Socialno delo, Vol. 39 (2000), Part 4-5
CARE FOR OLD PEOPLE
ARTICLES
Narcissistic Disorder, Mental Crises, and Ecological Supportive Aid in Old Age - 263, (Abstract)
ABSTRACTS
Abstracts
Srečo Dragoš
Getting Older in the Light of Social Capital (in Slovenia)
The quality of life of older population and the capacity to solve problems that emerge in this period of life significantly depend on the quantity of social capital in society. Since individuals cannot create it without contacts with others, the kind of social networks and trust that are available in Slovenia cannot be unimportant. The paper presents, on the basis of opinion polls, a number of data and entailing trends from which the disposal of social capital in Slovenia may be inferred. Non-activated human resources of the unemployed, contentment with social networks and the material state, general trust in people and especially in friends (with regard to sex, age, education, geographic location, religion, political preferences), changing confidence in state and civic institutions, voluntary practices, state of health, and trust in medical services - all these are indirect indicators of social capital, and it is upon them that life in later periods will depend as well. The data show that is the disposal of social capital is not optimal in our society, and in some dimensions its quantity is rather critical.
Keywords: social networks, trust, opinion polls.
Dr. Srečo Dragoš is a senior lecturer of sociology at the University of Ljubljana School of Social Work.
Vida Miloševič Arnold
Professional Roles of Social Workers with Aged People
In introduction, the author lists the models of social work practice and the development of professional roles of social workers. She presents the directions that have emerged in the field of gerontological social work. Professional roles of social workers are then analysed from the standpoint of their suitability for work with aged people. The services of Slovene social security are listed, together with the various professional roles they offer to social workers.
Keywords: social work fields, social work mission, old person's rights.
Vida Miloševič Arnold is a social worker, supervision specialist, and lecturer at the University of Ljubljana School of Social Work.
Bernard Stritih, Miran Možina
Narcissistic Disorder, Mental Crises, and Ecological Supportive Aid in Old Age
The features of narcissistic disorder and personality disorder in old age are presented on two cases of aged people, one from the authors' practice and one from literature. Narcissism is taken as an important dimension on the scale of mental health. According to numerous investigations, many people who work in helping professions have a personal experience of deficient and destructive narcissism, so that its research is important for clients and helpers alike. The paper presents the basic frame of recognising (diagnosing) personality disorder. For the choice of helping method, however, the type of disorder is less decisive than the difficulty it presents. The assessment of that difficulty is based on the assessment of the level of psychosocial functioning (by help of the GAF scale). The clients who turn for help to social workers are in the main from the middle levels of the scale (codes 30 to 60). In a recent work (1999), the Swiss psychiatrist and psychotherapist Jürg Willi has presented the idea of "ecological supportive aid" which, in the authors' view, is very useful in social work for help to the people with personality disorder and other more difficult clients. After presenting the key concepts of that idea (co-evolution, personal niche, interaction efficiency, collusion, pseudodidactic attempts), the authors point out that personality disorder may be seen as an attempt at self-healing and as a form of (co)evolutionary adjustment. The ecological survey of the sub-group of histrionic, narcissistic and borderline personality disorders is followed, in conclusion, by a few possible starting points and directions for ecological supportive aid to the people with narcissistic disorder in old age.
Keywords: personality disorder, social work, diagnostics of mental disorder, psychotherapy.
Dr. Bernard Stritih is a senior lecturer of social work at the University of Ljubljana School of Social Work. Miran Možina is his assistant.
Gabi Čačinovič Vogrinčič
Family and an Old Person
The first part of the paper defines, on the basis of three family psychology models, the changes a family needs to undergo for the project of facing one (or more) of its members' old age. Stierlin's concept of delegation, Lidz's model of what needs to be assured in a family community, and Bion's model of working group point to important themes about which the family can reach an agreement. In the second part, the social work project of reorganisation of life with an old person is defined. The first step is the establishment of a working agreement. In the process of reaching the instrumental definition of a problem, the whole family is addressed, and all the members, involved in the problem, examine their feasible part in its solution.
Keywords: delegation, working group, personal niche, social work working relationship, family project of help.
Dr. Gabi Čačinovič Vogrinčič is an associate professor of psychology and social work with the family at the University of Ljubljana School of Social Work.
Srečo Dragoš
Social Networks and Old Age
Growing old has an impact on social networks, on the choice of people we meet, and on the way we do it. Even more importantly, however, the reverse is also true - social networks have an impact on growing old. That impact is discussed in detail in the second half of the paper, where relations between networks and their resources of support on the one hand and sex, psychological, physical and medical indicators of old population on the other are presented. The findings are relevant for all who work with people, in particular for social workers, but also for the state strategy of developing services for the aged (for social policy). Growing old is not only a social and sociological but also a biological, cultural, economical and phenomenological phenomenon; its complexity is pointed out in the first half of the paper, where in particular the phenomenological conceptions of Dasein, of growing old and of time are discussed.
