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 older people

2.1 Legislative framework for social work

2.2 Main directions of social work with elderly and elderly people

Conclusion

Bibliography

Applications

Introduction

One of the trends observed in recent decades in developed countries of the world is the growth 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 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 the life expectancy of 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 towards an increase in 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 and elderly people is based (compiled by N. M. Lopatin) (10);

Book 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;

BenefitB. 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 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 “elderly” (or “very old”) people, similar to how in France there is the concept of the “third” or “fourth” age. The boundary of the transition from the “third” to the “fourth age” is considered to be crossing the line in 75-80 years old. “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 years are considered elderly; from 75 to 89 years are considered 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 with 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, sociological, socio-psychological, socio-economic and other data 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 activities.

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; at the age of 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, practically healthy people among the elderly population make up approximately 1/5, 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 and senile age, the mobility of mental processes decreases, this manifests itself in increased deviations in the psyche.

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 pensioners 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 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 the fact that an elderly person no longer has the same strength, the same energy, cannot bear the load, often gets sick, and needs special nutrition.

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

As government statistics show, the increase in the number of late marriages is determined mainly by high divorce rates. As a rule, these are repeated marriages. 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 group of older people significantly changes his relationship with society, such value-normative concepts as purpose, meaning of life, goodness, happiness, and so on. People's lifestyles are changing significantly. Previously, they were connected 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. The break from work negatively affects the health, vitality, and psyche of people. And this is natural, since work (hard work) is the source of longevity, a condition for maintaining good health. And many retirees would like to continue working; psychologically, they are still 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 their work hours (12; 59)..

So, a person’s transition to a 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 of the final stage of human ontogenetic development, sociocultural attitudes and expectations in relation to a certain socio-demographic stratum - older people (4; 73). Special attention should be given 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 a person’s life after maturity, a gradual weakening of the body’s activity occurs. Older people are not as strong and unable to withstand prolonged physical or nervous stress as in their younger years; the total energy reserve becomes less and less.

Along with the darkness, 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 work of some systems of the body is maintained for a longer period and even improves, 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 of 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 activity and allows one to overcome the destructive (destructive, negative) phenomena of aging. All this leads to the conclusion that the period of late ontogenesis is a new stage of development and specific action general laws 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 performance as a whole 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 the respiratory, circulatory and muscular performance of elderly 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 involutional 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 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 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 at the same time what is remembered is preserved better than with mechanical imprinting; the basis of strength in old age is internal and semantic connections; logical memory becomes the leading type of memory (3; 54).

Older and older people do not form a monolithic group. Further changes during the period of gerontogenesis depend on the degree of maturity of a particular 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. The creative activity of the individual is of particular importance 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; closure of interests on oneself - selfishness, self-centeredness, increased attention to one’s health; uncertainty about the future - all this makes old people petty, stingy, over-cautious, pedantic, conservative, lacking initiative, etc.

Fundamental research by domestic and foreign scientists, however, testifies 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 never 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 are predominantly women who find the main application of their strengths 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: this is connected various forms activity, and moral satisfaction. 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 grumblers, dissatisfied with the situation the surrounding world,

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. is quite widely supported in the world psychological literature. Bromley. 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) dependence relationship, when an old man financially or emotionally dependent on a spouse or child;

3) a defensive attitude, which is characterized by exaggerated emotional restraint, some straightforwardness in one’s actions, and 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 to young people, withdrawn, prone to fears;

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 may also be associated with living separately from younger family members. However, more significant in old age are psychological aspects(isolation, self-isolation), 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 given rise to a limited social circle. 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 relationships among 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 the attitude towards old people towards the aging process as a whole.

In order to work with elderly and old people, you need to clearly understand 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 citizens and disabled people” (August 1995)

3) The decrees of the President of the Russian Federation are of great importance for solving the problems of the elderly and disabled: “On measures to create an accessible living environment for disabled people”; “On additional measures of state support for disabled people” (October 1992); "About scientific and information support 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"; “The procedure and conditions for 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).

The 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 recent years, a mechanism has been developed to provide social services to elderly and elderly people. The elements of such a mechanism include centers social services, in including branches social assistance at home, emergency social care departments, medical and social departments, day care departments. In addition, for those who need constant medical care and cannot do without outside help, there are stationary 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”;

Much 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 additional social support, helping to achieve longevity, ensuring a peaceful old age.

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

3) Development of the methodological, scientific base of social work with elderly and elderly people;

4) Training of modern professional personnel.

2.2 Main directions of social work with elderly and elderly people

1) Social security and services

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

Social security is provided government agencies, enterprises, individuals, through contributions (deductions from wages) 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 still continues to be insufficient, despite regular increases in pensions (16;204).

Local authorities also provide assistance to older people: differentiated additional payments to non-working pensioners are increasing; Various categories of elderly are provided with discounts on housing costs, travel on suburban transport in the summer, free prescription medications, free vouchers to sanatoriums, 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 departments of social assistance at home, as well as a number of other social assistance institutions (psychological and pedagogical, emergency psychological) (12; 75).

The Center for Social Services 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 special workshops or subsidiary farms and feasible labor activity for pensioners in them.

Temporary stay department (for at least 15 people). It carries out therapeutic, 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 domestic 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; providing clothing, shoes and basic necessities; one-time provision of financial assistance; assistance in obtaining temporary housing; provision of emergency psychological assistance, including via a “helpline”; providing legal assistance; provision of other types and forms of assistance determined by other regional 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 the elderly and elderly living in families, providing them with paid services.

This is how, for example, work is organized at the Mercy 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 for 15 beds in a local hospital, and a charity canteen. There is a day care unit for the elderly. It is intended for household, medical and cultural services, and organization of recreation for pensioners. The issue of opening a nursing department on the basis of a local hospital is being considered (service is free). In addition, the Center provides specialized medical and social assistance to lonely, seriously ill people (17; 239).

In our stormy, 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, an agreement on lifelong maintenance with dependents is concluded in accordance with the law and all legal norms. 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, advisory.

2.) Social care for older people

Guardianship of older people is one of the main directions in 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 being admitted to boarding homes.

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

In boarding houses general type 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 being 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 and 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 are single by choice;

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

3) those who do not want to stay 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 this is enabled by expanding home care. Home-based services guaranteed by the state have recently become more diverse. This includes catering and home delivery of food; assistance in purchasing medicines and essential goods; assistance in obtaining medical care and escort to 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 that take into account their everyday needs. 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 aids (crutches, hearing aids, glasses, etc.)

7) implementation of health activities (massage, water procedures, physiotherapy)

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. Hospices are a humanistic, medical institution for cancer patients in the last stage 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 a way to get rid of the fear of suffering that accompanies death, a way to perceive it as a natural continuation 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 the hospice. Here such fields of knowledge as gerontology, gerontopsychology, and geriatrics interact.

4) Providing psychological assistance

As already said 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, advisory assistance (personal problems, family conflicts, stress)

Leisure activities (organization of interest clubs, studios folk art,sports 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 in the work of religious organizations.

The problem of social work with elderly and elderly people is of national significance. 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 clearly understand 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 legal framework for social work has been created, which defines the goals and objectives of social work; sources of financing; programs for the social protection of 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) providing psychological assistance.

The need for social and domestic 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, disability.

Further necessary:

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

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

Train personnel; develop social technologies.

In connection with the increasing importance of the work of social service centers, develop standard designs for the construction of centers; highlight 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) AlperovichV. Social gerontology. Rostov n/d, 1997.

2) AmosovN. M. Overcoming old age. M., 1996.

3) Gamezo M.V., Gerasimova V.S., Gorelova G.G. Developmental 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 disabled and elderly people. Tyumen, 1995.

5) DmitrievA. B. Social problems of older people. M., 2004.

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

7) ConI.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 // AiFDolgozhitel 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 grow old 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: Popular reference book / Ed. L. I. Petrovskaya. M., 1996.

18) Population aging in the European region as one of the important aspects of modern development: materials of the 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

No. 1 2 3 a 3 b 4 a 4 b 5a 5b 6a 6b 7a 7 b 8 Ka 1 79 94 26 18 18 12 28 26 33 19 12 13 11 39 2 54 132 27 16 12 15 14 24 21 11 3 12 9 43 3 69 111 36 15 11 18 16 27 27 29 5 17 20 42 5 84 95 21 17 25 11 11 28 26 38 7 17 16 44 5 92 119 24 19 21 18 18 22 27 18 15 15 44 6 54 121 28 13 20 20 21 28 52 26 5 12 14 36 7 68 75 34 20 16 13 24 29 27 32 8 14 9 41 8 85 72 21 12 18 15 21 21 43 27 7 17 18 42 9 93 62 41 11 14 17 23 23 33 23 11 17 14 44 10 114 68 22 16 17 17 24 14 22 28 10 21 17 43 11 117 69 26 17 18 29 21 21 26 24 7 21 13 39 12 87 85 24 14 2 6 13 17 26 28 19 8 25 14 44 13 96 83 37 18 24 13 18 27 43 20 7 13 16 43 14 79 97 41 20 22 18 21 18 47 18 9 14 19 44 15 86 86 22 21 23 17 27 21 43 19 1 1 12 19 45 Wed. score 83.8 91.27 28.67 16.47 19 16.4 20.27 23.67 33.2 23.4 8.2 15.87 14.93 42.2

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 is the 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 chronic diseases that do not respond well 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 consists of 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). Studies conducted in different countries indicate 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 the fact that an elderly person no longer has the same strength, the same energy, cannot bear the load, often gets sick, and 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 work (hard work) is the source of longevity, a condition for maintaining 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 of 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 end 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 the period of gerontogenesis depend on the degree of maturity of a particular 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. The creative activity of the individual is of particular importance 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.

Fundamental research by domestic and foreign scientists, however, testifies 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 social and psychological types of old age:

1) active creative old age, when veterans continue to participate in public life, in educating young people, 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 labor activity; 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 of the 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) The decrees of the President of the Russian Federation are of great importance for solving the problems of the elderly and disabled: “On measures to create an accessible living environment for disabled people”; “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).

The Russian state, when developing and adopting relevant legislative acts, harmonizes them with the starting positions of the Universal Declaration of Human Rights (1948), the Final Act of the Helsinki Conference (1975), and 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 salary 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 service for the elderly and the elderly is carried out 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; provision of emergency psychological assistance, including via a “helpline”; provision of legal assistance; provision of other types and forms of assistance determined by regional and other characteristics.

A new form of care has emerged - 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 consumer, medical and cultural services, and organization of recreation for pensioners. The issue of opening a nursing department on the basis of a local hospital is being considered (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 prompts 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, are unable to 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 have recently become more diverse. This includes catering and home delivery of food; assistance in purchasing medicines and essential goods; assistance in obtaining medical care and escort to 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 aids (crutches, hearing aids, glasses, etc.)

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, folk art studios, 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. Developmental 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 disabled people and the 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 one of the important aspects of modern development: materials of the consultation of the international seminar. M., 1995.

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.

INTRODUCTION………………………………………………………………………………3

CHAPTER 1. SOCIAL PROBLEMS OF ELDERLY PEOPLE………….5

1.1. Social status of a person in old age……………………………..5

1.2. Quality of life of older people as a social problem………..8

CHAPTER 2. TECHNOLOGIES OF SOCIAL REHABILITATION

ELDERLY PERSONS……………………………………………………..13

2.1. Medical and social rehabilitation of older people……………….13

2.2. The role of rehabilitation centers……………………………………...19

CHAPTER 3. THE NEED FOR IMPLEMENTING NEW TECHNOLOGIES INTO THE PRACTICE OF SOCIAL SERVICES FOR THE ELDERLY POPULATION…………………………………………………...36

3.1. Regional innovative model for organizing social services for older people……………………………………………………………...36

3.2.New technologies for social services for elderly citizens……………………………………………………………………………………….44

CONCLUSION……………………………………………………………50

LIST OF REFERENCES…………………………52

INTRODUCTION

The constant increase in the proportion of elderly people in the entire population is becoming an influential socio-demographic trend in almost all developed countries.

