FAMILY CARE FOR THE ELDERLY

22 Norwegian Journal of development of the International Science No 43/2020 группы в плоскости параметров ОПЖ – общая 3. Степанов С.А., Тарко A.M. Россия в XXI смертность. веке: проблемы идентификации и национальных целей.- М.: Библио-Глобус, 2015. 164 с. СПИСОК ЛИТЕРАТУРЫ: 4. Тарко А.М. О настоящем и будущем России и мира. Тула. Изд-во Промпилот. 2016. 196 с. 1. Индекс человеческого развития субъектов 5. Тарко А.М. Обратная сторона роста СовреРоссийской Федерации. менные структурные экономические кризисы и https://wiki2.org/ru/%D0%98%D0%BD%D0%B4%D пути их преодоления. // Свободная мысль. 2015. № 0%B5%D0%BA%D1%81_%D1%87%D0%B5%D0 5, с. 81-94. %BB%D0%BE%D0%B2%D0%B5%D1%87%D0%B 6. Тарко А.М. Опыт анализа динамики боль5%D1%81%D0%BA%D0%BE%D0%B3%D0%BE_ ших временных рядов демографических парамет%D1%80%D0%B0%D0%B7%D0%B2%D0%B8%D ров стран мира и России. // Пространство и время, 1%82%D0%B8%D1%8F_%D1%81%D1%83%D0% № 1(11), 2013, с. 94-102. B1%D1%8A%D0%B5%D0%BA%D1%82%D0%BE 7. Democracy Index 2019. Democracy Index %D0%B2_%D0%A0%D0%BE%D1%81%D1%81% 2019. The Economist Intelligence Unit. D0%B8%D0%B9%D1%81%D0%BA%D0%BE%D0 https://www.eiu.com/topic/democracy-index. (дата %B9_%D0%A4%D0%B5%D0%B4%D0%B5%D1% последнего обращения 2020-06-11). 80%D0%B0%D1%86%D0%B8%D0%B8 (дата по- 8. Тарко А.М. Моделирование глобального следнего обращения 2020-06-11). цикла двуокиси углерода и Парижское климатиче2. Рейтинг социально-экономического поло- ское соглашение. // Norwegian Journal of developжения субъектов РФ. Итоги 2017 года. ООО «Рей- ment of the International Science. № 36, 2019, V. 1. p. тинговое агентство РИА Рейтинг». 14-24. http://vid1.rian.ru/ig/ratings/rating_regions_2018.pdf (дата последнего обращения 2020-06-11).

PROBLEMS OF AGING SOCIETY, INSTITUTIONAL AND FAMILY CARE FOR THE ELDERLY

Arsenyev Yu.

Professor, Doctor Technical Science, RANEPA, of Tula Branch

Davydova T.

PhD in Pedagogic Sciences, associate Professor, Tula State Pedagogical University

Abstract

The problems of aging society, institutional and family care for the elderly are studied. We discuss models and methods of servicing the elderly, strategies of behavior of center staff and family assistants, their advantages and disadvantages

Keywords: aging of society, institutional and family services for the elderly, models, techniques, strategies of behavior of parties, performance.

Introduction. Today, in the economically developed countries of the world, there are processes of increasing life expectancy and aging of the population. To solve this problem, the UN has proclaimed the concept of creating a "society for all ages". The problems of aging are caused by the leveling of family values, collective solidarity of States, threats to the survival and improvement of social security systems in certain countries of the world. The exclusion of older people from the productive life of society exacerbates the problems of social inequality among and within certain age groups and the growth of intergenerational conflicts. Let's explore the essence and specifics of old age in more detail.

Methodology. Required companions of human aging - feelings of weakness, ill health, malaise, and there is a lot of pain at the same time in different organs. Somatic manifestations of ill health are expressed in any form of physical discomfort (feelings of general weakness, smashedness, severity, discomfort). These unpleasant and painful sensations are natural and normal at a later age. The Soviet gerontologist I.V. Davydovsky (1966) introduced a distinction between senile illnesses and diseases. If the disease is a consequence of the adverse effects of extreme stimuli of internal and external environment, then senile ailments are illnesses of the age itself. The concept of soreness, or ill health, is often applied to conditions characterized by a relatively small intensity of painful feelings that an elderly person experiences during the entire period of aging. The response to these sensations is accompanied by a moderately reduced emotional background.

