

REQUIREMENTS FOR PROFESSIONALISM OF SOCIAL

WORKERS SERVING SENIOR AND OLD PEOPLE

Currently, there is a widespread trend: people who devote themselves to caring for and working with older people are becoming younger and younger. From these positions, caring for old people is a meeting of different generations, respect for age on the part of young employees, their tolerance for the principles and established beliefs of the old person, his life attitudes and values.

Caring for old people is a careful and caring observation of others, the ability to enter the world of their experiences while simultaneously perceiving and rechecking one’s own feelings. This is the ability to perceive old people as they are.

Caring for old people is tactful, planned actions, trust and assistance in the processes of adaptation of an old person to changed living conditions.

Caring for the elderly is, finally, accompanying the dying, providing assistance to family members at this difficult moment.

Only by accepting these principles and placing them as the basis of professionalism can one withstand all mental and physical exercise related to caring for the elderly.

It is important to understand one more circumstance: in an old person we see his current appearance and practically cannot imagine him as a child, a man or woman in the prime of life, beautiful, strong and self-confident or, on the contrary, soft, generous, looking to the future. Meanwhile, it is important, seeing in front of you an old and sick, and often demented (feeble-minded) person, to recreate his appearance, to remember that he carries within himself childhood and adolescence, youth and maturity.

Often, some aspects of the behavior of old people that cause rejection and surprise in young people, seem unusual or immoral to them, are actually within the cultural norm of the previous generation and do not indicate a deterioration in the person’s mental abilities. When confronted with the negative aspects of old age, there is a danger of gerontophobia developing in young social workers; moreover, they may become imbued with a pronounced phobia of their own future aging.

Research by the Hungarian psychologist N. Hun showed that the worst grades and negative opinion nurses working in nursing homes and geriatric psychiatric hospitals know about old people. It should be noted that there are practically no special studies of the population’s tolerance towards helpless old people. In nursing homes in Sofia, a condescending, patronizing attitude towards centenarians was revealed on the part of medical workers and service personnel. But a disdainful, let alone insulting attitude towards old people was not found in any case. However, one noteworthy feature was identified. When asked whether they would like to live to be 100 years old, all employees of nursing homes answered negatively; moreover, they all perceived this prospect as a tragedy for themselves and especially for their loved ones.

The most important thing in social work should be the ability to establish contacts with the most uncommunicative old people. Social workers need to master the art of communicating with an old person, since otherwise various interpersonal misunderstandings, misunderstandings and even open mutual hostility arise.

According to the old people themselves, their requirements for social workers are as follows: first of all, kindness and honesty, selflessness and compassion. The ability to listen is one of the main qualities of a social worker, and conscientiousness, responsibility and self-demandingness should determine his professional status.

Mastering the skills to communicate with older people is not an easy task; In addition to the ability to listen to an old person with an understanding of his needs, it is necessary at the same time to collect objective information about him, analyze and evaluate the situation in which he finds himself, determine what his objective difficulties are and what is the result of subjective experiences.

It is important not to let the old person lead the conversation and further contacts.

You should switch the conversation very kindly and respectfully, directing it in the direction that the social worker needs.

It is also important to be able to end the conversation with dignity, without offending the old person and convincing him with your behavior that all his problems will be taken into account and, if possible, satisfied. You should never categorically refuse requests or assert that all requests will be fulfilled. The highest indicator of the professionalism of a social worker is the trust of the old person, acceptance of advice; all efforts should be aimed at activating the old person, encouraging him to independently resolve personal problems.

DEONTOLOGY IN SOCIAL WORK WITH THE ELDERLY AND

BY OLD PEOPLE

Deontology (a combination of Greek words: deontos - duty, due, proper, logos - science) is a science that studies the ethical principles of behavior in the performance of one's professional duties. Deontology, as a separate field developed since ancient times, has until now been more associated with medicine, constituting its own section.

Social work in its current understanding and interpretation cannot do without deontology. L.V. Topchiy and A.A. Kozlov define deontology as a set of ethical standards of professional behavior for social service workers.

In deontology, they include basic principles, moral precepts that make it possible to provide effective social services to the population, eliminating unfavorable factors in social work, aimed at optimizing the system of relationships between various categories of social service personnel and clients, preventing Negative consequences social services: professional duty, selflessness, professional endurance and self-control, trust between specialists and clients, professional secrecy, etc.

Deontological problems arise especially acutely when communicating with seriously ill old people who have lost the ability to self-care. It is well known that patient and balanced people cope most successfully with caring for the elderly. Of course, moral support is the most valuable, therefore a social worker who does not limit his activities to formal services, and who also manages to become a friendly and attentive interlocutor, assistant and adviser, will turn out to be an ideal comforter for an old person.