This process is due to two reasons. Firstly, advances in healthcare, control of a number of dangerous diseases, and increases in the level and quality of life lead to an increase in the average life expectancy of people.

On the other hand, the process of a steady decline in the birth rate, below the level of simple generation replacement, a decrease in the number of children born to one woman during her entire reproductive period, leads to the fact that the level of natural mortality in our country has exceeded the birth rate. Each generation is replaced by the next generation of smaller numbers; The proportion of children and adolescents in society is steadily declining, which causes a corresponding increase in the proportion of older people.

Humanity is aging, and this is becoming a serious problem, the solution to which must be developed at the global level.

The relevance of research into working with older people in the social sphere is due to the following circumstances:

Firstly, the increasing role of social service institutions in organizing social support for older people in modern conditions;

Secondly, a social worker is a person who is in direct contact with the client, he knows his problems and tries to help him;

Thirdly, the need to identify older people, recognize their problems and take the most effective ways to eliminate them.

The object of the study is the technology of social work with older people.

The subject is the process of providing various assistance by rehabilitation centers, social services, and social workers.

The goal of the work is to identify social problems of older people, as well as to introduce new technologies of social work with this category of citizens.

The task of social workers and loved ones is to provide the elderly person, as far as possible, with knowledge and understanding of gerontopsychology, material and moral support and respect.

The rhythm of aging significantly depends on the lifestyle of older people (usually pensioners), their position in the family, standard of living, working conditions, social and psychological factors.

In order to work with older 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 and other types of research.

CHAPTER 1. SOCIAL PROBLEMS OF ELDERLY PEOPLE

1.1. Social status of a person in old age

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 to develop and implementation of specific approaches, forms and methods of social work with older people.

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.

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. Suffice it to say that currently 35.5 million people receive pensions and benefits in the Russian Federation. And if in 1957 there were 89 pensioners per 1000 people, then in 1993 there were 239 people. And in 1995, for example, less than 5% of the country’s national income was spent on social security needs, in 1990 it was already 13.5%. In 1993, 9.7 trillion rubles were spent on pensions, or, in fact, every fourth ruble from the wage fund went and goes to Pension Fund RF.

The growing trend in the number of elderly people requires a radical change in social policy in relation to this, the most socially unprotected category of society.

Persons aged 70 years or over make up 28.3% of the total population over working age, and their number in the population has increased markedly since 1979, especially in cities.

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 and are approaching the problem of old age and its definition from different points of view: biological, physiological, psychological, functional, chronological, sociological and others. And hence the specificity of solving problems of social and social status, role and place in the family, and the organization of social security and services, social rehabilitation, social care for older people, and so on. We must not forget that the aging process varies widely among different population groups and individuals.

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

As is known, in practice, elderly people are usually considered to be people who have retired. However, this measure cannot be universal, since retirement age varies 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 Provision in the RSFSR” 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.

Experience shows that the elderly 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, and so on.

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, primarily negatively affects his moral and financial situation, negatively affects his mental state, reduces his resistance to diseases and adaptation to environmental changes.

With the transition to the category of older people. pensioners, often radically changes not only the relationship between a person and society, but also such value guidelines as the meaning of life, happiness, good and evil, and more. The way of life itself, the daily routine, goals and objectives, and circle of friends 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 future, 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, and passive ones - to the past. The former are therefore more optimistic and believe more in the future.

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.

Over the past decade, a temporary decline in the dependency ratio has occurred as the burden of persons over working age has decreased.

This figure will reach its minimum value for Russia in 2007 – 569 people of disabled age per 1000 people of working age.

1.2. Quality of life of older people as a social problem

Most older people live in cities, but the socio-economic problems of the elderly population are especially acute in rural areas.

This situation reinforces the importance of state support for families that include elderly people and are simultaneously experiencing socio-economic difficulties: poverty, unemployment, large families, illness, relocation, etc. It is no longer an exception, but most likely a trend – an increase in the number of elderly people living alone.

Social work with older people involves the use of various theories, among them: liberation, activism, minorities, subculture, age stratification and others.

According to liberation theory, as people age, they become alienated from those who are younger; In addition, there is a process of liberation of older people from social roles - meaning roles related to work, as well as leadership and responsible roles. This process of alienation and liberation is conditioned by the social situation; in which aging people find themselves. It can also be considered one of the ways older people adapt to the limitations of their capabilities and come to terms with the idea of ​​inevitably approaching death. According to the theory of liberation in the social aspect, the process of alienation of older people is inevitable, since the positions they occupy at some point must pass to younger people who are able to work more productively. A number of critics call this theory the most inhumane, others ask the question: is “liberation”, “separation” a universal and inevitable phenomenon?

This theory is currently being replaced by the activity theory, whose adherents claim that aging people, parting with their usual roles, feel a sense of loss and uselessness in society. At the same time, self-esteem is undermined. To maintain their morale and positive self-awareness, they should not give up active life, but rather, take up new activities. By continuing to perform active, socially significant roles and interact with others (for example, working part-time or engaging in voluntary social activities), older people maintain psychological peace. The degree to which people adapt to old age largely depends on the nature of their activities in the early stages of life: if, as old age approaches, a person masters many different roles, it is easier for him to cope with the loss of those roles that he played in the past. People who had emotional and psychological stability and activity at the age of over 30 years retain vital energy even after 70 years; People in their 30s, who are characterized by fear and conservatism, exhibit anxiety for the rest of their lives.

The authors of the minority theory note that old people constitute a minority of the population, which predetermines their low socio-economic status, discrimination, warnings against them and many other phenomena.

The theory of subculture refers older people to a certain subculture, which is defined as a set of unique norms and values ​​that differ from the norms and values ​​prevailing in society. If aging people manage to make new friends and maintain existing connections, they are able to create a subculture that helps them maintain a sense of psychological stability. There are two important points that justify this idea: 1) psychological closeness between people belonging to a given age group; 2) their exclusion from interaction with other groups of the population. Thus, it is assumed that discrimination against older people and their sense of community give rise to the emergence of an old age subculture. According to the authors of this theory, an increase in the number of villages for retirees and other similar housing complexes and institutions would contribute to the formation of a distinctive subculture.

Older people have the right to a full life, and this is only possible if they themselves take an active part in resolving issues that affect them, when they have freedom of choice. Some experts consider the most fruitful theory of “age stratification,” according to which each generation of people is unique and has only its own experience.

Of course, the development of theories of aging that are adequate to the complex nature of man, taking into account the positive capabilities of a person in old age, as well as their dissemination in society along with appropriate social measures, continues. This process can become an additional factor in achieving longevity for all members of society, since ideally these theories and the formation of individual lifestyle options based on them should contribute to an increase in active longevity.

At the same time, therapeutic models that form the foundation of practical work with older people should use three principles: 1) studying the individual in his social environment; 2) understanding of the psychosocial formation and development of personality as a lifelong process; 3) taking into account the sociocultural factors of the formation and development of the individual. Of course, different theories correspond to each of these principles to varying degrees.

Modern social work with the elderly should be built in accordance with the UN principles for older people of 2001: “Making the lives of older people full.”

1) develop a national policy regarding the elderly, thereby strengthening the connection between generations;

2) encourage charitable organizations;

3) protect older people from economic shocks;

4) ensure the quality of life in specialized institutions for the elderly;

5) fully provide an elderly person with social services regardless of his place of residence - in his homeland or in another country.

These principles are grouped as follows:

1 – INDEPENDENCE;

2 – PARTICIPATION;

4 – REALIZATION OF INTERNAL POTENTIAL;

5 – DIGNITY.

CHAPTER 2. TECHNOLOGIES OF SOCIAL REHABILITATION

ELDERLY PEOPLE

2.1. Medical and social rehabilitation of older people

In social work with older people, various forms and methods are used. This includes social services at home, urgent social assistance, targeted social protection, and so on. This system operates various institutions, in particular social service centers, day care units, inpatient facilities and special residential buildings for the elderly.

Especially important for the elderly, their medical and social rehabilitation is acquired.

It is generally accepted that wheelchairs, walking sticks, and coughing are attributes of old age, that aging and illness are one and the same thing. Numerous studies in the US have shown, however, that this is not the case. And old people can be active and cheerful.

Of course, with age, the need for medical care increases. Due to the natural aging of the body, a number of chronic diseases appear; the proportion of people in need of constant medical supervision and the help of cardiologists, neurologists, gerontologists, and geriatricians is growing. The civilization of a society is determined, in particular, by how wide the network of special clinics, hospitals, rest homes and sanatoriums for the elderly is.

Among the diseases that older people are susceptible to are, for example, senile insanity. This is the extinction of the body’s vital functions due to atrophy of the cerebral cortex. This disease is accompanied by extreme exhaustion, loss of strength, and almost complete cessation of mental activity; develops in old age or as a result of a long illness.

Often this disease is caused by the losses of older people (loss of family, friends, role in society, which results in a feeling of uselessness, uselessness). Sometimes this gives rise to mental disorder, illness. The worst outcome is suicide. To prevent suicide, a “helpline” is used (two-way communication: both the elderly and the elderly call). Centers for the elderly are also being created for their communication.

Research (particularly in the USA) has shown that the process of memory loss can be slowed down. As it turned out, a lot depends on the attitude towards older people (as decrepit or as vigorous, active).

Another disease of older people is senile alcoholism. Alcoholism is a disease of all ages, but it is a particularly difficult problem for older people.

The situation of elderly disabled people remains difficult.

A big problem is vision and hearing loss in older people. As noted at an international conference in March 1992, the United States has put a lot of effort into developing comfortable hearing aids over the past 10 years, and the problem has been largely solved, which, unfortunately, cannot be said about our country.

What determines the health status of older people and their well-being?

First of all, from living conditions, nutrition, activity, social connections. Many diseases of older people are the result of their lifestyle, habits, and nutrition. If from a young age a person eats right and moves actively, then he does not have many diseases.

Thus, the ratio between the main nutritional elements (proteins, fats, carbohydrates) in the diet of older people (and not only the elderly) in our country is 1:0.74:5.4, but should be different (1:0.7 :3). Carbohydrates predominate due to consumption white bread, pasta, sugar. The principle of healthy eating is more vegetables, fruits and berries, less meat. Of course, this is possible under normal socio-economic conditions.

Social services should take care of the physical health of older people, encourage them (and help create conditions) to engage in physical exercise. Practice shows that participation in competitions, marathon races, walrus swimming, cross-country skiing, and so on has a beneficial effect on the health of everyone, including older people. It is not the results that are important, but the participation itself.

However, a sick person, naturally, has no time for marathons. (According to special studies conducted by the Institute of Gerontology of the Academy of Medical Sciences of our country, 12% of all elderly people and 25-30% of old people are bedridden). Aging and associated deterioration in health and illness predetermine the need for ongoing medical care, home care, and placement of the elderly or sick in specialized homes or hospitals. The need for the construction of the latter is also determined by the fragmentation of families, the increase in the number and proportion of single people in the country's population.

In preserving the health of older people, a significant role can be played by the state’s urban planning policy, the creation of conditions for their settlement in suburban areas, on the outskirts of cities, on the lower floors of high-rise buildings, and the possibility of exchanging apartments. Studies show that older people are less likely to visit doctors for cardiovascular diseases (1.4 times) if they live on the first floors. The incidence of illness decreases by 25% if the volume of indoor air per person doubles.

