Social work with elderly and elderly people. Coursework: Social work with older people Deontology in working with older people

Deontology (a combination of Greek words: deontos - duty, due, proper, logos - science) is a science that studies the ethical principles of behavior in the performance of one's professional duties. Deontology, as a separate field developed since ancient times, has until now been more associated with medicine, constituting its own section.
Social work in its current understanding and interpretation cannot do without deontology. L.V. Topchiy and A.A. Kozlov define deontology as a set of ethical standards of professional behavior for social service workers. In deontology, they include basic principles, moral precepts that make it possible to provide effective social services to the population, excluding unfavorable factors in social work, aimed at optimizing the system of relationships between various categories of social service personnel and clients, preventing the negative consequences of social services: professional duty, selflessness, professional endurance and self-control, trust between specialists and clients, professional secrecy, etc.
Deontological problems arise especially acutely when communicating with seriously ill old people who have lost the ability to self-care. It is well known that patient and balanced people cope most successfully with caring for the elderly. Of course, moral support is the most valuable, therefore a social worker who does not limit his activities to formal services, and who also manages to become a friendly and attentive interlocutor, assistant and adviser, will turn out to be an ideal comforter for an old person. Those who are too harsh, domineering, and work mainly for money or for the sake of a career cannot cope with this type of activity. In turn, old people with their life experience They very easily understand and perceive falsehood and insincerity in relation to them. A hasty person who does not know how to listen and is preoccupied with his own problems will never gain the trust of old people.
The social worker needs Special attention pay attention to your appearance and the form of communication with old clients. Too much fashion clothes, the abundance of cosmetics and jewelry does not contribute to establishing contacts between old people and social workers. Old people are especially distrustful of frivolous, superficial people who make promises but do not keep them. Lack of concentration, carelessness, restlessness, and verbosity also cause wariness on the part of the old person towards the social worker and do not contribute to the establishment of trusting contacts, which are necessary for both parties.
When caring for old patients who have lost the ability to self-care, the social worker with all his behavior and actions must support and awaken the desire to maintain maximum mobility for as long as possible and perform at least the most basic self-care actions. In any case, the dignity and sense of independence of older people must be respected.
An old person should become the subject of an individual approach for a social worker. A feeling of respect for an old person, interest in his life path and experience usually increases confidence in the social worker and his authority as a specialist. We should never forget that when talking with an old person, you should try to maintain an expression of interest, sympathy and goodwill on your face. All this will allow you to get acquainted with the social history of the old person, place and living conditions, understand intra-family relationships, their significance for the old person, understand interpersonal relationships between young family members and the old man, to help resolve their internal disagreements and grievances. The role of rehabilitation of elderly and old people in this case should be assessed from both a social and moral point of view. It also provides a significant economic effect, since restoring the ability to self-care frees a large number of medical personnel from caring for sick elderly people, if they are admitted to a hospital, as well as relatives, relieving them of the need to leave their professional activities.

Socio-medical deontologywith older and older people

Deontology is a science that studies the ethical principles of behavior in the performance of professional duties, constituting a separate section of medicine. According to a number of authors (L.V. Topchiy, A.A. Kozlov, P.D. Pavlenok), deontology is defined as a set of ethical standards of professional behavior for workers in medical and social services. In deontology, they include basic principles, moral precepts, medical and social effective service to the population, selflessness, professional duty, trust between specialists and clients, maintaining professional secrecy, etc. Especially with elderly and sick people, you need to behave patiently and balancedly so that they do not notice falsehood and insincerity. A worker with elderly people must behave honestly and conscientiously, carefully and patiently. An old person should become the subject of an individual approach for a medical social worker. A sense of respect for an old person gives additional authority to a worker in the medical and social sphere.

3.2. Changes in organs and systems during the aging process

Changes in human organs become noticeable and increase upon completion of the active reproductive period of ontogenesis.

After 40-50 years, a person begins to show signs of aging: wrinkles, age spots, warts appear on the skin, the skin becomes dry and rough, its elasticity is lost and it becomes flabby.

Energy processes in the body, blood supply to tissues and organs, as well as flow through the vessels of the brain in a 75-year-old person compared to a 30-year-old person decrease by 30%, the work of the respiratory system by 56%, and the urinary system by 31%.

Old age is a stage of individual development during which the body experiences regular changes in its physical condition, appearance, and emotional sphere.

Senile changes increase in the postproductive period of ontogenesis. However, the onset of decline or complete loss cannot serve as a lower limit for old age.

Menopause in women is typical for older people. Graying of hair is observed. In men, the secretion of male sex hormones by the gonads decreases and the secretion of gonodotropic hormones increases. The overall result of the manifestations of aging at the level of the whole organism is an increasing decrease in the viability of the individual with age and a decrease in the effectiveness of adaptive homeostatic mechanisms. For example, the speed of impulses decreases with age from 20 to 90 years by 10%, the capacity of the lungs - the respiratory nervous and muscular systems - by 50%.

The aging process affects almost all structures and functions of the body.