Keywords: social work, phenomenology, social policy, health, ageism, feminism.
Dr. Srečo Dragoš is a senior lecturer of sociology at the University of Ljubljana School of Social Work.
Jože Ramovš
Inter-generational Links, Self-help, and the Quality of Old Age
The opening thesis is that the starting point for social gerontology is integral anthropology. The first part presents a comprehensive image of humans in view of six dimensions in transverse section, three periods of life in longitudinal development, and oscillation in quantity-quality polarisation. This is followed by a presentation of the systemic links of three generations in a unity. The central part is devoted to the concept of quality ageing, developed from the author's analysis of human needs in old age. What stands out is the realisation that the need of interpersonal relationship, the need of passing on experiences and insights to the young and the middle generation, and the need to experience the meaning of old age are neglected with contemporary old people. The concluding part of the paper elaborates on the statement that self-help and help for self-help are the most adequate way to quality ageing in our situation, particularly in view of the emerging social problems on account of the growing proportion of aged people. This opens up great opportunities and tasks for social work, especially with developmental action-research projects of introducing voluntary self-help. A very successful case of this sort in the last decade is the project of introducing and expanding old age groups for self-help and networks of inter-generational groups for quality ageing.
Keywords: social gerontology, integral anthropology, self-help, self-organisation.
Dr. Jože Ramovš is an anthropologist and a social worker, head of Anton Trstenjak Institute and an associate professor at the University of Ljubljana School of Social Work.
Jana Mali
Care of the Demented Residents of the Home of the Elderly in Preddvor
The introductory part of the paper presents the work with the demented residents at the Home. It is followed by the presentation of dementia as an illness, the ways and forms of work with a demented patient, and the possible forms of confronting the illness at homes of the aged. There are three basic forms of care for the demented: integrated, segregated and partly segregated, the latter being used in the said Home. The final part of the paper summarises a research on the impact of the group of demented residents upon the residents themselves, their families and the workers in the Home. Since their inclusion into the group the demented residents are more autonomous, easier to manage, better oriented, and more approachable, individually, by the workers. The relatives do not exhibit a good knowledge of the illness itself or the form of work at the Home, but they feel a need for this kind of work.
Keywords: dementia, care, group work.
Jana Mali is a social worker employed at the Home of the elderly in Preddvor.
Adela Postružnik
Non-material Aid for Aged People
Our state social policy - the system of pension insurance and the network of social and medical institutions - has made relatively good material and medical provisions for old people. However, the attitude towards them and the separation of generations under the contemporary living conditions push them over the social edge into solitude and uselessness. This non-material side of their social position is probably one of the worst in history. At this time of unstoppable ageing of society and growing proportion of old people, institutional care is a need dictated by the contemporary way of life. Our society has not yet sufficiently integrated "new forms" of aid to old people, such as aid at home, day care for old people, etc. In certain circumstances, however, moving an old person to a home is a necessity. But to improve the quality of life in old age either at home or in the institutional "home", both material and non-material, social needs have to be satisfied.
Keywords: social needs, self-help, inter-generational linkage, volunteers, home for old people.
Adela Postružnik is a social worker in the Home of the Retired Danica Vogrinec, Maribor. She is also the co-ordinator of the project "Voluntary work of secondary school students - intergenerational linkage".
Alenka Košak
Nurses' and Social Workers' Views on Death
The author has conducted a research based on a questionnaire for nurses and social workers at an oncological institute and a paediatric clinic. The death of a patient is a psychological burden, especially if it is a child. Help is needed by the dying patients, their relatives, and the workers. The latter need better support for their distress when their patients are dying, and permanent education on the subject of death. The relatives frequently have no idea to whom to turn for help, when they loose their family member, and usually do not even seek such help. Though in the last few years, several organisations and self-help groups of the bereaved have emerged, they are still available only to a handful of people.
Keywords: dying, death, mourning.
Alenka Košak is a social worker.
Blaž Mesec
Robert Atchley's theory on the Continuity in Ageing
R. C. Atchley's gerontological theory, which states that the basic internal and external structures of people continue from middle age throughout old age, is based on Atchley's longitudinal study that included, at its start in 1975, the whole elderly population of a small city in Midwestern USA, but at its end included only 30% of initial respondents. The paper's critical comment is that his theory does not explain anything. It merely establishes a fact, i.e. e., the continuity of patterns through time. This continuity seems so impressive, that no variation in ageing process (instead of unchanged continuity) remains for the gerontological theory to explain. Because of a large attrition rate even the generality of the continuity has to be doubted, as it may well be the consequence of self-selection of highly adapted old people.
Keywords: gerontology, gerontoboetics, social work with old people, continuity.
Dr. Blaž Mesec is an associate professor of methodology at the University of Ljubljana School of Social Work and Dean of the School.