ALMEIDA, Helena, “Elderly and social work. Values for mediation on contemporary society”, Socialinis Ugdymas (Social Education), Nr. 11(22), Vilnius Pedagogical University, 2010, 84-92.
ELDERLY AND SOCIAL WORK. VALUES FOR MEDIATION IN CONTEMPORARY SOCIETY1
Helena Neves Almeida2 helena.almeida@fpce.uc.pt
Abstract The text analyses the link between theory-practice-values, related to the social work on the field of elderly people. New methodological proposals retain two statements as transverse elements: personalizing relations and valuing citizenship. Respect for human dignity and personal identity is one of the historical ethical bulwarks of knowledge in the sphere of social intervention, one of its postulates and operational principles. This ethical principle has been a benchmark for professional practice as a whole for many years. Respect for difference is fundamental to the establishment of compensating and rehabilitating measures, and it fosters the humanization of the structures, especially where residential care is involved. Accepting the elderly as citizens implies giving them rights founded on values such as respect for difference and human dignity. Key-Words: elderly; social work mediation; citizenship; personalization.
The International Plan of Action on Ageing 2002 (Madrid) included the elderly on the development agenda, associating public politics to social, economics, cultural and historical questions. “Population ageing is poised to become a major issue in developing countries, which are projected to age swiftly in the first half of the twenty-first century. The proportion of older persons is expected to rise from 8 to 19 per cent by 2050, while that of children will fall from 33 to 22 percent. This demographic shift presents a major resource challenge. Though developed countries have been able to age gradually, they face
challenges
resulting from
the
relationship
between ageing and
unemployment and sustainability of pension systems, while developing 1
International Conference -The role of social Educator/Worker in strengthening social cohesion (Vilnius, April 17, 2008). 2 Ph.D. in Social Work. Faculty of Psychology and Pedagogical Sciences, University of Coimbra (Portugal)
countries face the challenge of simultaneous development and population ageing�. The Report of the Second World Assembly on Ageing (ONU, 2002), presents that life expectancy in European societies has dramatically improved: from 43.5 years in 1900 to 75.5 in 2000 and an expected 82 in 2050 for men, and from 46.0 to 81.4 with an expected 87.4 for women. Thanks to sixty years of peace, medical progress and better living and working conditions, a growing proportion of Europeans are now enjoying longer and more active retirement. This has far-reaching impacts on welfare systems, with the associated expenditure expected to rise to 2.5% of GDP by 2030 and 4.3% by 2050. At the same time, access to health services and healthy life expectancy still vary considerably between income groups and regions. Social risks such as old-age dependency and social isolation are expected to rise as a result of these demographic trends. Today, 28% of the population over 70 currently lives alone. Up to two-thirds of people over 75 are dependent on informal care, mostly provided by the immediate family, especially women. One in six older people live in poverty, with elderly women particularly exposed to low pensions as a result of incomplete careers. The demographic phenomenon of an ageing population has led researchers to study its impact both at family level, and at the level of social security policy in the domain of the third age. Two factors are involved in this approach: 1 – the changes occurring in, first, the role of women in the society, and, more especially, in the support provided to the family and to the elderly, due to the entry of women into the labour market since the 1970s (in 1995, 61,4% of women worked, in Europe) ; 2 – in the 1990s did public and private authorities consider it necessary to develop and safeguard amenities for protecting and assisting this segment of the population3. The informal support, which is given by families and proximity networks, is a social assistance service that complements institutional support in our society. But the quality of the services provided at the formal (institutional) and
3
In Portugal, between 1991 and 1998 there was an increase of more than 50% of day centres, the home support triplicates and the number of homes for elderly almost duplicates.
Elderly and Social Work. Values for mediation in contemporary society./ Helena Neves Almeida /Vilnius 17 April 2008
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informal (primary solidarity networks) levels, and their orientation, is an unknown quantity. Moreover, the institutions that train skilled professionals to operate as social workers in this domain cannot be indifferent to this question, since the product that they train will be an important factor when it comes to assessing the care provided. In this context, the academic training of the people who work directly and indirectly with the elderly cannot confine itself to theoretical aspects alone; it must be linked to practice and to the principles that guide it (Fig. 1):
Figure 1 – Knowledge to work with elderly THEORETICAL
PRACTICAL
ETHICAL
1. The Theoretical Dimension, which covers knowledge that helps to understand and explain the phenomenon, such as population ageing, the social
and
psychological
factors
associated
with
old
age,
intergenerational relations, health and education, social policy direction, theroretical references and intervention methodologies. 2. The Practical Dimension, which implies learning in situ about the lifestyles, the space and the construction of social relations, the functioning
of
the
institutions,
the
operational
measures
and
programmes, the models, the intervention procedures and techniques, the inter-institutional interaction, network and partnership work, and working as a team. 3. The Ethical Dimension, which considers the transverse values that should guide professional and institutional practice, particularly, respect for others, personalization of relations and care, humanization of the structures, respect for the right to be different and for human dignity.