Nature created man in such a way that the human brain, the most complex creation of nature, is the apotheosis of its activity, and it can lead any restructuring of cell activity. Is a cell capable of independent logical actions? We must look for conditions under which the cells themselves would be cleansed of toxins - main reason aging, they themselves would be cured of diseases with the help of leukocytes, phages, etc., which they themselves invented, they themselves would change their structure and shape and, finally, they themselves would acquire the qualities necessary to achieve active longevity. By using modern science and technology made this possible.

Longevity depends on reproduction, cell renewal or cell division. If these processes were followed, people would not lose their youth. In order to maintain this rule, it is necessary to assimilate at least the most basic information about the physical, design features of your own body as early as possible.

While we are healthy, or feel healthy, we exaggerate ourselves, our body, our capabilities without any thought, without thinking about the consequences. A specialist doctor should

Z. N. Khismatullina

ORGANIZATIONAL-METHODOLOGICAL AND SOCIAL WORK

WITH SENIOR AND OLD PEOPLE

Key words: gerontology, older people, old people, social work with older people, technologies of social work with the elderly, deontology. gerontology, elderly people, old people, social work with elder age, technology of social work with elderly people, deontology

The article is devoted current topic- the problem of social work with old people, which is currently the focus of attention of many social institutions, social and research programs aimed at ensuring an acceptable standard of living for elderly and old people.

The author notes that among the key points that should be remembered when developing social work with older people are the uniqueness of individual experience, the need for biological and psychological approaches to old age, the importance of the social environment with its support and mutual assistance, public attitude towards frailty in old age , the concept of individual resources available to any person.

The article is devoted to the theme of current interest - the issue of social work with old people, which are currently in the center of attention of many social institutions, social and research programs, aimed at ensuring an acceptable standard of living of elderly and old people.

Author notes that among the main points, that we must remember during the development of social work with elderly and old people, are: uniqueness of individual experience, the need of biological and psychological approaches to old age, the importance of the social environment with its support and mutual help, public attitudes toward feebleness in old age, the notion of individual resources that are available to anyone

There are 143 million people living in Russia, of which 35 million are pensioners, that is, every fourth. In 2050, a maximum of 98 million people will live in Russia, while every third Russian will be over 60 years old. These are the UN forecast data published by the Russian Institute of Demographic Research.

Alas, the ruthless statistics do not give reasons for optimism. After all, global population aging is considered not as the highest achievement of human civilization, but as a “headache” for the governments of economically prosperous and developing countries.

Are old people useful members of society or are they economic and moral waste? Philosophers, poets, natural scientists, sociologists and politicians have tried to answer this question; their opinions are varied and contradictory: from enthusiastic praise to pessimistic neglect.

On modern stage development of mankind, most scientists and political figures agree that with the global aging of the population, numerous problems associated with it will increase. The “load” of the working population will increase sharply, and it will inevitably be necessary to intensively develop those branches of medicine that are most

are closely related to maintaining the level of health of elderly and old people. This additional burden will have a painful impact both on the state of society as a whole and on the position of pensioners themselves, since this is the least socially protected part of the population. All this emphasizes the need for correct demographic and social policies regarding elderly and old people.

Problems of social work with old people are currently the focus of many social institutions, social and research programs aimed at ensuring an acceptable standard of living for elderly and old people. It should be taken into account that the older generation is in a period of human life that turns out to be post-professional, giving rise to a variety of problems - economic, psychological, medical, everyday, social, etc.

Retirement, that is, termination of active work professional activity, a narrowing circle of friends, and approaching physical weakness cause an irreversible set of psychological, value, and motivational changes, which ultimately lead to the emergence of a new life rhythm or sense of time. First of all, the social fullness of life is lost, since the quantity and quality of the elderly person’s connections with society is limited. In this situation, older people are trying to determine, and this is natural, a new meaning for their lives.

All this indicates the enormous relevance of the problem - the problem of population aging and, in connection with this, the need in modern society for specialists in the field of social gerontology. Taking into account modern requirements for professional activity in this field, such specialists should be trained. Specialists who would be able not only to understand and accept an elderly person for who he is, but would also be able to establish contact with him and solve the problems of an elderly person, taking into account the specifics of his social status. Specialists in the field of social gerontology must know the socio-psychological characteristics of older people, their medical problems, the specifics of communication with them, the system of social protection for people of retirement age, and must also successfully navigate the current environment, skillfully apply modern technologies when working with elderly people. .

In general, the professional training of social sector specialists in working with people of the “third” age should be based on a combination of theoretical and practical work of students. It is practice that has great importance when forming professionally significant character traits of a future social worker working with older people, it reveals his professional suitability for the chosen specialty.

If we consider the tasks of a social worker working with the elderly population, the range of his responsibilities, as well as the goals and objectives of training future specialists in the field of gerontology in a single context, then we can identify the core that unites all the components of this difficult, but such a significant and necessary profession - this is the ability , and most importantly, the desire to go to older people, find forms of communication with them, work with them, to help them and support them.

