A N N A L E S A C A D E M I A E M E D I C A E S T E T I N E N S I S
R O C Z N I K I P O M O R S K I E J A K A D E M I I M E D Y C Z N E J W S Z C Z E C I N I E
2007, 53, 1, 98 103
BOGUMIA
A FR
CZAK, BARBARA STAWSKA
PENSIONERS QUALITY OF LIFE IN SOCIAL CARE HOUSES
JAKOŚĆ ŻYCIA PENSJONARIUSZY DOMÓW POMOCY SPOA
ECZNEJ
Zakład Protetyki Stomatologicznej Pomorskiej Akademii Medycznej w Szczecinie
al. Powstańców Wlkp. 72, 70-111 Szczecin
Kierownik: dr hab. n. med. Bogumiła Frączak
Streszczenie Społecznej jest zły. 3. W Domach Pomocy Społecznej po-
winni być zatrudniani psychoterapeuci.
Wstęp: Ludzie starsi wymagają troskliwej i komplek-
sowej opieki stomatologicznej. Mają prawo zarówno do H a s ł a: gerontologia  jakość życia  stan psycho-
niej, jak i do godnego przeżywania starości. W wieku społeczny.
starszym wzrasta zapotrzebowanie na wsparcie społeczne,
zwłaszcza ze strony rodziny. Wielu seniorów spędza ostatni
etap życia w Domu Pomocy Społecznej. Instytucje nie są Summary
w stanie zapewnić ludziom starszym pełnego wsparcia,
gdyż prawie cała sfera potrzeb psychicznych pacjentów jest Background: Elderly people need special and complex
dla nich niedostępna. Dom Pomocy Społecznej pozostaje dental care. They have the right to a dignified life and for the
tylko instytucją realizującą opiekuńczy model opieki nad dental care. In elderly the need for social and family support
pacjentem. grows. However, many seniors live their last stages of life
Celem pracy było zbadanie jakości życia i stanu psycho- in the Social Care Houses. Governmental institutions fail to
społecznego pensjonariuszy Domów Pomocy Społecznej. provide full support to seniors since almost the entire psy-
Materiał: Zbadano 135 osób w wieku od 66 do 87 chosocial domain is neglected. Social Care Houses, despite
lat. having the word  home in its name, are only institutions
Wyniki: Stwierdzono, że jakość życia pensjonariuszy providing the patients with nursing care.
Domów Pomocy Społecznej nie zapewnia im szczęśliwej The aim of the work was to study the quality of life and
egzystencji, a ich stan psychospołeczny jest zły. Większość psychosocial status in residents of Social Care Houses.
z nich nie była zadowolona ze swego dotychczasowego Material: The study enrolled 135 individuals aged from
życia. Towarzyszyło im poczucie znudzenia, osamotnienia 66 to 87 years.
i obawa przed przyszłością. Pomimo uczucia samotności Results: It was found that the quality of life in residents
mieszkańcy Domów Pomocy Społecznej mieli silną ten- of Social Care Houses was low and their psychosocial status
dencję do izolowania się od otoczenia. Mała aktywność was poor. Majority of the studied individuals did not like
psychiczna i fizyczna wpływała na pogorszenie się stanu their life so far. They were overwhelmed by the feeling
psychospołecznego mieszkańców. Wydaje się słuszne, aby of tiredness, loneliness and fear about tomorrow. Despite
w Domach Pomocy Społecznej zatrudniani byli psycho- feeling lonely the residents of Social Care Houses showed
terapeuci. strong tendency towards isolation. Low psychical and physi-
Wnioski: 1. Jakość życia pensjonariuszy Domów Po- cal activity influenced negatively the psychosocial status
mocy Społecznej nie zapewnia im szczęśliwej egzystencji. of the seniors. It seems that psychotherapists should be the
2. Stan psychospołeczny pensjonariuszy Domów Pomocy staff members in the Social Care Houses.
PENSIONERS QUALITY OF LIFE IN SOCIAL CARE HOUSES 99
Conclusions: 1. The quality of pensioners life in Social complex support and care. Family home is the keystone,
Care Houses does not offer happy existence to them. 2. the guarantee of tenderness, love and safety. Family home
The pensioners psychosocial state is poor in Social Care environment is well-known and recognizable, however,
Houses. 3. It seems that Social Care Houses should employ simultaneously providing a great variety of stimuliarising
psychotherapists. from its complexity. Thus, such an environment is not only
stimulating but also stable and secure.
