Modern demographic data unequivocally testify to the increase in the number of elderly and aged people. For example, according to American studies, the number of elderly people in the United States in 1900 was 4% of the population. By 1980, the number of people over 65 had doubled to over 25 million. According to the authors' forecasts, by 2020 there will be more than 50 million old Americans, which will be 17.3% of the population. Similar data can be given for other industrialized countries.

It is widely believed that the most significant factor in the aging of the population is the decline in mortality and the increase in life expectancy. However, many authors see the main role in this process in the decline in the birth rate.

Specialists also approach the problem of old age from different points of view: chronological, social, biological, physical, functional, etc. In the United States, the age of 65 is traditionally considered the starting point. However, this figure can by no means be used as a universal measure, since not only in the United States, but also in many countries, the age of retirement is changing. In addition, as noted more than once, early retirement has become quite common.

Obviously, older people cannot be considered as a homogeneous group. American scientists believe that four subgroups can be distinguished in it: 1. elderly people - 55 - 64 years old;

2. old people - 65 - 74 years old;

3. very old people - 75 - 84 years old;

4. elderly people- 85 years and above.

The main problems of these groups of people are related to health, financial situation, employment and housing. It is quite natural that with the growth of their number, especially the old and elderly, the need for their medical and social services increases. It creates serious problem for the welfare state. Although some experts argue that the cost of caring for the elderly is growing not as a result of an increase in this group's share of the population, but due to the general rise in the cost of medical and social services per capita.

The main systems for providing the most important species services for the elderly and aged people are called "formal" and "informal". Formal services include government, charitable, private institutions and agencies, while informal services include family members, friends and neighbors. Feature the provision of formal services in developed Western countries and the United States in that they are provided at the place of residence of the elderly and the elderly.

So, in 1992, the Swedish Parliament decided to implement a national program for helping the elderly, according to which all responsibility for a number of aspects, including the costs of inpatient and semi-inpatient services and the organization of special housing, lies with local authorities. Social workers in the UK are now also trying to introduce different areas of work with older people in their place of residence. In the US in the 70s. grants have been made for research programs for the elderly, including the establishment of day care centres. The point of the experiment was to find cheaper alternatives to home care.

In the UK, where centers day care for the elderly appeared in the 60s, their organization was based on a more flexible concept, and the expected results were not associated with the material side of the matter. They were created to expand the scope of services within the community. By 1980, 617 day care centers had already been opened, which made it possible to alleviate the isolation of old and lonely people. Typically, such centers have a cafe, a hairdresser, workshops, and employees who help to continue their education work in them.

Day care centers in the United States, although based on the British model, were fundamentally different. It was supposed to separate the medical and social aspects of long-term care. That is, they served older people who needed daytime care but did not need inpatient care. These services included, among others, catering, personal care, recreation, education, rehabilitation of physical and professional abilities and medical service. In recent decades in America, much effort has been directed towards increasing the number of day care centers and linking them into a single network of services within the community.

Currently, in addition to day care centers, there are institutions in foreign countries that offer not only temporary, but permanent residence.

For example, in Sweden, these are homes for the elderly with a wide range of care and treatment services for people who do not want to live at home. One of the principles of service for the elderly in this country is the principle of freedom of choice, in particular the preservation of the right of the elderly to freedom of choice of housing. If a person wants to live at home, he should have this right, even if this increases the need for assistance. People who are in great need of care and are unwilling (or unable) to live in normal household conditions should be able to choose to live in “special conditions”. Homes for the elderly are traditional form services and is still preferred by many older people in Sweden.

In the UK, boarding houses offer temporary or permanent residence, most of which are intended for the elderly, who do not have families and whose relatives are unable to care for.

At the end of the 60s. In Sweden, the first so-called "service houses" were built. According to the idea of ​​their creators, pensioners could move to such institutions even at a capable age and, as the need arises, receive an increasing amount of assistance and treatment. However, the development of events went a little differently. The expansion of home services, as well as the improvement of living conditions in general, has led to the fact that an increasing number of people preferred to stay at home as long as possible. Therefore, the request to move to the “service house” usually comes when the need for care increases significantly.

"House of service" is an apartment in which a group of elderly people, regardless of kinship, live together. In these apartments or in the immediate vicinity there is a staff who can provide assistance around the clock. Group living has emerged as an element in the development of open forms of treatment and care for people with mental disorders, physical illnesses, movement disorders, as well as people in a state of senile insanity.

The forms of organization of such apartments are different and depend, in particular, on the needs of residents in treatment. In certain cases, group accommodation is a temporary solution, a stage in preparation for completely independent living. In other cases, such apartments become a place of permanent residence.

A similar form of care for the elderly exists in the UK. There it is called "softened living conditions." Such conditions are intended for active elderly people. In fact, this is a group of small houses, apartments or cottages, where residents can live independently. If necessary, a guardian comes. Such guardians can be patronage workers who act as assistants, intermediaries between the family and the elderly person.

Noteworthy are family-type shelters for the elderly and elderly living outside the family in the United States. They have become widespread. They can be of various shapes, but the common features in them are as follows:

1. assistance is provided by a private person who provides his home, but is not a relative;

2. for a fee, an elderly person is provided with a room, assistance in overcoming difficulties, protection, provision of medicines;

3. the shelter should be small to create a warm family atmosphere;

4. Guardianship supervision and control is carried out by professionals from the staff of the agency that administers this senior care program.

Of these elements, only the first remains unchanged, while the rest vary. For example, in one shelter there may be 24 old people, and in another - 10. There are no strict criteria for selecting those who provide assistance. Some states do not have high requirements for staff training, while others, on the contrary, pay great attention to staff training. The frequency of monitoring visits by staff members also varies. Some programs offer weekly monitoring, others monthly.

Family-type nursing homes serve mainly three categories of the population: the mentally ill, the mentally retarded, the old and the sick. Such institutions are a cross between a state shelter and a family. They are intended for those who cannot live on their own. Their advantages compared to state-run shelters are that they create a warm family atmosphere, there is the possibility of individual care, the opportunity to communicate and maintain relationships with the family. They also have lower cost of services than specialized public shelters. These shelters are favorably treated by people living nearby, which cannot be said about other forms of organizing shelters.

Family-type shelters originated in the United States in 1979 at the initiative of the Department of Health and Human Services. Since then, many government agencies have been working on this program.

Typically, middle-aged women with higher education work in such shelters and the motives for their activities are: altruism, the desire to take care of someone, and escape from loneliness. The motive may be money, but usually these people do not stay long in such a difficult job. Working women are paid from the client's funds (pensions, allowances). But, if the client does not have a regular income, there are other forms of payment, such as sponsorship contributions. V last years in the United States, there has been a tendency to expand the categories served in family-type shelters, as well as the differentiation of these shelters by client categories.

And yet, as noted earlier, many older people want to live at home. In the countries under consideration, developed social system assistance to the elderly and elderly at home. This system includes care and treatment. For example, in Sweden, after an appropriate check, an elderly person is assisted in cleaning, cooking, personal care, and grocery shopping. Home treatment is carried out by nurses, nurses, doctors working in a particular hospital or clinic to which their patients are “attached”.

Much of the care and treatment needs of older people are provided by their relatives, providing assistance on an informal and sometimes reciprocal basis. In certain cases, relatives may be compensated by local authorities.