Among the key points that should be remembered when developing social work with older people are the uniqueness of individual experience, the need for biological and psychological approaches to old age, the importance of the social environment with its support and mutual assistance, public attitudes towards frailty in old age, the concept of individual resources available to anyone.

Organizational and methodological social work with elderly and elderly people includes: identifying the problems of an elderly person’s appeal to a social worker; making a social diagnosis and planning social assistance; joining forces with other specialists in order to most fully resolve the problem; social work with the family of an elderly person.

Client and his problem

When old man ends up in the social service department, he becomes a client. Its appearance means that the social worker becomes responsible for taking actions for the sake of this client.

A social worker begins working with an elderly client by obtaining answers to the questions: a) what is his problem; b) why it is a problem; c) whose problem is this? d) why this problem is important now. Thanks to these questions, it is possible to determine how many people the problem affects, what crisis event led the elderly person to seek help, etc. Before taking subsequent actions, the social worker needs to use appropriate questions to remove the client’s passivity in accepting the situation and restore his initiative.

If necessary, to paint a complete picture, the social worker seeks consent to contact other people, the client’s family. The elderly client's agreement to cooperate is an opportunity for further discussions, interviews, meetings with family, etc. .

Diagnosis and planning of social assistance

Diagnosis of the problem begins with small introductory interviews. It is believed that a diagnosis requires at least an hour of interview, because... the problem must be clarified. Such a discussion should be “generalized”. This means that it covers aspects of health, daily life activities, and the emotional needs of the client, expressed in depression, anxiety or unhappiness, and feelings of dependence. Weighing all these facts gives an understanding of the degree of difficulty of the problem.

In social diagnosis, obtaining information about the client plays an important role. Information can be obtained as a result of an examination of a person, his living and living conditions, environment, and also with the help of questionnaires. For example, the question “What is the most difficult thing for you in everyday life?” associated with the task of identifying those factors that pose a risk to his life. Another purpose of obtaining information may be to study the social conditions of an elderly person’s life, for example, when cleaning his apartment or room. Nutritional characteristics can also be a source of obtaining the necessary information about the client. It is important to obtain information about the elderly person’s family, friends, religious views, and spiritual interests in order to create a holistic picture necessary to make a correct social diagnosis.

In diagnosing a client, the social worker does the following:

accepts the situation as a complex interaction of physical, mental, emotional and social factors, the strengths and weaknesses of the elderly client, the significance of the situation for him;

^ balances his desires and needs;

^ agrees on the range of services and those acceptable changes among everyone involved in the client’s situation.

When all the nuances have been explored, the social worker enters the social assistance planning phase. This includes developing strategies:

^ by decision existing problems;

in order to prevent the development of problems in the future;

With the goal of renewing or strengthening the elderly client's resources for those problems that still arise.

All planning can range from simple coordination of activities to more complex plans.

Interdisciplinary cooperation

In many situations, the social worker must work closely with several members of other professions and related disciplines for the benefit and needs of the elderly client. First of all, contacts with medical workers in clinics or hospitals (general therapists, physiotherapists, surgeons, etc.) are useful. However, these connections can be broader and involve the neighborhood, local government, law enforcement agencies, etc.

Any information from any sources can be useful to better provide assistance and plan further work. The ability to coordinate such work with people from different professions, where each has different perspectives and a set of value orientations, requires considerable time and development of the skills of a social worker.

Working with family

It is a semantic component in social work with older people and, as a rule, begins with an understanding of the characteristics of the family of older people, with aspects of its daily life, intra-family interactions, and relationships between generations. An elderly person, in some sense, is part of the family with its sphere of social relationships and support. Any change in his daily existence must be considered in the context of his position in the family group and its ability to respond to such changes.

Working with the family of an elderly client includes the elderly person himself, members of his family, circle family relations and neighborhood social support. The context of this work arises from the attempts made by the elderly client himself, his relatives, and those around him.

The main requirements of the technology of social work with older people are:

1. Prevention of the causes that cause problems for older people.

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

3. Respect for equality and opportunities for older citizens when receiving social assistance and services.

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

5. Identifying the individual needs of older citizens for social assistance and services.

6. Targeting in the provision of social services with a priority of assistance to older citizens in situations that threaten their health and life.

7. Use of new technologies of social work aimed at meeting the needs and needs of older people.

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

9. Ensuring that older people are aware of the possibilities of social assistance and services.

The central element of organizational and methodological work with a client is the social worker’s development of the communication skills necessary for him to conduct social work “face to face.” To do this you need to have different skills, but the main thing is building relationships. The first contact with the client is based on respect, empathy and warmth, which is demonstrated by the social worker.

In order for a social worker to be ready to start a conversation with those who have difficulties and problems, who are in need, they need to be able to show empathy. Empathy is a more professional feeling and reaction. Being empathetic, a social worker understands the feelings of another and his personal attitude in response to them, but is not filled with them. In addition to empathy, relationships require warmth and respect, which is manifested in trust, acceptance of another point of view or personal opinion.