Those who are too harsh, domineering, and work mainly for money or for the sake of a career cannot cope with this type of activity. In turn, old people with their life experience very easily understand and perceive falsehood and insincerity in attitude towards them. A hasty person who does not know how to listen and is preoccupied with his own problems will never gain the trust of old people.

A social worker needs to pay special attention to his appearance and the form of communication with old clients. Too fashionable clothes, an abundance of cosmetics and jewelry are not conducive to establishing contacts between old people and social workers.

Old people are especially distrustful of frivolous, superficial people who make promises but do not keep them.

Lack of concentration, carelessness, restlessness, and verbosity also cause wariness on the part of the old person towards the social worker and do not contribute to the establishment of trusting contacts, which are necessary for both parties.

When caring for old patients who have lost the ability to self-care, the social worker with all his behavior and actions must support and awaken the desire to maintain maximum mobility for as long as possible and perform at least the most basic self-care actions. In any case, the dignity and sense of independence of older people must be respected.

An old person should become the subject of an individual approach for a social worker. A feeling of respect for an old person, interest in his life path and experience usually increases confidence in the social worker and his authority as a specialist. We should never forget that when talking with an old person, you should try to maintain an expression of interest, sympathy and goodwill on your face. All this will allow you to get acquainted with the old person’s social history, place and living conditions, understand intra-family relationships, their significance for the old person, understand interpersonal relationships between young family members and the old person, and help resolve their internal disagreements and grievances. The role of rehabilitation of elderly and old people in this case should be assessed from both a social and moral point of view. It also provides a significant economic effect, since restoring the ability to self-care frees a large number of medical personnel from caring for sick elderly people, if they are admitted to a hospital, as well as relatives, relieving them of the need to leave their professional activities.

MEDICAL AND SOCIAL WORK

WITH ELDERLY PEOPLE.

In Russia, in conditions of deepening social problems, the deterioration of population health indicators increases the objective need to solve interrelated problems of a medical and social nature at a qualitatively new level. The needs of practice arose the need to create new mechanisms, forms and methods of medical and social care as a complex of social services. In this regard, in the 90s in our country, medical and social work began to develop as a qualitatively new direction of social work and type of professional activity.

Its formation is due to the current state of health care, social protection of the population and, in particular, the elderly, in the conditions of reforms in the economic and social fields. Medical and social work is also considered as a new type of multidisciplinary professional medical activity. psychological, pedagogical and socio-legal nature, aimed not only at restoring, but also preserving and strengthening health, including for the elderly.

It fundamentally changes the existing approach to health care, since it involves a systemic medical and social impact at earlier stages of the development of disease processes, potentially leading to severe complications, disability and death. Thus, medical and social work acquires not only a pronounced rehabilitation, but also a preventive orientation, which is of particular importance for the elderly.

The goal of medical and social work is to achieve the optimal possible level of health, functioning and adaptation of elderly people, people with physical and mental pathology, as well as social disadvantage. The object of medical and social work is various groups of people, including the elderly, who have pronounced medical and social problems, which are closely interconnected and their solution is difficult within the framework of unilateral professional measures. Working with such populations is equally difficult and not effective enough for both medical workers and social service specialists, since they inevitably find themselves faced with a range of problems that go beyond their professional competence.

Medical and social work can be divided into two main aspects: medical and social work with a preventive focus and medical and social work with a pathogenetic focus.

Medical and social work of a preventive nature includes the implementation of measures to prevent socially dependent disorders of somatic mental and reproductive health, the formation of an attitude towards healthy image life, ensuring access to information on health issues, participation in the development of targeted programs of medical and social assistance at various levels, social administration, ensuring social protection of the rights of citizens in matters of health care, etc.

Medical and social work with a pathogenetic focus includes measures to organize medical and social care;

conducting a medical and social examination; implementation of medical, social and professional rehabilitation of the elderly and disabled; carrying out social work in certain areas of medicine and healthcare, correcting the mental status of the client and especially the elderly, creating a rehabilitation social infrastructure, ensuring continuity in the interaction of specialists in related professions, etc.

The main strategic goal of medical and social work with older people should be considered to be maintaining and improving their quality of life.

reflecting not only the severity of the symptoms of the disease, but also the functional state of the elderly person, the state of his physical and mental health, social activity, ability to self-care, material security and living conditions, as well as satisfaction with the feeling of his own physical and mental well-being. One of the features of the period of elderly and senile age, both in relatively healthy and sick people, is the upcoming socio-psychological restructuring, which causes significant stress and tension in the adaptive mechanisms of the body.