In conclusion, we can say that the issue of providing services to older people now and in the future in developed foreign countries will be how to combine formal and informal care at home, in the community and in hospitals. Back in the late 60s. In Sweden, the first so-called "service houses" were built. According to the idea of ​​their creators, pensioners could move to such institutions even at a capable age and, as the need arises, receive an increasing amount of assistance and treatment. A similar form of care for the elderly exists in the UK. There it is called "softened living conditions." Such conditions are intended for active elderly people. In fact, this is a group of small houses, apartments or cottages, where residents can live independently. If necessary, a guardian comes. Such guardians can be patronage workers who act as assistants, intermediaries between the family and the elderly person.

Also noteworthy are family-type shelters for the elderly and elderly living outside the family in the United States. They have become widespread. They can be of various shapes, but the common features in them are as follows.

Thus, the foreign experience of technologies of social work with the elderly is considered on the example of the USA and Sweden. In Sweden, the Parliament has decided to implement a national program for the elderly, in which all responsibility for a number of aspects, including the cost of inpatient and semi-residential services and the organization of special housing, lies with the local authorities. Social workers in the UK are now also trying to introduce different areas of work with older people in their place of residence. IN USA. grants have been made for research programs for the elderly, including the establishment of day care centres. The point of the experiment was to find cheaper alternatives to home care. In the countries under consideration, a social system of social assistance to the elderly and the elderly at home has been developed. This system includes care and treatment. For example, in Sweden, after an appropriate check, an elderly person is assisted in cleaning, cooking, personal care, and grocery shopping. Home treatment is carried out by nurses, nurses, doctors working in a particular hospital or clinic to which their patients are “attached”.

Introduction

Chapter 1. The main social and psychological problems of the elderly and old people

1.1 Older people as a social community

1.2 Psychological characteristics of the elderly and old people

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

2.1 Legislative framework for social work

2.2 The main directions of social work with the elderly and old people

Conclusion

Bibliography

Applications

Introduction

One of the trends observed in recent decades in the developed countries of the world is the growth in the absolute number and relative proportion of the population of older people. There is a steady, fairly rapid process of reducing the proportion of children and young people 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 over in the world, by 1975 their number had increased to 550 million. According to forecasts, by 2025 the number of people over 60 years old will reach 1 billion 100 million people. Compared with 1950, their numbers will increase by more than 5 times, while the world's population will only increase by 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 of 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, life expectancy for 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 the elderly in the total population continues, it becomes clear that the problem of social work with the elderly is of national importance. The topic requires further development.

Object: social work with the elderly and old people.

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

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

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

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

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

For writing the work were used various sources and research. Among them:

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

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

V. Alperovich's manual "Social gerontology" (1), which deals with the main problems associated with aging;

The book of the famous psychologist I. Kohn “Personality Persistence: Myth or Reality?” (7), in which he singles out and describes different types old people and the relationship of old age”;

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

Research methods:

Analytical;

Statistical.

Chapter 1. The main social and psychological problems of the 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 determine with different points vision - 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 persons from 60 to 100 years old. Gerontologists propose to divide this part of the population into "young" and "old" (or "deep") old people, just as in France there is the concept of "third" or "fourth" age. The border of the 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, headship in the family, distribution of household responsibilities, etc.

According to the World Health Organization, the age of 60 to 74 is recognized as old; 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 the elderly, a variety of groups stand out: vigorous, physically healthy; sick; living in families; lonely; satisfied with retirement still working, but burdened by work; unhappy, desperate in life; sedentary homebodies; spending intensively, diversified their leisure time, etc. ”(1; 28).

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

For older people, the main problems are:

Deterioration of health;

Maintaining an acceptable material standard of living;

Obtaining quality medical care;

Change in lifestyle and adaptation to new living conditions.

Life limitation.

The aging process is closely related to the constant increase in the number of patients suffering from various diseases, including those inherent only in the elderly and senile age. There is a constant increase in the number of seriously ill old people in need of long-term medication, care and care. The 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 the age of 60 and older, it exceeds the incidence rates of persons younger than 40 years by 1.7-2 times. According to epidemiological studies, approximately 1/5 of the elderly population is practically healthy, the rest suffer from various diseases, and multimorbidity is characteristic, i.e. a combination of several diseases that are chronic in nature, poorly responding to drug treatment. So, at the age of 50-59 years, 36% of people have 2-3 diseases, at 60-69 years old, 4-5 diseases are found in 40.2%, and at the age of 75 years and older, 65.9% have more than 5 diseases (1 ; 35).

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

The structure of the incidence of elderly and senile age has its own characteristics. The main form of pathology is chronic diseases: general arteriosclerosis; cardiosclerosis; hypertension, cerebrovascular disease; emphysema, diabetes mellitus; eye diseases, various neoplasms.

In the elderly and senile age, the mobility of mental processes decreases, this is manifested in the strengthening of deviations in the psyche.

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

According to Z.–Kh. M. Saralieva and S. S. Balabanov, every fifth family of pensioners has difficulty in purchasing clothes and shoes. It is in this group of families that there are people living "from hand to mouth" (!3; 29).

Many older people continue to work, and for material reasons. According to ongoing sociological surveys, 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 the elderly and old people largely depends on the family they live in, as well as on their marital status.

Increasingly widespread nuclear family(it consists of spouses and their children) leads to a change in relationships and ties 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 are caused by alienation, social injustice, and the contradictions of social progress. A lonely person can be seen as the result of a weakening of ties with a particular 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 prevailing atmosphere in the family - benevolent or unfriendly, normal or abnormal, by the way responsibilities are distributed in the family between grandfathers (grandmothers), their children and grandchildren. All this affects the desire of older people to live together with their children and grandchildren or separately (20; 47). Held 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, in urban planning, the distribution of apartments. It should be possible to exchange apartments and so on.

The meaning of marriage and family is not the same at different stages of a person's life. An elderly and old person needs a family, primarily in connection with the need for communication, mutual assistance, in connection with the need to organize and maintain life. This is due to the fact that an elderly person no longer has the same strength, the same energy, cannot endure stress, often gets sick, and needs special nutrition.

When it comes to older people, the main motive for marriage is the 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 sympathy also play an important role.

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

The transition of a person to the group of the elderly significantly changes his relationship with society and such value-normative concepts as purpose, the meaning of life, goodness, happiness, and so on. The lifestyle of people is changing significantly. Previously, they were associated with society, production, social activities, and in old age they lost their former social roles. Retirement is especially difficult for people whose labor activity was highly valued in the past, and is now recognized as useless, unnecessary. The gap with work activity negatively affects the state of health, vitality, the psyche of people. And this is natural, since labor (feasible) is a source of longevity, a condition for maintaining good health. And many pensioners would like to work more, psychologically still young, educated, professionals in their field with vast work experience, these people can still bring a lot of benefits. But, unfortunately, up to 75% of older people do not work or are only partially employed. For example, in 2003, 82,690 pensioners applied to employment centers in search of a job. Only 14,470 pensioners tripled their jobs (12; 59).

So, the transition of a person to a group of elderly people changes his life, which acquires a number of new, far from always favorable and desirable features. There is a problem of social adaptation of the elderly and old people. Here, social gerontology can come to the aid of a social worker - the field of research of the final stage of ontogenetic development of a person, sociocultural attitudes and expectations in relation to a certain socio-demographic stratum - the elderly (4; 73). Particular attention should be paid to the psychological problems of the elderly and old people.