From a psychological point of view, communication is a two-way process of giving and receiving information. Special attention from the social worker will be required for older clients who have difficulty communicating. Therefore, it is very useful before starting a conversation to tactfully determine whether there are any manifestations of deafness, blindness, or speech difficulties. All this makes it difficult to understand the client, but the social worker does not need to exaggerate the difficulties. Communication should be built in a normal audio register; if necessary, compensating means are used: lip reading, gestures, drawing, recording questions and answers, the presence of relatives, loved ones or other specialists. The main thing is the social worker's tolerance and respect for the client's autonomy.

Following communication skills in direct work with an elderly client, key components follow: discussion, negotiation, protecting the client’s interests, counseling. To have a clear plan, the following points need to be clear at the beginning of the discussion: 1) what needs to be done; 2) what resources will be required; 3) who are the participants in the discussion; 4) what is the desired goal and minimum goal; 5) what actions will be taken; 6) how long will it take.

Negotiations are purely business (and probably financial) in nature, in which the expectations and claims of each party are clarified. As a process, negotiations can be divided into phases (application, discussion, agreement, adoption of the chosen solution, etc.).

Protecting the interests of a client can be defined as a certain system of actions of a social worker to support this client. But at the same time, the most active participation of the client himself is important, since older people often lose faith in their own strength. Routine planning and a skilled approach that details the work with the elderly client is helpful. The effectiveness of protection increases the client’s trust in the social worker.

Counseling as a process involves active listening, which requires the social worker to concentrate and constantly confirm that he is listening to the client. You need to listen to the elderly client carefully, taking in both what is said and what is not said in words, looks, silence and non-verbal communication.

Intervention in crisis situation. The theory of crisis intervention in social work has a specific meaning, especially when working with older people. Each time a social worker requires a different understanding of the nature of the crisis and his role in resolving it. A crisis can be caused by an experienced and threatening loss, a traumatic event that actualizes the existing ability of the elderly client and his family to resist it. In the practice of social work, there are situations of panic, chaos, trauma that require immediate response,

however, the search for a solution can sometimes be protracted and take weeks and months until the elderly client and his family “ripe” to fully understand the problem. Usually, after a period of stress, discomfort and attempts, a more or less successful response to the situation is found.

Targeted approach

The targeted approach is quite successfully used in working with the elderly and their families - this is one of the forms of direct work with the client. The significance of the target approach is that:

The approach is based on reaching an agreement and establishing contact between the social worker and the client, which frees the latter from the feeling of a “grateful recipient”.

The client and social worker work together to identify the Main Problem or rank the problems in order, deciding where to start.

A time limit is set during which it is planned to achieve any results.

The actions taken are divided into individual tasks and distributed between the client and the social worker.

Reviewing progress and setting the next block of tasks allows you to incorporate something from what has already been achieved, which in turn is a good way to improve the effectiveness of social work interventions.

The targeted approach is poorly applied in cases where there are problems in the client's mental health, severe mental disabilities and defects, i.e. where the client himself is not able to accept the problem and how to work with it. In many other cases, this method is quite useful; it provides a clearer focus on the client's problem. It is also effective when working with family members and representatives of other professions to identify a range of difficulties and find solutions.

Methods of working with older people:

1. Conversation method. The conversation should be based on the principles of goodwill, maximum naturalness and ease. It is necessary to prepare for it: 1) clearly imagine the goal; 2) develop a conversation plan; 3) think through sample questions.

The principles of the conversation are:

Limiting the speech of a social worker.

In no case should a social worker “put pressure” on the client, evaluate him or his actions, or condemn him.

Features of a social worker’s speech during a conversation with a client include:

1) maximum approximation to the client’s speech, including freeing speech from professional terms; 2) the social worker’s use of those characteristics, descriptions, etc., that the client uses; 3) brevity and accuracy of the social worker’s statements; 4) embedding the simplest questions into the client’s speech to develop further dialogue.

In a conversation, you can use the technique of paradoxical questions, which will allow you to reveal internal contradictions and look into the true attitude of an elderly person to the subject of conversation. It is advisable to use this technique in cases where the client “hides behind” some well-known truth and “runs away” from the situation.

The purpose of an individual conversation is to help a person overcome fixation on a traumatic experience, to help find a way out of a frustrating situation.

2. Method role playing games. Role-playing is when the participants act out specific situation. Situations are taken from life, from the practice of family relationships and reflect a certain side of these relationships, usually containing conflict. The situation sets out the initial objective data, describes the characters and their characteristics. Listeners are invited to take on the roles of the characters and play out the situation as they imagine it.

Roles can be: 1) passive - the participant will fully follow the instructions;

2) active - only general information is given, and the participant has complete freedom of action.

The situation proposed for playback is given in the most general terms. This is done for many reasons. Firstly, it is impossible to completely formalize a life situation. Secondly, the more detailed the situation is described, the more constrained the “players” will feel. Therefore, all players are given the opportunity to supplement the situation with the details necessary, in their opinion, to create a sense of reality. Approximate themes of role-playing games for older people are determined by their social roles in the family.

