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Abstract
Isohanni M. An old people's home as a therapeutic community.
The therapeutic community method is generally applied in the treatment of institutionalized psychiatric patients, but its application is very limited in the care of old people. In our post-industrial society the number of elderly people is continously increasing. As a consequence of the expanding of the age pyramid at its apex, the need for high-quality institutional care for the elderly is increasing. This was one of the major background factors which initiated an action research at a Finnish old people's home in 1983; its aim was to resolve whether therapeutic community principles could be applied. The results suggest that many classical therapeutic community practices are useful, although in the everyday programme possible senility, the need for rest, and cognitive limitatins among elderly residents must be taken into consideration. Most elderly people in an old people's therapeutic community are appreciative residents. The general atmosphere is usually good and the quality of the resident's life is relatively hight. The outcome evaluation of the action research showed that 20% of the elderly had a very good outcome, 42% good, 27% satisfactory and while had an 11% ambivalent outcome. Residents with mental health problems and elderly men did not adapt to the therapeutic community as well as others, but somatically handicapped, demented and behaviour problem residents did. In another part of the evaluation study the organizational maturity of the old people's therapeutic community was compared with the forty other traditional old people's homes in the same territory. The results suggest that in all organizational sub-processes - housing, treatment, administration, team work, know-how -the old people's therapeutic community functioned significantly better than the controls, namely traditional old people's homes.