1.2 Psychological characteristics of the elderly and old people

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

In the period of human life after maturity, there is a gradual weakening of the body's activity. Older people are not as strong and not able, as in their younger years, to withstand prolonged physical or nervous stress; the total energy supply is getting smaller and smaller.

At the same time, materials are accumulating that lead scientists to understand 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.

The strengthening and specialization of the action of the law of heterochrony (unevenness) is noticeable; as a result of this, the work of some body systems is preserved and even improved for a longer time, and in parallel with this, an accelerated, with at different paces the involution of other systems, which is explained by the role and significance they play in the main, 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; various systems of the body are activated, which preserves its vital activity, allows overcoming 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 different ways increasing the biological activity of various structures of the body (polarization, redundancy, compensation, construction), which ensure its overall performance after the completion of its reproductive period (2; 53).

Along with this, there is a need to strengthen conscious control and regulation of biological processes. This is carried out with the help of the emotional and psychomotor spheres of a person. After all, it is well known that a certain system of training can improve the functions of respiration, blood circulation and muscle performance in the elderly. The central mechanism of conscious regulation is speech, the importance of which increases significantly during the period of gerontogenesis. B. G. Ananiev 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 major acquisitions the historical nature of man become a decisive factor in the ontogenetic evolution of man” (quoted in: 3; 111).

Thus, various kinds of changes in a person as an individual, occurring in the elderly and senile age, are aimed at actualizing the potential, reserve capabilities accumulated in the body during the period of growth, maturity and formed during the period of gerontogenesis.

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

The elderly and old people do not constitute a monolithic group. Further changes during the period of gerontogenesis depend on the degree of maturity of a particular person as a person and subject of activity. There are numerous data on the preservation of high viability and working capacity of a person not only in the elderly, but also in old age. A large positive role in this is played by many factors: the level of education, occupation, maturity of the individual, etc. Of particular importance is creative activity personality as a factor opposing the involution of a person as a whole (15; 43)..

Unfortunately, the typical personality manifestations of an old person are considered to be: a decrease in self-esteem, self-doubt, dissatisfaction with oneself; fear of loneliness, helplessness, impoverishment, death; gloom, irritability, pessimism; a decrease in interest in the new - hence the grumbling, grouchiness; closing interests on oneself - selfishness, self-centeredness, increased attention to one's health; uncertainty about the future - all this makes old people petty, stingy, overcautious, pedantic, conservative, low-initiative, etc.

Fundamental research by domestic and foreign scientists, however, testifies to the diverse manifestations of the positive attitude of the old person to life, to people, to 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 - my thoughts are 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 the typology of F. Giese, 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 the education of youth, etc.;

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

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

4) people whose meaning of life is taking care of their own health: 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, increased anxiety.

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

a) aggressive old grumblers, dissatisfied with the state the world around,

criticizing everyone but themselves, teaching everyone and terrorizing others 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 constructive attitude of a person towards old age, in which the elderly and old people are internally balanced, have good mood, satisfied emotional contacts with people around;

2) the relationship of dependence, when the old person is in material 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, reluctant acceptance of help from others;

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

5) the 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, experience a feeling of loneliness, their own uselessness.

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

The main stressors of elderly and senile people can be considered the lack of a clear life rhythm; narrowing the scope of communication; withdrawal from active work; "empty nest" syndrome; withdrawal of a person into himself; feeling of discomfort from closed space and many others life events and situations. The most powerful stressor is loneliness in old age. The concept is far from clear. If you think about it, the term "loneliness" has a social meaning. A person has no relatives, peers, 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 center of attention, thoughts, reflections of an old person may be an exceptional situation that has given rise to a limitation of the circle of communication. The heterogeneity and complexity of the feeling of loneliness is expressed in the fact that the old person, on the one hand, feels a growing gap with others, is afraid of a lonely lifestyle; on the other hand, he seeks to isolate himself from others, to protect his world and stability in it from the intrusion of outsiders. Practicing gerontologists are constantly faced with the fact that complaints of loneliness come from old people living with relatives or children, much more often than from old people living separately. One of the very serious causes of disruption of ties with others lies in the disruption of ties between old people and young people. Not the most humanistic position is fixed: the absence of a real life projection for the future is clear both for the oldest person and for his young environment. Moreover, such a relic phenomenon as gerontophobia or hostile feelings towards old people can be called not uncommon today (5; 94).

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

In order to work with the elderly and old people, it is necessary to clearly understand the social and psychological problems of the 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 the elderly and old people

2.1 Legislative framework for social work

The problem of social work with the elderly is of national importance. Legislative and legal basis social work are:

1) Constitution Russian Federation

In Russia, as in a welfare 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); "O labor pensions in the Russian Federation” (November 2001); "On the social protection of disabled people in the Russian Federation" (July 1995); "On Veterans" (January 1995); “On the Fundamentals of Social Services in the Russian Federation” (December 1995); "O social services elderly and disabled citizens” (August 1995)

3) Of great importance for solving the problems of the elderly and disabled are the decrees of the President of the Russian Federation: “On measures to create an accessible living environment for disabled people”; "O additional measures state support disabled people” (October 1992); “On the scientific and information support of disability and disabled people” (July 1992) and a number of resolutions 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 institutions social services”; “On the Procedure and Terms of Payment for Social Services Provided to Elderly Citizens and Disabled Persons by State and Municipal Institutions of Social Services” (April 15, 1996); "On the development of a 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 funding; a program of social protection for the elderly and the disabled has been formulated. All efforts are aimed at improving the living conditions of older people, their social services, strengthening additional social support measures, helping to achieve longevity, and ensuring a peaceful old age (10).

Russian state, developing and adopting relevant legislative acts, harmonizes them with the initial 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 updated in 1996.

The main principles of social protection are: humanity, social justice, targeting, comprehensiveness, ensuring the rights and freedoms of the individual, as well as consistency, competence and preparedness of specialists.

In recent years, a mechanism has been established for providing social services to the elderly and the elderly. The 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, departments day stay. 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 of social work with the elderly and elderly have been developed (!9; 79).

The Department for Elderly and Disabled Citizens of the Ministry of Labor of the Russian Federation prepared a number of regulations on the creation and organization of the work of institutions of stationary and non-stationary social services, 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”;

July 27, 1999 No. 29(31), "On Approval of the Exemplary Charter of a State (Municipal) Institution", "Integrated Center for Social Services for the Population";

Much work is carried out within the framework of the federal target program "Older Generation". The Older Generation program should promote social support for the elderly, 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 measures for a comprehensive solution of issues, taking into account age characteristics, the state of health of all categories and groups of pensioners.

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

1) Improving the living conditions of the elderly, their social services, strengthening additional social support measures, helping to achieve longevity, ensuring a peaceful old age.

2) Further formation of the legal framework for social protection and public services.

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

4) Training of modern professional personnel.

2.2 The main directions of social work with the elderly and the elderly

1) Social security and service

Social security and services for the elderly and elderly include pensions and various benefits; the maintenance and service of the elderly and the disabled in special institutions of the bodies of social protection of the population; prosthetics, benefits for the disabled; helping the homeless.