A change in the social status of an elderly person is associated with various factors, including retirement, loss of close relatives and friends due to their death, limited ability to communicate with survivors, difficulties in self-care, and worsening economic situation. All this violates the usual patterns of life and requires the mobilization of physical and mental reserves. The degree of adaptation of an elderly person to his new social status is determined to a large extent by his level of health. It is obvious that a pronounced decrease in the functional state of an elderly person’s body makes his position more dependent on society. At the same time, medical and social work of a preventive and pathogenetic orientation, ensuring the mobilization and increase in adaptive capabilities, maintaining the level of health of the elderly and improving the quality of their life, becomes essential. In recent years, Russia has been actively developing a legal framework that makes it possible to develop industry-specific regulatory legal documents to provide the elderly with medical and social care at the level of professional medical and social work. The most important documents are “Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens”; federal laws“On the basics of social services for the population in the Russian Federation”; social services for elderly citizens and disabled people”, “On social protection of people with disabilities in the Russian Federation”, “On psychiatric care and guarantees of the rights of citizens during its provision” and other legal acts. Based on the legal framework at the departmental level, regulatory documents are being developed that will make it possible to introduce medical and social work, which is in demand at the time, into the practice of social institutions of society.

In identifying the place of medical and social work among related activities, it is necessary to note the coordinating role of a specialist in medical and social work in resolving a set of problems that arise especially among older people, and which require the participation of specialists in related professions - doctors, psychologists, teachers, lawyers and others. Being a type of multidisciplinary activity and implemented in the field of mutual interests of healthcare and social protection of the population, medical and social work uses forms and methods that have developed in the healthcare system - preventive, rehabilitation, psychotherapeutic, etc.; in the system of social protection of the population - social counseling, social benefits, social services at home, social services in inpatient institutions, organization of day care in social service institutions, provision of temporary shelter, etc.

Medical and social work has much in common in its essence with medical care and the activities of health authorities in general. But at the same time, it does not exceed the limits of its competence, does not pretend to perform therapeutic functions, but provides for close interaction with medical personnel and a clear delineation of areas of responsibility. Thus, on the other hand, medical and social work should be considered as a type of social work aimed at protecting and supporting physical and mental health, and primarily individuals.

elderly people, and on the other hand, it is a type of activity aimed at achieving “social well-being” and significantly improving their quality of life.

CHANGE IN SOCIAL STATUS

ELDERLY PERSON AND RELATED

PSYCHOLOGICAL PROBLEMS

A change in the social status of a person in old age, caused primarily by the cessation or limitation of work activity, the transformation of value guidelines, the very way of life and communication, as well as the emergence of various difficulties in both social and everyday and psychological adaptation to new conditions, dictates the need development and implementation of specific approaches, forms and methods of social work with older people. The importance of everyday attention to solving social problems of this category of citizens is also increasing due to the increase in the proportion of older people in the structure of the Russian population, which is observed in last decade not only in our country, but throughout the world.

The growing trend in the number of older people requires a radical change in social policy in relation to this, the most socially unprotected category of society, especially now, in the context of the transition to market economy.

In organizing social work with older people, it is necessary to take into account all the specifics of their social status not only in general, but also of each person individually, their needs, requirements, biological and social capabilities, certain regional and other features of life.

It should be noted that scientists and practitioners have approached the problem of old age and its definition from different points of view: biological, physiological, psychological, functional, chronological, sociological, etc. And hence the specificity of solving problems of social and social status, role and place in family, in the organization of social security and services, social rehabilitation, social care for the elderly, etc.

The aging process of certain population groups and individuals occurs far differently.

Thus, when characterizing the category of older people as social, or rather, as socio-demographic, it is necessary to take into account age characteristics within the group of people itself.

In accordance with the classification of the World Health Organization, the population aged 60 to 74 years is considered elderly, those aged 75 to 89 years are old, and those 90 years and older are long-livers.

As is known, in practice, elderly people are usually considered to be people who have retired. However, this measure cannot be universal, since the retirement age is different in different countries. However, women tend to retire earlier than men. So, in our country, they have the right to receive an old-age pension from the age of 55, while men - from the age of 60. In addition, the Law “On Pension Security in the Russian Federation” provides for differences in retirement age for different social and professional groups. However, in the vast majority of countries in the world, older people include citizens aged 60 years and older.

For a social worker, a number of social and psychological factors related to the lifestyle and standard of living of older people, family situation, ability and desire to work, health status, social and living conditions, etc. are also extremely important.

Elderly people are very different people. Among them there are healthy and sick; living in families and living alone; happy with retirement and life and unhappy, despairing of life; inactive homebodies and cheerful, optimistic people who play sports, lead an active lifestyle, etc.

Therefore, in order to successfully work with older people, a social worker needs to know their socio-economic status, character traits, material and spiritual needs, health status, and be well aware of the achievements of science and practice in this direction. A change in a person’s social status in old age, as practice shows, first of all, negatively affects his moral and financial situation, negatively affects mental condition, reduces its resistance to diseases and adaptation to environmental changes.

With the transition to the category of older people, pensioners, not only the relationship between a person and society often radically changes, but also such value guidelines as the meaning of life, happiness, good and evil, etc. The very way of life, daily routine, and social circle also change.