An elderly person "agrees" with aging, if for him or her the main problem of life becomes physical condition, limitation of physical abilities, painful experience of physical decline. The moment of realization of age-related changes in physical and psychological capabilities is a critical point in relation to an elderly person with society, an approaching or already approaching dependent position of a person. At the same time, older people are able to create a "convenient" reality for them. Thus, the Israeli gerontologist H. Hayes (1980) studied the Jewish subculture in the community where

Norwegian Journal of development of the International Science No 43/2020 23 interfamily ties are weakened due to the influence of immanent or inherent when a person does something modern society, which is alien to the elderly Jews who because he enjoys it; the set tasks (a person does not do were in the same day center of London, offering an al- it because he likes it, but because he thinks it will benternative reality to meet the needs of their clients of late efit him; the implementation of actions under pressure age. These centers have now changed the way they or influence of others; the lack of motivation (a person work, but the results of the research are important for has no connection between what he does and his desire understanding the strategy of adaptation of older people to do it, or he cannot understand why he does it). to the state of decrepitude and infirmity. Researchers O'Connor and Valleran, who have

The staff of the center did not talk about families studied the lives of older people in boarding schools in and problems of the elderly, about what is happening Canada, linked the 4 levels of motivation of the need outside the center, but only about internal events. Cli- for autonomy to the motivation of older people. They ents were not allowed to share their memories because found out what and how consciously they were doing it destroyed the sense of community in the centre. in the context of their objectives, identifying 23 most Death was ignored in this community (the dead were important areas of older people's lives, 6 of which were not remembered or spoken of). The violators of these equivalent to men and women: a) health; b) interperrules were subjected to social pressure, up to and in- sonal relationships; c) religion; d) biological needs; e) cluding a ban on visiting the centre. It was customary current events; f) entertainment. to attribute a great role to luck and occasion, rather than Through a block of questions for each sphere, they to human merit. In unforeseen situations, patients were reflected the connection between the allocated levels of told that the person could not do anything about it, and motivation of the need for autonomy and 4 variants of that was his fate. The center emphasized two points: the answers of the elderly: a) i enjoy it (the highest level of rhythmic and cyclic organization of life in the center, a motivation); b) i expect that I will feel good (the level certain flow and strict sequence: holidays, classes in of tasks set); c) i do this because i am expected to do so circles, the emphasis on the need for mutual assistance (under pressure); d) i don't know or don't see what it to each other and joint participation in ongoing activi- will give me (lack of motivation). ties. This created a sense of timelessness and avoidance The results of the analysis of the life of elderly of sadness. This did not come from the staff's policy, people in the boarding schools, which differ in the level but in response to the needs of clients, who eventually of autonomy granted, have shown: a) the transition found themselves in an optimal and reliable world for from one's own home to another and the change in enthem. H. Heyzan called his work "The Limbo People" vironment is detrimental to the independence and other (The Limbo People, 1980). Recall that Limbo is the rights of vulnerable older people; b) older people with first circle of A. Dante's hell, where "those who are be- self-determined motivation (first and second levels) are tween good and evil" are housed, as well as the Limbo best adapted to the living conditions in residential of Catholic Hell, where the souls of the Old Testament homes; c) older people who love independence are easrighteous and the souls of infants who have died with- ier to adapt to life in boarding schools, where independout baptism are found according to the Church doctrine. ence and independent behavior are encouraged; d) for H. Heyzan meant his Limb - it's a condition of a man elderly people with the third and fourth levels of motiwho has reached decrepitude and lives in an optimal vation it is better to live in boarding schools, where the environment for him. He showed what happens to old rules of living and the procedure of actions and relapeople if they are left to themselves, how they adapt to tions with the staff are clearly specified. their state of infirmity and decrepitude. But the clients Studies by other scientists have shown: a) physical of this center are old Jews, who find it difficult to accept decline, weakness and intellectual weakness of older themselves in a different culture for them. Their own people lead to a background decrease in affective tone, culture is organized in such a way that an elderly person reflecting the decline of physical and psychological enhas the right to expect that he or she will act as a patri- ergy; b) painfulness of mental aging is manifested in arch, be respected, and since this did not happen, the the known symptoms of mental disorders; dementia elderly themselves created an environment in which (senile dementia) is the condition for which people are there was respect for each other. least prepared by modern culture, but it is possible to