K e y w o r d s: gerontology  quality of life  psycho-social Many people spend their last life period in a Social Care
state. Houses. The conditions and environment of Social Care
House as well as the way of its running and functioning are
the decisive factors influencing the old age life level and life
Introduction quality in institutional conditions. The state institutions are
not able to provide full support to the elders since nearly
The fast growing population of elderly people makes the entire sphere of their psychical needs remains closed
the problem of old age become one of the most crucial in for the institutions. A Social Care House, even though it is
the contemporary world. Every elder person has the right to intended to be the  home , is only an institution following
live a good quality life. He/she should be taken care of and a certain custody model of care over the patients [5, 6, 7,
respected. Ensuring the appropriate life quality to elderly 8, 9, 10].
people should become the first priority issue.
Considering its mental aspects, the old age period starts
from the moment a person discontinues active life. Such Research work objective
people tend to recollect their memories and make life ba-
lances, tend to transfer their experiences and possessions The research aimed at investigating the quality of life
to their successors; they seem to stop future planning and and psycho-social state of pensioners living at a Social Care
wait for their life to end. House.
Mental activeness to a great extent depends on the fea-
tures of the nervous system. The changes intensify par-
ticularly when the elder person has to face new tasks in Material and methods
new conditions. The difficulties in communicating with
the external world, particularly in the cases of people who The investigation based on surveys carried out on 135
have limited interests or hobbies, can be one of the reasons pensioners residing at Social Care Houses in Szczecin and
of their gradually subjective attitude towards the real life the surrounding area. There were 98 seniors from Social
and therefore the inclination to recall past experiences and Care House  Combatant House on Krucza Street, Szczecin,
events. In the opinion of many specialists that the most real 25 seniors from Social Care House in Dębce and 12 seniors
and true life is the life focusing on the advantages of the from Social Care House in Nowe Czarnowo.
present-day, the life free from attempts to restore the past Each pensioner was investigated only once, they did it
and aspiration to control the future [1, 2, 3, 4]. voluntary and were asked questions aiming at determining
Hardly any new experiences, reluctance to make any of their psycho-social state.
intellectual efforts and living in the world of past memories The survey included relevantly prepared, research re-
can result in rigidity of thinking schemes, increase in think- lated questions that would enable evaluation of pensioners
ing materially and difficulty in changing opinions. The extent psycho-social state. The survey questions covered the sphere
of adverse changes in mental activeness depends mostly on of emotional support assessment of pensioners in a Social
the intellectual training duration and the mind development Care House, the degree of their physical activity, mental
level reached. Weakening of perception functions happens activity and their attitude to their future.
to progress slower in people at higher intellectual levels. The results obtained were subjected to statistical analysis
The human beings to get familiar with the surrounding based on the self-reliance test Chi2 for multi-cross-reference
world in the course of doing various activities, accomplish- tables and Fisher s precision test, applicable for analysis of
ing different tasks, learning intentionally or learning unin- groups containing 50 or less people.
tentionally from the experiences. Therefore, better mental
efficiency can be observed where elderly people continue
living in their natural life conditions. The supportive fac- Results
tors, allowing to maintain relevant mental health, include:
constant participation in social and family life, involvement The pensioners claimed to have either not satisfactory
in various activities, taking responsibility for themselves life (47.41%) or partially satisfactory, i.e. not satisfactory
and helping others. The natural environment for the elder in certain life aspects (46.67%).
is their family. Living with the family provides the best It appeared that 37.50% of respondents claiming to
conditions to satisfy their needs and enables to offer them have satisfactory life simultaneously like spending their
100 BOGUMIA
A FR
CZAK, BARBARA STAWSKA
free time actively. There were no respondents whom, re- prevailed. 17.78% of seniors declared to be definite pessi-
siding in a Social Care House, would declare to have been mists while 51.11% thought about themselves as pessimists,
enjoying their life there (tab. 1). even though simultaneously the latter group did not consider
to have had more misfortunate than other people.
