INCLUSIVE ZAGREB: ELDERLY AT RISK

We started a new round of city labs under the title Inclusive Zagreb. Fourth session was dedicated to elderly at risk where we explored sources of social exclusion. This included lack of formal and informal support, digital, legal, economic and social factors. We specifically discussed mental health issues in residential care, digital exclusion of elderly in residential care, elderly living alone, and then based on these discussions, 3 community projects were implemented in December 2022 and January 2023.

Virtual Place

Hybrid Pop-Up CityLab: Platform & Location Department for Social Work at the Faculty of Law, Nazorova 51, Zagreb

Date

Start: 09.11.2022
End: 09.11.2022

Partners

City of Zagreb

15.00-15.15 Introduction 15.15-16.15 moderated group discussions in separate three groups: mental health issues in residential care, digital exclusion of elderly in residential care, elderly living alone 16.15.-17.00 conclusions from sessions, overall conclusion.

December 2022 and January 2023. Implementation of community projects

Total participants: 69 Total students: 29 Total Staff members: 4 Total representatives of societal stakeholder: 8 city representatives, 24 professionals, 4 not specified.

MENTAL HEALTH ISSUES IN RESIDENTIAL CARE: Depressiveness can be defined as an emotional state of a person that manifests itself through "feelings of sadness, low mood, sorrow and dejection (Ajduković, Ručević and Majdenić, 2013: 150). People who have symptoms of depression feel weaker, they are tired, they are no longer interested in things that used to interest them and lose interest in them, they have various mood changes, guilt appears, their appetite is disturbed, etc. (Vulić-Prtorić and Sorić, 2001 according to Ajduković, Ručević and Majdenić, 2013). They may also have disturbed sleep, feel a great deal of fatigue, think a lot about death, etc. (Stjepanović, Jendričko and Ostojić, 2015). Along with dementia, one of the most common mental disorders, among others, is depression, and the problem continues because only a small percentage of older people are treated for depression (Cole, Ballavance, Mansour, 1999 according to Vadla, Božikov, Blažeković-Milaković and Kovačić, 2013). The fact that a person did not have depressive episodes earlier in life does not mean that they will not occur in old age, but the risk is lower than for people who have already experienced depressive episodes earlier (Ajduković, Ručević and Majdenić, 2013). If it appears for the first time at an older age, it is probably the result of problems that a person has with physical health (Ajduković, Ručević and Majdenić, 2013). Serious clinical depression is manifested by 2 to 5% of the elderly, and some symptoms of depression are experienced by 8 to 16% of them. Depression not only affects the psychological well-being of the individual, but also has an impact on other aspects of the individual's life, such as their physical health (they move less), it decreases quality of life, have increased costs and their health condition generally deteriorates (increased mortality from some diseases) (Katon, 2003 according to Ajduković, Ručević and Majdenić, 2013). This problem also affects the individual's family, which is often unable to recognize depression in the elderly, and their mood is seen as a consequence of other health problems (Katon, 2003 according to Ajduković, Ručević and Majdenić, 2013). Depressiveness directly affects the quality of life of an individual, but it can also indirectly affect the environment. Research has also shown that these depressive symptoms of the elderly can be transmitted or spread to other family members (Gonzales, et al., 2010 according to Souza et al., 2014). Professionals are affected in such a way that those who take care of the daily care of a person suffering from depression may become less and less able to provide them with the necessary support over time because they feel increasingly burdened by the depressive symptoms of the user (Hinrichsen and Hernandez, 1993, according to Martire, et al., 2008). Depressive symptoms can increase when an elderly person goes to a nursing home, and studies have shown that as many as 12.6% of the elderly who just entered the nursing home had depressive disorders, and 18% of them had symptoms of depression, but they were not recognized as such and for that reason they were not treated (Schaie and Willis, 2001 according to Ajduković, Ručević and Majdenić, 2013). The answer to the question of how exactly this affects social stability and values is that people are afraid of aging and all the negativity that it brings with it, such as the stigmatization of older people, financial instability due to the costs of treatment and small pensions of the elderly, non-treatment of diseases that manifest in the elderly due to the attribution of their symptoms to other diseases (physical instead of mental), etc. Also, this leads to a negative image of aging and insufficient sensitization of society for the elderly. Depression can lead to numerous consequences such as: social isolation, permanent immobility, increased body weight or malnutrition, low self-esteem, suicide, impaired individual well-being, increased possibility of death for those who have just entered a nursing home and developed depression as a result of entering the home for as many as 59% and many others (Beekman, Deeg, Braam, Smith and Tilburg, 1997, Ajduković, Ručević and Majdenić, 2013 and Stjepanović, Jendričko and Ostojić, 2015). With the right approach and method of treatment, depression can be greatly reduced or even cured completely (Nedley, 2001 according to Šilje and Sidik, 2016). Furthermore, because of this, it is very important that depression and its symptoms are recognized so that they can be treated, and the role of doctors and psychogeriatricians is very important in its recognition or even in the prevention of the disease itself, i.e. that depression does not occur at all (Šilje and Sidik, 2016). It should be added that some studies have shown that social isolation is not one of the predictors of depression in the elderly (Schaie and Willis, 2001 and Wilby, 2011 according to Ajduković, Ručević and Majdenić, 2013).