The problem of hopelessly ill people and the issue of artificially ending the lives of such people are extremely complex and at the same time delicate. Cases of killing patients at their request in order to get rid of excruciating pain are assessed differently and ambiguously. And this is indeed a difficult problem. There are not only medical, but also social and humanistic aspects.

In conclusion, briefly about the problem of longevity.

Numerous studies in many countries have shown that the achievement of deep old age is facilitated by an active lifestyle, and especially work, nutrition, social and living conditions, as well as hereditary factors.

It has also been established that at present the overwhelming number of people die under the influence of various pathological processes long before the exhaustion of the potential vital forces genetically inherent in a person. Science has proven that the life expectancy of a person as a biological species should be 90-100 years. Some scientists even estimate this period as 110-120 years. And the presence of centenarians in different countries, especially in certain regions, reinforces the validity of such statements.

In 2050, there will be approximately 2 billion people in the world who are over 60 years of age (3.5 times more than today).

I will also note that with the growth of civilized forms of life, its average duration gradually increases. However, in certain periods (wars, epidemics, crises, and so on), the reverse process can also be observed. In our country, for example, the average life expectancy was in the 30s of the 20th century. 45 years old, in the late 80s - more than 73 years old, now (in Russia) - 58 years old (men) and 71 years old (women).

Social services and provision for older people provide a huge field of activity for a social worker.

Having knowledge and experience, appropriate mental qualities, they can significantly contribute to improving the lifestyle of older people, ensuring their independence, dignity, and helping them take their rightful place in society. The arsenal of such possibilities for socionomes is quite wide. The main thing is to implement them.

Social work as the most important section of activities in the field of serving older people and disabled people has become increasingly relevant in recent years. Although the social concern of the state and society in relation to the disabled and old sick people in Russia has always been manifested, the issue of specialists who would carry out this activity has never been discussed or resolved.

Social work (in the broad sense of the word) with such categories of people as the disabled and the elderly was carried out systematically in the bodies and institutions of social security (social protection). Among those carrying out this activity were employees of boarding homes, social service centers, municipal and territorial authorities.

Since the introduction of these positions, social workers have been assigned a specific role, which is determined by the type of institution, the nature of the services provided, and the goals (objectives) and expected results.

The place of activity of a social worker in connection with these circumstances seems to be moving, it is dynamic. At the same time, as workers of this category are introduced into the social protection system, their functions are expanded.

The activities of social workers extend to all categories of disabled and elderly people, both in the population (including in families) and in boarding homes. At the same time, the specifics of the activities of social workers especially emerge. In some cases, it has the character of organizing assistance from various services (medical care, legal consultations, and so on), in others it acquires a moral and psychological aspect, in others - the character of correctional pedagogical activity, and so on.

It must be emphasized that in addition to direct “consumers” (disabled people, elderly people), the scope of activity of social workers also extends to service personnel, for example, in boarding homes, with whom social workers have to interact. In this regard, the level of education of social workers, their professionalism, knowledge psychological characteristics disabled and elderly people.

Due to the wide and varied functions of social workers in serving older people, there is a need for these specialists with different levels of education.

For that category of disabled and elderly people who are in the population, the range of activities of social workers covers a wide range of tasks, ranging from the provision of social and domestic assistance to psychological and pedagogical correction and moral and psychological support.

For disabled people and elderly people in inpatient institutions, the activities of social workers also have a wide range, ranging from social adaptation in boarding homes to the integration of disabled people into society.

2.2. The role of rehabilitation centers

Elderly people and disabled people in the Russian Federation have all the socio-economic and personal rights and freedoms enshrined in the Constitution of the Russian Federation, the constitutions of its constituent republics, and other legislative acts. However, a change in the social status of a person in old age and a disabled person associated with the cessation or limitation of labor and social activities; transformation of values, lifestyle and communication; experiencing difficulties in social, everyday and psychological adaptation to new conditions, gives rise to serious social problems.

The most acute problem is the limitation of life activity of the elderly and disabled. Limitation of life activity is understood as a complete or partial lack of a person’s ability or ability to carry out self-care, movement, orientation, communication, control over one’s behavior, as well as to engage in work activities.

In solving this problem, improving the system of social rehabilitation and social assistance for the elderly and disabled is of paramount importance.

Social rehabilitation is a set of measures aimed at restoring a person’s rights, social status, health, and legal capacity.

Social rehabilitation is a complex of socio-economic, medical, legal, professional and other measures aimed at providing the necessary conditions and returning these population groups to a full life in society.

An integral element of social protection of older people and disabled people at the present stage is the provision social assistance - that is, provision in cash and in kind, in the form of services or benefits, provided taking into account the social guarantees legally established by the state for social security. It is, as a rule, in the nature of periodic and one-time additional payments to pensions and benefits, in-kind payments and services in order to provide targeted, differentiated social support for these categories, eliminate or neutralize critical life situations caused by unfavorable socio-economic conditions.

Thus, along with the provision of traditional forms of social security: cash payments(pensions, benefits); in-kind provision; services and benefits; stationary and non-stationary types of services - great importance is attached to new forms of emergency social assistance to disabled citizens of the Russian Federation in dire need.

Social services and provision for older people 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.

In 1995, the social protection system of our country included 959 inpatient institutions for the elderly and disabled, more than 700 social service centers, 900 social assistance departments at home, as well as a number of other social assistance institutions (psychological and pedagogical, emergency psychological assistance, etc. Further).

The most developed network of social services in Chelyabinsk, Samara, Rostov, Vladimir and a number of other regions.

Let's consider the content of the work of the Social Service Center (for elderly citizens and the disabled). As a rule, it includes several sections. IN day care unit (designed to support at least 30 pensioners and disabled people) food, medical and cultural services are organized. Participation in feasible labor activities in special workshops or subsidiary farms is provided.

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

IN home social assistance department (it serves 120 people in the city, 60 people in rural areas) provides permanent or temporary (up to 6 months) social services at home for pensioners and disabled people who need outside help (free or on a paid basis).

One of the primary tasks of social assistance departments at home is the active identification of disabled citizens in need of home care. Research conducted in this direction by the Central Research Institute for the Examination of Working Capacity and Labor Organization of Disabled People (CIETIN) showed that among disabled citizens (pensioners and disabled people of working age), 22.2% need home care.

A study by CIETIN staff of the contingent of persons accepted for home care in 10 administrative territories of Russia showed that the overwhelming majority (80.8%) of them are women; men, respectively, accounted for only 19.2%.

By age, 2/3 of those served were aged 75 years and older (66.1%), moreover, the share of persons aged 85 - 89 years accounted for 14.6%, and centenarians - 3.6%. Persons under the age of 60 made up only 6.8% of those served, approximately the same number and 65-69 year olds - 7.5%. At the same time, there were already 19.6% of those served in the age range of 70 - 74 years.

According to the degree of self-care, all respondents were distributed as follows: 46.7%, provided food was delivered to their home, could fully serve themselves, while 90% of them either did not use mobility aids at all or used a cane.

Approximately the same number of those surveyed partially served themselves - 46.2%; 7.1% were completely unable to take care of themselves. Among the indicated 53.3% of disabled and elderly people, 6.0% were constantly on bed rest, and 30.0% had difficulty moving only within the living quarters. 35% of people from this combined group did not use aids when moving, others either used crutches or a cane (50%) or a wheelchair (15%).

The need of served single disabled citizens in various types social services and the degree of satisfaction.

Also, in addition to the list of services provided by regular departments of social assistance at home, employees of specialized departments assist in the preparation of hot food for the persons they serve, feed weakened pensioners and the disabled, carry out wet cleaning of residential premises, provide sanitary and hygienic assistance (wiping, washing , hygienic baths, cutting nails, combing hair), as well as carrying out various medical procedures, providing emergency first aid, carrying out sanitary and educational work with those served and their relatives. Appendix 2 contains lists of services provided for by various regulatory documents for regular and specialized departments of social assistance at home.

Emergency social assistance service The Social Service Center provides a wide range of 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”:

Providing legal assistance within its competence;

Providing other types and forms of assistance determined by regional and other characteristics.

Of significant importance in the crisis situation in Russia is targeted social protection old people. It turns out primarily to those most in need: single pensioners, disabled people, elderly people over 80 years old.

Sociological studies in our country have shown that the main directions for ensuring the well-being of the elderly (in their opinion) are: increasing pensions, improving pension provision, developing home care services, increasing the number of nursing homes and improving living conditions in them.

Improving pension provision is one of the most important areas of social security in modern states. This problem is solved in different ways.

In some countries, pensioners receive pensions 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 was and is practiced in our country. There is also the prospect of voluntary old-age insurance (the right to an additional pension). Unfortunately, in the 90s, pension provision in Russia was extremely insufficient. The size of the pension is much less than the subsistence minimum, and it is often paid at the wrong time.

In a number of regions of the country, local authorities provide significant assistance to older people: differentiated additional payments to non-working pensioners are increasing; Various categories of elderly are provided with benefits for housing and telephone payments, free medications are provided according to doctors' prescriptions, and so on.

It is necessary to pay attention to social services for the elderly. Here it is important to provide, taking into account the loss of self-care ability, the provision of special comfortable shoes, clothing, various kinds of instruments and devices that would make it easier for old people to move around the street, housekeeping, and perform certain hygiene procedures

To solve these problems, architects, designers, and gerontologists have long identified promising directions for the development and production of appropriate household appliances. These proposals boil down to creating:

· lift systems for caring for bedridden patients and providing them with sanitary and hygienic assistance;

· special furniture and mechanisms for cleaning premises, taking into account the age specificity of the elderly and the like, as well as a number of simple but very necessary devices and devices that create convenience for the elderly and increase the safety of household operations;

· systems of handrails and support brackets for an old person to take a bath;

· special stands that make it easier to put on shoes;

· gentle ramps instead of thresholds and the like.

The proposals are good, but, unfortunately, in our country they are being implemented extremely unsatisfactorily

A study of the opinions of the directors of boarding homes, on the basis of which social service centers are formed, about the advisability of such a symbiosis showed that all respondents consider this not the best option, giving the following arguments:

· with rare exceptions, boarding homes for the elderly and disabled are located at a considerable distance from residential areas and have poor transport connections, which creates serious obstacles for older people to visit the day care department every day;

· the sanitary and hygienic requirements for the boarding home as a closed institution are violated: persons visiting the day care department are not comprehensively examined, like permanent residents;

· by contacting the latter, using the common dining room, library, cinema hall, they create the danger of introducing infections into the boarding house;

· the living conditions of permanent residents are deteriorating due to their compaction to allocate space for a day care department. In addition, additional budgetary funds are not allocated for the maintenance of the department, which indirectly affects the material well-being of residents of the institution;

· the moral and psychological climate among permanent residents is deteriorating, many of whom protest against the fact that those visiting the day care department freely enjoy all the benefits of the boarding house (furniture, library, cinema hall, medicines, receive medical care, as well as free or reduced-price meals) and at the same time, their pension is retained in full, while those living in a boarding house receive only 10% of the pension, the rest of which goes to state income.

In this regard, in many administrative territories, social service centers began to be created as autonomous institutions, neither territorially nor functionally associated with boarding homes. At the same time, 56 centers still remain “tied” to boarding homes.