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

One of the important areas of social security is the improvement of pensions. It is solved in different ways. In some countries, a pensioner receives a pension and wages completely regardless of its size and in any branch 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 is also in Russia. Voluntary old-age insurance (the right to an additional pension) also has a perspective. But our pension provision is still insufficient, despite the regular increase in the size of pensions (16; 204).

Also, assistance to the elderly is provided by local authorities: differentiated additional payments to non-working pensioners are increased; various categories of the elderly are provided with benefits for paying for housing, travel to suburban transport v summer time, prescription drugs are dispensed free of charge, free vouchers to sanatoriums are provided, and so on.

Social services for the elderly and the elderly are provided by the Centers for Social Services for Senior Citizens.

In 2005 in the system of social protection of our country, there were 1959 stationary institutions for the elderly and disabled, more than 900 social service centers, 1100 departments of social assistance at home, as well as a number of other institutions of social assistance (psychological and pedagogical, emergency psychological) (12; 75) .

The Center for Social Services for Elderly Citizens, as a rule, includes several departments:

Department of day care (calculated for at least 30 pensioners). Food, medical and cultural services are organized here. It is desirable to have a special workshops or part-time farms and the feasible labor activity of pensioners in them.

Department of temporary stay (not less than 15 people). It carries out health-improving and rehabilitation measures; cultural and domestic services; meals around the clock.

Department of social assistance at home (serves 120 people in the city, and 60 people in the countryside). It provides permanent or temporary (up to 6 months) social services at home for pensioners who need outside help (free of charge 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 essentials; one-time provision of financial assistance; assistance in obtaining temporary housing; emergency psychological help, including by "hotline"; provision of legal assistance; provision of other types and forms of assistance due to regional and other specifics.

A new form of care has appeared - hospice. Here doctors, social workers, priests and volunteers have united their efforts. Their credo: a person should not end his life in a public hospital bed among strangers (29; 69).

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

Here is how, for example, the work is organized in the Center for Social Services at Home "Mercy" in the city of Kalinin. The center helps about 1110 lonely elderly and disabled people. Under it, there are departments of medical and social assistance, special and hospice care at home, a geriatric department for 15 places 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, organization of recreation for pensioners. The issue of opening a nursing care unit on the basis of the district hospital (free of charge) is being considered. 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 single old man who has his own living space is a potential hostage of mafia-commercial structures that “work” in the housing market. According to the statistics of the Main Department of Internal Affairs only for 2007. out of 37 thousand people who exchanged housing with the help of dubious firms, only 9 thousand were registered for a new place of residence. In Moscow, it is now successfully operating special service- "Mossotsgarantiya". It is accountable to the Government of Moscow 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. To do this, in accordance with the law and all legal norms, an agreement on life maintenance with a dependent is concluded. The decision is made by the commission of the Committee for Social Protection (17; 203).

In a crisis situation in Russia, targeted social assistance to the elderly is essential. First of all, it turns out to be the most needy: lonely pensioners, the disabled, the elderly over 80 years old.

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

2.) Social care for the elderly

Guardianship of the elderly 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. It is established over capable adult citizens who, for health reasons, cannot protect their rights and interests themselves. The guardian must: protect the rights and interests of the ward, live with him (in most cases) and provide the necessary living conditions for him, care for him and his treatment, protect him from abuse by third parties. A guardian over a capable person may 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 system of boarding schools.

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 boarding houses common use decreased. This is due to the fact that the practice of providing assistance at home to disabled citizens is expanding. Now people who have completely lost the ability to move and require constant care come to boarding schools.

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

In nursing homes general type help the elderly to adapt psychologically to new conditions. The newcomer is informed about the services provided, the location of rooms, offices. The features, needs, interests of older people are studied in order to resettle them in accordance with their individual psychological properties, so that they can find people close to them in terms of temperament, interests, and do not feel lonely. Employment needs and leisure preferences are being studied.

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

Three groups of people can be distinguished among the residents of boarding schools:

1) those who came here at will alone;

2) arrived at will, living with families;

3) those who do not want to be in a boarding school, but are forced to apply here by different reasons(material, family climate).

Naturally, older people want to live in their own home, in a familiar environment. And this allows expanding home care. State-guaranteed home services have recently become more diverse. This is catering and home delivery of groceries; assistance in purchasing medicines, essential goods; assistance in obtaining medical care and accompaniment to medical institutions; home cleaning help assistance in the provision of ritual services and the burial of the lonely dead; organization of various social and domestic services (renovation of an apartment; delivery of firewood, water); assistance in the preparation of documents, the exchange of housing.

Back in the 80s, in some boarding schools, special departments were created, in which the elderly, in need of permanent care lived there during the absence of relatives from the house (business trip, illness). Now these are temporary residences.

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

3) Medical and social rehabilitation

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

Tasks of medical and social rehabilitation of the 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 methods of rehabilitation.

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

4) organization and implementation of medical and social patronage of lonely elderly, and elderly living in families

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

6) assistance in providing disabled people with the necessary aids(crutches, hearing aids, glasses, etc.)

7) implementation of recreational 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, the hospice helps him to live his remaining days with dignity. Hospices are a humanistic, treatment facility for terminal cancer patients. Fundamental difference hospice from traditional hospitals is to create conditions for a full, normal life hopeless patient" is the way to get rid of the fear of suffering that accompanies the onset of death, the way to its perception as a natural continuation of life. The experience of hospices convinces us that in conditions of effective palliative care(when pain and other distressing symptoms can be brought under control) reconciliation with the inevitability of death is possible, which people accept calmly and with dignity. The hospice employs social workers, doctors, priests, volunteers (16; 276).

The geriatric center has much in common with the hospice. Here interact such areas of knowledge as gerontology, gerontopsychology, geriatrics.

4) Providing psychological assistance

As already mentioned in Chapter I, the transition of a person 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 active adaptation of the individual to the conditions of the social environment. This requires the following measures (1; 138):

Organization of psychological, advisory assistance (personal problems, conflicts in the family, 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, Q&A evenings)

Solving the problems of employment of the elderly

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);

Recruitment of religious organizations.

The problem of social work with the elderly and old 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; programs of social protection of the elderly and elderly have been formulated.

1) social security and social services;

2) medical and social rehabilitation;

3) social guardianship;

Conclusion

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

In order to work with the elderly and old people, it is necessary to clearly understand the social and psychological problems of the 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 the elderly and old 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; programs of social protection of the elderly and elderly have been formulated.

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

4) social security and social services;

5) medical and social rehabilitation;

6) social guardianship;

4) provision of psychological assistance.

The need for social services, social guardianship, medical, social and socio-psychological rehabilitation of the elderly arises as a result of disability; changes in the social status of a person; bad financial situation. All areas of social work are closely interconnected with each other and serve one goal: to restore broken or weakened, lost social ties and relationships, the loss of which occurred as a result of age, serious illness, disability.

Further necessary:

Contribute to the restoration of an atmosphere of mercy, humanism in relation to the elderly and old people. The efforts of the state and the church should be united; to revive the 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;

Solve the problem of employment of the elderly, to do this, improve the legislation on the labor of the elderly.

Create a database of elderly and old people in need of specific types of assistance;

Improve the quality of medical and social assistance and psychological assistance.

Bibliography

1) Alperovich V. Social gerontology. Rostov n / a, 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) Dementieva N.F., Ustinova E.V. The role and place of social workers in servicing the disabled and the elderly. Tyumen, 1995.

