INTRODUCTION
Loneliness among older adults is an issue that is often avoided, and amid the flow of responsibilities in people’s productive years, the loneliness of seniors is often overlooked. This is not because younger people are not troubled by it; it is often because they do not perceive the feelings of seniors, and sometimes it is also due to preserving comfort. For some time now, one rule has held, and this is probably worth mentioning because everyone comes to accept it over time, implicitly or explicitly. “No matter what an older person does, they should not burden the lives of younger people.” Even though this sentence may seem rather insensitive, and even though our article is focused on social work, where a client is precisely a person of senior age, this sentence is often replayed in clients’ minds repeatedly.
LONELINESS OF SOCIAL WORK CLIENTS IN SENIOR AGE
A client dependent on help feels this dependency and considers it a burden imposed on those who assist them. Very often, even the thought itself may lead to depression and self-pity and then to a certain acceptance of reality that things will not simply change. This cycle often repeats, and if it goes unnoticed, i.e., if we do not talk with the senior about their difficulties, this trauma can later have severe health consequences. Especially in cases where a client is a resident of a social-care facility, such as a senior center, a social services home, or a retirement home, signs of loneliness and sorrow may appear more intensely. Of course, this depends on the situation, family circumstances, the senior’s personality, financial background, health condition, or even whether the senior came from a village or a city. In any case, we can conclude that a person who has been active throughout life and remained active until late age, not only through employment, will gradually find it more difficult to adapt to life in an institution.
It is also worth asking what could motivate such a person to want to enter such a facility. There may be several reasons, such as handing over owned property that has since been used by family, family conflicts, a health-related injury, or declining health, among many others. Even in professional circles, it is often difficult to talk about the harsh fates and situations that people in senior age may be experiencing. As people grow older, especially at the start of receiving an old-age pension, they may lose self-confidence and self-respect and come to feel unnecessary. The old-age pension is generally a replacement for wages for a person unable to carry out gainful work because of advanced age. Let us pause on the word activity: in that period, a senior performs only those activities their health condition allows. It can be said that health in senior age depends on multiple factors, whether genetic factors or factors related to lifestyle during productive years. Lifestyle and life habits have a major impact on a person’s health. Whether it is stressful work, excessive physical workload, conflicts in the family, lack of finances, or a lack of life organization, all of this can particularly worsen overall health.
Physical movement and appropriate exercise, however, play a major role in maintaining health in senior age, both physical and psychological. In the publication by Jana Pyšná, “The Quality of Life of a Senior and Movement,” we find information that the risk of premature death decreases if a person of senior age reaches an expenditure of 1500 kcal per week. For maintaining health, muscle strength, and flexibility, regular movement is therefore extremely important. When there are barriers to carrying out physical activity, a certain level of effort is still needed. A suitable alternative in such situations may be, for example, regular exercise (Pyšná, 2009). Regular movement and exercise significantly affect health status and also create a better basis for coping with feelings of loneliness and anxiety.
In social-service institutions, however, it is often precisely those seniors whose health no longer allows them to perform even personal-care tasks and ordinary tasks of an actively living person. They become dependent on others’ help, and some look for ways to remain useful to their surroundings even in such a condition. It is also not unusual for clients of such facilities to often reminisce about periods they have lived through and to talk with each other about their families and the joys these memories bring. In some cases, of course, these are also sources of worry. This process of communication and mutual sharing of personal information helps clients in the struggle against loneliness and sadness, strengthens interpersonal relationships, and improves cognitive processes. A simple conversation is therefore, in many instances, the only and unique form of support for creating a better atmosphere in the facility.
In retirement homes, clients are assigned caregivers with whom they spend, one could say, most of their time outside interactions with other clients. Therefore, caregivers represent the most visible source of help, and clients often confide their suffering to them. This may include dissatisfaction with the facility, grief from the loss of a close person, the fact that nobody from the family comes to visit, and also issues related to physical pain or illness. Sharing distress with another person brings a certain form of relief, a sense of being understood, and reassurance of one’s own significance and experience.
Compassion from another person therefore becomes a major means of overcoming loneliness, not only for a person in senior age. Compassion is a form of recognition of a person’s lived state; it is a way of understanding their experience and highlighting the importance of that state. Since the human being is a social being, they need a sense of belonging and the sharing of experienced situations and emotions with another person. Compassion can take an active form by moving into concrete actions aimed at relieving pain, for example a small gift, taking the senior’s side, or fulfilling a long-neglected need. Passive compassion is the conversation already mentioned and the creation of a caring atmosphere. Compassion is the opposite of selfishness and is a merciful expression toward a person experiencing difficult times. In our context, this may include loneliness, where we may implicitly find an unsatisfied need for the person’s essential unity with the world of other people (Čáp, Palenčár, 2012).
Loneliness is a feeling that clients of social work and, more generally, people can experience not only when they are physically alone, but also when many people are nearby. It is a state characterized by unease and a sense of one’s own incompleteness and dissatisfaction in the absence of certain persons to whom the person attributes the power to create harmony and calm in their own mind. People of every age carry with them not only some “sentiment” for maintaining harmonious relationships; it is often the main driving force for continuing to function and pursue meaningful goals through selected activities or obligations. The triggers of such depressive states and depression itself can be immeasurable, especially among older people, where experiencing is particularly sensitive, and thus conversations with retirement home clients often cannot avoid tears and emotionally demanding atmosphere in terms of coping and pursuing other goals with the client.