T a b l e 1. The correlation between satisfaction with life and the
frequency of going out The optimistic approach to life had very significant
influence on pensioners assessment of their life so far.
T a b e l a 1. Zależność pomiędzy zadowoleniem z życia
a częstotliwością wyjść z domu
Among the pensioners having been satisfied with their
life the people who believed to be optimist prevailed. There
Satisfaction with life
Zadowolenie z życia
were no optimists among those unsatisfied with their life.
Going out
rather
That group was predominated with people of a pessimistic
frequency
satisfied satisfied not satisfied
approach to life  34.38% (tab. 3).
Częstotliwość
zadowolony raczej niezadowolony
wyjść z domu
zadowolony T a b l e 3. The correlation between satisfaction with life and
optimistic attitude to life
n % n % n %
Very often T a b e l a 3. Zależność pomiędzy zadowoleniem z życia
3 37.5 10 16.13 3 5.77
a optymistycznym nastawieniem do życia
Bardzo często
Sometimes
5 62.5 46 74.19 38 73.08
Satisfaction with life
Czasami
Zadowolenie z życia
At all
20 0.0 6 9.68 11 21.15
rather
W ogóle
Optimizm
satisfied satisfied not satisfied
Total Optymizm
28 100.0 62 100.00 52 100.00 zadowolony raczej niezadowolony
Razem
zadowolony
p = 0.03727
n % n % n %
p  level of significance / poziom istotności różnic
Very optimistic
4 50.00 2 3.17 0 0.00
Duży
The respondents who actively participated in social life
Rather optimistic
uttered positive assessments on the life in a Social Care
Raczej 2 25.00 28 44.44 6 9.38
House. However, seniors did not enjoy going for walks nor
otymistyczny
attending the group interest classes. There were 73.13% of
Rather
pensioners claiming they preferred either to be alone or did
pessimistic
2 25.00 31 49.21 36 56.25
not like the group interest classes. Only 3.73% of respond- Raczej
pesymistyczny
ents regularly attended the group activities and found the
Pessimistic
activities enjoyable and satisfying.
0 0.00 2 3.17 22 34.38
Pesymistyczny
Among the pensioners who were not pleased with their
Total
life there were 85.71% of them remained isolated from other
8 100.00 63 100.00 64 100.00
Razem
pensioners (tab. 2).
p = 0.00001
Another essential factor appeared to be the pensioners
p  level of significance / poziom istotności różnic
attitude to life. Among the pensioners in CSH the pessimists
A significantly large group of respondents revealed
T a b l e 2. The correlation between satisfaction with life and activity
to be afraid of their future, which also affected their as-
in interest groups
sessment of life. That fear often made them feel the life
T a b e l a 2. Zależność pomiędzy zadowoleniem z życia
senseless. The more satisfied of life a pensioner was the
a działalnością w kółkach zainteresowań
less of fear was spoken about. 50.00% of dissatisfied people
Satisfaction with life
affirmed not to be afraid of their future and seemed to get
Zadowolenie z życia
Activity in
along with the consequences of time passing by. Certain
interest groups rather
fears were observed only in respondents whom were not
Działalność satisfied satisfied not satisfied
satisfied with their own life, i.e. 12.50% of respondents
w kółkach zadowolony raczej niezadowolony
(tab. 4).
zainteresowań zadowolony
The significant element in the lives of elderly people
n % n % n %
are their families. Majority of respondents had their close
Very often
0 0.00 3 4.76 2 3.17
Bardzo częsta
family members. 69.63% of them confessed to have children
Occasional
and/or grandchildren. It appeared that both the satisfied
2 25.00 22 34.92 7 11.11
Sporadyczna
and the unsatisfied from their life had families. However,
None
the fact of having the close relatives did not influence their
6 75.00 38 60.32 54 85.71
Żadna
life self-assessment.
