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Dementia and family. The role of Alzheimer cafe in reducing the burden of caregiving families
34-46.Views:266In the last years, the international researches have turned towards families caring for elderly people with dementia /see the works of Zarit et al. 1985, 2005; Aneshensel et al. 1995; and Kaplan 1996/. The majority of these researchers analysed the stress burden of the caring family member and its consequences, role conflicts, and the tensions in the caregiving family (Zarit et al. 1985; Aneshensel et al. 1995; Kaplan 1996; Zarit et al. 2005). The revelation that in terms of Romania, we know nothing or almost nothing about the burden of families caring for elderly people with dementia and its effect on the primary carer, played was an important factor in the choice of topic. This is why, in a vast empirical analysis, in Transylvania, 50 interviews and questionnaire surveys were made with people caring for elderly with dementia in their own homes and 50 families whose relatives with dementia have been moved to a long-term residential home in the past 12 months from the time of the survey. Gathering data took three years (2015–2017). The research included the inquiry interview with the primary caregiver family member, in which we assessed the functional barriers and the psychosocial difficulties (Szabó 2000). The analysis of the levels of social skills was built upon this, and it unfolded the main characteristics of self-sufficiency, existing social skills, and social adaptation. This survey pointed out the everyday tasks in which the client requires help. With regard to family care, we have also analysed the independent living ability of people with dementia. These three angles offered the guidelines for the assessment of “objective burden” of the caring family member. Reviewing the distribution of caring tasks within the family is based on this, which helps us finding out who the key persons are, the ones undertaking the primary caregiving duties. For analysing the formation of roles within the family, we have devised our own criteria (Szabó–Kiss 2015). Starting from the objective burden, in regard to the “subjective burden”, we have obtained valuable indications about the emotional effect of caregiving family member. The detailed assessment of self-sufficiency through which we have analysed the measure of functional degradation of people living with dementia, was added to the devices of the analysis (Szabó 2000). The internationally approved scale of memory and behavioural problems (Zarit 1985) is connected to this, which measures the distractive attitude of the person living with dementia and its effect on the primary caregiver. The survey of the primary caregiver’s burdening is also connected (Zarit 1985), and so is the assessment of the negative and positive attitude towards the caregiving tasks (Farran et al. 1999). A six-step focus group is added to the devices of the research, in which the primary caregivers, by hearing each other’s cases and following thematic questions, open up more easily about the critical periods of caregiving and the pivotal factors of institutional placement.
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Elderly care out from the care system: the challenges of family carers
2-24.Views:424The overburdened long term care system increases the role of family carers in taking care of older adults. Undertaking the role of care put a great burden to family carers and cause many negative effects to the family roles, the field of employment and to the carers’ personal physical and mental health too. The formal care system solely focuses for the need of care receivers and hardly find services targeted to family carers. This study, using the analisis of ten family caregiver interviews, overlaps the main difficulties they are facing.
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Családi gondozók izolációjának veszélye - a gondozásból fakadó megterheltség kapcsolati dimenziói
98-100Views:108Elöregedő társadalmunkban az ellátórendszerek fokozódó terheltsége miatt erősödik a családtagok gondozási szerepe. Az idősgondozást végző családtagok (családi gondozók) helyzetét nemzetközi szinten évtizedek óta vizsgálják. A gondozás jelentős megterhelődést (burden) okoz, amely számos tényezővel összefüggő, komplex jelenség (Liu - Heffernan – Tan, 2020). Káros fizikai és pszichés hatásokkal járhat, pl. csökkenő ellenálló képesség, izoláció, fizikai és pszichés kimerültség (Ducharme - Lebel – Bergman, 2001). Bár a családi gondozók száma jelentős hazánkban (500 ezer főre becsülik, Gyarmati, 2019), kevés rájuk vonatkozó vizsgálat zajlott (pl. Jeneiné Rubovszky, 2017, Patyán, 2018). 2018-as adatfelvételünk jelentős gondozási terheket igazolt (Tróbert - Széman, 2019). A COVID-19 idején a kutatást folytatva (Tróbert – Bagyura - Széman, 2020) a pandémia negatív hatását tapasztaltuk a gondozási folyamatban.