Another study of elderly people from the boarding have satisfaction and high quality of life even in such a school is related to the theory of environmental pres- condition; c) at a young age, the probability of dementia sure and human needs conducted by E. Deichi and R. is low, but after 80 years of regression of mental funcRyan, well-known researchers of motivation issues. tioning occurs exponentially: a) in 75-79 years old, they They identified three basic psychological needs: inter- get dementia up to 6% of elderly people; b) in 80-84 action, activity, community and communication with years old, up to 11%; c) by 90 years old, up to 40%; d) others; autonomy; competence and ability to influence in senile dementia, sometimes there is a "harmonious" the surrounding situation. These needs lead to the fact decay of higher mental functions, slow and gradual dethat people are oriented towards growth, social integra- pletion of intellectual functions, a consistent narrowing tion and the ability to integrate into the social system. of thinking, creativity, shriveling and erasing of perBut these studies have been carried out on younger peo- sonal characteristics, which is a consequence of linearly ple without taking into account the impact of aging pro- increasing changes in the brain. cesses. The further development of this theory has al- At the same time, the general and mental tone does lowed to distinguish four levels of the need for auton- not usually decrease, with a significant loss of past inomy: these are the following levels: the highest, tellectual reserves, shrinking of the volume of thinking

24 Norwegian Journal of development of the International Science No 43/2020 processes, mental and motor activity remains at the there is a tendency to give a high assessment of satissame level, the need for daily employment, communi- faction in literally all aspects of the Therefore, it is imcation with others, friendly participation often remains. portant to increase information about residential homes Memory impairment has an equal impact on past and and to encourage older persons to make their choices present events. Personal changes are moderate and about lifestyle change voluntary and informed [5]. there is usually no gross violation of ethical norms. In Elderly people today have no idea what awaits general, dementia is a disease that affects not only men- them after moving to a hospital without the possibility tal capacity, but also the individual. It is sad and some- of comparing the quality of care in a number of residentimes embarrassing for relatives: a sick person does not tial homes; the belief that they are no longer entitled to behave as before the disease, friendliness changes to move to a residential home, and their apparent passivity rudeness, accuracy to sloppiness. Good care for demen- is due to a closed life in hospital. Progress in institutia patients requires from a well-trained staff of "greater tional care depends on the degree of freedom of older presence" - the highest level of involvement, empathy, persons (residents of residential homes) to express their flexibility, flexibility, correct response to emerging own opinions. If they are not dependent on caregivers, emotions of the patient: with his anxiety - to calm, they are free to act without any consequences for their hope, with anger or anxiety - to calm down, calmly re- words, and their opinions are not inferior to those of act. It is important to accept the patient objectively de- those who decide for them. But then it is not clear mentia. whether the staff of residential institutions will trust and

Admission to a residential home for an elderly per- respect the people they serve if they express everything son is a specially organized event on social assistance, they feel and think about. This makes it possible to which he or she accepts taking into account objective highlight psychological issues and problems in institu(difficulty in servicing himself or herself, fear of even tional care, as well as ways to address them. Ways of greater physical weakness) and subjective (hardships of solving problems should be related to monitoring the service, family conflicts, etc.) reasons. The main rea- quality of services and the participation of older people sons for the admission of elderly people to the boarding in their social services. The main principles are: activity school, as a critical moment of life, include: the state of with a focus on the positive qualities and competencies health, requiring constant care, conflict situation in the of older people rather than their disability and forms of family, the desire to maintain independence. All of discrimination due to age; adaptation with a focus on these older people have been unable to adapt to the new the ability of older people to cope with difficulties and living conditions that have chosen institutional care and create opportunities for them to do so; independence guardianship as a new way of life. However, unfore- with the needs of older people so that they remain in seen situations, new people, unfamiliar environment, control of their lives. Typical mistakes in the behavior unclear social status - all this forces a person to adapt of residential care staff that worsen the condition of to many things and events, but also to respond to their older patients are: manipulation of lies instead of honinternal changes, assessment of themselves, their capa- estly reporting to patients about their illness; doing any bilities, which are very painful and difficult, with the work for older people because of their slowness instead risk of various diseases and even death. of giving them the opportunity to do so themselves;

