Threatening Conditions and Challenges in the Modern Living of the Old People in Republic of Macedonia

The aging is not only a personal but also a social challenge from several aspects, several dimensions; a challenge aiming to build system approaches and solutions with a long term importance. Aims : the main aim of this research is to investigate the conditions and challenges in the modern living of the old people, primarily in terms of the social care. However, this research is concentrated on a big group of the population and their challenges are the most intensive in the modern living. The investigation of the conditions and challenges in the aging are basis and encouragement in realizing the progressive approaches in order to improve the modern living of the old people. The practical aim of the research is a deep investigation and finding important data, analyzing the basic indicators of the conditions, needs and challenges in order to facilitate the old population to get ready for the new life. Methods and techniques: Taking into consideration the complexity of the research problem, the basic methodological approach is performed dominantly by descriptive-analytical method. The basic instrument for getting data in the research is the questionnaire with leading interview for the old people. Results: The research showed that the old people over 70-79 years old in a bigger percentage manifested difficulties primarily related to the functional dependency, respectively 39,33 % of the participants in this category showed concern about some specific functional dependency from the offered categories. The percentage of the stomach diseases with 38,33 % is important, as well as the kidney diseases with 32,83% related to the total population and the category of the old people over 80. Conclusion: The old people very often accept the life as it is, often finding things fulfilled with tolerance and satisfaction. However the health problems of the old people are characterized with a dominant representation. The chronic diseases and the diseases characteristic for the aging are challenge in organizing adequate protection which addresses to taking appropriate regulations, programs and activities.


Introduction
Each period of the human life is followed by challenges and it is characterized basically with specific conditions.In the childhood, the period of youth, adulthood and the period of the old age, the life challenge represents an aspiration to perform income activities which will facilitate finding something unknown followed by curiosity and doubtfulness; something that stands in front of the individual and the future, motivate him to mobilize his inside forces (physical and psychological), to face up the reality, seeking for solutions with more or less success.The individual must get prepared to accept the life, including the obstacles, to enjoy the life or at least to be satisfied with it, even if he accepts the reality as it is.The force of each individual is addressed to face the challenge that the reality brings.It is conditioned by several agentives originated from personal facts or the level of social community development.
The power of accepting the conditions as well as the facing and adapting to the challenges with its individual character, primarily is conditioned by the age, gender, the ethnicity, marital and family status, education, health and other relevant indicators.
The challenges in the old age, respectively the life of the old person is polyvalent in terms of social conditions and social care.In that direction they are conditioned by the place of living of the old person, the service access as well as the access of the institutions for care and support( clubs, centers, advisory office, old people's homes and pensioning houses), the life education and the information technology, legal regulations and similar.
Despite the conditions analysis, the main topic of this research are the challenges in the modern living of the old people, which addresses us to alarming, worrying conditions form one side, and possible most urgent actions addressed to raising the quality of the social care of the old people in Republic of Macedonia, from the other side.
In this research are included 600 old people older than 60 from the both genders.The sample is stratified, respectively the questionnaire is performed in 4 institutions which are supposed to be the most accessible to the old people and those are the family doctors (280 people), old people form Skopje, Kicevo and Strumica, daily centers and clubs in Skopje, Kicevo and Strumica (155 people), pensioning houses in Skopje, Kicevo, and Strumica (60 people) and old people's homes (state and private) in Skopje, Kicevo and Strumica (105 people).At the same time, the sample is designed in accordance with the institutions it is completed as: the family doctors' clinics (280 participants or 47%), clubs and daily centers (155 participants, or 26%), pensioning houses (60 participants or 10%) and old people homes (private and state) (105 participants, or 18%).

Threatening conditions
As each period, as well as the period of aging is followed by conditions which make the living of the old people difficult, and very often it leads to powerlessness.In the younger ages the threatening conditions are more dependent of the errors and mistakes in the way of living or the negative influences in the living environment.
During the period of aging, firstly, in the deeper aging, the threatening conditions mostly are results of the health, physical and social threaten, and the powerless to independently make normal conditions for living.In such condition, the aging is followed by conditions of functional dependence, even more conditions of neglecting and abuse.
The findings for such conditions in aging guide us that there it is needed to investigate these conditions, in terms of building a need for looking for solutions in order to improve the quality of living in the frameworks of the social care.
The results gained from the research will be presented through three basic indicator presented in the following tables: Table no.1. 1 Age and gender and functional dependence of the old people and table no. 1. 2 Health threat of the old people.