Total
8 100.00 63 100.00 63 100.00
A more important factor appeared to be the frequency
Razem
of contacts with family. The pensioners satisfied with their
p = 0.02608
lives affirmed to contact their family several times a month
p  level of significance / poziom istotności różnic
PENSIONERS QUALITY OF LIFE IN SOCIAL CARE HOUSES 101
T a b l e 4. The correlation between satisfaction with life and fears T a b l e 5. The correlation between satisfaction with life and
about tomorrow frequency of contacts with family
T a b e l a 4. Zależność pomiędzy zadowoleniem z życia a obawą przed T a b e l a 5. Zależność pomiędzy zadowoleniem z życia
przyszłością a częstotliwością kontaktów z rodziną
Satisfaction with life Satisfaction with life
Zadowolenie z życia Zadowolenie z życia
Fears about Contact s
rather rather
tomorrow frequency
satisfied satisfied not satisfied satisfied satisfied not satisfied
Obawa przed Częstotliwość
zadowolony raczej niezadowolony zadowolony raczej niezadowolony
przyszłością kontaktów
zadowolony zadowolony
n % n % n % n % n % n %
Definite lack of
Few times a week
fears
Kilka razy 0 0.00 0 0.00 0 0.00
4 50.00 6 9.52 4 6.25
Zdecydowanie
w tygodniu
brak obaw
Once a week
0 0.00 0 0.00 0 0.00
Lack of fears
Raz w tygodniu
3 37.50 21 33.33 8 12.50
Brak obaw
Few times
Rather lack of
a month
7 87.50 24 38.10 6 9.38
fears
Kilka razy
1 12.50 27 42.86 31 48.44
Raczej brak
w miesiącu
obaw
Once a month
0 0.00 22 34.92 10 15.63
There are some
Raz w miesiącu
fears
0 0.00 9 14.29 13 20.31
Rarely than once
Istnieją pewne
a month
obawy
1 12.50 14 22.22 38 59.38
Rzadziej niż raz
Definite fears
w miesiącu
about tomorrow
No contact
Zdecydowany 0 0.00 0 0.00 8 12.50
0 0.00 3 4.76 10 15.63
Brak kontaktu
strach przed
Total
przyszłością
8 100.00 63 100.00 64 100.00
Razem
Total
8 100.00 63 100.00 64 100.00
Razem
p = 0.00001
p  level of significance / poziom istotności różnic
p = 0.00007
p  level of significance / poziom istotności różnic
(87.50%). The number of contacts with family was the Discussion
least among the pensioners unsatisfied with their life. It
appeared that 15.63% of pensioners had no contacts with Positive assessment of life is a determinant of good and
their relatives at all, while 59.38% had contacts less than enjoyable old age life [11]. The investigations carried out by
once a month. other researchers revealed a high percent (66.50%) of people
There was no relation noticed between the type of con- satisfied with their life. However, our own investigations showed
tact with family and pensioner s satisfaction of life. The that the majority of pensioners of Social Care Houses were not
respondents did not consider it important whether it was satisfied with their life and assessed it negatively (47.41%).
a telephone contact (12.30%) or a visit (40.16%). In their publication, Sierpińska et al. [12] report that
In most cases the elderly experienced large satisfac- peace and quiet as well as high activity and mobility are
tion from contacts with their family. Among them 27.87% supportive factors in adaptation to wear prosthesis. The au-
admitted to look forward to such contacts while 36.06% thors own investigations proved the relationship between the
admitted not to enjoy such contacts. The was a minor level of physical activity and the feeling of life satisfaction.
group of pensioners whom did not want to meet their rela- The frequency of going outside the Social Care House and
tives (6.56%). active participation at group interest classes at a Social Care
The cheerfulness experienced from contacts with family House had an influence on life assessment. The majority of
appeared an important factor while pensioners self-assessing pensioners in the group of pensioners satisfied with their life
their life. Positive assessment of their life situation prevailed predominated those who led a very active life. On the other
among the pensioners for whom the contacts with family hand, the pensioners unsatisfied with their life kept isolated
were the source of pleasure. The apparent unwillingness to from the other Social Care House residents and preferred
contact their families was observed only among the pen- to stay alone. Thus, the physical and mental activity is the
sioners having a negative attitude towards their own life prerequisite for a positive old age life model.