Information about these institutions plays an im- treating older people as young children; constant reportant role in the subsequent socio-psychological ad- minder and accusation that they are unbearable; ignoraptation of older people in residential institutions. Up ing, cold treatment instead of adequate response. to 80% of elderly people had elementary and often dis- Р. Wood has provided a range of support for eltorted information; the idea of a residential home was derly people with dementia: stimulation and activity; identified with the hospital schedule, with daily doctor occupational therapy; music; pets and fish; multi-senvisits, constant daily supervision of the nursing staff; in sory stimulation; work with memories; orientation in times of crisis, after admission to the hospital, emo- reality; confirmation therapy. tional stress, severe losses and grief, most elderly peo- Beginning in the 1980s and 1990s, many Western ple did not plan to move to hospitals but accepted the countries began to make the transition from institudecision to move; the transition to permanent social and tional care to home-based care. It has greatly eased the health care is seen by older people as a failure to cope financial burden on the state, but has increased family with their lives, becoming in their eyes those whose responsibility towards older people. In recent years, competence is not credible, and having to play a role Russia has also been using this form of social services attributed to this institution: to learn to adapt their be- for older people. However, opinions about the effechavior to the formal routine of daily life and to meet all tiveness of this form are mixed. expectations of hospital staff. A number of studies have Research on family care and assistance to older shown that after 1 month's admission to residential people was first started in the USA and then in Europe homes, the number of elderly people with full mobility (England, Denmark, Germany, France). On the one has decreased (from 39,% to 28,9%) and the number of hand, the family, mostly female, cared for elderly relapeople moving around (from 9,6% to 13,8%) only tives, but on the other hand, studies show that disability within their room has increased; dependence on the is more prevalent among those who have lived in famstaff being cared for causes fear of "retaliation" for ex- ilies than among those who have lived in different respressing dissatisfaction or complaint on the part of the idential homes, and the former have more resources and elderly; it is very difficult for elderly people to decide opportunities than the latter. Relatives were more likely to make a complaint if they do not have a choice, so

Norwegian Journal of development of the International Science No 43/2020 25 to provide home care, social and health care to older The motives for caring for and caring for older people persons. in these groups are complex and ambiguous. Elderly

Taking care of an elderly relative is often a chal- care is becoming an increasingly scarce profession, and lenge for the family. It is associated with severe fatigue fewer and fewer young people are willing to help famand strain and leads to stress. Specialized research is ilies with the ever-increasing number of caregivers, being conducted to identify aspects of changeable care who in most cases are in the hands of dilettantes and and approaches to help families cope with their respon- require significant adjustments because of the possible sibilities more effectively and with less loss to the fam- negative consequences for older persons and their careily. The importance and role of the government in givers. There are families who bear the heavy cross of providing assistance to the elderly is illustrated by the caring for relatives who have been in a state of comexample of the United Kingdom, which passed the plete disrepair for many years, and whose love and reCommunity Assistance Act in 1990 with articles on as- spect for them have been replaced by deep despair, essistance to persons with disabilities and pensioners in pecially in the face of housing and domestic problems hospitals and in their private homes. Under the Act, the and senile dementia. Relatives of such patients find authorities are required to introduce a system of care clear signs of socio-psychological desaptation in the management for older persons and to provide services form of neurotization, conflict and progressive psychoonly to older persons in need (an automatic right to so- somatic diseases. They themselves need the help of a cial services for older persons is not entitled to, but only psychologist or psychotherapist. With such a high need to, medical care). This law allowed for an increase in to relieve stress for family members living together the number of organizations providing care for older with an elderly person, especially the sick and incompeople and ordered local authorities to buy services petent, it is almost impossible, as there are no methods from private organizations. It was in 1990 that UK so- of psychological support, and to improve support for cial policy shifted to the needs and requirements of both the elderly and their families is a priority. older people, which led to the emergence of a large pri- In such families, there are two strategies of behavvate sector to provide services to older people. The ob- ior explained by psychological differences: relatives injectives of the law were to: move from institutional care sist on immediate hospitalization of the patient on the to home care; coordinate services offered at home; pay grounds of his or her dangerous behavior, impossibility more attention to the needs of relatives caring for older to organize care or even his or her own tiredness (and people; and organize an assessment and management the relationship between family members, even in the system to improve standards. presence of medical staff, is characterized by conflict

