Zagotavljanje avtonomnosti in vključevanja stanovalcev pri organizaciji življenja v domu za stare - Kaiser, Domen (2019)
V teoretičnem uvodu diplomskega dela sem predstavil nekaj splošnih značilnosti institucionalnega varstva starih ljudi, opisal področje avtonomije in vključenosti stanovalcev v življenje v domovih za stare ljudi, predstavil vlogo in naloge socialnih delavcev v domovih za stare pred prihodom stanovalca v Dom, pa do stanovalčevega odhoda iz Doma ali smrti. V zadnjem poglavju teoretičnega uvoda sem opisal, kakšen vpliv ima odhod v dom za stare na življenje starega človeka in kakšne naloge ima pri tem socialna delavka. Glede na temo sem se odločil za izvedbo kvalitativne raziskave, s katero sem iskal odgovore na tri raziskovalna vprašanja: (1.) Kako in na kakšen način so stanovalci doma za stare vključeni v organiziranje življenja v Domu in kakšna je njihova avtonomija, možnost odločanja? (2.) Na kakšen način socialna delavka zagotavlja vključenost in avtonomnost stanovalcev pri organizaciji življenja v domu za stare ljudi? (3.) Kakšne naloge in vlogo ima pri postopku sprejema stanovalca v Dom socialna delavka in kakšen vpliv ima odhod v Dom na življenje starega človeka? Vzorec sestavlja devet stanovalcev in je izbran po naslednjih kriterijih: ženske in moški stanovalci z demenco stanovalci, ki so odvisni od pomoči drugega (nesamostojno gibljivi) in stanovalci, ki so še dokaj samostojno gibljivi stanovalci, ki v Domu bivajo več kot tri leta in tisti, ki bivajo manj kot tri leta stanovalci in stanovalke, ki so se sami odločili za odhod v Dom in tisti, ki so bili v odhod v Dom prisiljeni na podlagi situacije. Empirične podatke sem obdelal po metodi kvalitativne analize. Z rezultati raziskave sem prišel do ugotovitev, da imajo bolj samostojni stanovalci visoko stopnjo avtonomije odločanja in možnosti vključevanja v organizacijo življenja v Domu. Pri nesamostojno gibljivih stanovalcih in stanovalcih z demenco pa so avtonomija, svoboda gibanja in vključevanje v življenje v Domu delno omejeni zaradi premajhnega števila zaposlenih, kar posledično pomeni, da so omenjeni stanovalci marsikdaj prisiljeni počakati na pomoč, ko jo potrebujejo ali si jo želijo. Raziskava je tudi pokazala pomanjkljivosti v informiranju stanovalcev glede prireditev in pri zagotavljanju individualizirane oskrbe. Slabša informiranost pa se bolj kot pri samostojnih stanovalcih kaže pri nesamostojno gibljivih stanovalcih in stanovalcih z demenco, kar omejuje njihovo avtonomijo. Stanovalci imajo v Domu možnost odločanja in dogovarjanja glede tem, vsebine in terminov izvajanja dejavnosti ter aktivnosti, ki so organizirane v Domu. Pokazalo se je, da imajo vsi stanovalci, ne glede na oviro, možnost izraziti želje, potrebe, ideje in so pri tem večinoma upoštevani s strani zaposlenih. V Domu organizirajo različne sestanke, na katerih lahko stanovalci izrazijo svoje mnenje, podajo predloge za spremembe in želje glede različnih področij življenja v Domu, ki jih zaposleni upoštevajo. Prav tako imajo v Domu sestanke za sestavo jedilnikov, na katerih sodelujejo poleg stanovalcev tudi njihovi sorodniki. Vsi stanovalci, tudi nesamostojno gibljivi in stanovalci z demenco, imajo možnost sodelovanja in obiskovanja vseh dejavnosti, aktivnosti in prireditev. Socialna delavka, glavna medicinka sestra, delovna terapevtka in direktorica spodbujajo in osveščajo zaposlene o pomembnosti spoštljive, odprte in ustrezne komunikacije tako med zaposlenimi, kot med zaposlenimi in stanovalci. Socialna delavka je stanovalcem vedno dostopna in pripravljena pomagati tako v zadevah, ki se navezujejo na življenje v Domu, aktivnosti, dejavnosti in oskrbe, kot pri drugih zadevah. Socialna delavka s starimi ljudmi in njihovimi sorodniki vzpostavi stik že pred prihodom starega človeka v Dom, se z njimi spozna ter jim po potrebi pomaga pri ureditvi dokumentacije. Ob tem starega človeka in njegove sorodnike spodbudi, da ob sprejemu v Dom s seboj prinesejo za stanovalca pomembne osebne predmete in stvari, s katerimi si lahko opremi sobo. S tem pa se tudi lažje prilagodijo na nov življenjski prostor. In the theoretical introduction to the thesis I introduce a few general characteristics of institutional care of the older people, describe the field of autonomy and inclusion of the residents in the life in the homes for older people, present the role and tasks of social workers before admittance of the residences in the home, and until they depart or pass away. In the final chapter of the theoretical introduction I describe the effect that moving into a home for older people has on an older person, and the tasks of a social worker in that period of instituional life. With regard to the topic I chose to conduct a type of qualitative research, looking for answers to three research questions: (1.) How and in what way are the residents of a home for older people included in organizing the life in a home, and what is their autonomy, their ability to make choices? (2.) In what way does a social worker ensure autonomy and inclusion of residents in the organization of living in a home for older people? (3.) What is the role and which are the tasks of a social worker when admitting a resident into a home for older people, and what kind of an effect does moving to a home for older people have on the life of an older person? The sample consists of nine residents and was selected according to the following criteria: women and men residents with dementia residents depending on assistance (no independent mobility) and residents who are still independently mobile residents who have lived there for more than three years and those who have been living there for a shorter time residents who decided to move to a home for older people themselves and those who were forced to move because of their situation. Empirical data was processed using qualitative analysis. The results of the research lead me to the finding that the more independent residents have a high level of autonomy in decision-making and the chance to be included in the organization of living in the home for older people. Residents without independent mobility and those with dementia have partially limited autonomy, freedom of movement and inclusion in living in a home for older people, because of the limited number of employees. This, in turn, means that those with limited abilities are sometimes forced to wait for help when they need or want it. The research has also pointed to shortcomings in informing the residents of events and in the provision of individualized care. Poor information provision has a bigger impact on the residents without independent mobility and those with dementia, limiting their autonomy. Residents of a home for older people have the option to make decisions and discuss the topics, content and dates of activities that are held at the nursing home. It was made evident that all the residents, regardless of any impairments, have the option to express their desires, needs and ideas, and that the employees mostly take them into consideration. The home for older people also holds various meetings where residents can express their opinion, give proposals for changes and express desires relating to different areas in of living in the nursing home that the employees then consider. The home for older people also holds meetings regarding the menus, where residents are joined by their relatives. All residents, even those without independent mobility and those with dementia, have the option to participate in and attend all activities and events. The social worker, the head nurse, the occupational therapist and the director encourage and inform the employees on the importance of respectable, open and appropriate communication, both between employees and between employees and residents. The social worker is always available to the residents and willing to help them in matters related to living in the home for older people, the activities and care, as well as with other matters. The social worker establishes contact with the older person and their relatives even before they enter the home for older people, meets them, and, if needed, also assists them with documentation. They also encourage the older person and the relatives to bring important personal items and other things for decorating their room when moving into a home for older people. This helps them adjust to their new life.