5) Dmitriev A. V. Social problems of the elderly. M., 2004.

6) Dolotin B. "For the older generation" // Social Security No. 7, 1999.

7) Kon I.S. Permanence of personality: myth or reality? M., 1987.

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

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

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

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

12) Pochinyuk A. Social work for the elderly: 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 on social work / Edited by E.I. Single. M., 2001.

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

16) Social work with the elderly. Handbook of a specialist in social work. 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 contemporary development: materials of the consultation of the international seminar. M., 1995.

19) Kholostova E. I. Social work with the elderly M., 2003.

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

Working

Non-working

	Working pensioners	Non-working pensioners

1.Result: temp = 1.9

Critical values

p≤0.05 p≤0.01

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Self-esteem the obtained empirical value of t (1.9) is in the zone of insignificance.

The main areas of social work with older people in conditions modern society are:

• - social support;
• - social help;

Social support, at the same time, is aimed at creating conditions and

opportunities necessary for the self-realization of an elderly person in a new socio-demographic quality.

The main forms of social support for the elderly are:

• - improvement and development of the system of pensions and pension services, including non-state pension funds;
• - system improvement pension legislation and systems of social support and care for the elderly throughout society;
• - ensuring and developing the employment of older people, taking into account their capabilities and abilities and subject to control over the observance of their rights by employers;
• - creation and development of a system of institutions for the self-realization of older people and their self-assertion in a new social quality (clubs, cooperatives, public organizations and unions)
• - targeted social support for single elderly people and elderly couples;
• - the formation in society of a proper attitude towards the elderly at all levels of its organization.

The main goal of social support for the elderly should be to enable them to enter the new system social connections and relationships, preserving and using their intellectual, labor, social and personal potential.

Social assistance is an activity for the complete or partial solution of a number of social problems an elderly person by relevant organizations, institutions and specialists. For its implementation, the following main forms of social assistance to the elderly are used.

• 1. Social services, that is, providing an elderly person with everything necessary in cash or in kind, in the form of specific services. It can be carried out at home, in homes and Day Care Centers or in a hospital setting and be urgent, one-time, solving a pressing problem, or systematic, carried out on a long-term or ongoing basis.
• 2. Social services, which are a specification of the system of social services at the individual, personal level. Most often, older people need such social services as social-medical, social-domestic, social-legal or socio-psychological.

Types and forms of social assistance aimed at preserving the family, solving its problems, can be divided into emergency, aimed at the survival of the family. Social work aimed at maintaining the stability of the family, on social development family and its members.

Both social support and social assistance to the elderly are implemented in social practice at such basic levels as the macro and micro levels of social work.

The macro level is the measures taken at the level of the state and society in relation to the elderly as one of the social communities. Its main elements are:

• - formation of social policy taking into account the interests of older people;
• - development and implementation of relevant social federal programs;
• - formation of a system of socio-economic support for the elderly;
• - training of specialists to work with them.

The micro-level of social work with older people is the measures taken by specific individuals and structures in relation to an individual elderly person, taking into account his personal characteristics, social environment, the capabilities of a particular specialist. Both of these levels constantly interact with each other in real social practice, complementing, concretizing, and, sometimes, compensating for each other.

Competently and skillfully organized social work with such a complex category of the population as the elderly implies compliance with a number of fundamental principles, such as the principle of state guarantees, the availability of social services and equal opportunities to receive them, personal consent to receive social assistance, an individual approach to its organization, trust and confidentiality.

Currently, for society and the state, the task of improving and developing both the system of organizations and institutions working with older people, including non-state ones, and improving the directions and methods of activity of existing structures is relevant.

In the organization of social work with the elderly, 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, needs, biological and social opportunities, certain regional and other features of life. It should be noted that scientists and practitioners approached the problem of old age and its definition from different points of view - biological, physiological, psychological, functional, chronological, sociological, etc. And hence the specificity of solving problems of social and social status, role and place in family, but organizations of social security and service, social rehabilitation, social guardianship of the elderly, etc.

At present, there is a widespread trend: all those who dedicate themselves to caring for and working with old people are getting younger. From these positions, caring for old people is a meeting of different generations, respect for age on the part of young employees, their tolerance for the principles and established beliefs of an old person, his attitudes and values.

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

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

Caring for the elderly is, finally, accompanying the dying, helping family members at this painful moment.

Only by assuming these principles and putting them at the basis of professionalism, it is possible to endure all the mental and physical stress associated with caring for old people. It is important to understand one more circumstance: in an old person we see his current appearance and practically cannot imagine him as a child, a man or a woman in the prime of life, handsome, strong and self-confident or, on the contrary, soft, generous, aspiring to the future. Meanwhile, it is important, seeing in front of you an old and sick, and often a demented (feeble-minded) person, to recreate his appearance, to remember that he carries childhood and youth, youth and maturity. Often, some aspects of the behavior of old people that cause rejection and surprise in young people, seem unusual or immoral to them, are actually within the cultural norm of the past generation and do not indicate a deterioration. mental abilities person. When confronted with the negative aspects of old age, there is a danger of gerontophobia in young social workers; moreover, they may be imbued with a pronounced phobia of their own future aging.

Research by the Hungarian psychologist N. Hun showed that the most worst grades and a negative opinion of old people have nurses working in nursing homes and in geriatric psychiatric hospitals. It should be noted that special studies there is practically no tolerance (tolerance) of the population towards helpless old people. In nursing homes in Sofia, a condescending and patronizing attitude towards centenarians was revealed on the part of medical workers and attendants. But a disdainful, even more offensive attitude towards old people was not found in any case. However, one noteworthy feature was established. When asked if they would like to live to be 100 years old, all employees of nursing homes answered in the negative, moreover, they all perceived such a prospect as a tragedy for themselves personally and especially for their loved ones.

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

According to the old people themselves, their requirements for social workers are as follows: first of all, kindness and honesty, disinterestedness and compassion. The ability to listen is one of the main qualities of a social worker, and conscientiousness, responsibility and exactingness to oneself should determine his professional status. Mastering the skills to communicate with old people is not an easy task; in addition to the ability to listen to an old person with an understanding of his needs, it is necessary at the same time to collect objective information about him, to analyze and evaluate the situation in which he finds himself, to determine what his objective difficulties are and what is the result of subjective experiences. It is important not to let the old person be the leader in the conversation and in further contacts.

It should be very friendly and respectful to switch the conversation, directing it in the right direction for the social worker. Equally important is the ability to adequately end the conversation without offending the old person and convincing him with his behavior that all his problems will be taken into account and, if possible, satisfied. You should never categorically refuse requests or assert that all requests will be met. The highest indicator of professionalism of a social worker is the old person's trust, acceptance of advice, all efforts should be directed to activating the old person, encouraging him to solve personal problems on his own.

