VOLUME 10, NUMBER 4, 2007

Principles of the Ljubljana Charter and attitudes of the World Health Organization aimed at the health care of elderly
Božidar Voljč

The ministerial conference on health care reforms, organised by the WHO Office for Europe in 1996 in Ljubljana, adopted »The Ljubljana Charter on reforming health care«, with recommendations about how to organise health care systems oriented towards better health and quality of life. The Charter summarises basic values as well as principles among which are enriching the health systems by strengthening ethical values, the quality and cost-effectiveness of work, supporting stable financing, underlining the key role of the primary health care, developing an adequate health policy, respecting the citizens voice and choice, reshaping the performance of health care, introducing different orientations for health care providers, improving the management and learning with experience. All these values and principles can be used to ensure the health needs of all age groups of the population. WHO included the health of the elderly together with the proposed activities for their healthier and active life, as a separate target into the strategy »Health for All«.
In Slovenia the constant increase of its elderly population, accompanied by a lower natality rate, changes both the structure of population and the health needs of the society. Documents and strategies adopted in Slovenia for the organization of the health care of its elderly, are outlined in the principles of the Ljubljana Charter as well as the views of WHO. The article summarises in seven paragraphs the basic points which in accordance with the Charter as well as with WHO should not be neglected in organizing an effective and efficient health care for the elderly.

Key words: aging of population, new health challenges, principles for introduction of changes, quality of health care, ethical values, health for all, active and healthy aging, primary health care, home care, cooperation.

Dependence, independence or inter-dependence? Revisiting the concepts of »care« and »dependency«
Michael Fine, Caroline Glendinning

Research and theory on ‘dependency’ and ‘care-giving’ have to date proceeded along largely separate lines, with little sense that they are exploring and explaining different aspects of the same phenomenon. Research on ‘care’, initially linked to feminism during the early 1980s, has revealed and exposed to public gaze what was hitherto assumed to be a ‘natural’ female activity. Conversely, disability activists and writers who have promoted a social model of disability have seen the language of and the policy focus upon ‘care’ as oppressive and objectifying. ‘Dependency’ is an equally contested concept: sociologists have scrutinised the social construction of dependency; politicians have ascribed negative connotations of passivity; while medical and social policy discourse employs the term in a positivist sense as a measure of physical need for professional intervention. Autonomy and independence, in contrast, are promoted as universal and largely unproblematic goals. These contrasting perspectives have led social theory, research and policies to separate and segregate the worlds of ‘carers’ from those for whom they ‘care’. Drawing on the work of Kittay and others, this paper explores the ways in which sociological perspectives can develop new understanding of the social contexts of ‘care’ and ‘dependence’.

Key words: care, dependency, independence, inter-dependence, disability, ageing

The research on dementia in social work
Jana Mali

The phenomenon dementia was the main subject of research in the field of social work with the elderly at the Faculty of Social Work Ljubljana in the last few years. The research on the work with people suffering from dementia in homes for the elderly (2003–2004) was based on examination the experiences with people with dementia in Slovenian homes for the elderly. We found out that in our homes three different models for the treatment of the residents with dementia were used: the integrated, the segregated and the semi segregated one. Workers encounter numerous problems regarding organisation, space, qualification of workers, lack of normative regulations, and finance. Our suggestions were oriented towards developing a social model of the care for people with dementia. It would be based on individual approach to each person and on collaboration of medical and social profiles of workers on an equal basis. We have also pointed out the need to develop the appropriate network of care for people with dementia who live in the community and decided to research care for people with dementia in the community. The results show that the relatives are exhausted in care for people with dementia, they can not find additional forms of informal and formal help, existent help is not adequate. Social workers use traditional forms of treatment. They offer institutional help for people with dementia.

Key words: persons with dementia, social work with persons with dementia, institutional care, community care.

Examples of good and innovative practices in supporting disabled elderly people and their family carers in the European Union
Hvalič Touzery Simona

This article gives an overview on examples of good and innovative practices in supporting disabled elderly people and their family carers in Europe. These practices can be of great value also to other countries. The examples of good and innovative practices are divided into the following categories: respite care, help to demented people and their carers, help to the family carers, quality standards, alternative to the institutional care, palliative care and hospices, voluntary work, public financing of care, paid leave, new technologies, integrated care, European Carers Charter.

Key words: innovative practices, good practices, family carers, disabled elderly, EU.