When the first centers were created, rotation of visitors to day care departments after a certain time was not yet provided for. However, the positive experience of these institutions made them popular among the population of retirement age, and found a large number of people willing to use the services of the day care department. In this regard, taking into account the number of pensioners living in the service area of ​​the Center and the number of applicants to visit the branch, in many territories the time frame for which one group should be recruited was calculated, so that during the year everyone could visit the center twice and more than times. This is done in the cities of Chelyabinsk, Shakhty of the Rostov region, and in certain centers of the city of Moscow. The duration of visiting Centers in different territories varies: from 2-3 months to 2 weeks (in Moscow). At the same time, as the results of a survey of those visiting the department showed, the 2-week period does not satisfy the majority of older people, since during this time people do not have time to get to know each other well, they do not have time to form micro-teams and interest groups that help get rid of the feeling of loneliness and preserve established connections even after the end of the period of visiting the department. Cultural events during a 2-week “shift” are usually reduced to holding one concert by local artists, as well as one lecture or conversation, and the organization of leisure activities (club work, amateur performances, evenings of relaxation in daytime with dancing, choral singing, and so on) essentially does not take place. As a result, most visitors come to the branch only during lunch to receive free hot meals.

The department enrolls pensioners and disabled people, regardless of their marital status, who have retained the ability for self-care and active movement, on the basis of a personal application and a certificate from a medical institution stating that there are no contraindications to admission to the department.

The department provides premises for a first-aid room, club work, a library, workshops and others.

Meals can be provided either in a specially equipped department room or in nearby catering establishments. To organize the rest of those served in the department, sleeping quarters are equipped (at the rate of at least 2 beds per 10 visitors) with individual bedding.

Persons served may, with their voluntary consent, participate in feasible labor activities in specially equipped workshops or on subsidiary farms. The products of the subsidiary farm are used to provide food for the persons served, and the surplus can be sold with subsequent crediting of income to the account of the Center.

Pensioners and disabled people are served by the department free of charge. Meals for those served can be free or for a fee, the amount of which is established by the management of the Center in agreement with the local administration.

By decision of the management of the Center and the local administration, certain services in the department may be provided for a fee (massage, manual therapy, visiting cultural and entertainment events, and so on). Cash, collected for certain types of services, are credited to the Center’s account and directed towards its development.

According to staffing table, the day care department is headed by the head of the department. In addition, it provides for the positions of a nurse, a cultural organizer, a sister-hostess, a nurse, a cloakroom attendant, and, when organizing catering in the department itself, also a barmaid and waitress. If there are workshops or subsidiary farming, the position of occupational therapy instructor is introduced.

A study of the contingent of people visiting day care departments in 24 Social Service Centers (300 people) showed the following: 80.7% were women, 19.3% were men. According to age gradations, elderly people (60-74 years old) predominated - 48.6% and senile people (75-89 years old) - 46%.

An analysis of the marital status of those surveyed showed that these departments are visited mainly by single and lonely citizens - 65.7%; 12% are single married couples. 22.3% of those visiting the department live with relatives of varying degrees of kinship, but 15.7% do not receive any material or household assistance from their relatives, and relationships with them among older people are predominantly strained or downright hostile.

Visitors to the day care department have different educational levels: 22.4% of citizens have primary education or are illiterate; 40.3% of people have incomplete secondary and secondary education; 38.8% of visitors have special secondary or higher education.

The majority of department visitors (58%) provide self-care entirely; 42% provide self-service with partial assistance from social workers, relatives and other persons. 58.6% of them did not use any mobility aids, the rest used canes (the majority depending on the time of year) and only 2 people out of 300 surveyed walked with the help of crutches.

A study of the motives for visiting a day care department showed that the leading one for the vast majority of people is the desire to communicate (76.3%), the second most important is the opportunity to receive free or reduced-price lunch (61.3%); The third in the hierarchy of motives is the desire to spend one’s leisure time meaningfully (47%). Motives such as the desire to save oneself from the process of cooking (29%) and unsatisfactory material security (18%) do not occupy a leading position among the main contingent of those visiting the department. At the same time, almost half of the citizens (46.7%) also have other motives that attract them to the day care department. Thus, a daily visit makes them “be on their toes,” “disciplines,” “fills life with new meaning,” and “allows them to relax.” For some citizens, long-term visits to the department contributed to a significant improvement in health (reduction of bronchial asthma attacks, vascular crises, etc.). A cozy atmosphere, the friendliness of the department staff, as well as the opportunity to receive medical care and engage in physical therapy at any time have a positive impact on the emotional sphere.

The hierarchy of motives for visiting the day care department is largely related to both the age of the respondents and the educational level. This circumstance should be taken into account when forming the contingent of each “shift” and when developing a plan of leisure and other activities for each such “shift”.

Currently, the staffing table of day care departments does not provide for the position of a social worker; his job responsibilities are performed partly by the head of the department and partly by a cultural worker. At the same time, issues of staffing the department's contingent, forming micro-collectives among department visitors, providing psychological assistance, to a certain extent organizing leisure activities and others should be dealt with by a specially trained person - a social worker. It can be assumed that in the future such a position will appear on the staff of day care departments.

In recent years, a new structural unit has appeared in a number of Social Service Centers - the Emergency Social Assistance Service. It is intended to provide one-time emergency assistance aimed at maintaining the livelihoods of citizens in dire need of social support. The organization of such a service was caused by changes in the socio-economic and political situation in the country, the emergence of a large number of refugees from hot spots of the former Soviet Union, homeless people, as well as the need to provide urgent social assistance to citizens who found themselves in extreme situations due to natural disasters, and so on.

In accordance with the regulatory document, the Emergency Social Assistance Service must be located in a specially designated room that has all types of communal amenities, storage facilities for storing items of natural assistance (clothes, shoes, bed linen, a set of medications and dressings for providing emergency first aid and other), have a telephone connection.

The main activities of the Service are:

· providing the necessary information and advice on social assistance issues;

· provision of free hot meals or food packages (using coupons at a designated catering establishment; coupons can be issued for one visit to the canteen or, after examining the social and living conditions of the victim, for a period of a month);

· provision of clothing, shoes and other essential items;

· providing financial assistance;

· assistance in obtaining temporary housing (in some cases, together with the immigration service);

· referral of citizens to the relevant authorities and services for a qualified and complete resolution of their issues;

· provision of emergency psychological assistance, including via a “helpline”;

· provision of other types of assistance determined by regional characteristics (including urgent legal assistance to disabled people and older people who are unable to receive the services of the state legal service).

The staffing table of the Emergency Social Assistance Service includes the following positions: head of the service, psychologist (0.5 rate), lawyer (0.5 rate), social work specialists (2 positions), social worker.

Due to the fact that the Emergency Social Assistance Service is at the initial stage of its development, it is undergoing changes, constantly improving, introducing new forms of social services for citizens, and with it the entire social assistance service for disabled citizens is being improved. Thus, in a number of administrative territories, new structural units began to appear within the Social Assistance Centers - temporary stay departments (from 4 weeks to 3 months) for older people and disabled people (for example, in the Novosibirsk and Samara regions). They are located, as a rule, in the buildings of former trade union health resorts (rest homes, pioneer camps), as well as rural district hospitals, which were abandoned by health authorities, medical units of industrial enterprises on a shared basis, and so on). The selection of disabled citizens for these departments is carried out with the help of social workers, veteran organizations, and upon personal appeal from disabled citizens. In a number of territories (for example, in the Arkhangelsk region), such branches function only in the autumn-winter period, when lonely old women from nearby villages gather in them to spend the winter warm and well-fed, and return to their gardens in the spring. Such departments may provide for the provision of pre-medical and medical care, the organization of meaningful leisure time, and psychological assistance. This form of social service has not yet become widespread, but the positive experience of the functioning of such departments suggests that they are needed and their further development has prospects.

Thus, the considered issues of creating and developing social assistance services for disabled citizens in Russia give reason to predict their further improvement, in which new cadres of social work specialists will take an active part, the training of which is currently being given the most serious attention.

CHAPTER 3. THE NEED FOR INTRODUCING NEW TECHNOLOGIES INTO THE PRACTICE OF SOCIAL SERVICES FOR THE ELDERLY POPULATION

3.1. Regional innovative model for organizing social services for older people

Russia is a country with a complex medical and demographic situation, a high average share of elderly people in the population (at 20.8%), exceeding the share of the child population, and significant regional differences in the level and quality of life of older people. Learning to live in conditions when the structure of the population by gender and age has changed, when it is necessary to coordinate the interests of all age groups, when ensuring the well-being of children and the elderly will require consistently high expenditures of resources of all types - this is not an easy task for a transforming society.

One of the natural macroeconomic consequences of aging as a socio-demographic process is an increase in the need for social services, which affects the development of the social service system for the population, determining the volume of funding for social service institutions in the budgets of the constituent entities of the Russian Federation and local budgets.

First of all, elderly citizens (about 30 million people) form a stable demand for social services. It will increase in the foreseeable future. The structure of demand for social services is gradually changing; expensive services for constant outside care at home, social and medical services, and nursing services are becoming necessary. The demand for places in protected housing is growing noticeably.

This is explained by the presence of groups of elderly people with special needs: elderly disabled people (5.3 million people), people over 70 years old (12.5 million people), centenarians (about 18 thousand people aged 100 years and older), lonely long-term ill elderly people, elderly residents of remote rural areas (about 4 million people).

A decade of reforms has brought significant achievements in the field of social services for the elderly population: the right to social services in the Russian Federation has been established by law, social services are developing rapidly, and there are social service institutions for the population various types, financial, material, technical, and personnel support for their activities is constantly improving, the technologies used for social services are being improved, methods for individual assessment of the need for assistance and social services are gradually being introduced, and the participation of non-state structures in these activities is expanding.

Since 1991, the number of inpatient social service institutions for elderly citizens and various types of disabled people has increased from 737 to 1207, and the number of places in them has increased by 12.3 thousand.

The peculiarity of the Russian situation is that both stationary and non-stationary social services are equally in demand by the elderly population, and semi-stationary forms of social services often turn out to be the most socially acceptable and cost-effective.

In Russia, approximately 0.7-0.8 percent of the total number of elderly citizens permanently reside in inpatient social service institutions.

There is a constant increase in the attendance of older people in non-stationary social service institutions. In 2002, 12,957.8 thousand people were covered by non-stationary forms of social services. At the same time, of the total number of persons served, 10,865 thousand people applied to emergency social service departments (services). This structure of appeal reflects negative trends in the quality of life of older people.

The number of people served at home by specialized departments of social and medical services is growing and amounts to 129.2 thousand people. However, this indicator is unstable, and the stated need for social and medical services at home is obviously lower than the real “latent” demand for them.

It is necessary to simultaneously increase quantitative and qualitative indicators of social services, take more fully into account the differentiation of incomes of consumers of social services, and take measures aimed at the real creation of a market for social services, when the supply of social services comes not only from state and municipal structures. This is closely related to the task of protecting the rights of older people as consumers of services and introducing the institution of independent control.

The task of improving the quality of social services provided comes to the fore, which is associated with overcoming differences in the quality indicators of social services characteristic of individual regions, populated areas, cities and villages.

Simultaneously The search for new approaches to ensuring high quality social services, new forms of service provision, and organization of the activities of social service institutions does not stop.

Thanks to an active policy in the field of social services for the elderly population, the basis is created for proactive actions and the use of new social technologies, including those tested on the experience of other countries, in order to accelerate the development and increase the efficiency of social service institutions.

The introduction of innovation is justified if it serves to achieve specific priority goals. In a transforming society, the innovation process contributes to the achievement of practical results on such priorities as:

Respect for rights and enforcement safe conditions for the elderly;

Improving the quality of life and maintaining independence in old age through the provision of social services;

Providing effective support to families providing family care to older people;

Establishing partnerships at all levels.

