Vpliv institucionalizacije na življenja stanovalcev domov za stare ljudi

• Main Author: Miklavčič, Barbara
• Format: Bachelor Thesis
• Language: Slovenian
• Published: 2019
• Subjects: staranje; institucionalizacija; potrebe; zlorabe; socialno delo; aging; institutionalization; needs; abuses; social work; Pogost; sami
• Online Access: https://repozitorij.uni-lj.si/IzpisGradiva.php?id=107996; https://repozitorij.uni-lj.si/Dokument.php?id=118896&dn=

V diplomskem delu sem želela raziskati, kako bivanje v instituciji, kot je dom za stare ljudi, vpliva na življenja tamkajšnjih stanovalcev, kako pravila za delovanje domov za stare ljudi vplivajo na kvaliteto življenja starih ljudi in v kolikšni meri so zadovoljene njihove potrebe oziroma ali tam prihaja do kakšnih zlorab. Zanimalo me je, kaj v institucionalni oskrbi je še možno spremeniti, da bi le-ta omogočala boljšo in kakovostnejšo oskrbo starim ljudem. Odločila sem se za kvalitativno raziskavo, saj sem želela pridobiti besedne opise, s tem pa nadvse podrobne podatke o temi mojega raziskovanja namesto številčnih podatkov. V teoretičnem uvodu sem najprej opisala demografske spremembe, ki trenutno potekajo, ter naštela dejavnike, ki vplivajo na staranje prebivalstva v današnji družbi. Ker je starih ljudi v današnji družbi vedno več, se pojavljajo vprašanja, kako zanje ustrezno poskrbeti. Za zdaj je še vedno najbolj pogost odgovor na to vprašanje institucionalizacija oziroma odhod starega človeka v dom. Prav zato sem namenila pozornost tudi temu, kako je potekal razvoj institucionalizacije skozi zgodovino in prehajal od medicinskega k socialnemu modelu obravnave starih ljudi. Opisala sem tudi etične podlage za strokovno delo na področju socialnega varstva, ki naj bi jih upoštevali pri delu s starimi ljudmi po domovih. Podrobno sem se posvetila tudi potrebam starih ljudi, ki nam morajo biti vodilo za njihovo obravnavo. V institucijah, kjer je na kupu veliko število različnih ljudi, je neizogibno dejstvo, da tak prostor prinaša tudi najrazličnejše zlorabe. Tako sem opisala dejavnike tveganja, ki lahko pripeljejo do zlorab, in pa znake za njihovo prepoznavanje. Na koncu teoretičnega uvoda pa sem pozornost namenila še specifičnosti socialnega dela s starimi ljudmi in socialnemu delu v domovih za stare ljudi. V empiričnem delu so prestavljeni rezultati raziskave, v kateri je sodelovalo devet ljudi, povezanih s štirimi različnimi domovi za stare ljudi. Od tega pet stanovalcev, ki živijo na različnih oddelkih po domovih, dva sorodnika stanovalcev in dva zaposlena v domovih za stare ljudi, ki sta imela različen profil zaposlitve. V intervjujih sem pozornost namenila trinajstim področjem: odločitvi za prihod v dom, jemanju zdravil, gibanju, zasebnosti, negi in intimnosti, krajam, občutku varnosti, financam, možnostim pritožbe, zapuščenosti in izoliranosti od zunanjega sveta, odnosu zaposlenih, izkušnjam žaljenja, zanemarjanja ali fizičnega nasilja in pa odnosom med stanovalci v domovih. Preko omenjenih tem sem raziskovala, s katerimi področji institucionalnega življenja so stanovalci zadovoljni in kje se še kažejo pomanjkljivosti glede zadovoljevanja njihovih potreb. Ugotovila sem, da se pomembne razlike v zadovoljevanju potreb v instituciji kažejo med tistimi stanovalci, ki so še samostojni, in tistimi, ki so odvisni od pomoči drugih. Tisti, ki lahko večino svojih potreb zagotovijo sami, z institucionalnim življenjem nimajo težav. Težave nastopijo pri tistih, ki so v domu neprostovoljno, pri tistih, ki sami ne zmorejo več osnovnih opravil in morajo vedno čakati na pomoč zaposlenih, in pa tistih, ki so finančno šibkejši, kar zanje pomeni, da si marsikdaj ne morejo privoščiti dodatnih storitev, za katere je potrebno doplačilo. Pomanjkljivosti so bile torej izpostavljene predvsem pri zasebnosti, pogostosti nege, pri zagotavljanju spremstva, pri omejevanju gibanja stanovalcev, ki so nesamostojni, na področju podpore pri sprejemanju pogostosti smrti v domovih, pri pomanjkanju pogovora in individualne obravnave stanovalcev in pri zadovoljevanju potreb zaradi pomanjkanja števila zaposlenih v domovih. Pomanjkljivosti na ostalih področjih, kot so nadzor nad jemanjem zdravil, pri krajah in pri odnosu zaposlenih, so bolj redke in jih navajajo le nekateri od sogovornikov. Izpostavljeno pa je bilo, da so stanovalci po domovih zadovoljni z varnostjo in možnostjo pritožbe, kjer