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Social security and safety of older adults in Poland
9-11Views:94Poland’ population will be ageing at a fast rate in the coming decades. It is projected that in 2070 the Polish ratio between people aged 65 and over and those aged 15-64 years will be 62.6, the highest among EU-27 countries. Population ageing appeared in the public debate in Poland as a separate subject in the 1990s, following a negative natural population increase and the looming impact of the massive withdrawal of baby boomers from the labour market on the pension system. One of the reasons for older persons’ growing interest in retirement was pension system reforms planned by successive governments.
The announcement of the year 2012 as the European Year for Active Ageing and Solidarity Between Generations (decision no. 940/2011/EU of the European Parliament and of the Council of 14 September 2011) contributed in Poland to the emergence of a senior policy from a social policy and initiated major legislative, institutional, and organisational changes at the national, regional and local levels of government. It also inspired the redefinition of measures used hitherto in line with the evolution in the perception of older people from social care recipients to active members of their communities entitled to education and economic, social, civic and political activity. In 2013, the Senior Policy Council was established as a consultative and advisory body to the Ministry of Labour and Social Policy, and then similar councils supporting regional and local authorities were organised.
In order to encourage greater activity among seniors, a special governmental programme was created in December 2013, which grants funds on a competitive basis to projects concerning social activities, education, and intergenerational cooperation submitted by informal and formal groups of seniors.
The national government’s key documents on senior policy, one for the period from 2014 to 2020 and the other spanning the years until 2030, are Resolution 238 of 24 Dec. 2013 by the Board of Ministers on the Adoption of Long-term Senior Policy in Poland for the Years 2015-2020 and Resolution 161 of 28 Oct. 2018 by the Board of Ministers on the adoption of Social Policy Towards the Older Persons 2030. Security-Participation-Solidarity. In 2015, the Polish Parliament passed the elderly people act, which requires institutions in charge of the well-being of older persons to monitor and report on their situation. The reports submitted by the institutions are used by the Ministry of Labour to compile and present an annual evaluation of the status of the older population in Poland.
The regional governments’ senior policy is reflected in their social policy strategies. The strategies’ operational goals started to address needs specific to older people since 2002, focusing in particular on improving their quality of life, developing round-the-clock care services, at-home care services, and rehabilitation services, and on reducing social exclusion and marginalization of seniors.
Social security and the safety of older adults are progressively improving in Poland, but the greatest progress has been made in the area of active ageing. Social care services for the elderly still require improvement, because the predominant family care model is inefficient in many ways due to:
- limited financing of care services by public institutions,
- the growing proportion of single elderly persons,
- the increasing number of people aged 85+ (the so-called double population ageing),
- social insurance disregarding long-term care to an elderly family member as an insurable risk,
- a lack of legislation allowing employed people to seek a long-term leave to give care to an older family member,
- the informal expectation that women who retire at the age of 60 years will take care of the oldest family members.
While neither the scale nor the quality of home care services given to older persons is regularly surveyed in Poland, it can be presumed that the scale of care services is insufficient and that they excessively burden families with a member in need of care. Between 2010 and 2018, the number of persons aged 65+ increased in Poland by over 1.5 million, the number of the users of attendance services and specialised attendance services by 29,000 (from 99,000 to 128,000), and the number of residences in homes and facilities providing assistance to aged persons by 7,000 (from 20,000 to 27,100.)
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A telemedicina szolgáltatás térhódítása a pandémia idején
127-137Views:215During the pandemic, the role of information and telecommunications in health care became particularly important. An alternative way of communicating between the doctor and his/her patient has been through online forms of communication and the tools commonly used in everyday cases where a face-to-face meeting is not absolutely necessary, or in an emergency, a face-to-face meeting may be preceded by a remote consultation. In this situation, diagnosis is a huge responsibility and an ethical burden for the physician. Although this can be facilitated by the findings of the laboratory, the previously completed imaging diagnostics, and the online systems that create direct communication, there are also conditions for the development of a new diagnosis that can be confirmed by perception. During the coronavirus pandemic, efforts were made to minimize the number of personal doctor-patient encounters in the primary and outpatient care systems to curb the epidemic, in order to curb the epidemic. In cases where a personal relationship between the doctor and the patient has already been established, the patient’s relationship between the doctor and the patient has already been established, the patient’s medical history is known and they are forced to use telemedicine, they are practicing their profession in the best sense. The usefulness of telemedicine during the pandemic has been demonstrated, and its further development is a major challenge for both informatics and medicine.