A definite milestone in terms of the dissemination of new approaches and technologies in social services for older people was the holding in November 2002 in Saratov of the first All-Russian Congress of Social Workers under the motto “Social work for older people: professionalism, partnership, responsibility.”

The use of new technologies for social services for elderly citizens is becoming increasingly widespread in connection with the establishment of a single moral and ethical standard of treatment of the elderly, based on respect for him.

The basic principle of modern social services is clearly formulated and becomes publicly available - a focus on an individual assessment of the client’s needs, a more advanced mechanism for the provision of social services based on individual plans, and the participation of older people themselves in planning the activities of social services.

The contribution of social protection authorities and directly social service institutions can be illustrated by the example of the Kemerovo region, where in the period 2000-2003, with the support of the Russian Ministry of Labor, the pilot project “Support and development of social services for older people in the city of Kemerovo and the Kemerovo region” was successfully implemented. Within its framework, the cities of Kemerovo, Novokuznetsk and Berezovsky received the status of model territories, two general boarding houses and two comprehensive social service centers received the status of model institutions. The project was financed by the UK Department for International Development.

The system for the development and implementation of new technologies for social services for elderly people at home included:

Conducting research to study the needs of older people for social services;

Studying the social and economic capabilities of social institutions providing services;

Development of new models of work to meet the needs of elderly clients;

Training of personnel, including social work specialists and senior social workers;

Monitoring and adjustment of the “working” model, taking into account the experience gained during its application.

In Kemerovo equipped educational and methodological (model social) apartment with means of rehabilitation and social adaptation of clients, which allows you to effectively assess the capabilities that an elderly or disabled person has for an independent life, individually select and purchase technical means of rehabilitation. The opening of the apartment took place on October 1, 2002.

The educational and methodological apartment was converted from a standard city apartment and is fully adapted for living in it and organizing the life of people with disabilities, maintaining independence and autonomy. The cost of remodeling the apartment was 250 thousand rubles. The project provides for widened doorways, the absence of thresholds, a wide balcony door and a convenient exit to the loggia, which allows a disabled person to move freely around the apartment in a wheelchair. The sanitary unit is equipped with special handrails. The entrance to a residential building is equipped with a removable ramp; wheelchair thresholds. The electrical equipment of the apartment is designed in such a way that a person with disabilities can handle it independently.

A wide range of rehabilitation and adaptive equipment was required. As part of the project “Support and development of social services for older people in the city of Kemerovo and the Kemerovo region,” 138 types of rehabilitation equipment worth 231.1 thousand rubles were installed in the educational apartment: bathroom equipment - 34 types; self-service equipment – ​​27 types; equipment for housekeeping – 58 types; equipment for safe movement and movement – ​​10 types; walking aids – 9 types.

On the basis of a model social apartment, training seminars are held for social workers and students studying in the specialty “Social work”, relatives who provide care for elderly family members, on the rules and techniques of caring for the elderly and people with disabilities using rehabilitation equipment. Specialists from the social rehabilitation department of the Integrated Center for Social Services for the Population of the Central District of Kemerovo assist them in the selection and purchase of rehabilitation means. In the model apartment, meetings of communication clubs, “Obereg” and “Looking for a Job” clubs (members are disabled people who want to find a job) are held.

The apartment is visited by representatives of medical institutions, which helps to strengthen interaction with medical structures on issues of social rehabilitation of older people and disabled people, including referral to the social rehabilitation department of relatives who have been caring for seriously ill patients for a long time.

In the region The activities of social workers have been streamlined. It is being implemented, and quite successfully, new system teamwork to implement home care. The services provided are more responsive to individual needs and have become more diverse and effective.

If previously a significant part of the time of social workers was spent delivering food to clients, now they work in teams and provide various types of social services. All model centers offer courses for social workers, where they improve their skills and acquire professional knowledge.

Regularly surveys are conducted using questionnaires that provide information on how satisfied customers are with changes in service and how they evaluate its effectiveness. A survey on the quality of care was conducted in model inpatient facilities using a method known in the UK as the Internal Assurance of Quality program. All organizers of social services for older people and project experts drew attention to the great potential of this program.

The project “Support and development of social services for older people in the city of Kemerovo and the Kemerovo region”, based primarily on human resources, enthusiasm and passion of employees, embodies the best ideas of international cooperation and mutual support in the interests of older citizens.

Currently, the Russian-European Foundation, as an organization implementing the project with the support of the Ministry of Labor and Social Development of the Russian Federation, social protection authorities of the constituent entities of the Russian Federation, is successfully implementing measures to disseminate the innovative experience accumulated in the project.

3.2. New technologies for social services for older citizens

The Ministry of Labor of Russia and the social protection authorities of the constituent entities of the Russian Federation are constantly actively working to strengthen existing and develop innovative forms of social services for elderly citizens and people with disabilities: including gerontological, gerontopsychiatric, rehabilitation centers, houses (departments) of mercy, social assistance institutions for people without a fixed place residence and occupation, specialized departments of social and medical services at home, social and health centers, special residential buildings for single elderly people, social apartments.

Gerontological centers – new type social service institutions for elderly citizens, where geriatric care is provided. The need for their creation is caused by the growing number of elderly citizens and centenarians in need of enhanced medical care. Gerontological centers have been opened in the Republic of Tatarstan, the Krasnodar and Stavropol Territories, in the Volgograd, Voronezh, Novosibirsk, Omsk, Oryol, Smolensk, Yaroslavl regions, the Khanty-Mansi Autonomous Okrug and Moscow.

The Regional State Institution occupies a special place in organizing work with older people in the Novosibirsk region "Novosibirsk Gerontological Center" whose main task is to develop new technologies in working with older people, providing organizational and methodological assistance to social service institutions for older citizens.

Currently, in order to improve the activities of gerontological centers, the Department for Veterans Affairs, the Elderly and Reception of the Population of the Ministry of Labor of Russia, providing organizational and methodological work and support in strengthening the material and technical base of these institutions, is preparing methodological recommendations for the social protection authorities of the constituent entities of the Russian Federation on organizing the activities of these centers. Developing centers are comprehensively supplied with modern medical, technological and rehabilitation equipment under the federal target program “Older Generation”.

They are playing an increasingly important role in helping pensioners social service centers. Currently, there are over 1.9 thousand such centers. Compared to the initial stage of development of these institutions, new for the period of the 80s, their rapid quantitative growth has ceased. In recent years, 40-50 new centers have been opened annually.

However, as a result of improving the system of types and forms of social services, including a range of services (medical, utilities, trade and others) provided to elderly citizens, characteristic feature centers became theirs versatility.

A new form of social services for elderly citizens and disabled people has been introduced in the Amur Region - social advisory centers for working with citizens at their place of residence.

In the Primorsky Territory created teams of social workers for growing garden produce. The Center for Social Services of the Population enters into agreements with citizens receiving home-based services to grow garden produce on their plots of land. Part of the harvest is given to low-income citizens as financial assistance, and part is sold to public catering establishments. The proceeds from the sale are also used to provide financial assistance to low-income pensioners.

People are playing an increasingly important role in supporting single elderly citizens. special homes for single elderly people with a range of social and welfare services, which are a promising model of the structure of life support for older people in the context of an increase in the number of elderly population (700, more than 22 thousand residents). In every fourth special house Social services have been created. The largest number of houses is in Moscow, Sverdlovsk, Vologda, Novosibirsk regions, and Krasnoyarsk Territory.

Social apartments are one of the options for creating an optimal living environment for elderly citizens and people with disabilities. Total number There are about 2.5 thousand such apartments, more than 3 thousand elderly citizens live in them, a third of whom are served by social service departments at home and specialized departments of social and medical services. This area of ​​social services is actively developing in Moscow, Sverdlovsk, Chita regions, Krasnoyarsk and Primorsky territories.

Considering the need to provide targeted, prompt assistance as close as possible to citizens who live in remote rural settlements, social protection authorities are actively developing various models mobile social service. The feasibility of this form of social service is increasingly confirmed in practice. For many veterans and disabled people, it is extremely difficult to contact medical, law enforcement and other socially significant institutions, including those providing household and commercial services to the population. Mobile social services cost people at least half as much as the prevailing rates for transport and other services in the area.

The search for new social technologies that increase the availability of social services to the population in modern socio-economic conditions led in the Penza region to the idea of ​​​​creating interdepartmental centers for resolving social issues under municipal self-government bodies in the form of rural mini centers(there are 384 mini-centers in the Penza region).

Almost all constituent entities of the Russian Federation have created institutions and departments of social assistance for persons without a fixed place of residence. There are 47 special boarding homes for the elderly and disabled for 7.2 thousand people, in which there are elderly citizens and disabled people without a fixed place of residence, who have partially or completely lost the ability to self-care and have voluntarily agreed to live in stationary social service institutions.

Today in Khabarovsk there are 140 thousand old-age pensioners who receive more than 18 types of benefits - for housing and communal services, communications, public transport, pharmaceutical provision and sanatorium-resort treatment. Many of them also receive regional and city compensation payments and targeted financial assistance. On average, more than 86 thousand elderly Khabarovsk residents enjoy the right to provide such benefits every month.

Since the beginning of this year, 934 million rubles have been spent on social support for older people in the city from all sources, including 312.8 million rubles from the Khabarovsk budget.

A network of institutions has also been created in Khabarovsk to provide various forms of social services for older citizens - two regional boarding houses for the elderly and disabled, four special houses for veterans. There is a regional Center for Social Adaptation of Citizens in Difficult Life Situations, five municipal Centers for working with the population, three Veterans' Homes, and a network of municipal stores "Veteran" has been deployed, where discounts are provided.

Today, 250 thousand elderly citizens live in the region, among them 34 thousand are war veterans, over 125 thousand are labor veterans. And all of them, like no one else, deserve special respect and attention.

The regional government has special control over the provision of housing for participants of the Great Patriotic War. For the 60th anniversary of the Victory, houses and apartments for veterans were commissioned in Khabarovsk, Pereyaslavka, Vyazemsky. In total, 11 special houses for veterans with a range of social services have been built and operate in the region, in which about 1 thousand war and labor veterans live. More than 3 thousand elderly citizens live in stationary social service institutions and boarding homes, where they receive support and assistance.

In general, the existing social policy in the region is aimed at improving medical, consumer, and transport services for older citizens, improving their living conditions, providing social services and guarantees, and creating conditions for their social and creative activities.

16 inpatient social service institutions for elderly citizens in the Khabarovsk Territory cannot accommodate all those in need. The queue for social service hospitals moves very slowly, and sometimes people have to wait for several years for a place. There are currently 450 people on the waiting list.

Also, many of these institutions, especially those located in settlements remote from the center, are not suitable for people with disabilities. As a result of these and other (including technical) problems, living space standards are often not met in such institutions, there is not enough furniture, and so on. The average cost of daily meals per person is only 74 rubles. Also, due to low wages and the lack of a social package, such institutions are only 67% staffed.

CONCLUSION

Purpose course work was to identify social problems of older people. During the work, a lot of literature was studied and based on this, the analysis of the results allows us to draw the following conclusions:

1) 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.;

2) from the study it is clear that the most acute problem is the limitation of life activity of the elderly and disabled;

3) during the study it was found that day care departments are very popular among people of retirement age;

4) the work examined the structure of the system of social service institutions. The most important task which is to maintain the standard of living of elderly people and people with disabilities in extreme situations, promoting their adaptation to the conditions of a market economy;

5) the main goal of serving people is to create mobile structures focused on a specific person, while the social worker organizes the provision of services by independent, voluntary and government organizations, he is also responsible for cooperation with medical institutions and agencies of various kinds;

6) it has been established that a centenarian and his family are one of the most relevant

problems of our society as a whole, and social medicine in

in particular. This problem seems unsolvable

public or government measures aimed at

strengthening social protection of the population; even less

degrees - through medical means;

7) it was revealed that for quality service to older citizens, high training of personnel in the field of psychology, sociology, pedagogy, as well as social workers is necessary.