(14.81%). In that group 20.37% of respondents confessed Among the people satisfied with their life the optimists
not to like meeting their close relatives (tab. 5). prevailed. The attitude to life is the decisive factor while
102 BOGUMIA
A FR
CZAK, BARBARA STAWSKA
assessing both the past life and present situation. People the pensioner s life, that the pensioner could feel important
of optimistic nature more willingly accept what their life and remembered. That protected the pensioners against feel-
brings them, grasping as much happiness as possible. The ing lonely and forlorn, the feelings so destructive for all peo-
investigations confirmed that among the pensioners at Social ple regardless their age. In their investigations, Gołębiewska
Care House the pessimists prevailed. and Sierpińska [13], proved that the feeling of loneliness the
In their publication, Szwarc and Szyszko-Wydra [11] re- most often occurred in the group of the eldest (62.50%), and
port that people considering their life enjoyable, in most cases least often in the group of the youngest (22.70%).
did not reveal any worries about their future. The Authors The residents of Social Care Houses investigated by the
own investigations confirmed the relationship between the authors of this article, in most cases affirmed to be happy
fear of future and positive assessment of life. It appeared and most satisfied with family contacts. Only a few of them
that in fact the relation in terms of statistics exists, however admitted they would rather not meet their close relatives.
it seems to result rather from a specific attitude to reality The observations indicate that it is just the family who
and life philosophy adopted. Most of the respondents did not provides the elder person with strength for further existence,
consider themselves helpless. That result is a great surprise improves the quality of old age life and makes life worth living.
particularly that they were pensioners of Social Care Houses. The benefits arising from heartwarming family contacts are
The helplessness appeared to be the feeling of significantly incomparable to any other factors and nobody else is able to do
high negative load, difficult to accept. The basis of peaceful as much as the relatives to improve the elder s state of mind.
and enjoyable existence was the feeling of being someone
important and helpful. Helplessness is strictly connected with
the dissatisfaction of life and gets intensified in discontented Conclusions
people. The respondents who admitted they were unable to
cope with misfortunate events on their own, in most cases 1. The quality of pensioners life in Social Care Houses
were among those dissatisfied with their life. In fact, among does not offer happy existence to them.
the respondents satisfied with their life there was no-one 2. The pensioners psycho-social state is poor in Social
claiming to be helpless. In their publication, Gołębiewska Care Houses.
and Sierpińska [13], reported that in an investigated group 3. It seems that Social Care Houses should employ
of younger seniors (age 60 69) there was the lowest percent psychotherapists.
of helpless people (12.10%) and the highest percent of happy
people (65.10%). The investigations of the above authors
revealed that the respondents affirmed their helpfulness in as
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Komentarz nauczania rozszerzonych o zagadnienia geriatryczne nie
tylko studentów medycyny. Fakt ten potwierdzają wyniki
Biorąc pod uwagę starzenie się społeczeństwa na ca- badań niniejszej pracy, w której Autorki, na podstawie spe-
łym świecie, w tym także i w Polsce, temat pracy porusza cjalnej ankiety opracowanej przy współpracy z Zakładem
istotny problem natury społecznej. Z badań Skrzypowskiego Psychologii i Socjologii Lekarskiej PAM, potwierdzają
wynika bowiem, iż liczba ludzi powyżej 60. r.ż. w naszym brak akceptacji przebywania w środowisku obcym, gdzie
kraju przewyższa liczbę dzieci do lat 10 i młodzieży do osoby starsze czują się nieszczęśliwe. Zły jest także ich
lat 20. Prognozy zaś GUS przewidują, że w Polsce w ro- stan psychofizyczny. Liczy się dla nich nie tylko sam fakt
ku 2020 osoby starsze powyżej 60 r.ż. stanowić będą 1/5 posiadania rodziny, ale kontakt z nią.
społeczeństwa. Publikacja ta jest wartościowym opracowaniem przed-
Populacja osób w podeszłym wieku jest bardzo zróż- stawiającym wiedzę potrzebną nie tylko lekarzom różnej
nicowana tak pod względem aktywności fizycznej wydol- specjalności, ponieważ opiekę w Domach Pomocy Spo-
ności organizmu, koordynacji nerwowo-mięśniowej oraz łecznej powinni sprawować także psychoterapeuci i reha-
zmiennych cech psychofizycznych. Ważnym jest zatem bilitanci.
w jakim stopniu osoby te są nie tylko samodzielne ale jak prof. dr hab. n. med. Jadwiga Banach