3. Method of socio-psychological training. Provides a general impact on the individual, creates optimal conditions for the regulation of the whole organism, and also helps to increase the emotional stability of group members.

This method has an activating effect, which is due to the creation of a special educational and experimental environment that ensures that older people understand what individual and group psychological events unfold in the processes of interpersonal communication, how each participant influences others, what is the role of joint activity in this and what its content.

4. Self-correction method. It is a highly effective method when working with older people. It includes a number of links: the individual’s acceptance of the goal, taking into account the conditions of the activity, its programming, evaluation of results and correction. The implementation of these links presupposes the presence of a certain attitude of an elderly person to his actions and actions, the rational use of his individual capabilities.

Self-correction of actions and behavior is based on various social mechanisms of manifestation and interaction of individual characteristics. One of the mechanisms is for older people to use their favorable opportunities and strengths.

Thus, for a social work specialist dealing with the problems of older people, a number of social and psychological factors related to the lifestyle of older people, family situation, ability and desire to work, health, and social and living conditions are important. In order to work with older people, you need to know their social status in the past and present, mental characteristics, material and spiritual needs, and in this area rely on a scientific approach.

As you know, there are two main approaches to social work with older people. Proponents of the first approach believe that all clients are the same. The difference lies only in the nature, degree of frailty and the services they need, so social work must be based on these needs of geriatric clients.

The needs of old people may vary: by type - lack of products, inability to purchase them on their own; poor, poorly equipped housing or its complete absence; inaccessibility of medical care; by degree - the need to provide the full amount of assistance or in some individual parts; short-term or long-term social assistance.

Proponents of the second approach place the differences rather than the similarities of older people at the basis of social work. According to this point of view, elderly and senile clients should be viewed primarily as individuals, individuals whose unique traits, characteristics and goals should be the center of attention.

Based on this postulate, actions are planned for each individual person, and not for entire groups of older people. To implement this approach, not only versatile professional training is required, but also certain personal qualities of social workers.

Without a doubt, the quality of social work does not depend on one approach or another; in any case, conscientious performance of work duties is the only measure of the professional suitability of a social worker.

Responsibility and compliance with all legally established standards are the basic requirements for the professional competence of persons who have chosen to provide assistance to elderly and elderly people as their activities.

In this case, social workers must:

provide complete freedom of choice for an elderly person to choose the most important social problem for him;

maintain a respectful attitude when meeting with an elderly person; show benevolent interest in the elderly client’s past;

avoid a familiar and ironic tone when communicating with an elderly client; avoid establishing too close, trusting relationships; do not impose your point of view and your will on the old person.

It is especially strictly necessary to adhere to the following rule - to maintain complete frankness and awareness of everything related to the fulfillment of the requests and instructions of the old person, to treat them with complete seriousness and responsibility.

We must never forget that the most acute reminder to an old person of helplessness, powerlessness and complete dependence is the lack of information “on his case.” By showing interest in the little things of everyday life, which are so important for old people, offering them a choice, it is necessary to promote independence and activity, at least in ordinary, everyday matters. It is this approach that helps to form and strengthen in old people a sense of comfort, well-being and gratitude towards the social worker.

The social worker is obliged, already at the first meeting, to notify the elderly client about what social powers he has in providing him with assistance and resolving issues that concern him.

The first commandment of a social worker should be to refrain from rash promises, assurances of the ability to quickly solve all the emotional, material, physical and other needs of old people, as well as regulate the client’s family or neighborhood relationships.

In turn, the social worker is not only not obliged to fulfill all the requirements and whims of the old person without exception, but must be able to use his authority to explain to him the essence of social work in a manner that is respectful for the old person - this is the activation of the client’s physical and psychological capabilities. No matter how old a person is, he needs to be convinced that the main thing in social care at home is to help him maintain independence for as long as possible.

ability in the most basic self-service. And this is only possible with his active participation, while passivity will lead to a negative result, namely immobility and complete dependence, and possibly the need for inpatient social services. This principled position of the social worker eliminates the aggravation of relationships and the emergence of conflict, and the elderly client understands that the social worker is not an unpaid servant, but a partner, a companion who, as part of his duty, is obliged to: 1) promote his own activity; 2) help him cope with life’s difficulties on his own; 3) instill a sense of security and independence; 4) avoid infantilism, that is, the desire to have, as in childhood, a patron and fulfiller of all desires and whims.

An elderly person as an object of social work is at the same time a subject who is capable of not only realizing the content and goals of work with him, but also becoming or not becoming its accomplice. That is why a social worker must actively counteract the attitude of certain elderly and old clients to perceive themselves as helpless and defenseless, and without any remorse transfer all everyday problems and even responsibility for their lives onto him.

It must be frankly admitted that among a certain part of the older population, after all the socio-economic reforms in the country, dependency began to appear, a sense of resentment and injustice began to degenerate into social squalor, and begging and the search for all kinds of free handouts acquired the character of “ labor activity" Of course, the emergence of this phenomenon was also facilitated by the aggressive and intolerant attitude of a number of politicians towards the older generation, the passive and indifferent attitude towards the elders on the part of all production and other enterprises, intolerance and contempt for the older people of the younger generation, and the spread of gerontophobic stereotypes at the state level.