With age, the value hierarchy of self-esteem changes.

Older people pay less attention to their appearance, but more to their internal and physical condition. The time perspective of older people is changing.

Leaving into the past is typical only for very old people; the rest think and talk more about the future. In the minds of an elderly person, the near future begins to prevail over the distant one, and personal life prospects become shorter. Closer to old age, time seems to flow more quickly, but less filled with various events. At the same time, people who actively participate in life pay more attention to the future, while passive people pay more attention to the past. The former are therefore more optimistic and believe more in the future.

Anticipating old age in the imagination is often more painful than reality. Thus, V.V. Veresaev, who in his youth was insanely afraid of growing old, wrote in his declining years that this fear was in vain, and natural wisdom compensated for the inevitable losses.

With age, the idea of ​​increasing the value of life appears.

But age is still age. Old age brings with it a change in usual living standards, illness, and difficult emotional experiences. Elderly people find themselves on the margins of life. We are talking not only and not so much about material difficulties (although they also play a significant role), but about difficulties of a psychological nature. Retirement, loss of loved ones and friends, illness, narrowing of social circles and areas of activity - all this leads to an impoverishment of life, the withdrawal of positive emotions from it, a feeling of loneliness and uselessness. The situation, however, is that with an increase in life expectancy and a decrease in the birth rate, a significant part of the population consists of elderly people and, therefore, there is a need for a special organization of assistance to the elderly.

It is necessary to take into account features that are determined by at least two characteristic features lifestyle of older people.

various events. However, these events fill all of his individual space and time. So, the arrival of a doctor is an event that can fill the whole day. Going to the store is also an event that is preceded by careful preparation. In other words, there is a hypertrophy, “stretching” of events.

An event that is perceived by young people as an insignificant episode, for an old person becomes a matter of the whole day. In addition to the “extension” of events, the fullness of life can be achieved through the hypertrophy of any one sphere of life activity.

The second feature is determined by a peculiar sense of time. Firstly, an elderly person always lives in the present. His past is also present in the present - hence the thriftiness, thriftiness, and caution of older people. They are, as it were, preserved in the moment, and the spiritual world and its values ​​are also subject to such preservation.

Secondly, the movement of time in old age slows down and becomes smoother.

We touched upon psychological problems here, but the main one is probably, as B.Z. rightly called it. Woolf's "drama of lack of demand."

disability, serious illness, or poverty, or homelessness) drama of lack of demand - unrealized potential, feeling or fear of one’s own uselessness.

Moreover, the potential of an older person most often does not outwardly correspond (or corresponds very little) to the mentality of new generations. But they all have a common basis, which is much more significant than the differences - universal human values. For an older person they have experienced their own individual existence, for a younger person they most often have a significantly different existence. Violation of the continuity of generations, which presupposes - if we proceed from the principle of conformity to nature, that the elder exists for the sake of the younger and dies, leaving them alive - the violation of such unity is painful for everyone and at all times.

In general, the lack of demand for an elderly person is in conflict with the social essence of a person. This means we need to reinforce it, including socially. In particular, by means of social work, in the areas available to it, in order to mitigate the situation as much as possible. Maybe not all over Russia all at once, but at least... in your own society.

The essence of social work with elderly people is social rehabilitation. In this case, such rehabilitation is restoration of usual responsibilities, functions, types of activities, and the nature of relationships with people. The main thing for a social worker is the transformation of an elderly person from an object (client) of social work into its subject. Overcoming and mitigating the drama of lack of demand occurs on the basis of one’s own everyday experience, including professional and family experience. It is important not only to give to a person, but also to help him continue to give of himself, thereby maintaining stability, a guarantee of a certain stability, a sense of good prospects, an optimistic and realizable hope that the person remains in demand in new circumstances.

psychological order, which are extremely important for understanding the inner world of older people, but, of course, it is necessary to remember that older people are the most socially vulnerable part of the population. Their income is usually significantly below average, and their needs, especially for medical care, dietary nutrition, and comfortable housing, are much higher. Very often, older people live separately from their families, and therefore they are unable to cope with their illnesses and loneliness. And if previously the main responsibility for the elderly lay with the family, now it is increasingly being taken on by state and local authorities and social protection institutions.

SOCIAL PROTECTION OF ELDERLY PEOPLE

AND SOCIAL SERVICE MODELS

Social protection of older people in modern socio-economic conditions is carried out in two main areas - social security and social assistance.

In accordance with current legislation, social security for elderly citizens is aimed at protecting their financial situation, providing cash and in-kind assistance, and strengthening the social service system for older people.

The Government of the Russian Federation, together with the social protection authorities, is taking specific measures to ensure a gradual transition to the formation of a pension system based on a more complete implementation of the principles of social insurance, the introduction of a mechanism for accounting for the labor contribution of working citizens, and the development of non-state pension funds and etc.