Thus, summing up the study, social problems of older people were identified, solving the following problems:

1) identification of the main social problems of older people;

2) research into problems of interaction between a social worker and an elderly person;

3) identification of the main forms of service to citizens;

4) the role of rehabilitation centers;

5) the need for new technologies for social services for older people.

The practical significance of the study is that the results, main conclusions and generalizations contribute to a deeper understanding of the social problems of older people, establishing contacts between the social worker and the client to carry out joint work.

LIST OF REFERENCES USED:

1. Alperovich V.D. If you are over 60... // Rostov-on-Don. 1999

2. Alperovich V.D. Gerontology. Old age. Sociocultural portrait. //

Tutorial. – Moscow., 1998.

3. Dementyeva N.F., Modestov A.A. Boarding houses: from charity to

rehabilitation. - Krasnoyarsk, 1993, 195 p.

4. . Forms and methods of medical

1991, 135 p. (CIETIN).

5. Dementyeva N.F., Shatalova E.Yu. . Social and psychological adaptation of older people during the initial period of stay in boarding homes. / Methodological recommended - M., 1992, 18 p. (CIETIN).

6. Dementyeva N.F., Shatalova E.Yu., Sobol A.Ya. Organizational and methodological aspects of the activities of a social worker. In the book; Social work in health care institutions. - M., 1992, (Department of Family Problems, Women and Children of the Ministry of Health of the Russian Federation. Center for Universal Human Values).

7. Zainyshev I.G. Technology of social work // Moscow. 2003

8. Principles and concept of development of medical and social rehabilitation

sick, disabled and elderly people.- Methodological

9. Order of the Ministry of Social Protection of the Population of the RSFSR dated 02/04/1992 No. 21 “On

approval of the Regulations on the territorial urgent service

social assistance."

10. Social services for the population and social work abroad.

M., 1994, 78 p. (Institute of Social Work / Association

social service workers).

11. Social work / Ed. prof. IN AND. Kurbatova. – Rostov-on-Don: “Phoenix”, 2000, 576 p.

12. Social gerontology./ Under general. Ed. R.S. Yatsemirskaya - Moscow, 1998

13. Social work with older people: Handbook

social work specialist. – Moscow: Institute of Social

works., 1996

14. Kholostova E.I. Social work // Textbook. - Moscow. 2005

15. Kholostova E.I. Social work with older people: Educational

allowance. – M.: Publishing and trading corporation “Dashkov and K”, 2002. –

16. Technologies of social work: Textbook under general. ed. prof.

E.I. Kholostova. – M.: INFRA-M, 2002. -400 p.

17. Kholostova E.I. Elderly person in society: At 2 o'clock M.: Social

Institute of Technology, 1999.-320p.

18. Kholostova E.I., Dementieva N.F. Social rehabilitation: Educational

allowance. – M.: Publishing and trading corporation “Dashkov and K”, 2002.

19. Chernosvitov E.V. Social medicine Proc. aid for students higher

textbook establishments. – M.: Humanite. ed. VLADOS center, 2000. -304 p.

20. Shchirina M.G. Demographic and clinical-epidemiological

research in gerontopsychiatry. - GRM, r.14, no.12.

21. Encyclopedia of Social Work (translation from English).

M., 1993, vol. 1, 480 p. (Center for Human

values).

Alperovich V.D. If you are over 60... // Rostov-on-Don. 1999. p.11, 280.

Kholostova E.I. Social work // Textbook. - Moscow. 2005, p.596.

social work/association of social service workers).

Dementyeva N.F., Modestov A.A. . Boarding houses: from charity to rehabilitation. - Krasnoyarsk,

1993, p.95.

Kholostova E.I. Social work // Textbook. - Moscow. 2005, p. 595.

Dementyeva N.F., Shatalova E.Yu., Sobol A.Ya. . Organizational and methodological aspects of activity

Social work / Ed. prof. IN AND. Kurbatova. – Rostov-on-Don: “Phoenix”, 2000, p.307.

Dementyeva N.F., Shatalova E.Yu., Sobol A.Ya. . Organizational and methodological aspects of activity

social worker. In the book; Social work in health care institutions. - Moscow. 1992

(Department of Family Problems, Women and Children of the Ministry of Health of the Russian Federation. Center for Universal Human Values).

Dementyeva N.F., Ustinova E.V. .

citizens. - Moscow. 1991, p.109.

Dementyeva N.F., Shatalova E.Yu., Sobol A.Ya. . Organizational and methodological aspects of activity

social worker. In the book; Social work in health care institutions. - Moscow, 1992,

(Department of Family Problems, Women and Children of the Ministry of Health of the Russian Federation. Center for Universal Human Values).

Dementyeva N.F., Ustinova E.V. . Forms and methods of medical and social rehabilitation of the disabled

citizens. - Moscow. 1991, p.125 (CIETIN).

Social work with older people: A handbook for a social work specialist. - Moscow:

Based on the results of our work, we identified the need for medical and social work with older people. To substantiate the effectiveness of using medical and social service technology before social service technology, we will conduct them...

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Introduction

According to the classification of the World Health Organization, the population aged 60 to 74 is considered elderly, those aged 75 to 89 are old, and those aged 90 and older are considered centenarians. Sociologists call these periods human life“third age”, and demographers introduce the concept of “third” (6075 years) and “fourth” (over 75 years) ages. In Russia, about 1.5 million older citizens need constant outside help and social services.

According to the Constitution of the Russian Federation, every citizen is guaranteed “social security by age, in case of illness, disability, loss of a breadwinner, for raising children and in other cases established by law.” This means that the state undertakes obligations to contribute to the preservation and extension of the full life of an elderly person and recognizes its duty to him. To implement full-scale functions of social assistance, support and social security, the Russian Federation has a social protection system, for the functioning of which budget funds are allocated. The entire working population, the entire society as a whole, supports elderly and old fellow citizens.

Elderly people over 60 years of age are the fastest growing group of the Russian population. Compared to 1959, its number at the beginning of the 1990s doubled, and its share increased to 16% and continues to grow, and by 2015 it may reach 20%. By this time, every third of the elderly will be in the age group of 75 years and older.

This is especially true now, when the constant increase in the proportion of elderly people in the entire population is becoming an influential socio-demographic trend in almost all developed countries.

This process is due to two reasons. Firstly, advances in healthcare, control of a number of dangerous diseases, and increases in the level and quality of life lead to an increase in the average life expectancy of people.

On the other hand, the process of a steady decline in the birth rate, below the level of simple generation replacement, a decrease in the number of children born to one woman during her entire reproductive period, leads to the fact that the level of natural mortality in our country has exceeded the birth rate. Each generation is replaced by the next generation of smaller numbers; The proportion of children and adolescents in society is steadily declining, which causes a corresponding increase in the proportion of older people.

The population is inevitably aging. And this entire layer of society needs constant social protection and support. Therefore, we can confidently speak about the high relevance of this work. The task of social workers and loved ones is to provide a lonely elderly person, to the extent possible, with material and moral support and respect.

The subject is specific technologies of social work with older people.

The purpose of the work is to consider technologies of social work with this category of citizens, including in the city of Prokopyevsk.

The hypothesis of this work is that the effective use of appropriate social work technologies is a factor in increasing the social security and activity of elderly and old people.

The theoretical foundations of this work are the works of such sociologists as Zh.T. Toshchenko, M.V. Udaltsova. The problems of social medicine and social gerontology in their relationship are considered in the works of E.I. Kholostovoy, R.S. Yatsemirskaya, I.G. Belenkaya, V.M. Vasilchikova. This problem was also considered from a historical perspective by M.A. Kuznetsova, E.S. Novak, V.G. Krasnova.

Chapter 1. Social aspects of old age

1.1. Social status and problems of the elderly

According to classification World Organization According to the World Health Organization (WHO), the elderly are people aged 60 to 74 years, the elderly are those aged 75-89 years, and the centenarians are people aged 90 years and older.

In accordance with UN and International Labor Organization (ILO) documents, elderly are considered to be persons aged 60 years and older. It is these data that, as a rule, are used in practice, although the retirement age in most developed countries is 65 years (in Russia it is 60 and 55 years, respectively, for men and women).

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.

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.

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. Therefore, practice shows that older 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, and so on.

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 his mental state, reduces his resistance to diseases and adaptation to environmental changes.

There are far more women than men among older people around the world. According to the All-Russian Population Census of 1989. There were 633 men per 1,000 women aged 60-64 years, 455 men per 1,000 women aged 65-69 years, and 236 men per 1,000 women aged 80 and older. And to date, this trend has not changed.

Based on the data, the number of women is higher in older age groups. This significant difference is partly explained by the earlier mortality of men, partly by the greater longevity of women. In Russia, which suffered from the Second World War, this disproportion reached such large proportions due to military losses, as well as due to high level mortality of men from unnatural causes. This is how the problem of female loneliness in old age is formed.

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

In the family and household sphere, an elderly person may currently turn out to be more helpless than a child. He often cannot use a computer, cannot learn to drive a car, and does not know how to use complex household appliances.

The morbidity rate in old age is 2, and in senile age 6 times higher in comparison with the morbidity rate in younger people. In old age, bones become fragile and break easily even with minor bruises. The gait becomes slow and unsteady, coordination of movements is gradually lost, and the thinning of articular cartilage leads to the development of pain, changes in posture, and curvature of the spine. The discs of the spine become thinner, the back bends, and a characteristic “senile” posture appears. When doing things, even not burdensome ones, with age a person increasingly gets tired and tends to do calm, monotonous, uncomplicated work. In older people, the sense of smell, taste, and vision weakens.

Old age brings with it a change in habitual living standards and difficult emotional experiences. Every elderly person lives a difficult life (it is difficult to imagine a person who would live to be 60 years old without experiencing either suffering or stress). However, older people in modern Russia, who have experienced a number of global social cataclysms, are in a particularly difficult situation. The worst thing for a person (after the loss of the illusions of youth) is to experience the collapse of all his internal values, to lose everything that he was guided by. Older people cannot reorient themselves to values, that is, accept the values ​​of the capitalist world.

The character of an elderly person is deformed due to aging. This deformation is quite complex. For the time being, all workers (no matter in what area of ​​social employment) retain character traits that are of hereditary origin. With age, professional deformation of character appears, the so-called accentuation of certain character traits - suspiciousness, hot temper, vulnerability, anxiety, pedantry, touchiness, emotional lability, hysteria, isolation, exhaustion, pickiness, unfair assessments of one’s actions and the actions of others, regression of mental abilities.

Elderly people often find themselves on the margins of life. 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 most common mental disorder in older people is depression. It occurs twice as often in elderly and elderly people as in young and middle-aged people. The mood is low, a persistent feeling of melancholy or anxiety is characteristic, a feeling of uselessness, hopelessness, helplessness, and unreasonable guilt appears. The main need becomes the desire to avoid suffering, new unexpected situations and contacts. Interests are limited to everyday life, TV, health care, and interest in former favorite activities, family, friends, and work fades away. Biochemical changes in the body make older people more vulnerable to depression and anxiety. Depression can also have somatic manifestations: loss, or vice versa, increased appetite, insomnia or drowsiness, constant fatigue, pain that cannot be explained by a physical illness.