Against this background cos this system social work with elderly and old people and social workers, in particular, were identified as the only government link obliged to take full care of the needy old people, providing them with comprehensive (social, economic, psychological, emotional) support and at the same time showing empathy, respect, compassion, which the elderly need most of all.

It can be stated that over the past period, effective social work with various groups of the older population has taken shape.

The main objectives of social work with elderly and elderly people are: to provide assistance in the processes of adaptation of old people to changed living conditions, to recognize and eliminate difficulties of a personal, social, environmental and spiritual nature that adversely affect them;

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

protect them in accordance with the law by resorting to the use of power; promote greater use by each client of their own capabilities for social self-defense;

use all means and sources for social protection of people in need.

The essence of social work with people of the “third age” is to create a network of social service institutions that promote the formation of favorable situations, useful contacts, and decent behavior. It must ensure satisfaction

Addressing the needs of older people as a special social group of the population, creating a good atmosphere for decent support of their capabilities. Social work helps to identify the positive potential of “elderly” citizens and helps to evaluate the accumulated practical experience.

The scope of activity of social workers in solving various issues related to elderly and elderly people is extremely extensive. Often, even with the strictest regulation, unexpected situations and problems arise that require an immediate and correct solution. The demands that social work theorists place on social workers are very high. Thus, social workers must initially have the following qualities:

Morality is the need to act in accordance with the requirements of ethics and morality, the need to do good and bring benefit to people;

Honesty - the manifestation of this quality should be both in words and in deeds;

Conscientiousness is a sense of moral responsibility for one’s behavior and a warning against a purely formal attitude towards one’s professional duties;

Objectivity - avoid excessive emotionality in assessing the problems of an old client;

Justice - a social worker must always be fair towards his client, despite his own likes and dislikes;

Tactfulness is the quality of a person who has to deal with people who are weak, sick, irritated, whose pride is already sufficiently hurt by certain circumstances in which they find themselves;

Tolerance is a moral quality characterized by a respectful attitude towards the interests, beliefs, beliefs, habits of other people, the ability to accept them as they are;

Attentiveness and observation;

Composure and self-control;

Kindness and love for people;

Self-criticism - the ability to analyze one’s activities, the ability to correct one’s mistakes without looking for self-justification;

Adequacy of self-esteem - a real understanding of one’s professional and social capabilities to solve the client’s problems, on the one hand, and on the other hand, not to underestimate self-esteem;

Patience is a must-have quality when working with old people who have poor vision or hearing impairment;

Communication skills - the ability to quickly and correctly build communication;

Optimism and willpower;

Emotional stability - self-control, the ability to self-regulate, which allows a social worker to control himself in various situations of professional activity;

The desire for self-improvement;

Creative thinking.

So, social work with elderly and old people cannot do without deontology. Deontology (a combination of Greek words: deontos - duty, due, proper, logos - science) is a science that studies the ethical principles of behavior in the performance of one’s professional duties.

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

Deontological problems arise especially acutely when communicating with seriously ill old people who have lost the ability to self-care. It is well known that patient and balanced people cope most successfully with caring for the elderly. Of course, moral support is the most valuable, therefore a social worker who does not limit his activities to formal services, and who also manages to become a friendly and attentive interlocutor, assistant and adviser, will turn out to be an ideal comforter for an old person. Those who are too harsh, domineering, and work mainly for money or for the sake of a career cannot cope with this type of activity. In turn, old people with their life experience very easily understand and perceive falsehood and insincerity in attitude towards them. A hasty person who does not know how to listen and is preoccupied with his own problems will never gain the trust of old people.

A social worker needs to pay special attention to his appearance and the form of communication with old clients. Too fashionable clothes, an abundance of cosmetics and jewelry are not conducive to establishing contacts between old people and social workers. Old people are especially distrustful of frivolous, superficial people who make promises but do not keep them. Lack of concentration, carelessness, restlessness, and verbosity also cause wariness on the part of the old person towards the social worker and do not contribute to the establishment of trusting contacts, which are necessary for both parties.

Literature

1. Social work with older people: textbook. allowance/answer. ed. A.Yu. Levagin. - Ulyanovsk: UlGU, 2002. - 211 p.

2. Theoretical and practical foundations of working with older people: a methodological manual / resp. ed. N.B. Shmeleva. - 2nd ed., add. - Ulyanovsk: UlGU, 2007. - 196 p.

3. Khismatullina, Z.N. Social gerontology: textbook / Z.N. Khismatullina. - Kazan: Kazan Publishing House. state technol. University, 2008. - 264 p.

4. Kholostova, E.I. Social work with older people: textbook. manual - 4th ed. / E.I. Kholostov. - M.: Publishing and trading corporation "Dashkov and K", 2006. - 348 p.

© Z.N. Khismatullina - Ph.D. sociol. Sciences, Associate Professor department social work, pedagogy and psychology KSTU, e-mail: [email protected].