One type of service is home care. Because home care was out of character boarding houses function that caused all sorts of organizational difficulties for these institutions, it became necessary to create an independent service for the provision of social assistance to disabled citizens with special needs. structural divisions. Such structural subdivisions were the departments of social assistance at home for single disabled citizens, which were organized under the district departments of social security. Their activities were regulated by the "Temporary regulation on the department of social assistance at home for single disabled citizens." In addition to the types of social and household assistance that have already become traditional, social workers were supposed to provide assistance in maintaining personal hygiene, if necessary, fulfill requests related to postal items, assist in obtaining the necessary medical care, and take measures for the burial of dead single pensioners. The services were provided free of charge. Close cooperation with Red Cross committees to organize patronage of single pensioners in need of medical care. A social worker, who is part of the staff of the social assistance department, was supposed to serve at home 8-10 disabled pensioners or single disabled people of 1-2 groups. Departments were created in the presence of at least 50 disabled people in need of home care. In 1987, a new normative act introduced some changes in the activities of social assistance departments. Basically, the changes concerned the organization of departments of social assistance at home. The contingent of persons subject to home care was more clearly defined, and it was also provided that persons receiving a pension in maximum dimensions pay a fee equal to 5 percent of the pension. Enrollment in home care was carried out on the basis of a personal application and conclusion medical institution about the need for such services. Thus, there was a situation when the functions of social services for the disabled at home were simultaneously performed by two organizations: the state - social assistance departments, and, to a lesser extent, the public - the service of mercy of the Red Cross. At the same time, both the types of social services provided and the circle of people to whom these services were provided both by state and public organizations coincided in many respects.

Thus, historically, public organizations carried out those types of activities that the state, due to the lack of economic, logistical and organizational reasons, was unable to perform. This is evidenced by the history of the development of the service of medical and social assistance to disabled citizens: in the post-war years, when the state did not have the strength and means to develop a home-based service, it developed a system of nursing homes for the elderly and disabled. To a large extent, the development of individual home care was constrained by vicious ideological attitudes, according to which preference was given to the development collective forms providing social services. The satisfaction of the needs of the population in home care was partially taken over by the Red Cross Society.

Of course, the service of mercy relieved the acuteness of the problem, however, did not solve it completely. Over the years, as a result of an increase in the absolute number and relative number of the elderly in society, the need for social assistance for this category of citizens has become significant: boarding houses cannot accommodate all those in need; the number of disabled people living separately from their relatives is growing; demographic prospects suggest a further increase in the proportion of elderly people in the population - all this led to the solution of the tasks of social services for the disabled at the state level, the creation of a state system, a public service directly involved in the provision of medical, social and domestic services at home.

It is no longer enough, and indeed it is illegal, to speak only of social services for certain categories of the population. Social work has absorbed the methods and techniques used by psychologists, psychotherapists, teachers and other professionals who are in contact with the fate of people, and social position, economic well-being, moral and psychological status.

From a theoretical standpoint, social work can be viewed as a penetration into the needs of a person (family, team, society, etc.) and an attempt to satisfy it.

Meanwhile, considerations are being expressed about the broader tasks of social work on the interaction of a social worker with the environment. At the same time, the social worker is assigned the role of contributing to the expansion of people's competence, as well as the development of their abilities in terms of solving life problems; help people access resources; encourage organizations to be considerate of people; promote interaction between individuals and those around them; seek links between organizations and institutions providing social assistance and

support; influence social policy and environmental policy.

Legal Framework

Elderly people are a special category of the population that needs state support. And it takes care of them by issuing laws that ensure decent life To old people. They can also contact social services to help them. In turn, the social service, in order to correctly and competently solve all vitally important issues about the elderly, is based on the Laws of Ukraine:

• · Decree of the Ministry of Social Protection of the Population of Ukraine "On the Approval of Typical Regulations, on the Territorial Center for Social Services for Pensioners and Lonely Disabled Citizens and on the Department of Social Assistance at Home" dated April 1, 1997. No. 44 Official Bulletin of Ukraine. - 1997. - Number 39. - Art.57.
• · Decree of the Council of Ministers of the URSR “On special boarding schools for the elderly and disabled” dated March 2, 1990 No. 49 IAC League.
• · Decree of the Ministry of Labor of Ukraine "On the approval of typical provisions for houses - boarding schools (boarding houses) for the elderly, disabled and children" dated December 29, 2001. No. 549 Official Bulletin of Ukraine. -2002. -No. 5. - Art. 212.
• · Law of Ukraine “On social protection of war and labor veterans, lonely and elderly citizens”.

In demography, the quantitative and qualitative composition of the population is usually depicted in the form of a pyramid, the base of which is newborns, children; then there is a gradual narrowing of the pyramid, taking into account mortality in each age period; its peak is made up of persons aged 90 years and older. Until now, this group of old people was not considered to be of great importance for public health and social services in studies of the state of health of the population.

By the end of the 20th century, the demographic situation had changed radically: the age structure of the population of most countries of the world, including Russia, no longer resembles a pyramid, but a column, characterized by a relatively small number of children, young and mature people and a relatively high number of older people. groups. For the first time in many countries, a situation has developed in which the number of all age groups, including the most advanced age, is approximately the same.

Even more surprising is the fact that the proportion of centenarians who live to 90-100 years and more is constantly increasing. The number of centenarians aged 85 years and older in a number of countries, according to the population censuses of recent years, varies from 12 to 68, those aged 100 years and over - from 0.5 to 1.1 per 10,000 population. It is expected that in 2018 average age at the time of death will be 85.6 years. It would seem that the dream of mankind is coming true, man has always longed to live for centuries, and his fantasy in this direction was unrestrained, if only not negative sides senile period of life.

It is quite natural and logical that an increase in the absolute and relative number of older people and centenarians leads to a growing likelihood of multiple pathologies in them. According to D.F. Chebotarev, the pathology of sick old people can be compared with an iceberg, in which 4/7 of the volume is hidden under water. Complaints of old people direct the doctor's attention to the tip of this iceberg, meanwhile, for proper treatment and care, it is necessary to know the whole pathology, i.e. see the whole iceberg. For the social sphere, the main thing is the fact that among old people there is a tendency to slowly growing painful pathological processes that take a chronic course and are difficult to treat. If we take into account that from the age of 40 - 45 there is already an "accumulation" of diseases, it is clear why there are so many people among very old people who are not capable of even the most elementary self-care.

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

The results of clinical and epidemiological studies were also disappointing. mental health the elderly and elderly population. With an increase in life expectancy, the number of mentally ill old people, mainly with dementia, is steadily increasing. According to demographic projections, the number of demented old people will increase by 50% at the beginning of the next century. Some geriatric psychiatrists are of the opinion that the spread of dementia and other intellectual-mnestic disorders in old people in recent years has become an epidemic (“silent epidemic”), and senile dementia will become the “disease of the century” in the near future.

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

The vast majority of older people need the widest range of services and assistance provided to them by strangers, whether they be family members, neighbors, medical, social or charity organisations. In relation to Russia, for the most part, families are unable to take on all the worries about old and helpless relatives. The whole burden of caring for the elderly will fall primarily on the shoulders of state social services and, to a lesser extent, given the current state and the transition in the future to paid medical care, to the health authorities.

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

Among labor pensioners, the absolute majority belongs to old-age pensioners. There is reason to believe that in the near future this indicator will fluctuate within the range of 88-90% of the number of labor pensioners. However, 75% of pensioners are still outside the scope of attention and activities of the social protection system. It is these elderly and old people who cannot realize their needs for the social assistance they need, and the fact that they need it, especially when solving material and domestic difficulties, is beyond doubt. It is also alarming that about 50% of old people, after the first contact with the officials of the social protection system, do not come for social assistance again, as they still have a feeling of bitterness and resentment. One of the reasons for this feeling is the insufficient state funding of social services and benefits for low-income segments of the population, the lack of strict consideration of the targeting of social protection.