Local authorities provide significant assistance to older people.

In the Russian Federation, several models of social services for older people have developed and operate. Social services include a set of social services that are provided to elderly citizens and disabled people at home or in specialized state and municipal institutions.

The main principles of activity in the field of social services for elderly citizens are: provision of state guarantees; ensuring equal opportunities in receiving social services and their accessibility; continuity of all types of social services; orientation of social services to the individual needs of citizens; priority of measures for social adaptation, etc.

The most important models of social services have become such as social services at home; semi-stationary services in day (night) departments of social service institutions; stationary social services in boarding homes, boarding houses, etc.; urgent social services; social advisory assistance;

provision of living space in special homes for the elderly, etc.

SOCIAL SERVICE CENTERS

The prevailing model of non-stationary social services is becoming centers for social services and rehabilitation of the disabled and elderly.

Centers may have various social service units in their structure: day care departments for the elderly and disabled, social assistance at home, emergency social assistance services, etc.

The center's tasks include identifying the elderly and other people in need of social support; determination of specific types and forms of assistance, provision of various social services of a one-time or permanent nature; analysis of social services for the population; involvement of various state and non-state structures in resolving issues of providing social, medical, social, psychological, and legal assistance to elderly people and other people in need.

The largest number of social service centers operate in Chelyabinsk, Samara, Rostov, Vladimir and a number of other regions.

In Kostroma, the first such center was opened in December. There is a day care center for 50 people, where pensioners receive two meals a day and other social services throughout the month. The center has its own medical unit and is regularly treated by qualified doctors. Physical education classes are conducted, leisure time for older people is well organized - writers, poets and musicians perform, evenings and concerts are held, exhibitions of paintings by famous artists are organized, etc. Conditions have been created for feasible work in a small sewing workshop. Elderly people have two recreation rooms, a library, billiards, newspapers and magazines, and a TV. Lectures and discussions, necessary consultations, etc. are held.

The most important part of the center’s work is social services at home for lonely elderly people: purchasing and delivering food, providing medicines, organizing cleaning in the apartment, various social services and their payment (handing over linen to the laundry, clothes to be cleaned, insulation of window frames and doors and etc.), information and consultation, etc.

Social workers maintain contact with the work collectives where their wards previously worked, ensure that they do not forget, provide assistance and show attention to their former employees.

The Kostroma Social Service Center has become an important methodological center for workers of the newly created social service centers.

An analysis of the main activities of social service centers indicates that this model of social service, focused on working with older people, has become most widespread and recognized and is the most typical. However, it does not yet cover many categories of older people who feel the need for socio-psychological assistance, communication, socio-legal consultations, and adaptation to new conditions.

Social service centers are becoming effective non-stationary forms of social support for older people and other categories of the population of the Russian Federation.

Home-based services for the elderly and disabled began back in 1985, then, two years later, the first territorial center for social services and social assistance departments at home was opened. By the beginning of 1990, 10,000 people used the help of individual workers and up to a person attended day care in three such centers. With the transition to a market economy, the social protection department Chelyabinsk region implemented a number of measures to reorganize the entire social service system, taking into account the specific situation and specifics transition period. Regulations were developed on a new type of institution - a state social assistance center.

Compared to a regular territorial center, this institution is distinguished by a wider range of population served and a larger number of different types of services and social assistance.

The center introduced positions of social workers for cultural work, professional rehabilitation of the disabled, provision of various types of assistance, etc. The center’s employees also deal with issues of employment of pensioners and disabled people, providing them with social vehicles, sanatorium and resort vouchers, organizing free meals and etc.

In the districts and cities of the Chelyabinsk region there are social assistance centers, on the basis of which there are 192 social assistance departments at home, serving more than 27 thousand people, as well as 15 day care departments and 40 emergency social assistance services. 31 centers employ specialists in family and childhood issues. The centers have rooms for relaxation, eating, medical procedures, and feasible work activities. Employees of the centers, municipal authorities, with the help of the public, quickly identified all those in need of social assistance, the data of which was entered into the centers’ files. 800 thousand people, or approximately a quarter of the entire population of the region, were registered. In this complex and painstaking work, the social protection authorities were greatly assisted by funds mass media. In order to inform the population in the region, leaflets were distributed - announcements that talked about social assistance centers, their functions and addresses.

turn out to be different kinds social services: material and in-kind assistance, provision of free first aid kits, organization of free meals, provision of industrial and food essentials. Agreements are concluded with food, shoe, clothing, and agricultural enterprises to obtain goods at lower prices.

There are shops "Family" and "Mercy", auctions are held, etc.

The “World of Tourism and Art” program has been developed and is being implemented, in accordance with which visits to theaters and museums, concerts and cinemas are organized, and consultations are provided on issues of pensions, benefits and compensation. Low-income pensioners are given vouchers to tourist centers, providing not only hotel accommodation, four meals a day, but also a number of cultural events. All this is aimed at maintaining the moral and psychological climate of older people and their social potential.