In old age, the reality of aging brings with it many causes of loneliness. Old friends die, and although they can be replaced by new acquaintances, the thought that you continue to exist is not sufficient consolation. Adult children distance themselves from their parents, sometimes only physically, but more often out of an emotional need to be themselves and have the time and opportunity to deal with their own problems and relationships. With old age comes apprehension and loneliness caused by deteriorating health and fear of death. Special studies confirm that thoughts about imminent and inevitable death, one way or another, are present in the minds of everyone over 60. This is explained by the fact that with age, a person’s psychological defense changes accordingly, with which he is born and the program of which includes consciousness own death.

The loneliness of an elderly person aggravates all his problems due to the absence of family members and relatives who can provide material or psychological support. Deteriorating health makes an elderly person more dependent on other family members; he needs their care and help, especially during exacerbation of illnesses.

At the same time, pensioners, being in the family, try to provide all possible assistance to their relatives (cooking breakfast, buying groceries, washing dishes, etc.), which allows them to feel needed and useful.

The well-being of older people is largely determined by the existing atmosphere in the family - friendly or unfriendly, and the distribution of responsibilities between grandparents, their children and grandchildren.

But current trends in development family relations lead to the destruction of old patriarchal families in which several generations live together - modern youth strives for economic independence and independence. In many families, young people no longer show the same sympathy and respect for the older generation; not everyone is ready to accept them into their family.

Increasingly, there are families consisting of elderly spouses who, after the death of one of them, will move into the category of singles.

The meaning of marriage and family varies at different stages of a person’s life. An elderly person needs a family, primarily due to the need for communication and mutual assistance. The main motive for marriage among older people is similarity of characters and views, mutual interests, the desire to get rid of loneliness, the desire to acquire a friend and life partner in old age.

According to government statistics, the increase in the number of late marriages is determined mainly by high rates of divorce, which is primarily characteristic of urban residents. As a rule, these are not first marriages (social workers can provide great help by organizing dating services for middle-aged and elderly people).

Older men are more likely to marry than older women; Having lost their spouse, older men most often give up housekeeping, create new families, and go to live with their children or in boarding homes.

Family ties and contacts of older people are maintained mainly in a direct line, i.e. with kids; Relationships with brothers and sisters are activated in cases where there are no closer relatives.

Living together or close to each other and maintaining fairly frequent contacts, parents and their adult children provide mutual services and assistance - not only material, but also moral.

Financial situation is a problem that can compete in its importance with health problems and psychological problems. Elderly people are alarmed about their financial situation, the level of inflation, and the high cost of medical care. Many older people continue to work solely for financial reasons.

The situation of an elderly single person in modern Russia is complicated by such factors as financial difficulties, deterioration of physical and mental health, loneliness, addiction, etc. All this makes life difficult for an elderly person. Loneliness due to the loss of loved ones, loss of social status in society, cessation of work leads to a deterioration in a person’s well-being and makes the problem of loneliness in pensioners urgent, requiring government support and guarantees of social security. To overcome these problems and implement adaptation measures effective means is the creation of centers for medical, social and psychological assistance.

The priority direction of social work with the elderly is organizing their living environment in such a way that an elderly person always has a choice of ways to interact with this environment. Freedom of choice gives rise to a feeling of security, confidence in the future, and responsibility for one’s own and other people’s lives.

1.2. Formation of a social security system for older people

The history of providing social and medical assistance to the disabled population in Russia is closely connected with the activities of the Russian Red Cross Society. It arose in 1867 as a philanthropic Society for the Care of Wounded, Sick Soldiers and Prisoners of War.

In 1960, the Bureau of Home Health Nurses was created under the committees of the Red Cross Society to assist health authorities in providing medical care and care for lonely elderly patients. In order to facilitate the work of visiting nurses to provide assistance in the everyday care of patients, a lot of work was carried out to form a sanitary asset among the population. However, social services provided by sanitary activists on a voluntary basis developed poorly. In this regard, in 1969 an attempt was made to involve medical school students and students of medical institutes in this work.

In the mid-70s. XX century As an experiment, home-based services for single pensioners were organized for the first time in a number of regions by employees of boarding homes for the elderly and disabled from the Ministry of Social Security. This activity was regulated by the Temporary Regulations on the procedure for organizing home-based services for pensioners in boarding homes, approved by the Ministry of Social Security of the RSFSR on October 28, 1975.

Since that time, a new state form of social and medical services has emerged - social and medical services for disabled single people at home. To enroll in home care, a certificate from a medical institution confirming the absence of chronic diseases was required.

A boarding house serving citizens at home was supposed to provide them with the following services: food delivery to their home, laundry, room cleaning, medicine delivery, and health monitoring. Since home care was a function that was not typical of boarding homes and caused organizational difficulties for these institutions, the need arose to create an independent service to provide medical, social and domestic assistance to disabled citizens. Such structural units were departments of social assistance at home for single disabled citizens.

In 1987, the functions of social services for the disabled at home were performed by two organizations: the state one - social assistance departments and the public one - the charity service of the Red Cross Society. Over time, the population stopped paying membership fees to the Red Cross Society, as a result of which this public organization had a significantly reduced ability to support this service, in connection with which its activities were reduced to a minimum, while the service of medical, social and household assistance at home began to rapidly expand.

According to the instructions of the Ministry of Social Protection of the Population of the Russian Federation and the Red Cross Society of the Russian Federation “On the interaction of social protection bodies and the mercy service of the Russian Red Cross in matters of social protection of low-income groups of the population” dated May 25, 1993, it was recommended to regularly help single elderly citizens and the disabled.

Over the years, the number of lonely elderly people has increased and the need for social and medical services for this category of the population has acquired large-scale significance. The inability of boarding homes to accommodate all those in need, demographic prospects suggesting a further increase in the proportion of older people in the population led to the solution of the problems of social and medical services for the disabled at the state level, the creation state system, engaged in the provision of medical and social services.

In accordance with Art. 41 of the Constitution of the Russian Federation, older people have the right to health care and free medical care in state and municipal institutions. Federal Law “On the Fundamentals of the Civil Service of the Russian Federation” dated July 31, 1995 No. 119-FZ establishes the age limit for holding a public position - 60 years. The Law “On Employment of the Population in the Russian Federation” states that citizens who have been assigned an old-age or long-service pension cannot be recognized as unemployed. In accordance with the federal laws “On state pensions in the Russian Federation” dated November 20, 1997 No. 340-1; "On calculation and increase state pensions» dated July 20, 1997, No. 113-FZ, from February 1, 1998, the transition to calculating pensions using the individual pensioner coefficient began.

Social services for elderly citizens are regulated by the Federal Law “On Social Services for Elderly Citizens and Disabled Persons” dated May 17, 1995 and is provided by a network of stationary social service institutions, as well as social service centers, departments of social, specialized home care and emergency social assistance

The Law sets out in detail the list of services included in social services; principles of activity in the field of social services; conditions of organization in the field of social services; forms and types of social and medical services. It is on the basis of this Law that many social service centers have been created in Russia, since it discusses in detail the goals, objectives, and principles of organizing the activities of these centers.

Of certain importance are such legislative acts as the order of the Ministry of Health of the Russian Federation “On the creation of departments of social and medical care at home” dated December 27, 1994, the resolution of the Government of the Russian Federation “On the federal list of guaranteed social services provided to elderly citizens and disabled people by state and municipal institutions social services" dated November 25, 1995.

Implementation social programs must create conditions that meet the requirements and norms of a civilized state, under which an elderly person, like any citizen, has the right on equal terms to receive education, work, provide for themselves financially and have access to all social, medical, industrial and economic infrastructures.

Legal support for the management and implementation of social and medical services has great importance for implementation social rights citizens. Therefore, the problems of social and medical protection of elderly citizens are reflected in international and Russian legislative acts; At the same time, measures aimed at protecting older citizens occupy a significant place in the social policy of modern states.

Chapter 2. Social work with older people

2.1 Technologies of social work with older people

The technology of social work with the elderly should be based on the following requirements:

Preventing the causes of problems for older people;

Promoting the practical implementation of rights and legitimate interests, ensuring the possibility of self-expression of older citizens and preventing their exclusion from active life;

Maintaining equality and opportunities for older citizens when receiving social assistance and services;

Differentiation of approaches to solving problems of various groups of older people based on taking into account social risk factors affecting their situation;

Identification of individual needs of older citizens for social assistance and services;

Targeting in the provision of social services with a priority of assisting older citizens in situations that threaten their health and life;

The use of new technologies of social work aimed at meeting the needs and needs of older people;

Focus on developing self-help and mutual support among older people;

Ensuring that older citizens, as well as the entire population, are aware of the possibilities of social assistance and services.

The main directions for improving the well-being of the elderly are:

Increasing the size of pensions;

Improving the pension system;

Development of home care services;

Expansion of the network of nursing homes;

Improving living conditions in these houses.

Physical dependence in old age takes on acute forms due to loneliness. Divorce and widowhood of older people are accompanied by financial difficulties with the hope of stabilizing the situation in the event of remarriage. Trying to avoid loneliness and the hardships it causes, many older people strive for a new strong family union, built on the basis of mutual trust and intimacy. The task of social services is to, along with direct social assistance to elderly couples, promote the formation of tolerance and understanding in the assessment and acceptance of various, sometimes extraordinary forms family life in old age.

One of the significant technologies of social work with older people will be social adaptation. Social adaptation measures have a positive impact on certain categories of older people. This work is especially relevant for citizens without a fixed place of residence or occupation.

The social protection system also provides assistance in establishing a lifestyle and employment for older citizens, as well as (if necessary) professional retraining.

The labor, physical and material costs of caring for the elderly and, especially, elderly family members place a significant burden on the family, giving rise to problems that cannot always be solved by the family itself. Social patronage of such families, as well as families of pensioners and single elderly people, makes it possible to foresee the moment of a crisis situation and timely take adequate measures in order to neutralize it.

An important role is played by the system of non-stationary institutions of the social protection system for older people, since this form is the most economical and closest to the real needs of older people. Moreover, non-stationary social protection institutions allow you to choose an individual service option, including on a paid basis. Within the framework of such institutions, systems of psychological, medical, social and legal assistance to older people are being developed.

Social service centers provide support for leisure and feasible social activities of the elderly, promote educational, educational and physical training work among the elderly.

The need for social services in inpatient settings remains quite high. In the future, the network of inpatient social service institutions should not only expand, but also change. The currently dominant traditional multi-bed boarding houses should gradually be replaced by other types of hospitals.

A humanized approach to social services for the elderly will significantly improve the situation of clients of social services, which implies:

Introduction of a state-guaranteed minimum of social services provided to older people in order to maintain an appropriate level of safety and comfort of life in old age; provide senior citizens with favorable conditions for the realization of their rights and legitimate interests, participation in social, economic, cultural and spiritual life; ensure the protection of older citizens from unfair or illegal actions in the field of social protection and services;

Preventing refusal by state social services to provide guaranteed social services for any reason, including due to chronic infectious diseases, as well as tuberculosis, sexually transmitted diseases, mental illnesses, alcoholism, substance abuse;

Respecting the choice of citizens and providing opportunities for the client to exercise the right to an alternative solution (choosing a public or private institution, receiving services on a permanent or temporary basis, free or for a fee, choosing an assigned social worker) by reforming the network of social service institutions and radically improving the quality of services provided ;

Taking into account national and cultural characteristics, ideological and religious views of clients of social services through individualization of social services.

The organization of social services for the elderly should be aimed at ensuring a safe old age by reducing the impact of social risk factors and the highest possible degree of implementation of social guarantees in combination with the provision of a wide range of services in the field of prevention and development, so that the elderly can maintain social tone and their usual way of life for as long as possible while remaining active and contributing members of society.