Caregiving in the family often refers to the respon- or hidden hostility, unwillingness to cooperate with sibility and activities of people who feel they are caring doctors, lack of reliable pharmacotherapy);relatives in for an older member of their family, firstly, and are en- good relationships with each other and with the attendgaged in some regular caregiving activities, and sec- ing physician object to the hospitalization of the patient ondly. It is often difficult to distinguish between normal and wish to arrange treatment at home in all circumfamily exchange (mutual exchange), assistance and stances, using acceptable ways of using medication [6care as an interaction in which one family member 10]. helps another on a regular basis to ensure his or her in- From the socio-psychological point of view, the dependent existence. The interaction includes a com- way to optimize the conditions and solve the problems plex of tasks of instrumental (assistance in financial of aging includes training family members in ways to management, assistance with transportation, purchase, interact with older people, which provides psychothercleaning of the apartment) and personal (assistance in apeutic function of the family in relation to the persondressing, washing, bathing, toilet). This situation of ality of the elderly person, prevention of cruelty, rehafamily care should be separated from the family ex- bilitation and compensation for the efforts of people change of assistance or mutual support, mutual assis- caring for older people in need of outside help. The tance. Also, couples often complement each other when main challenges faced by caregivers include: lack of managing, for example, a household. This everyday ex- psychological knowledge about behavior, character and change can turn into "care" or "help" as you get older. ways of communicating with older persons; the need to The individual will call themselves "helpers" in differ- find suitable work close to home, on a flexible schedent situations in response to changes in their lives. In ule, to stay at home when necessary to do heavy houseall external, objective circumstances, family members hold chores with a high level of monotony and unican create an environment for the older person to be formity; the role of a caregiver, with new knowledge, self-satisfied and satisfied, with moral participation as skills and contacts with an incapacitated older person; a determining factor. The family in the later stages of and the narrowing of one's own crescendo. Familyan older person's life is crucial. based care for the seniors, many of whom have chronic

However, the very fact that an elderly person is in illnesses or disabilities, is one of the most devastating the family often complicates the life and personal prob- stressful events in the family life cycle, linked to the lems of relatives. Older persons are usually cared for by mass of negative and undesirable consequences for the social workers and family members of older persons caregiver (testing of strong negative emotions with a whose motivations do not coincide. The former are paid long-term character, the degree of fatigue, exhaustion by the state for work with little prospect without any or the burden of the subjects). There are no separate direct benefits and social status. The latter perform their stages of family care, which have many individual difmoral duty, which does not have a monetary equivalent. ferences due to the degree of illness or disability and

26 Norwegian Journal of development of the International Science No 43/2020 personality traits. There is a known model of the stress cult stress situation, giving the assistant "learning expeprocess (L. Piarley and his staff), which allows to dis- rience"; emotionally focused coping (managing the tinguish four factors: primary stressors (time, effort, en- symptoms of stress). ergy), secondary stressors (family, work, conflicts), The training of assistants in these coping strategies secondary intraphysical stress (self-esteem, loss of is very useful for them, but the effectiveness of this self), the results of care (health and wellbeing).This training depends on the nature of stress. If stressors are model shows how to reduce, or contain, stress and difficult to change, cognitive strategies are more prostress factors. An important role is played by the avail- ductive. Typically, stressors and coping strategies afability of resources: psychological (high self-esteem, fect each other, and an ineffective coping strategy can coping strategies) or economic (high income, financial exacerbate different problems. Family support is a dyassistance). Assistants are less susceptible to stress if namic process that is modified to take into account the these resources are available, while those who use in- nature of disability and unstable living conditions of adequate resources are more oppressed and suppressed. older persons, the depletion of assistant resources and This also applies to the career of an assistant, under- the intensity of various stressors. Any family support stood as a process of development, training or sociali- situation may have one or a number of common feazation. tures: becoming an assistant; placing an older person in