Life constantly makes adjustments to the forms and methods of social services and social protection of older people.

Thus, the Kuibyshev boarding house for veterans in the Krasnoglinsky district of the Samara region became, in essence, another institution - a center for social services for the population. There is a medical and social department, a social service department at home, a day care department, etc. It has its own farm and apiary, a repair and construction shop has been opened, and transport has been purchased. There is a good library, an auditorium with 450 seats, various cultural events, concerts of amateur artists and professional artists are held.

Having transformed from a boarding house into a center, this institution began to simultaneously combine inpatient and non-stationary forms of service in its activities. It is not a boarding house, although since 1989 there has been a day care department for pensioners and a temporary one for up to six months. In addition, services are provided to single pensioners at home, who can still live independently and mainly take care of themselves.

As a rule, the Kuibyshev Center and its medical and social department of social services receive mainly seriously ill, bedridden elderly people, who are literally carried in their arms. Each of them essentially needs a nurse. Among them there are a variety of people, including those with psychological problems, so they require not only medical help and care, but also a lot of psychological help.

And here psycho- and occupational therapy play an important role. There is also a work instructor. The employees of the center manage not only to provide their wards with a comfortable, well-fed life, but also to arouse interest in life, including through the organization of work activities: work in a subsidiary farm, a sewing workshop, etc. Doing feasible labor also provides the opportunity to sometimes make some good money. Here, even in the “lying down” department, occupational therapy was introduced to promote self-care. It is important to create a homely environment for the medical and social rehabilitation of older people.

The social service center plays a major role in helping single pensioners at home, providing various types of assistance: buying food and providing free meals in canteens and cafes, organizing the supply of industrial goods at lower prices, as well as legal and other legal assistance, informing its clients about questions that interest them, etc.

As you know, over the years the health of older people becomes worse, chronic diseases worsen, and the body becomes more and more vulnerable to disease. Therefore, along with medical and social services at home, special medical and social departments are being created at hospitals.

Despite the variety of forms of social work in the field, it is already possible to identify the basic principles and forms of the formation of social services that deal with the problems of older people. This is the creation and development of social service centers various types: day stay, weekly, temporary, organization of home care, paid and free (paid for those who live in families and who needed temporary help), creation of socio-psychological assistance centers, canteens for free food, chain of stores based on various forms of ownership for the sale of goods at socially low prices, provision of benefits for social services and employment of older people. Night houses, social hotels, etc. began to open.

SOCIAL SERVICES AT HOME

Social service at home is one of the main types of social work. Its main goal is to maximally prolong the stay of citizens in their usual habitat, support their personal and social status, and protect their rights and legitimate interests.

Among the main home services, guaranteed by the state, include: catering and home delivery of food; assistance in purchasing medicines and essential goods; assistance in obtaining medical care and escort to medical institutions; assistance in maintaining living conditions in accordance with hygienic requirements;

assistance in organizing funeral services and burying lonely dead; organization of various social services (housing repairs, provision of fuel, cultivation of personal plots, water delivery, payment of utilities, etc.); assistance in paperwork, including for the establishment of guardianship and trusteeship, exchange of housing, placement in inpatient institutions of social protection authorities.

Social assistance departments at home, as a rule, are organized at municipal social service centers or local social welfare authorities.

Social services at home can be provided on a permanent or temporary basis (up to 6 months). The department is created to serve at least 60 pensioners and disabled people living in rural areas, as well as in the urban private sector that do not have public amenities, and in urban areas - at least 120 pensioners and disabled people.

Social services at home are provided free of charge, with partial payment or for full payment. Free services are provided, for example, to single elderly citizens and disabled people who do not receive a pension supplement for care or who have able-bodied relatives who are required to support them by law but live separately, as well as those living in families whose per capita income is lower than that established for the given region minimum level.

Thus, the main activities of the department of social assistance at home are: identification and registration of pensioners and disabled people in need of service; provision of social services and other necessary assistance at home;

assistance in providing persons served with benefits and advantages established by current legislation.

DAY STAY DEPARTMENTS

Day care departments, also created on the basis of social service centers for the population, are also becoming increasingly developed.

They are intended for everyday, medical, cultural services for pensioners and disabled people, organizing their recreation, attracting them to feasible work, and maintaining an active lifestyle.

These departments are created in accordance with the Regulations to serve at least 30 people. They enroll elderly and disabled people, regardless of their marital status, but who have retained the ability for self-care and active movement, based on personal desire and medical conclusion.

In day care departments, premises are usually allocated for medical care, cultural work, workshops, libraries, etc. Sleeping rooms for organizing recreation, a dining room, etc. are equipped. Pensioners and the disabled, as a rule, are served by the social assistance department free of charge.