2.2 The system of social services for older people as one of the areas of technology for social work with older people

Social services and provision for pensioners include the assignment of pensions and various benefits, the maintenance and service of elderly single elderly people in special institutions of social protection bodies, free prosthetics, benefits for the disabled, assistance to the homeless, etc.

Social and medical services include a set of social services that are provided to older citizens at home or in specialized state and municipal institutions. The state guarantees the receipt of necessary services on the basis of social justice, regardless of race, national origin, origin and attitude to religion. The already mentioned social service centers, which help single elderly people adapt to a difficult life situation, have proven themselves very positively in ensuring a decent life for elderly citizens in the social protection system. Today, in almost all cities, work is underway to implement the program for developing a network of these centers.

Currently, there are 1,500 social service centers, 11 branches and one experimental comprehensive center for social protection of the population in Russia. Almost all centers have emergency social service departments, where citizens receive various targeted assistance (medical, clothing, food, legal).

In the context of the financial and economic crisis, the organization of trade and consumer services for low-income citizens at reduced prices is of particular relevance - the corresponding program was developed by the Committee for Social Protection of the Population together with interested departments and committees of the Moscow government, veterans and other organizations. The main goal of the program is to create unified system trade and consumer services for single low-income citizens, consolidating various financial resources for this, attracting the attention of charitable and veteran organizations. One of the ways to implement this program is to organize outbound trade and provide personal services in social service centers, social residential buildings and other social protection institutions. One of the primary tasks of social services is to identify those in need. Social service centers monitor older citizens with a view to accepting them into social service departments at home.

Social services for older people include stationary, semi-stationary and non-stationary forms.

Stationary forms include boarding houses or boarding houses for the elderly. To enter a boarding house, an elderly person must transfer 75% of their pension to the district Pension Fund, leaving only 25% for themselves.

A mandatory condition for admission is that pensioners transfer their housing to the municipal housing stock of the city where they live.

Residents of these boarding houses have the right to medical care, social adaptation, and free visits by a lawyer, a clergyman, and relatives.

Boarding houses are designed for elderly people who have retained partial or full ability for self-care in everyday life and need to create easier conditions to fulfill their life needs. The main purpose of these social institutions-- providing favorable living conditions and self-service, providing social and medical assistance.

Nursing homes are intended for permanent residence of citizens who have partially or completely lost the ability to self-care and require constant outside care. However, the number of people wishing to move to a nursing home has decreased after the creation of social service departments at home.

The semi-stationary form of service for the elderly includes social, medical, social and cultural services for pensioners, the organization of medical care, food, recreation, and ensuring their participation in feasible work activities. It is carried out by day and night care departments, as well as medical and social departments, and rehabilitation centers. The purpose of these departments is to maintain an active and healthy lifestyle for older people who are capable of self-care, and to overcome isolation and loneliness.

Non-stationary forms of social services include social services at home, urgent services, and social advisory assistance.

Temporary stay departments carry out medical, health and rehabilitation activities, cultural and consumer services, and provide food for lonely elderly people.

Departments of social and medical care at home provide permanent or temporary social, medical and social services at home to single pensioners who need outside help. The main goal of this department is to maximize the stay of lonely old people in their familiar home environment.

The emergency social assistance service of the Social Services Center provides for the provision of a wide range of services: provision of one-time necessary medical care, provision of necessary medications, one-time provision of free hot meals and clothing to those in dire need, assistance in obtaining temporary housing.

Departments of social and advisory assistance provide the necessary psychological, legal, legal and other support in social and medical service centers and by telephone.

In a crisis situation in Russia, targeted assistance to older people is of significant importance - primarily to those most in need, for example, single pensioners over the age of 80, and is expressed in the form of help with housework, provision of medical services, etc.

In a number of regions of the country, local authorities provide significant assistance to older people, increasing differentiated payments to unemployed single pensioners, providing travel benefits, and free receipt of some medications. Social services for pensioners are being developed, providing them with shoes, clothing, various devices for movement, etc.

A new form of social service is a nursing home, or hospice, a specialized institution that helps terminally ill people receive timely help that will alleviate their moral and physical suffering.

Nursing homes (hospices) are usually organized at hospitals and are intended to provide supportive treatment for seriously ill people, mainly the elderly. The main areas of work of this institution are:

Skilled nursing;

Social services;

Timely implementation of medical prescriptions and procedures;

Medical rehabilitation of the sick and elderly;

Dynamic monitoring of the condition of the sick and elderly;

Timely diagnosis of complications or exacerbations of chronic diseases.

So, a nursing home provides, firstly, emergency and emergency assistance; secondly, the timely transfer of seriously ill and elderly people with exacerbation of chronic diseases or deterioration of their condition to appropriate medical institutions. Elderly patients are constantly examined by doctors, their health status is monitored, dietary food, psychological assistance is provided.

Another new form of social service for older people is a lifelong maintenance agreement: older people enter into an agreement with an authorized organization, according to which, after their death, they bequeath their housing to it, and this organization, in turn, undertakes to help older people financially and provide services for their social and medical services. This form is especially effective for lonely elderly people who do not receive help from relatives.

So, the activities of social service centers in Russia indicate that this model of social service, focused on working with older people, has become most widespread and recognized. However, along with the already widespread forms of social services, new ones are being formed, which are becoming increasingly popular among lonely elderly people.

Thus, social assistance to lonely elderly people is provided by social assistance services, where older citizens turn to receive social and medical services in the conditions of socialization and adaptation to new living conditions.

Working with elderly and elderly people is considered one of the most difficult psychologically. Therefore, socio-medical work with this category of the population uses methods and technologies used by psychologists, psychotherapists, teachers, gerontologists, lawyers and other specialists.

2.3 Technologies of social work with older people in Prokopyevsk

One of the main institutions involved in social work with older people in Prokopyevsk is the Committee for Social Protection of the Population (KSZN).

KSZN was created in 1997. The main direction of its activity is to support vulnerable segments of the population (elderly, disabled people, veterans, etc.). KSZN is associated with various budgetary and other institutions, including various public organizations. They provide loans, food packages, etc.

Social service centers for the population are also under the jurisdiction of the KSZN. Basically, these centers work with beneficiaries. Here we are accepting documents for registration of benefits and other various social support measures. Also, within the framework of the work of social service centers, various divisions operate:

Urgent,

Nadomnogo

Social services.

The main areas of work of the emergency social services department include targeted delivery of potatoes, coal, food packages, and cash payments to elderly people. As part of social services, there are 3 social hairdressing salons and a social laundry. As part of social services, about 2,500 thousand people are served at home. They are provided with guaranteed free services (cleaning the apartment, assistance in preparing various documents) and additional paid services.

There is also a boarding home for the elderly and disabled in Prokopyevsk. Until 2003, it was under the jurisdiction of the Health Committee. On January 1, 2006, the boarding house officially became a state inpatient institution. The main functions of this institution are:

Therapy

First aid

The staff of the boarding home includes nurses, a therapist, a dietician and other positions. This establishment is designed for permanent residence 40 people. Here they receive qualified medical assistance and care.

Also, speaking about social work with the elderly, one cannot fail to mention the veterans' home. This is a separate building with 154 apartments, for elderly people who have demonstrated feats of labor, for veterans of the Great Patriotic War and labor. Here, older people live in 1 and 2 room apartments. They are provided with benefits for public utilities. You can also get 24-hour medical assistance here. In the building of the veterans' home there is a medical center, a store, and a library.

In general, there are not too many social institutions working with older people in Prokopyevsk. And taking into account their insufficient funding, we can say that the technologies of social work with older people in Prokopyevsk are not effective enough. But, however, this situation is observed almost everywhere in Russia.

Conclusion

Retirement, partial loss of ability to work, physical weakness, narrowing of social circles - all this causes a radical change in the rhythm of life in an elderly person. But it is obvious that elderly and old people are also different. There are quite a lot of older people who have retained not only health and vigor, but also a fresh outlook on life, a desire to communicate, benefit society, study and earn money.

The state social protection system is currently “tuned” to prolong the life of an elderly person. The new model of old age, accepted by the world community, regards the elderly person as significant human potential, which can and should be involved in social active life. The view of an elderly person as the ballast of society is completely unacceptable. The most important task of the system of social service institutions is to maintain the standard of living of elderly people and people with disabilities in extreme situations, to facilitate their adaptation to the conditions of a market economy. For quality service to older citizens, highly trained personnel in the field of psychology, sociology, pedagogy, as well as social workers are required.

Older people have the right to a full life. And this is only possible if they themselves take an active part in resolving issues that directly concern them. State authorities in the field of social support for older people need to:

Contribute to improving the quality of social and medical services provided to older people in government institutions;

Ensure sufficient pensions and the level of monetization of benefits to achieve a decent standard of living;

Improve the quality of life in specialized institutions for the elderly;

To draw public attention to the problems of older people in such a way as to create more comfort in the small architecture of cities, recreation areas, handrails, ramps in public places.

During the work, the hypothesis put forward was completely confirmed. We can say with confidence that a decent old age is real, subject to the effective use of appropriate social work technologies. Governmental support and the effective functioning of social services is a factor in increasing the social security and activity of elderly and old people.

In In Prokopyevsk there are several institutions whose activities are aimed at supporting older citizens. But, unfortunately, due to insufficient funding, their activities are not always effective. Therefore, the city, and the country as a whole, needs to continue to develop technologies for social work with older people.

List of used literature

1. Bondarenko I. Social cohesion and care for the interests of older people. [Text] // I. Bondarenko - Social work. - 2008. - No. 1

2. Vasilchikov V.M. Structure and main directions of development of the social protection system for older people in the Russian Federation.

3. Gavrilova E.V., Paskar A.I. Practice of social services for elderly citizens and disabled people at home. [Text] // E.V. Gavrilov, A.I. Paskar - Social services. - 2008. - No. 1

4. Glebova L.N. The state's concern is for the elderly. [Text] // L.N. Glebova - Social work. - 2008. - No. 2

5. Zainyshev I.G. Technology of social work: Textbook. aid for students higher textbook establishments.[Text] / I.G. Zainyshev - M.: Humanit. ed. VLADOS center, 2002.

6. Kravchenko A.I. Social work: textbook.[Text] / A.I. Kravchenko - M.: TK Welby, Prospekt Publishing House, 2008.

7. Kukushkina L.E. Social work in rural areas (from the experience of the Vladimir region). [Text] // L.E. Kukushkina - Social work. - 2008. - No. 2.

8. Kurbatov V.I. Social work. Textbook.- 4th ed.[Text] / V.I. Kurbatov - Rostov n/a: Phoenix, 2005. - (Higher education)

9. Maslennikova V., Salieva G. Model of social and pedagogical activities with older people in the Republic of Tatarstan. [Text] // V. Maslennikova, G. Salieva - Social work. - 2006. - No. 3

10. Pavlenok P.D., Rudneva M.Ya. Social work technologies with various groups population: Textbook. [Text] / Ed. prof. P.D. Pavlenka - M.: INFRA - M, 2009. - (Higher education)

11. Pisarev A.V. lifestyle of the elderly in modern Russia. [Text] // A.V. Pisarev - SOCIS. -2004. - No. 4

12. Federal Law No. 195-FZ “On the fundamentals of social services for the population in Russia.” Codes. Laws. Norms. [Text] / Novosibirsk: Sib. Univ. publishing house, 2008.

13. Kholostova E.I. Technologies of social work. [Text] / E.I. Kholostova M.: INFRA - M, 2002. - (Higher education)

14. Shcherbina V.V. Problems of technologization of social activities. [Text] // V.V. Shcherbina - SOCIS. - 1996. - No. 8

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