郑州轻工业学院
本科毕业设计（论文）
文献翻译
题 目： 郑州市日间照料中心发展
现状状及存在问题研究
学生姓名： 张 飞 专业班级： 劳动与社会保障11级1班 学 号： 541109040144 院 （系）: 政法学院 指导教师(职称): 杨岚（讲师） 完成时间: 2015年 4月 1日
Assessing the needs of older people in Albania
Background
According to the information provided by the National Institute of Statistics (INSTAT), the proportion of the population over 65 years of age in Albania has reached 12%in 2010.Furthermore, projections suggest that the proportion of older people in Albania will double over the next 35 years. Coupled with falling birth rates and increasing life expectancy, this will eventually lead to a substantial reduction of the economically active proportion of the population. At the same time, high levels of chronic illness, a huge burden of avoidable disability, economic deprivation and a lack of social opportunities mean that most elderly people in Albania are in a struggle to survive rather than enjoying the personal and social possibilities common in many other European countries. Consequently, the Albanian society as a whole is deprived of much of the contribution it could gain from the experience of its older citizens.
Demographic trends mixed with a society in economic and political transition raise concerns about increasing needs for care and social inclusion of older people in Albania. Moreover, there is a low level of preparation of the Albanian society to cope with chronic diseases and long-term care. Complex policies and actions should be considered by a number of stake holders, including government and civic society in Albania.
Aim and Objectives of the research work
The aim of the current study was to obtain relevant information in order to respond to needs of older people as they see them. Specific objectives of the research work were as follows:
To assess the quality of social services and health care services for elderly people from their perspective.
To assess the difficulties and potential barriers of elderly people to access social services and health care services in Albania.
To understand the determinants and the link between formal care, informal care and
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social services for elderly people in Albania.
To assess and identify the appropriate strategies for involving older persons in taking decisions self empowerment.
Methodology
Participatory research: the approach of this study consisted of a close collaboration with and direct involvement of older people in all activities of the research work. This approach has the potential to address the needs of older persons as felt by the older persons themselves, in their own environment and during a long period of time. Qualitative research methodology was employed consisting of focus groups and in-depth inter views, as described below: Focus group discussions were conducted in all prefectures of Albania involving old people aged 65+ years (there are 12 major administrative units in Albania referred to as
prefectures).Overall, 12 focus groups were conducted one in each prefecture of Albania. The overall number of participants in the focus groups was 107 (on average, there were 9 participants in each focus group).Detailed notes were taken from all focus group discussions for later analysis. It must be emphasized that all notes from the focus group
discussions were typed in an anonymous manner (i.e. all identifying information including participants names was removed).Immediately after each focus group discussion, the facilitator and note taker met with each-other in order to review the main themes of the discussion. The main patterns of responses were subsequently summarized. Responses from the discussions were analyzed by arranging the min the general categories identified in the inter view guide. After arrangement of responses, the different positions or opinions were identified.
The experts performing the qualitative data analysis summarized the various opinions, assessed the degree of consensus or differences expressed by the groups and synthesized the themes or patterns that emerged from the information collected in the focus-groups. In-depth interviews were also conducted with key informants working in senior leadership positions at local government and/or district social insurance institutes (which are branches of the Albanian Ministry of Labor and Social Welfare).The aim of in-depth inter views was to obtain additional and valuable information related to elderly peoples social and health needs,
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barriers to access services, and level of decision making and social participation in the Albanian society.
Focus groups with old people
The main themes that emerged from focus-group discussions with old people are summarized below:
Socioeconomic situation of old people:
According to participants in the focus groups, the elderly people in Albania face many financial challenges and socioeconomic problems which are worsened by the rapid transition from a centralized system towards a market-oriented economy which is associated with serious difficulties for this vulnerable segment of the population. Old people feel even more frustrated from the fact that both the local and central institutions (such as e.g. the National Institute of Statistics) claim that elderly people are not the most socioeconomic disadvantaged age-group of the population (according to these institutions, small children are the most disadvantaged population subgroup), which poses serious difficulties for the work carried out by the institutions, agencies, civil society and non-governmental associations working with elderly people in Albania.
Elderly people expressed similar concerns, problems and distress related to their poor socioeconomic conditions. The lack of money even for simple survival was one of the key complaints in almost all of the focus group discussions. Thus, old people reported that after they pay the bills for electricity and running water, they are left with insufficient money for food and essential medications which they need for treatment of several chronic conditions such as high blood pressure, cardiovascular disease, diabetes, gastrointestinal problems and many other diseases which they currently suffer from. The pretty low standard of living is quite obvious and is a daily source of economic and psychosocial distress for most of elderly people in Albania. Consistent with prior reports, the overall monthly income (including social pension and other sources of income available) reported by elderly people residing in urban areas was on average below100 ,whereas in rural areas it was below50 . Elderly people living in urban areas though have a somewhat better standard of living compared with those who live in rural areas.
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Health status of old people:
Similar concerns were expressed by elderly people with regard to the health status and health care services. Elderly people residing in urban areas have a better access to health care services, whereas those living in rural areas face serious difficulties to access health services. The lack of afford ability of medications is a serious concern expressed by almost all elderly persons. Thus, the vast majority of elderly people have no money to buy the prescribed drugs. Those who can afford have nevertheless to choose the cheapest drugs which are often ineffective to control such chronic conditions as hypertension, cardiovascular diseases, or diabetes. As a result, compatible with prior reports, chronic diseases are not kept under control and the health conditions of many elderly people tend to worsen due to ineffective treatment. This was felt by most of participants who attended the focus group discussions. Self-perceived image and social position of old people:
According to perceptions of old people, historically, the elderly have been respected and well-recognized in the Albanian society. They have been appreciated for their authoritative work, wisdom, dignity and experience accumulated during their lifetime. However, according to old peoples feelings and perceptions from focus group discussions, this is not the case in the new system (alias the transitional period from the former communist regime into a market-oriented system)where old people feel that the society considers this segment of the population as a huge economic burden and a futile subgroup for the society on the whole. According to old people, this is especially the case for women who are often victims of negative stereotypes: instead of being recognized for their values, skills, capability and contribution, old women in Albania are not appreciated and excluded from the society both at local and national levels. Furthermore, in old people s view, media is not playing its role in promoting old women values and their huge potential for contributing in decision making and participation in the Albanian society.
Thus, regarding social contacts and social networks, elderly people tended to express family and community negligence. The lack of sufficient respect is the most frustrating issue according to the perceptions and feelings of elderly people. Most of the elderly people reported that they hardly get any chances to actively contribute and to be included
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