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These dimensions are interdependent and their interlinking influences professional attitudes and performance. Their presence in training and intervention is a factor that helps in the monitoring of the quality of the services provided. Theoretical knowledge props up the bases for practice, and practice strengthens or reformulates the theoretical component, while values give meaning to actions which, in turn, express the underlying orientations and meanings when contextualized. There are several postulates guiding social intervention, and these three aspects come into play in any of them.
What concerns to social work
mediation, new methodological proposals retain two statements as transverse elements: personalizing relations and valuing citizenship.
1 – INTERVENTION PROCEDURES MUST BE PERSONALIZED. PERSON MUST BE AT THE CENTRE OF THE ACTION.
THE
Respect for human dignity and personal identity is one of the historical ethical bulwarks of knowledge in the sphere of social intervention; one of its postulates and operational principles.
This ethical principle has been a
benchmark for professional practice as a whole for many years. Respect for difference is fundamental to the establishment of compensating and rehabilitating measures, and it fosters the humanization of the structures, especially where residential care is involved. When a user enters the institution, the economicist administration that governs most social organizations means that he/she becomes a number, a unit of reference with specific costs, the bearer of problems and situations that, despite being different, are regarded as being the same as many others. In this context, there is a tendency to classify by means of objective references, which makes it possible to identify a situation quickly, in the event of a crisis. We are basically talking about hospitals, military and legal institutions. Even though a person has a name, he/she comes to be identified by a number, completely depersonalized and lacking in dignity.
This procedure is translated into a
dehumanization of the structures by the kind of relation it implies. Who the person is, where he/she comes from, what he/she thinks and feels about
Elderly and Social Work. Values for mediation in contemporary society./ Helena Neves Almeida /Vilnius 17 April 2008
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coming to that unit or staying in that organization is rarely of interest to the structure. When there is a breach between supply and demand, it is the people who have to adapt, not the system. Professional agents cannot think and act in the same way! Situations acquire meaning when they reflect the contexts, lifestyles, ways of thinking and acting of actual people. It is thus all too often necessary to make institutions and officials aware of the abstract and impersonal nature of the way the services
function;
using
people’s
names,
collecting
information
that
personalizes knowledge of the subjects’ characteristics and of the situation, so that appropriate responses can be found. On a recent visit to a residential home for the elderly in a municipality near Coimbra (Portugal), the social worker and I went into a bedroom where we found an 83 year-old woman, in a state of mental confusion and distress. We smiled, greeted her and, as a result of our manner, the dialogue that took place between the old lady and the social worker was revealing of the daily life in that institution. Addressing her, the old lady (named Maria) wailed:
- “Doctor, my mother is very ill”. - “No she isn’t Maria”, answered the Social Worker. - “How do you know then?” the old lady asked. - “Look… I’ve been with her… [silence] today it’s Friday, and I saw her on Wednesday... Yes on Wednesday.” - After a moment, Maria replied: “On Wednesday? Ah, that’s right; I went there with you...”
After this conversation, Maria calmed down, and hoped that she would get her tea. This shows that communication is an essential part of the intervention process, since respect for others is a cornerstone of social relationships, as little details of manner, such as listening and dialogue are important in the humanization of structures and the consequent well-being of the individuals. An elderly person does not exist as an abstract entity. construction.
He/she is a
Elderly people exist, each with their own life story, their own
personal and professional trajectory, with their own specific needs and motivations.
This aspect has to be retained.
Individuality and personal
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specificity are areas of instrumental and expressive mediation for those who have to relate with people of the same age group on a daily basis. Understanding this aspect is crucial to the humanization of the structures, and to ensure quality of life for the elderly. Although there are general procedures laid down, personalization makes it possible to suit the measures to the subjects. It is not for people to adapt to existing mechanisms. Personalizing action enables responses to go beyond the general and abstract dimension and be concrete, specific and individual, harmonizing the subjective and the objective, the individual and the collective. Personalizing is the same as considering the differences in the global and collective picture, but it also means establishing a frame of reference for common practices. With personalization, the subject, the institution and the professionals all gain. The subject sees his / her wish to be treated consistently and coherently, in keeping with his / her life circumstances, legitimated; the institution appropriates procedures to differentiate between equals, devising processes that enable differences to be accommodated, both on the level of rationalizing responses and on that of rights. Where do we view this dynamic? It’s in the intervention’s field. And this is why the interaction of the pivotal axes – theory, practice and values – is so important.
2 – CITIZENSHIP IS ENGAGED IN A PERMANENT STRUGGLE. THE ELDERLY ARE CITIZENS. The declaration of the rights of man and of the citizen that made the most impact on the consciousness of 18th century Europe was the Declaration of the Rights of Man and the Citizen issued in France after the storming of the Bastille in 1789. The affirmation of human dignity against political despotism, and in the name of the freedom and independence of the ordinary individual – the citizen – was developed further in the 19th century.