IMPLEMENTED COMMUNITY PROJECT: Handing out leaflets and talking to users of the home Sveti Josip who have just moved into the residential care about psychological adjustment.

DIGITAL EXCLUSION OF ELDERLY IN RESIDENTIAL CARE: The problem we are dealing with is the digital exclusion of the elderly. Elderly people are a vulnerable group because they have a need for participation in society, and they do not have the same abilities to use new technologies as younger people. The problem that arises is the resistance of the elderly towards digital technology, the lack of adaptation of new technologies to the elderly (font, language, accessibility), the lack of digital literacy education for the elderly - all this results in the digital exclusion of the elderly.

Digital inequality could be described as a difference in the possession and use of information and communication technologies, and is a consequence of the rapidly developing information society. The Internet and digital technologies are developing day by day, and there are more and more activities and services that are modernized and carried out online in order to facilitate access to services for the users themselves, so today we often have online referrals for going to the doctor, going to the bank or the post office has also been modernized to a certain extent, internet banking and the like have been introduced. However, it is difficult for older people to follow the accelerated development of new technologies and they often develop resistance to the use of new technologies and are actually excluded from the world of modern technologies that could make their lives much easier. A digital divide is being created in society. The digital divide represents the difference between younger and older people in the context of using new technologies. Young people follow the development of new technologies much faster and adapt to them much faster than older people. In fact, young people are a resource that could be used for the digital inclusion of older people, because young people have certain knowledge and experience that they could pass on to older people through volunteer work as a form of intergenerational solidarity. The exclusion of the elderly was particularly visible during the pandemic when all communication took place via digital platforms because physical contacts were limited, and the elderly did not have access to digital services, nor the knowledge to use them. In fact, it is a question of social exclusion that is fueled by digital exclusion. Therefore, it would be good to include the elderly in today's modern, digitized society, so that they too can make contact with their loved ones every day when they are not physically able to be together, but also to fill their free time and increase the quality of life in the institution.

IMPLEMENTED COMMUNITY PROJECT: providing information about digital services e-citizen for residents of the home for elderly Trešnjevka

ELDERLY LIVING ALONE IN CITY CENTRE Loneliness of elderly people in single households is seen as a problem by the users themselves, that is, elderly people who face the situation, but also those who could potentially find themselves in that situation. Some experts also see the above as a problem, while on the other hand, some people do not see the loneliness of elderly people in single households as a problem and do not try to improve the social network by providing help or starting some activities. The problem is evident in the fact that there is an insufficient number of organizations that take care of elderly people, that is, that deal with them and carry out activities, take care of their needs and wishes. In addition, if they exist, the problem is the unavailability of information, the lack of information among elderly people about their options, where they can get involved, what activities are carried out in their local community, who they can turn to. The problem can be seen in the fact that there is a high degree of dissatisfaction and poor psychological condition among the elderly, which has led to loneliness and unmet needs. The problem of loneliness in single households affects elderly people in such a way that they cannot meet some of their needs. For example, if they are less mobile and need something from the store, and they do not have a sufficiently developed social network, do not know their neighbors or do not have good relations with their neighbors, there is no one to take them to the store, if they cannot do it themselves. Most are affected by this problem, but some are comfortable with solitude and do not need to expand their social network and are comfortable with the life they have and are satisfied with it. According to the census, 50% of people are at risk of poverty, which means that every second person in a single household is at risk, and 10% is a very vulnerable population of single households. The problem begins to develop when the single life begins, because then they have to face the fact that they have to do everything by themselves, from household chores, going to the store/pharmacy/bank, etc., paying utilities and the like. In addition, they spend the whole day alone, which can be a relief at first, but over time it can be very difficult for them to bear that loneliness and not being able to talk to someone. An additional problem arises if they do not have neighbors with whom they are on good terms or family with whom they can keep quiet, and if they are not involved in any activities because they spend the whole day without communicating with anyone. Therefore, it can be concluded that the pace of development of this problem is fast and progressive. The more and longer they are alone, the greater the feeling of loneliness, and if, for example, they do not get involved in an activity or find someone to talk to or something that will occupy their thoughts and fill their day, it can quickly come to the point that they feel very lonely and depressed and to be more dissatisfied with their life. Due to the COVID-19 pandemic, this problem is increasing because social contacts had to be reduced, elderly people were not recommended to move among people because they are a sensitive group, this led to a reduction in contact, and for some even to the complete cessation of contact with other people, both friends, neighbors and family. Since the measures were in force for a very long time, it can be assumed that there was also a decrease in closeness with those people with whom they were close until then, and it is possible that there was a cessation of any communication, which with the weakening of the measures led to greater loneliness because they finally have the opportunity to see someone, but they no longer have anyone because social ties have been lost. The causes of the problem of loneliness itself are the unavailability of information about activities and the inadequacy of activities for the elderly, as well as insufficient activities specifically intended for the elderly. Also, the problem arises because of the smaller number of experts interested in the elderly and because of the isolation and lack of interest of the elderly themselves in improving the quality of life, but also because of isolation from the environment itself. The problem also arises due to the difficulty of providing help in the home because there are too few people who do it.

IMPLEMENTED COMMUNITY PROJECT: Held local gathering with structured activities for elderly living alone in the city centre

Tags

UNIC CityLabs | inclusion | Inclusion

Themes

Social inclusion | Ageing well

Type of Case

discussion group

Languages

Croatian

Organizing unic universities

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