The main sources of stress are three factors: family an institution; and severe loss (grief, death). Many asconflict; job destruction; and destruction of leisure time sistants never resort to the second moment, or resort to or social activity. In a situation of providing family as- it for some time, when the patient's behavior or subjecsistance, conflicts often arise between the assistant and tive sense of overwhelming burden on the assistant deother family members. There are three types of conflict: teriorates. before the diagnosis is made because of a dispute over Assistants often use inadequate methods to mancare giving; who and how much care is provided to the age stressors or do not know how to respond to them, elderly; and how much care and treatment is provided especially in the case of upset behaviors and depressed to the elderly. There are four indicators of conflict be- moods of older persons. Typical confrontational and tween work and family care: the emotional health of an avoidant reactions to them only worsen the situation by older person's family member; the number of tasks per- providing training to assistants in the management of formed by the caregiver; the presence of children in the their behavior, and by teaching them to take control of caregiver's home; and the coincidence of care and cur- their problems. These include: anxiety, anxiety, night rent work. incontinence, insomnia, depressive mood. The training

Additional socio-demographic variables (gender, allows you to learn how to make the right decisions in marital status, income level, availability and type of the light of changes in the environment, changes in the work, flexibility of working hours) affecting the con- level of activity and correction of behavior of the elflict between aid and work have been identified. In ad- derly. The training helps assistants to understand what dition, the degree of disability of an elderly relative and an older person cannot do on their own and why they the intensity of responsibilities for providing assistance need help, and to become more effective in interacting to him/her also influence the degree of disability. In ad- with an older relative. Placement of an elderly person dition to employment and care for the elderly, the sup- in a residential home is a significant risk of complicaport person should have the opportunity for leisure time tions, including a high mortality rate of elderly people or some other social activity. Social and recreational during the first year after moving; a sharp decline in acactivities are closely linked to social support, a multidi- tivity as a result of a change of residence; infringement mensional concept. Two types of social support are of individual rights, the degree of independence when known: instrumental support (assistance in solving spe- changing from one's home to another's unusual boardcific problems); emotional support (expression of posi- ing school, a collective, etc. Most of the assistants retive feelings to the assistant by other people). A distinc- main involved in their role, helping to ensure the daily tion is made between support provided by informal care of the elderly, they begin to interact with the staff sources (family, friends, and volunteers) and the formal of specialized institutions to "insure" the care of their social welfare system [11-15]. relatives, learn how to interact effectively with them. In

Social support from family and friends reduces the general, family-based care for older persons with impact of stress on the caregiver (wife, husband, daugh- chronic and often incurable illnesses poses a significant ter), who takes care of the elderly with dementia, and risk to the health and well-being of caregivers who meet has a positive impact on their physical and mental the needs of older persons. health. However, the family may be a source of support The analysis of the current situation implies expert or conflict. A coping strategy is a person's response to assessment of the condition, degree of disability of the stress factors in order to avoid their damaging effects elderly, their needs from different points of view and on their health. There are three types of such reactions criteria, assessment of the condition, needs and well(the first two are related to the assistant's low level of being of the assistants, family specific problems, clarity stress resistance, and the third to his or her high level of of medical diagnosis, use of various medical and auxilfatigue and exhaustion): coping, focusing on problem- iary means, determination of primary and secondary solving (managing stress factors and the situations stress factors. In the West, the stress process model is causing the problem for the assistant); cognitive coping often used as a guide for assessment. The methods of strategy (efforts to manage the significance of the diffi- working with assistants require flexible approaches,

Norwegian Journal of development of the International Science No 43/2020 27 consideration of individual differences, the need for in- family members. Each type of care can be useful in a formation to improve the education of assistants, their family situation. As a result, it should be decided who legal and financial support, and the improvement of in- will do what and when [11-15]. dividual and family counseling and group support. For Group support is particularly popular in the United example, the United Kingdom passed the Assistants States for family assistants, especially for caregivers Act in 1995, allowing a caregiver or caregiver who has with dementia. Most often, the groups discuss the probleft his or her previous job to identify and address their lems and feelings of the careers and mobilize therapeuneeds as caregivers once the needs of the caregivers tic potential in group interaction. The more helpers are have been identified. According to the law, services are involved in the dialogue, the better for their well-being provided to both the caregiver (elderly or disabled) and and situation resolution. Due to the demographic agecaregiver (assistants). In addition, the law establishes ing of the population, more and more people need help. the amount of financial assistance and benefits for as- Family members have a well-defined need to support sistants. their elderly relatives, a duty and a moral duty that does