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Local community practices to improve healthy aging in the North
25-26Views:109The governments of Finland, Denmark, Norway and Russia have developed national programs to address population ageing. There are also successful practices in healthy ageing at the local level in different countries, but they remain unknown among the global professional community and governmental authorities.
Healthy ageing has become an important policy issue at all levels of the society. The key international document is the World Health Organization’s (WHO) plan for a Decade of Healthy Ageing 2020–2030 which is the second action plan of the WHO ‘s Global strategy on ageing and health. The Plan consists of 10 years of concerted, catalytic, sustained collaboration to improve the lives of older people, their families, and their communities. Older people themselves are in the core of this plan, and it brings together variety of actors, including governments, civil society, international agencies, professionals, academia, the media, and the private sector. The Plan also notes that healthy ageing is not only a healthcare issue but also needs to engage many other sectors.
The aim of research was to search and introduce local community practices according the priority areas of WHO Decade of Healthy Aging action plan for gerontological policy in arctic countries.
Examples of good practices for the Priority 1 of the Plan: Change how we think, feel and act towards age and ageing
Fostering of Healthy Ageing requires fundamental shifts from existing stereotypes, prejudices, and discrimination towards older people. Older people should not be seen only as an economic burden for the welfare society, but as contributors to the state and communities, and as resourceful carriers of traditional values and wisdom. Governments eliminate age discrimination by variety of actions, such as legislative changes, and policies and programs which engage older people in decision-making.
Initiatives for Priority 2 of the Plan: Ensure that communities foster the abilities of older people
The environments which are built on decisions made not only by policy makers but involve citizens of all ages are better places to grow, play, live, work and retire. Even those people who have lost their capacity, shall be able to continue to enjoy everyday activities, to continue to develop personally and professionally, to participate and contribute to their communities while retaining their autonomy, dignity, health, and well-being.
Practices for Priority 3 of the Plan: Deliver person-centered, integrated care and primary health services to older people
Good-quality essential health services include prevention of diseases; promotion of healthy lifestyle; curative, rehabilitative, palliative and end-of-life care; safe, effective, good-quality essential medicines and vaccines; dental care; assistive technologies, while ensuring that the use of services does not cause the user financial hardship.
Local northern practices are mirrored against the recently released WHO Decade of Healthy Ageing 2020-2030 Action Plan with paying attention to indigenous elders. Based on these practices the national, regional, and municipal level authorities of the Nordic countries and Russia were suggested to consider the policy recommendations based of the research.
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Early recognition of dementia within the family
17-18Views:120The awareness of communities with dementia in Western Europe has moved closer to recognizing priority issues such as the environment or climate change. Dementia-friendly communities how have a history of 30 years and have achieved significant results through their work, both for those affected by the disease and those not directly affected. It probably affects many families, the topic is also getting into the spotlight in Hungary.
Without specific and detailed statistics and databases, dementia currently exists in the latent zone. The vast majority of the literature defines dementia as a diesease for which there is no treatment or cure. The effect of dementia is considered primarily as problems in the brain that negatively affect clear thinking, memory processes and result in additional emotional turbulence. Dementia is known as an age-related condition.
In general, dementia is identified as senility, incorrectly. Dementia can occur in different areas and at different levels in individual patients. As a result, families affected by the disease often face serious difficulties in identifying the disease. Without proper and detailed knowledge of the diagnosis, many families struggle with the situation of self care solutions at home. This personal involvement not only imposes a significant financial and emotional burden on the family but also often leads to separation and isolation, which can have additional negative effects on the disease itself and even on the mental health of the patient’s family members.
The global extent of dementia is generally known only to experts in the field, and to this day there is still a lack of adequate representation in the wider social dialogue. There is a unique and innovative incentive in Gyöngyös where Matralab’s integrated care centers offer day-care activities and solutions to support and provide experts advice to families with dementia. The project is implemented at the regional level, where 25 municipalities start monitoring the conditions and impacts of dementia in the region. As dementia is a prevalent and identifiable condition, affected families need help and support at the widest possible level.