Medical and Psycho-Social Problems Relating to the Quality of Life of Institutionalized Elderly People

Article excerpt

The authors investigated the attitudes of elderly people residing in a state-maintained retirement home in the city of Iasi in Romania and identified significant medical, psychological and social problems common to the subjects they interviewed.

Key Words: Elderly people, institutionalization, psycho-social problems, Romania

In Eastern Europe the "crisis of the protective state" is mentioned more and more today. The state-controlled social system is in difficulty. There is a problem not only in securing the financial resources necessary to finance the state support of aged people, but also one of regaining the trust of the elderly, who had been obliged to rely on the state system under the previous regime, and in the efficacy of the social mechanisms designed by that system to ensure their support.

The system is failing its minimal goal, which should be to guarantee elderly people the right to enjoy a degree of security while permitting them to enjoy as much independence as possible and to make use of their own resources as they think fit. At the same time, it is necessary to aim at realistic targets to ensure the highest possible quality of life for the elderly under the present financial constraints.

We believe that there are two ways in which the state may seek to improve its social activities in support of the welfare of elderly people who became dependent on it under the rule of the former government. The first is by effectively managing such social expenditures as are available. The second is by reorganizing the different elements in the system of social protection and medical assistance in order to achieve the decentralization of government actions in this respect.

In the first place, we consider as necessary a correct evaluation and a reconsideration of the already existing means of medico-social assistance such as the institutionalization of elderly people in senior homes, the classical form of social protection for this part of the population. This represents the purpose of the present study.

Methodology

The starting hypothesis of our study was that the accommodation of the elderly in senior homes is accompanied by an impoverishment of the status and role of elderly people, due to their being obliged either in part or in the whole to abandon much of their accustomed life style due to the changes imposed as a result of institutionalization in state-managed homes.

We studied the reaction of retired elderly people to institutionalization with special attention to such phenomena as their social perceptions, self-image and aspirations. Our subjects were 125 residents of the state-managed Senior Home in Iasi, an institution located in what is probably the most attractive part of the city. This Senior Home also has easy access to the center of the city due to the close proximity of public transport.

The residents occupy hotel-style dwelling units, either individually or shared between two persons, and are subject to few rules or restrictions other than the need to conform to the scheduled meal hours.

Our study relied on the analysis of sociological questionnaires. The residents in the studied group were predominantly female.

Results

The first aspect we analysed related to the an easy to quantify problem, namely the analysis of the personal budgets of the residents. This revealed a very high proportion of expenditure dedicated to expenses directly necessary for subsistence, with a secondary level of expenditure devoted to participation in the contemporary world around them, such as attending shows and purchasing newspapers, journals, and books.

Expenditure on medicine and savings took third place (see fig. 1). While the small proportion of income dedicated to savings can be explained by the low level of income and the lack of interest amongst elderly people in the idea of saving for the future, the low level of expenditure on health reflects the relative absence of systematic medical supervision. …