Depression affects up to 20% of people worldwide, and statistics show that women are predominantly affected by depression. From the perspective of clients of retirement homes or facilities for seniors, women constitute a large part, and thus there is also a significantly greater number of clients in such facilities who are in depressive and melancholic thinking. Depression can be described as a sense of constriction, weakness, despondency, or heightened sensitivity. Depression has many symptoms: somatic, social, psychological, and bodily. A depressed person may have slumped posture, pessimistic perception, a feeling of helplessness, and may perceive some things as exaggerated or overly burdensome in a one-sided way. The task of helping professionals working with depressive clients in social service institutions is to value every success, accept sadness, support self-reliance, overcome social isolation, and strengthen identified resources that make clients’ experience more pleasant (Fabian et al., 2014).
In social work settings, clients in senior age are encouraged toward activation through specialized activities conducted by a social worker or therapist. These may include drawing, embroidery, cooking, cutting out pictures, making collages, light gardening, and physical exercise. Clients of retirement homes usually participate in these activities willingly, and for them these activities provide a form of enlivening daily life in the facility. The therapies most commonly implemented in these conditions include, for example, Ergotherapy and Canisterapy. Canisterapy is one form of animal-assisted therapy, that is, therapy through interaction with a live animal—in canisterapy specifically a dog. It is carried out under the guidance of an experienced Canisterapist and a trained dog. In the case of Ergotherapy, the focus is on supporting the development of physical functions through specific activities. These may include social games, movement activities, handicrafts with a specific type of material, or activities that are clearly positive for the client. In social work settings, it is important to stress the aspect of providing Ergotherapy correctly. To perform Ergotherapy, the therapist must successfully complete training in that form of therapy. Activities led by an untrained helping professional cannot be labeled as therapy. At their core, these are activities that only imitate therapy, and while they may sometimes produce similar outcomes, they are not the same.
However, for the highest quality of providing Ergotherapy, it is currently possible, for example, at the Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety in Bratislava, through the Institute for Further Education of Social Workers, to complete accredited training in the therapeutic technique program, Ergotherapy module. The choice also includes Art Therapy, Psychomotor Therapy, Drama Therapy, Play Therapy, and Dance and Movement Therapy. After completing such training, we clearly improve the level of such services and, most importantly, contribute to a better mental state of our clients (www.ivsp.sk).
In any case, any effort and time spent with lonely seniors in the form of conversation, joint activity, or accompaniment represents tremendous value for the senior and substantially improves their overall well-being. To confirm these statements with empirical findings, we conducted a short qualitative survey focused on experiencing loneliness at the Retirement Home in Rimavská Sobota. The information-gathering method was interviews with 3 participants, where we asked the following questions: “Do you sometimes feel lonely?” “What helps you then?” “Which activities do you enjoy doing?” To the question of whether they sometimes feel lonely, they answered no; however, they later mentioned that they miss their family. “I have not seen my family for a long time.” They said that what helps them most in such moments is talking with other clients, friends, or the caregiver. “I tell everything to my friend, and immediately I feel better.” “When I have some problems, the caregivers help me.” Any contact is a very positive stimulus for participants, and even a phone call from a friend helps. “I just wait for her to call so we can talk.” When we asked what activities they enjoy, we discussed it through a description of routine activities in the facility. They most often said they spend their time resting, talking, and in good weather they enjoy being outdoors on facility grounds, where they can sit on a bench surrounded by well-kept greenery. They also have no problem joining social activities or playing social games. “When they give us cards or a game like People, then we play.”
The key point we wanted to express through this survey is that clients of social work in senior age especially value it when a helping professional listens to them, helps them, and addresses them in a way that makes them feel they truly matter. Senior clients therefore need to feel that care for them is not merely mechanical but genuinely sincere and sensitive. In addition, as noted above, seniors also have the need to be part of a collective, of society, and to gain a sense of belonging.
A similar idea also underpinned an educational project in Prešov, which enabled children from Detský domov in Prešov to meet seniors from the home for seniors Náruč, with the aim of spending time together and enriching and entertaining each other. Each meeting was previously arranged with a planned program (Nezbedová, 2016).
Such projects are particularly inspiring for both sides and allow the creation of intergenerational relationships while bringing positively charged moments for those involved. Securing such moments is especially important and essential for people who feel lonely because it improves their outlook on life. This is why projects aimed at improving seniors’ mental health are so significant.
CONCLUSION
In the paper, we drew attention to the importance of recognizing the internal psychological experience of clients of social work in senior age and the possibilities of support that can be provided to them within the care process in social service facilities. It is necessary to recognize the importance of ensuring as good social care as possible for people in retirement age and to focus on their overall satisfaction and quality of life. There are many ways to ensure satisfaction for clients in retirement age, but in practice the most effective measure against negative experiences is creating an appropriate relationship with the client, which should be an integral part of the profession.
Author: Mgr. Roland Sivok
REFERENCES
- FABIÁN, A., Svet sociálnej práce, Košice 2014, ISBN 978-80-8152-097-6
- ČÁP, J., PALENČÁR., Smrť a vedomie smrteľnosti, IRIS 2012, ISBN 978-80-89256-96-9
- NEZBEDOVÁ, L., Edukačný projekt zblížil deti z detského domova so seniormi, Dostupné online: https://eduworld.sk/cd/lenka-nezbedova/2959/edukacny-projekt-zblizil-deti-z-detskeho-domova-so-seniormi
- PYŠNÁ, J., Kvalita života seniorú a pohyb, Infopress 2009, ISBN 978-80-85402-98-8
- http://www.ivsp.sk/akreditovane-programy