Social work with the elderly and old people in the form in which it has developed in countries that are economically prosperous has been developing in the Russian Federation since the early 1990s, when our society came face to face with the consequences of the revolutionary transition to market relations. And, nevertheless, in Russia a certain modern experience of social work with poor and socially disadvantaged categories of elderly and old people has been accumulated.

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

According to V.D. Shapiro, social work in the broadest sense is the provision practical help elderly and old people, families and groups of old people with low material incomes, suffering from various chronic diseases, with impaired social contacts; creation of conditions for them conducive to their physical survival and, ideally, to the preservation of their social activity. V.D. Shapiro wrote as early as 1983 that an increasingly important place in the activities of social services will be occupied by the training of professionals who carry out programs for the provision of social services to the older population, and the training of professionals should be carried out at all levels of academic education. It is in this, according to V.D. Shapiro, and consists of a true understanding and application of social gerontology.

The opinion still prevailing among social workers that everyday experience and their own observations of their grandparents is enough for them does not hold water. For social workers, it is necessary, first of all, to understand and realize the many psychological, psychopathological, somatic, moral and ethical problems that arise in the elderly and old people, to master methods and technologies that would help and facilitate their efforts in everyday life. practical work and communication with the populations served. In this regard, the primary task for this stage is to expand the training of specialists in practical social work with the elderly.

It is well known that the interweaving of somatic, psychogenic, psychological problems of old people is so complicated that often, even with the greatest desire, without sufficient knowledge and special training, it is impossible to establish what determines the state of an old person - a somatic or mental illness. Sometimes it is difficult to determine who can provide more complete and timely assistance - a geriatrician or a geriatric psychiatrist. This is especially true for social workers, whose field of activity is very wide. Even with its strictest regulation, social workers face some new unexpected tasks and problems every day. They are required to be prompt, initiative, quick-witted in solving the specific needs of each old person whom they have accepted for social services. Social workers should be universally trained in all aspects of old age and old age. The main direction in their practical activities to meet the needs and requirements of helpless old people should be psychosomatic an approach .

Working with old people has always been considered and is considered everywhere one of the most difficult psychologically, and it is not for nothing that the staff turnover is so high. It is no secret that at present the majority of employees in the social sphere: doctors, nurses, administration, management and service personnel, are forced to work with old people due to some life circumstances. True calling is extremely rare.

To solve the priority tasks of servicing the elderly, it is necessary to have qualified personnel of social workers at all levels. According to S.G. Kiselev, at the beginning of 1994, among 115 thousand social workers, heads of departments of social assistance at home and directors of social service centers, only 5.9 thousand had a specialized higher or secondary specialized education. He raises the issue of improving the qualitative composition of social workers through the targeted direction of applicants to specialized universities and technical schools (in full-time and part-time forms of education).

The same opinion is shared by M. Elyutina, who writes about the need for gerontological monitoring, the development and implementation of geriatric programs, the development of gerontological orientation of social services and gerontological profiling in the training of social workers.

Obviously, the population of older age periods is a heterogeneous group characterized by a wide range of internal differences. In recent years, more and more often in publications, especially in the media, the elderly and old people appear only as victims. It has become fashionable to present old people devoid of any negative traits, suffering and deprived of attention both from their loved ones, and from society and the state as a whole. However, such an idyllic picture in relation to the elderly and old people, to put it mildly, is far from objectivity. Among them, as well as among other age groups, there are positive and negative people, sociable and non-communicative, highly moral and criminal personalities, teetotalers and alcoholics, etc. Old age is not the right to remission of all the sins of youth and adulthood. A person in old age remains the same as he was in his character, personality traits and forms of behavior in earlier years. age periods. Bad person does not become good in old age, and vice versa.

Differentiated Approach should become mandatory in social work with the elderly and old people as individuals, members of society, families, residents communal apartment, nursing homes, etc. Thus, according to the WHO definition, the “old” are significantly different from the “new old”, those who have recently retired. For social workers, it is important, first of all, comprehensive information about the contingent of elderly and old people they serve.

In geriatrics and geriatric psychiatry, it has become an axiom that physical and psychological characteristics people differ significantly over 5-year periods: 60 - 64 years, 65 - 69 years, 70 - 74 years, etc., therefore, in order to obtain social information and create a data bank on elderly and old people, it is important to know not only the demographic features of that or another area, but also a picture of demographic changes in this mass of the population.

In many countries, the proportion of persons reaching retirement age is already close to the maximum value and is not likely to increase in the future. However, among the elderly and senile population, there may be important changes, for example, the number of "old old" will increase, while the number of people who are no more than 15 years older after retirement will decrease. It is important not to confuse all groups of people of the third age, but to consider each group with a gap of no more than 5-10 years. Only then can objective data be obtained that characterize old people, which can be used to plan social work in the future.

Of course, it is impossible to predict whether the current population aged 60-64 years will be similar in 10 years to the group that is now 70-74 years old. However, it can be argued with a high degree of probability that changes in the organization of social services and the economy are inevitable, which will affect these age groups. First of all, these data are of particular importance for planning the activities of local social services and health care institutions. So, for example, if the state of health or financial and economic security in any sample of surveyed old people turns out to be worse than in other areas, then a specific problem can be identified that is of direct importance for this area, district, region. Other, less pressing problems can be identified: demographic projections in most areas indicate that the proportion of very old people in the elderly group will increase in the next decade.

Thus, if the modern system of social assistance and social work meets the needs of this contingent and such services are now used to the maximum extent, then in the future this system may not be adequate to new conditions if it is not planned to expand it in accordance with the growth of this population group.

Even more urgent is the need for objective information for intelligent planning and direct reorganization of social services in areas or regions where the needs of the rapidly growing number of elderly dependent on these services are not being fully met. It seems necessary to reiterate that in order to predict the needs for social services and social work, it is important to determine the dynamics of growth in the number of people aged 75 and over, and not the overall increase in the number of people aged 55 and over. According to G. Stoynev, 80% of people over 75 years old are the most helpless people and they need complete outside help and service. special attention the attitude of the elderly and old people themselves to the assistance they receive from social workers deserves.

Practical experience and specially conducted research allow us to identify several specific stereotypes of the behavior of elderly and old people:

1) active rejection of social assistance in Everyday life, distrust of social workers, unwillingness to be dependent on strangers, strangers;

2) explicit rental attitudes, the desire and perseverance in obtaining as many services as possible from social workers, imposing on the latter the performance of all household duties;

3) dissatisfaction and dissatisfaction with their living conditions is transferred to social workers with whom they directly communicate;

4) the social worker is perceived as an object that is responsible for their physical health, moral and material condition.

Of course, the bulk of the older population, with whom social work is carried out in its various forms, expresses its sincere gratitude to social workers and highly appreciates their work. However, unfriendly attitude, suspicion, dissatisfaction with the services provided is also not uncommon. Sometimes they resort to excessive admiration, praising the social worker in order to get from him those services that are not included in the list of duties performed.

Work with old people in all countries is considered one of the most difficult in all respects: the disappointment of those who care for them is great; to avoid it, high professional training, understanding and knowledge of the psychological characteristics of the elderly and senile age are necessary.