Functional dependency
The period of aging, as a last period of the human life, normally leads to decreasing of the human capabilities for work, social communication, as well as personal life care.During these period, in a higher percentage, despite the chronic diseases there are present the conditions of functional dependency which complicate and disable the normal human living.These conditions of aging are influential for investigation in our research.The functional dependency, physical and mental disability are investigated through four indicators: able to walk, limited ability to complete the basic needs, hardy able to walk in wheelchair and disable people.In this table are registered the people able to walk in order to make a realistic analysis of the sample, in terms of this indicator.
The presented data in Table no.1. 1 Age and gender of the old people and the functional dependency, in the three categories of age periods within the research showed that the age of the old people influence the functional dependency.As a result the first age category from 60-69 years showed that the old people able to walk actively participate in the everyday life and regardless the fact that they are pensioners, the find different things to work on (paid or not paid) in order to fulfill their day.Also, the research showed that this category of the population is dedicated to personal health care in terms of healthy food, as well as in terms of health control and support.
The second category, also, is characterized with relatively solid work and health capacity, because it is showed that the more active life of the old people, also leads to existing of the relative capacity, as well a support of the modern medicine and social conditions for living in general, which influence this category of the old people to posses capacity for normal living.However, approximately 1% till 2% of the old people from this category stays functionally dependent within the four indicators of the functional dependency.The functional dependency and the limitations in moving, guides this category to take steps for physical therapy in order to create conditions for normal living.
The investigation showed that the old people over 70-79 years old in a big percentage manifest difficulties in terms of functional dependency, respectively almost 39,33% of the examined people from this category showed concern about some specific functional dependency from the offered categories.
These conditions imply the need to secure direct access and help to the old people over 80 in order to satisfy their needs by health care centers, civil society, and the family including the appropriate social institutions.In that direction it would be very useful to include the need of the specific interventions of this specific category in the legal regulations for social protection of this population.

2 Health threat of the old people
The aging is followed by chronic diseases of the organs as well as of the bones and muscles.These diseases in a specific percentage are result of the aging process, but on the other side they are result of the untimely and inadequate health care of the old people.
Consequently, in the investigation of the conditions and challenges in the modern living of the old people necessarily is included the health threat in order to get basic knowledge of the health capacity, and at the same time to analyze the conditions and challenges for the further strategies, civil society in this scope.
In this research we decided to investigate the most common diseases of the old people in term of hearth diseases, diseases of the lungs, kidneys, stomach as well as brain and neural diseases.
While investigating these indicators we used the statement that the old people related to their health, primarily in terms of medicines they consume every day.The data about the health threat are presented in the The research showed that a significant percentage of the old people suffer hearth diseases, 71%, and we guess that the hearth diseases and the blood cells diseases are the most present.The values of the × ² and the intensity of the contingency show that there is an important statistical correlation between the old people and the health threat.
The percentage of the stomach diseases with 38,33 % is important, as well as the kidney diseases with 32,83% related to the total population and the category of the old people over 80.
The brain and neural diseases of the total examined population are represented with 19,5 % of the participants who declared that they suffer from brain and neural diseases, whereas the third age category shows a higher percentage 10,16% of the old people.
These conditions of the health threat lead to the conclusion that the aging as a period is characterized with more chronic diseases which must lead to taking appropriate steps, programs and activities primarily in terms of the medicine in order to help this population.

Conclusion:
The investigation confirmed the importance of the hypothesis that the subjective approaches of the old people in the modern living influence the organization and the realization of the social care.
The data presented in the Tables confirms the prediction that the old people mostly accept the life as it is, and they find interesting things to do when they consider themselves in a difficult situation.We analyzed out of the participants' declarations that the social communication through the stated indicators confirms the huge importance of the quality of living, consequently the proper manifestation of the social care towards the old person.This condition impose the necessity that the old people over 80 must have organized access and help in satisfying their needs by the health services, nongovernmental organizations, the family including the appropriate social institutions.In that direction it would be very useful the necessities by categories to be included in the law regulations for social protection of this population.
The conditions of the health threat leads us to the conclusion that the aging as a life period is characterized with more chronic diseases and there must be taken appropriate steps and there must be realized programs and activities, primarily in terms of the medicine in order to help this population.Despite the calmness and the tolerance of the old people in the communication with the above mentioned communities and services, still a significant percentage of them are feeling neglected which often leads to situation to decrease the contacts or completely give up from them.
Consequently, one of the main conclusions in this research is raising the level of consciousness for humanity, tolerance and respect towards the old people, setting legal regulations for overcoming these problems as well as establishing a public health nursing of medical staff and social workers similar to the family health nursing and the public health nursing for new born babies.
At the end of our data analysis from the research and the presented data in the tables for the conditions and challenges of the old people in terms of social care, we can conclude that the old people are very important category of the population in terms of demographic features and they have their own specific social, health, economic and cultural needs and characteristics, which make them a specific social group, but on the other side it is analyzed the need of bigger social care related the specificity and the quality of living which necessarily impose specific organization, approaches and normative regulation. LITERATURE

Table no .
1. 1 Age and gender of the functional dependency of the old people Table no.1. 2 Health threat of the old people

Table no .
1. 2 Health threat of the old people in terms of age and gender