Possible labor activity in specially equipped workshops or subsidiary farms is carried out, as a rule, under the guidance of an occupational therapy instructor and under the supervision of a medical worker. The products of subsidiary farms are usually used to provide food, and the surplus can be sold to obtain additional funds and credit them to the accounts of the central social service center.

Based on the existing Regulations, by decision of the management of the Center and the local administration, certain services may be provided for a fee in the day care department. These include: visiting cultural and entertainment events, massage, manual therapy, hairdressing, etc.

The funds received from these additional services are also transferred to the account of the CSC and are used for its development, improvement of nutrition and services for pensioners and the disabled.

For example, the day care department of the CSO "Otradnoye"

Moscow annually serves more than 1,200 pensioners and disabled people.

During their month-long stay here, they are provided with two free meals a day and receive medical care, including therapeutic exercises, necessary medical consultation, etc. The department has a gym and a library. Excursions to museums, trips to cinemas, as well as concerts, lectures and conversations, and other cultural and recreational events are organized for older people.

The day department of the social service center "Pokrovskoye - Streshnevo" also does a lot of useful things for its clients.

Moscow. All conditions for pensioners have been created here. There is a living room with upholstered furniture, a piano, a TV, a billiard room, a dining room, a gym, a nurse's office, etc.

The department is designed for 25 people, but usually there are at least 60 of them. The design of the center is carefully thought out, its interior is pleasing to the eye and lifts people’s spirits. This center has created social assistance departments at home. 130 social workers serve 1,500 lonely elderly and disabled people at home.

Day (night) departments are a form of semi-stationary social service and play an important role in providing effective social support to lonely elderly people and disabled people.

URGENT SOCIAL ASSISTANCE

In recent years, the urgent social assistance service has been increasingly developed; the main purpose of urgent social services is to provide emergency care of a one-time nature for elderly citizens and disabled people in dire need of social support.

Urgent social services include the following state-guaranteed services: one-time provision of free hot meals or food packages to those in dire need; provision of clothing, footwear and basic necessities; one-time provision of financial assistance; assistance in obtaining temporary housing; provision of emergency psychological assistance, including via a “helpline”; provision of legal assistance within its competence; provision of other types and forms of assistance determined by regional characteristics.

The service's activities are based on cooperation with other government, public organizations and institutions, charitable foundations and individual citizens.

Urgent social services are provided by these services on the basis of social services.

For example, the emergency social assistance service operates successfully in the Sakhalin region - the cities of Yuzhno-Sakhalinsk, Korsakov, Kholmsk and Makarov.

As noted in the Regulations approved by the Ministry of Social Protection of the Population of the Russian Federation, this service is intended, first of all, to provide immediate measures aimed at temporarily supporting the livelihoods of citizens in dire need of social support.

RESIDENTIAL INSTITUTIONS

By developing and improving the activities of non-stationary institutions and social assistance services for the elderly and disabled, social protection authorities are constantly concerned about creating more comfortable conditions for the life of older people in inpatient institutions. Boarding houses provide the opportunity for the elderly and disabled to stay there not only permanently, but also temporarily; weekly and daily stays are introduced in them. With the advent of social service centers, rehabilitation centers, departments of social assistance at home and day care, the functions, volume and some aspects of the activities of inpatient institutions change somewhat.

It is characteristic that for a long period in the country, essentially the same number of boarding homes remained, while the number and proportion of elderly people increased.

Thus, at the beginning of 1975 in the RSFSR there were 878 homes for the elderly and disabled, in which more than 200 thousand people lived, and at the beginning of 1991 there were 877 of them and there were a thousand people in them. This is partly due to the fact that the practice of providing social assistance at home to disabled citizens was expanding, but at the same time, the construction of new boarding houses was very slow due to insufficient allocation Money and a number of other reasons. Currently, there are 959 inpatient institutions for the elderly and disabled in the social protection system.

Nowadays, mostly people who require constant care and have largely lost the ability to move are admitted to boarding homes.

Scientists believe that it is necessary to develop a concept of medical and social care for the elderly, uniting for these purposes the efforts of all interested departments and organizations, to develop the necessary regulations, and to define and adopt a broader interpretation of the concept of “social service”. It should include: social and domestic assistance, social and environmental influence and moral and psychological support. It is necessary to create a data bank of elderly people in need of specific types of social services and forms of social assistance.

Practice shows that boarding homes for the elderly and disabled provide medical care and carry out a number of rehabilitation activities:

occupational therapy and employment, organization of leisure, etc.

Here, work is carried out on the socio-psychological adaptation of older people to new conditions, including information about the boarding house, residents and newcomers living in it, about the services provided, the availability and location of medical and other offices, etc. The characteristics of the character, habits, and interests of applicants are studied older people, their needs for feasible employment, their wishes in organizing leisure time, etc. All this is important for creating a normal moral and psychological climate, especially when resettling people for permanent residence and preventing possible conflict situations.