Legal and financial issues vary from country to not depend on prescribed rules. country. For example, in the United States, where there Women's employment at work, high divorce rates, are no state-run residential homes, older people must new marriages, and stagnating economic conditions reuse their own personal funds to support themselves. duce the family's resources to care for the older generThe following typical situations are identified when an- ation. Family care for the elderly is a significant probalyzing requests for psychological counseling in rela- lem of the family and society. Therefore, all approaches tion to elderly relatives. The main locus of complaints can be useful to help older persons achieve the best reis serious changes in the nature of patients: irritability, sults for older persons without placing a special burden intolerance, frequent complaints of lack of attention on caregivers. from others, etc. However, it turned out that at this time Changes in modern society are closely related to the patient was literally "strangled" with care, thereby many aspects of family and community life. A suffireminding him of the disease and depriving him of the ciently high share of older people in the total population opportunity to adapt normally and independently to the makes significant adjustments to the already estabnew situation. lished systems of ensuring the quality of life. This re-

Then came the period of cooling to the patient. quires targeted adaptation of social systems, scientifiThus, excessive care and guardianship, "diligent" be- cally sound and methodologically sound approaches to havior of relatives are provoking factors, which in the the development of socio-psychological assistance to end lead only to deterioration of the mental state of the older people and those associated with them, including patient. One way out is the K relationship model. Rog- family members and the entire Russian society. The ers, when family members are oriented towards trust in need to provide professional assistance to older people the patient, believes that he is a person capable of adapt- gives these activities new and relevant dimensions. ing to a difficult situation. Evidence of faith in the pa- Ageing is a natural process inherent in any person's life. tient is the healthiest attitude to him, without any dis- Therefore, it is necessary to reconsider the concept of counts, the assignment of feasible cases and family re- elderly people as needy, unproductive and unhappy sponsibilities, and a reference point for his independent people. Studies of socio-psychological problems allow service himself. A consultant psychologist should pro- us to identify theoretical prospects for the study of the vide significant assistance to the family, discussing the processes of personal aging and the functioning of seneffect of these principles with family members. The du- iors. ration of the counseling can be short- and long-term, Conclusion. Separation of elderly people into a depending on the complexity of the situation and the special group is conditional from the point of view of disability of the elderly. Typically, there are 5-10 meet- the social psychology of aging, as many elderly people ings where facilitators receive new information, try to do not identify themselves with this age group. The discuss new approaches and strategies, and receive ad- contribution of older people is valuable to society and ditional support. Long-term counseling usually ad- should be recognized. The potentially negative consedresses interpersonal aspects of family care. In general, quences of this process can and should be mitigated family counseling is aimed at reducing family conflict both by sound government policies aimed at reducing and increasing instrumental and emotional support. It is incentives for early retirement, retraining and support best carried out in the home of a support person or other for older people and by the science of answering the family members who express a willingness to cooper- most complex questions of social psychology of ageate. During the counseling process, all aspects of family ing. It is important to find out what organizational, support and the activities of the support person are an- managerial and practical measures need to be taken to alyzed, knowledge of the specifics of the illness and make applied research possible and effective. The sopossible alternatives to the behavior of the elderly rela- cial psychology of ageing is one of the most important tive is tested and, once the situation has been assessed, philosophical, social and psychological sciences, an inthe relatives and support persons should be asked what tegral part of professional training and competence of a kind of support they need. In order to make family specialist who focuses not only on work with older peocounseling successful and a kind of therapy, it is neces- ple, but also with any age group of the population, as sary to avoid long term disagreements with family the problems of old age are closely related to the intermembers, to focus on the solution of assistance to the ests of all groups and strata of society. Practical and orpatient's assistant, not to try to equalize the efforts of all