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

Old age is the sum of everything previously experienced and lived, as well as, for many people, unfulfilled life hopes and desires. Each person constantly carries in himself and with him successes and defeats, merits and faults, successful accomplishments and failed undertakings, “unlived life”, i.e. unfulfilled desires, hopes and expectations. Throughout life, a person had to make a choice between two or more possibilities, and one of them was always realized, while the others remained only desires. However, this does not mean that those desires have been forgotten. No, they play a big role in the life of an old person in the form of memories or regrets. In the words of the famous American psychologist and psychoanalyst Jung, a person constantly lives with his shadow, he is overwhelmed with everything that he does not want to consciously perceive, which, being repressed, remains in the subconscious and determines his behavior until his death.

It is impossible to perceive the old person in isolation, outside of him. life path. On the contrary, what it is now is a reflection of the multifaceted and multilayered formation of the personality. The biography of every old person is a reflection of a successful or failed fate, perhaps a broken or ruined life.

The most important thing is that every old person is a person and, as a person, has a value in itself. Personality is the core of human existence, its feelings, experiences and actions. Personality determines the behavior of a person in the process of aging. Each person is unique in his "I" and cannot be replaced by another person, and in this form there is no other person. The self-worth of a person must be fully preserved, it must be indivisible, “individu” in Latin means indivisible.

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

Each person, entering into constant contacts with the people around him and the world around him, builds his own individual world on the basis of his own “I”. From the point of view of psychoanalysis, childhood is a period when a person begins his existence and leads such a way of life in which the external and internal, earth and sky, "I" and "WORLD" are one, mutually intertwined in a living integrity. V adulthood these poles are separated, the formed consciousness allows you to distinguish between your individuality and the world, spirit and carnal urges. In constant tossing between your own "I" and the outside world, there is a danger of getting away from your essence and being swallowed up by this world, to which you give yourself as a victim. At the third stage, i.e. in old age, a person has a chance, if he correctly overcomes this age threshold, to regain the lost harmony, and at a higher level.

This brief introduction to the essence of the provisions of psychoanalysis related to the issue of mental aging of the individual, allows you to get an idea of ​​the complexity and psychological difficulty of the activities of social workers.

Of particular importance is the organization of social work with the elderly in Russia, where the proportion of older citizens in the population is 20.5%, cities - 16.4%; in rural areas - 23.3%. For every 100 people of working age, there are almost 36 people older than working age.

Such a high percentage of older people in the total population (about 20%) will continue for many years, according to calculations, until 2006. It is expected that by 2015 for one working person, and Russia will have one disabled person. Moreover, among the disabled, at least half are the elderly.

In pursuance of the Decree of the President of the Russian Federation in Russia, the federal target program "Older Generation" was developed and approved by the Government Decree, which presents a set of measures to improve social services for the elderly.

Social services for pensioners in Russia are carried out on the basis of the Federal Law "On social services for elderly citizens with disabilities" dated August 4, 1995. Federal Law “On the Fundamentals of Social Services for the Population in the Russian Federation” dated December 10, 1995, Federal Law “On Veterans” dated January 12, 1995, Decree of the Government of the Russian Federation. “On the Federal List of State-Guaranteed Social Services Provided to Elderly Citizens and Disabled Persons by State and Municipal Institutions of Social Services” of November 25, 1995. Decree of the President of the Russian Federation “On additional measures to implement the Federal Law “On Veterans” of April 30, 1996.

In accordance with the federal legislation, the following forms of social services for pensioners are defined: at home, including social and medical; semi-stationary in stationary social service institutions (boarding houses, boarding houses, etc., regardless of their name) urgent in order to provide emergency one-time assistance to those in dire need of social support; social advisory assistance aimed at the adaptation of elderly and disabled citizens in society, the development of self-reliance, and the facilitation of adaptation to changing socio-economic conditions. (Federal Law "On Social Services for Citizens", Article 16) The procedure for paying for all types of services is regulated by federal law.

Just as importantly, social workers offer a wide range of services to beneficiaries. According to the regulation on the social service center, these include: home delivery of food from stores, from the market; hot meals from canteens, necessary goods and medicines, humanitarian aid; registration of various utility and other payments, delivery of things for repair. On behalf of the social worker, he will contact a notary, call a doctor, receive ordered orthopedic shoes, help write a letter to relatives, draw up the necessary documents (including for placement in a boarding house), invite apartment repairmen or any kind of equipment (TV, refrigerator , etc.) Some territorial centers expand the scope of this rather wide list of services.

Basic services at home are provided free of charge, certain types of services not related to essential consumers are paid to pensioners, but provided that he receives a care pension supplement, the payment is 25% of the amount of the supplement.

The funds received for servicing are credited to the accounts of the centers and directed to their development. They are a significant help in connection with the acute shortage of funds in pension budgets. These funds are used to purchase overalls, footwear for social workers, and bicycles in rural areas.

After the creation of social assistance services at home, the queues for admission to boarding schools among people who are deprived of the possibility of self-service and in need of help and care have sharply decreased. Now these people can live at home, in familiar conditions, with the same lifestyles.

For the poor, free and subsidized meals are organized in private and state enterprises. Meetings of pensioners during lunches resemble a kind of clubs, partially solving the problem of scarce communication.

For pensioners who are temporarily unable to serve themselves and need medical supervision, social wards are being opened in districts and rural hospitals, some of them are developing into gerontological ones. Pensioners spent several months in them and, having healed, returned home.

Stationary departments have been set up in many social service centers. The forms of work of the hospital are close to the activities of boarding houses, but the stay here is temporary (from 1 week to 3 months). This form of service is especially noteworthy for older people who have temporarily lost the ability to self-service, but do not want to leave their comfortable home. The requirement in the departments does not threaten with psychological discomfort, which quite often occurs when an elderly person is placed in a boarding house.

Another form of work is the definition of day stay. The purpose of such departments is to help older people overcome loneliness. In such departments, they try to create a semblance of a home environment, a hospitable living room, in which it is customary to communicate with old acquaintances. Here you can also get medical assistance, wellness treatments, free or discounted meals. In such departments, various types of feasible labor are organized, where you can earn extra money by sewing, needlework, and again feel your usefulness.

Clients of the day department jointly celebrate holidays, birthdays, and as a result, old age and loneliness no longer look as sad as before. In the department of medical a sister who visits the sick, calls the doctor, fulfills his appointments.

Sociological studies of day care patients revealed that 74% of them are attracted by the desire to communicate, spend time together, participate in festive events, 26% get a free lunch, 29 the opportunity to save themselves from cooking.

Respect and civilization are concepts of the same order. Respect for old people is expressed by the material conditions of life that society can provide them - the size of the pension, the quality of housing, the conditions of health care, comfortable services. But no less important is the spiritual side of life - the inclusion of an elderly person in society. Material security outside of social communication leads to the degradation of the individual, to a reduction in life expectancy. social communication in solving the political problems of society, in the narrow affairs of one's own family, constant communication with other people.

The task of social workers and close people to help an elderly person, as far as possible, is associated with knowledge and understanding of the lerontopsychology of material and moral support and respect.

Thus, a special place in social work is occupied by the organization of home assistance to single disabled citizens. The help service, its employees, systematically visiting lonely, most often sedentary people, to some extent relieve them of forced loneliness.