jih v večini primerov upoštevajo. Na podlagi pridobljenih rezultatov sem zapisala tudi nekatere predloge, ki naj veljajo kot smernice za izboljšanje kakovosti življenja stanovalcev v domovih za stare ljudi. In my thesis I wanted to research how living in an institution such as old people’s homes, affect the lives of its residents, how the rules of functioning of old people’s homes affect their quality of life and to what extent their needs are being met or whether there might be any kind of abuse. I was interested in what can be changed in institutional care so that it could provide better quality care for old people. I decided to do a qualitative survey, as I wanted to obtain oral descriptions and consequently as much detailed data as possible about the topic of my research, instead of numerical data. In the theoretical introduction, I first described the demographic changes that are currently taking place and listed the factors that influence the aging of the population in today's society. As the number of old people is increasing in today’s society, questions arise, how to properly take care of them. For now, the most frequent answer to this question is institutionalization, moving to an old people’s homes. That is why I also devoted my attention to how institutionalization developed throughout history and to the transition from medical to social model of dealing with old people. I also described the ethical foundations for professional work in the field of social care, which should be taken into account when working with old people in old people’s homes. I also devoted a lot of attention to the needs of the old people, which should lead us when we are dealing with them. In the institutions where a large number of people is in a small space, it is inevitable that a variety of abuses can occur in that place. So I have described the risk factors that can lead to abuse and the signs for its identification. At the end of my theoretical introduction I also focused on the specifics of social work with old people and social work in old people's homes. In the empirical part, I presented the results of the research, that included nine people involved with four different old people’s homes. Five residents living in various departments in their homes, two relatives of residents and two employees, who have different job profiles. I focused on thirteen different areas in my interviews: the decision to come to old people’s home, the medicine residents are taking, physical activity, privacy, care and intimacy, thefts, the sense of security, finances, possibilities of complaint, abandonment and isolation from the outside world, attitude of employees, experiences of insult, neglect or physical violence and the relationship between residents in old people’s homes. Through these topics, I have explored the areas of institutional life where residents are satisfied and where there are still shortcomings in meeting their needs. I have found significant differences between meeting the needs of more independent residents comparing to those that have to depend on help of others. Residents that can satisfy most of their own needs do not have problems with institutional life. More problems are occurring with those residents that live in old people’s homes involuntarily, those that cannot manage basic tasks and have to always wait for the help of employees and those who are financially weaker because often they cannot afford additional services, that have to be paid extra. The participants in my research emphasized shortcomings mainly in the areas of privacy, frequency of care, the provision of escorts, the restriction of movement with more dependent residents, support with accepting more frequent deaths in old people’s homes, the lack of conversation and individual treatment of residents, and the lack of meeting residents needs due to lack of staff. The shortcomings in other areas, such as control over taking medicine, thefts and employee attitude are rarer and are mentioned only by some of the participants. It was pointed out that residents are satisfied with safety and the possibility of complaint, where, in most cases, they are taken into account. Based on the results obtained, I have also written some suggestions that should be considered as guidelines for improving the quality of life of residents in old people's homes.