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

old people. 4

2. Differential characteristics of elderly and old people. 7

3. Main tasks and professional responsibilities of social

employee. 10

4. Ethical principles of communication for a social worker 13

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

RELEVANCE AND IMPORTANCE OF SOCIAL WORK WITH

SENIOR AND OLD PEOPLE

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

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

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

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

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

In 2018, the average age at death is expected to 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 unbridled” (I.V. Davydovsky), if not for the negative aspects of the senile period of life.

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

“see the whole iceberg.”

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

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

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

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

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

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

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

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

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

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

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

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

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

DIFFERENTIAL CHARACTERISTICS OF ELDERLY AND

OLD PEOPLE

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

MAIN TASKS AND PROFESSIONAL RESPONSIBILITIES

SOCIAL WORKER

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

This is, first of all:

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

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

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

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

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

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

create and maintain a work environment and atmosphere;

identify and overcome negative feelings that affect people and himself;

recognize and overcome aggression and hostility in relationships with people;

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

observe, understand and interpret behavior and relationships between people;

communicate verbally and in writing;

organize and conduct conversations in various circumstances;

conduct negotiations, speak on the radio, etc.

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

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

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

c. helps in family education;

d. works with pensioners, disabled people, children;

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

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

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

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

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

Field worker;

Mobilizer;

Behavior corrector;

Information Manager;

Administrator;

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

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

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

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

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

These include:

Ability to listen to others with understanding and purpose.

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

Ability to create and develop relationships.

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

Ability to gain the trust of clients.

emotional mood.

Ability to conduct research or interpret findings.

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

Ability to establish inter-institutional relationships.

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

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

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

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

It should be based on the following principles:

Objectivity and independence.

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

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

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

selection and training of capable workers.

ETHICAL PRINCIPLES OF SOCIAL COMMUNICATION

EMPLOYEE

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

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

Interpersonal ethics are extremely complex.

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

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

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

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

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

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

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

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

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

be guided primarily by the interests of clients;

customer independence;

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

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

Serve your profession for the benefit of others.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

confidentiality of all information received;

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

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

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

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

ETHICAL RESPONSIBILITY TO THE PROFESSION.

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

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

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

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

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

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

SKILLS AND ABILITIES YOU SHOULD HAVE

SOCIAL WORKER

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

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

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

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

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

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

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

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

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

REQUIREMENTS FOR PROFESSIONALISM OF SOCIAL

WORKERS SERVING SENIOR AND OLD PEOPLE

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

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

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

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

Only by adopting these principles and making them the basis of professionalism can one withstand all the mental and physical stress associated with caring for the elderly.

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

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

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

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

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

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

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

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

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

DEONTOLOGY IN SOCIAL WORK WITH THE ELDERLY AND

BY OLD PEOPLE

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

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

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

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

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

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

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

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

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

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

MEDICAL AND SOCIAL WORK

WITH ELDERLY PEOPLE.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

CHANGE IN SOCIAL STATUS

ELDERLY PERSON AND RELATED

PSYCHOLOGICAL PROBLEMS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

SOCIAL PROTECTION OF ELDERLY PEOPLE

AND SOCIAL SERVICE MODELS

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

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

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

Local authorities provide significant assistance to older people.

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

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

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

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

SOCIAL SERVICE CENTERS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

SOCIAL SERVICES AT HOME

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

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

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

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

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

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

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

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

DAY STAY DEPARTMENTS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

URGENT SOCIAL ASSISTANCE

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

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

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

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

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

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

RESIDENTIAL INSTITUTIONS

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

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

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

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

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

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

occupational therapy and employment, organization of leisure, etc.

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

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

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

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

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

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

SPECIAL RESIDENTIAL HOMES FOR THE ELDERLY

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The vast majority of older people need a wide range of services and assistance provided to them by strangers, be they family members, neighbors, medical, social or charitable organizations. Problems of social work with old people are currently the focus of attention of many social institutions, social and research programs aimed at ensuring an acceptable standard of living for this category of the population.

Social work with elderly and elderly people in Russia began to develop in the early 1990s, and today a certain amount of experience has been accumulated in this area. According to social gerontologists, the main task of social work is to connect an individual or family with external and internal sources of those resources that are necessary to correct, improve or maintain a certain situation.

A change in the social status of a person in old age, caused primarily by the cessation or limitation of work activity, the transformation of value guidelines, the very way of life and communication, as well as the emergence of various difficulties in both social and everyday and psychological adaptation to new conditions, dictates the need development and implementation of specific approaches, forms and methods of social work with this category of the population. The attitude of elderly and old people themselves to the assistance provided to them by social workers also deserves special attention. Practical experience and specially conducted research allow us to identify several specific behavioral stereotypes of elderly and old people:

• rejection of social assistance in everyday life, distrust of social workers, reluctance to be dependent on strangers;
• desire and persistence in receiving as many services as possible from social workers, entrusting the latter with all household duties;
• dissatisfaction and dissatisfaction with their living conditions is transferred to social workers with whom they communicate directly;
• a social worker is perceived as an object who is responsible for their physical health, moral and financial condition.