However, the functioning of boarding homes as one of the main inpatient forms of social service for the elderly is associated with a number of serious problems. Among them:

the degree of satisfaction of the need for boarding homes, the quality of service in them, the creation of accompanying conditions for living, etc. On the one hand, in a number of territories of the Russian Federation there is still a queue of elderly citizens wishing to enroll in stationary social service institutions (in the last ten years the queue has remained at level of 18-21 thousand people, although with the creation of central social services there has been some reduction), on the other hand, older people are increasingly showing a desire to live in their familiar home environment.

The changes taking place in the life of society in connection with the transition to market relations required amendments to the existing legal documents on the boarding home, special boarding home and the adoption of new ones, as well as the preparation of normative documents on night stay homes, on the nursing home (department) care, about a social adaptation center for able-bodied persons without a fixed place of residence, about a support boarding house, about a territorial association of social services for the elderly.

Scientists and practitioners make various proposals for improving and promising forms of boarding houses.

Some of them believe that it is necessary systems approach to the planning and assessment of the activities of these institutions in the general structure of medical and social care for the elderly and disabled, its differentiation and integration, specialization of bed capacity, provision of wide diagnostic, treatment and medical rehabilitation opportunities, creation of nursing care institutions and departments on the basis of boarding houses, etc. d. All this will improve assistance to the elderly and disabled, more effectively use and implement differentiated financing, material, technical and drug support, and reconstruct existing new boarding houses in accordance with the requirements of life.

SPECIAL RESIDENTIAL HOMES FOR THE ELDERLY

One of the new forms of social services is the development of a network of special residential buildings for single elderly citizens and married couples with a range of social services.

In accordance with the approximate Regulations on a special house for single elderly people, approved by the Ministry of Social Protection of the Population on April 7, 1994, this house is intended for permanent residence of single citizens, as well as married couples who have retained full or partial ability to self-care in everyday life and need to create conditions for self-realization of their basic life needs.

The main goal of creating such houses is to provide favorable living conditions and self-service;

provision of social and medical assistance to elderly residents; creating conditions for an active lifestyle, including feasible work activity.

Special homes for single elderly people can be built either according to a standard design or located in converted separate buildings or in part of a multi-storey building. They consist of one- or two-room apartments and include a complex of social services, a medical office, a library, a canteen, and ordering points for foodstuffs, handing over laundry to a laundry or dry cleaner, premises for cultural leisure and work activities. They should be equipped with small-scale mechanization to facilitate self-service for residents. At such houses, 24-hour control centers are organized, provided with internal communication with residential premises and external telephone communication.

Medical care for citizens living in these houses is carried out, in accordance with the Regulations, by the medical staff of territorial treatment and preventive institutions, and the organization of social, commercial and cultural services is carried out by the relevant territorial bodies and services.

The Regulations clearly define the basic rules, requirements and conditions for the construction and provision of housing in special residential buildings for single elderly people, accommodation, payment, etc.

legislation, citizens living in such houses are paid a pension in full. They have the right to priority referral to inpatient institutions of social protection authorities.

Special residential buildings for single elderly people and married couples are one of the ways to solve the complex task of providing social assistance, as well as a whole range of social problems of elderly citizens.

There are still few such houses in Russia, but they are becoming increasingly recognized and developed.

In the Bashkir city of Sterlitamak, for example, with the active assistance of the mayor, they managed to build a nine-story house for lonely veterans and disabled people who find it difficult to care for themselves. This house has a whole block of household services, a dining room, and space for workshops.

In Kostroma, a special multi-storey building “Veteran” was built with 125 apartments for single elderly people. The project provides for: a service unit, a medical office, internal telephone communications and workshops in which they can work if desired. And next to this house there are shops, a long-distance communication center, a dental clinic, a philharmonic society, a stadium, a park, a hotel with a restaurant, and a church. All this will undoubtedly help solve many problems, satisfy the needs of lonely elderly people, and prolong their active life.

It is very noteworthy that the issue of specialized housing for the elderly and disabled, or rather taking into account the need for it and the methodology for its formation, was the subject of discussion by the board of the Ministry of Social Security of the RSFSR at the beginning of the year. It was noted that for many years, elderly and disabled people were classified only according to their ability to move, and their social activity status was not taken into account.

And usually, the matter came down only to the construction of boarding houses, while housing and industrial complexes were also needed, rehabilitation centers, residential buildings with apartments equipped for the disabled, specialized types of housing, territorial centers, production units, etc.

Surveys that were conducted in ten regional centers of the RSFSR showed how many elderly and disabled people of groups 1-P need special residential buildings with complexes of social services, paid boarding houses, and territorial centers with day and five-day stays.

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