It came to be recognized as
embodying the fundamental legal principles that had to be observed in the organization of civilized political communities. There were, however, setbacks in the sphere of the rights of man during the course of the 20th century, brought
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about by positivist conceptions and assaults on human dignity, of which the holocaust is one example. Yet, despite this, the end of the Second World War saw Europe reaffirming the defence of the rights of man and fundamental freedoms as intrinsic valences of the human individual. Since 1980, every continent has witnessed a rebirth of the universalism of fundamental rights, and a re-reading of these rights from the perspective of fundamental freedoms. With the globalization of the economy, the concept of citizenship has become relevant to the sequence of the marginalization of regions and the multiplication of the number of those excluded. Citizen’s rights are rights to participate in the government of the city4. As Dominique Schnapper points out, “in modern society, citizenship is, at the same time, the principle of political legitimacy and the source of social bonds.
Living jointly means being conjointly a citizen.
Modern democratic
society is defined as an inclusive project, potentially universal, of every citizen. In fact, it is characterized by the ambition to transcend, via citizenship, belonging to special groups, whether they are biological, historical, economic, social, religious or cultural. The citizen is defined as an abstract individual, with no identification and no specific qualification, on all sides of all concrete decisions. A citizen is not distinguished by sex, race, wealth, poverty, religious belief or lack of it, ethnic origin or nationality” (1998: 93) 5. With the expansion of political democracy and the steady emergence of economic, social and cultural rights (UNO, 1966), “the image of the citizen changed and social citizenship was added on to political citizenship” (Madiot, 1995:14). The term ‘social citizenship’ embraces the possibility of being active in society’s normative production and occupying therein a “durable social position” (Soulet, 1995:129), free of any itinerary of integration promoted by instances outside the subjects. Even though social citizenship does not have a clearly established legal existence, it goes beyond political citizenship, and
4
Marshall regards citizenship as the status inherent to a full member of a community and
whoever has it enjoys equality in terms of the associated rights and duties (MARSHALL, T.H., Citizenship and social class, 1950, in BARBALET, J.M. ( 1989) A cidadania. Lisboa: Editorial Estampa Lda.). 5
T.N.: The quotation was translated from Portuguese (original quotation not available).
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encapsulates it. Solidarity and the guarantee of protection for those who are excluded is one of the pillars of its articulation. The European Union Treaties signed in Maastricht (1992), Amsterdam (1997) and Lisbon (2007) has widened the sphere of citizenship to the very borders of the European Union area. In a post-modern context, new rights are taking shape: those related to integration, corresponding to the principle of belonging to society. Citizenship today is constructed in a variable geometric space, in a society that is travelling at different speeds and that is even at different levels (Koubi, 1995). A citizen is not born, he/she is made. A citizen is a “man in a situation”, to use Withol de Wenden’s description (1995: 167). Citizenship is not decreed, it is a quality recognized in an individual, in a given time and in a given space. Citizenship is engaged in a constant struggle. And so, “for there to be social citizenship people must feel that the institutions for social protection are theirs and, therefore, that they participate in the conduct of their destiny” (Espanha, 1997: 123). A process of change is never either unequivocal or one-directional. It is always a shared process. This is why it is based on an exchange of knowledge, which implies reciprocity and co-operation in the fight against social isolation, in teaching the value of communication, of working as a team and of negotiating, in stimulating discussion on the social reality around us. Why should we ever think differently when we are working with the elderly?
Is it because they have lost their
professional status, do they then become amorphous subjects? They are still subjects who have an interest in their surroundings; all that has changed is their expectations and the rate of action or learning. This educational aspect of social intervention attempted through participation creates conditions that influence change. This way of looking at participation fits with the development of practices to grant subjects independence -- that can be seen in tolerance reinforcement in opposition to rigid processes of thought and action – in building meaningful social networks and in valuing political awareness.
“Citizenship has a role to play in the
integration of society because it has special significance in terms of participation
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in social life” (Barbalet, 1989: 135) 6. It implies belonging to a community, and this is why citizenship can be described as participation in a community. Citizenship cannot be simply thought of “through the image of an independent citizen, whose sovereign power consists of putting vote slip in a ballot box. It is, above all, concerned with an ability to participate in social change, which is not just determinative in terms of the stability of society as a whole, but also in relation to the stability of identity and of freedom of the individual...
Citizenship also consists of the mutual recognition of the
differences within us, insofar as we share the same social and political space” (Roman, 1998:49) 3. Accepting the elderly as citizens implies giving them rights founded on values such as respect for difference and human dignity.
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T.N.: The quotation was translated from Portuguese (original quotation not available).
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SCHNAPPER, D. (1998). Os limites da expressão “empresa cidadã”, in MORIN, E.. e al. A Sociedade em Busca de Valores. Para Fugir à Alternativa entre o Cepticismo e o Dogmatismo, Lisboa, Instituto Piaget, Colecção Epistemologia e Sociedade, nº 85, pag.93-93. SOULET, Marc-Henry (1995). Politique de la pitié, politique de l’urgence, politique du risque: quelques fondements à l’intervention sociale dans une perspective des droits de l’homme. In, EASSW , Human Rigths & Social Work Éducation. Final Report of the EASSW European Seminar. WITHOL De WENDEN (1995). Synthese. In KOUBI, Geneviève , De la citoyenneté. Paris, Litec.
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http://br.youtube.com/watch?v=r3pOHjRRocs
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