Of course, the majority of the older population, with whom social work is carried out in various forms, expresses their sincere gratitude to social workers and highly appreciates their work. However, hostility, suspicion, and dissatisfaction with the services provided are also common.

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. They must be patient and caring towards anyone, even a very capricious and annoying old person.

The most important thing is that every old person is a person and as a person has intrinsic value. Personality is the core of human existence, his feelings, experiences and actions. It also determines human behavior during the aging process.

Basic tasks social work with the elderly and elderly:

• provide assistance in the process of adaptation of an old person to changed living conditions, recognize and eliminate difficulties of a personal, social, environmental and spiritual nature that adversely affect them;
• help cope with these difficulties through supportive, rehabilitative, protective or corrective influence;
• protect them in accordance with the law by resorting to the use of power;
• promote greater use by each client of their own capabilities for social self-defense;
• use all means and sources for social protection of people in need, etc.

To be successful in working with older adults, a social work professional must have generalist training. Understanding and awareness of the many psychological, somatic, moral, ethical, material and everyday problems that arise among elderly and old people, mastering methods and technologies that can help and facilitate everyday practical work and communication with this category of the population is just a few of the things that what a specialist should know and be able to do.

From the point of view of professional training, employees of social service institutions can be divided into specialists and non-specialists. Social service specialists have higher and secondary professional education- core and non-core.

Non-specialists (auxiliary service personnel) should be divided into three groups: skilled, semi-skilled and unskilled workers. As practice shows, they all have different levels professional qualifications, vocational training and professional excellence. Not all social service workers holding positions as social work specialists can successfully perform job responsibilities, have professional skills sufficient to successfully solve the specific problems of elderly clients. Without professional skills, it is impossible to organize individual social services in order to resolve the difficult life situation of an elderly person and ensure the socio-psychological harmony of his functioning.

Working with older people in all countries is considered one of the most difficult in all respects.

The concept of “professionalism in social work” was not immediately introduced into circulation and found application in the USA and Western European countries. Back at the beginning of the 20th century. it was argued that social work is not a profession and that a social worker is a secondary position. However, gradually the status of both social work and the social worker changed. The authority of this profession has increased significantly.

Professionalism in social work, as defined by L.V. The top thing is the knowledge, skills and abilities of a specialist that are constantly maintained at a high level, providing qualified assistance to people in resolving their life problems, achieving High Quality labor and results.

Consequently, the professionalism of a social worker is characterized by the presence of a number of professionally significant qualities:

• professional vocation;
• deep motivation to perform work in its various modifications;
• spiritual and moral qualities, a penchant for working with people;
• professional excellence;
• an objective-critical attitude towards one’s activities;
• professional knowledge and professional skills;
• the ability to learn throughout life and achieve self-realization;
• professional pride as a socio-psychological state of the individual;
• development of spiritual and moral qualities.

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

So, what qualities should a specialist have when working with the elderly and elderly?

Research shows that the most significant qualities for this category of social service clients are the following qualities of a social work specialist, which can be divided into 3 groups:

• personal characteristics: kindness, caring, honesty, responsiveness, friendliness, tolerance, humanity, sociability, compassion, selflessness, balance;
• communication skills: attention to others, ability to listen, courtesy, polite attitude towards people;
• attitude to work: conscientiousness, diligence, responsibility, self-demandingness.

Qualities unacceptable for social workers:

• personal characteristics: nervousness, self-interest, callousness, arrogance, dishonesty, cruelty;
• communication skills: rudeness, disrespect for people, disgust, anger, impoliteness, insolence;
• attitude to work: indifference to wards, constant haste, irresponsibility, laziness, dishonesty, unwillingness to help, frivolity, lack of concentration, extortion.

In general, clients would like to see more generous, understanding, and compassionate people in social workers.

The most important thing in social work should be the ability to establish contacts with old people, master the art of communicating with them, since otherwise various interpersonal misunderstandings, misunderstandings and even open mutual hostility arise. Thus, the ability to listen is one of the main qualities of a social worker.

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

The highest indicator of a social worker’s professionalism is the trust of an old person and acceptance of advice; all efforts should be aimed at activating it and encouraging it to independently resolve personal problems.

Social work in its current understanding and interpretation cannot do without deontology. L.V. Topchiy and A.A. Kozlov define deontology as a set of ethical standards of professional behavior for social service workers. In deontology, they include basic principles, moral precepts that make it possible to provide effective social services to the population, eliminating unfavorable factors in social work, aimed at optimizing the system of relationships between various categories of social service personnel and clients, preventing the negative consequences of social services: professional duty, selflessness, professional endurance and self-control, trust between specialists and clients, professional secrecy, etc.

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

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

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

Old people are especially distrustful of frivolous, superficial people who make promises but do not keep them. Lack of concentration, carelessness, restlessness, and verbosity also cause wariness on the part of the old person towards the social worker and do not contribute to the establishment of trusting contacts, which are necessary for both parties.

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

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