Research Principles in Social Work for Sustainable Human in Long-Term Care for Older People

Abstract

The well-being of older people is the main goal of research on the needs of older people in social work. To ensure the autonomy and integrity of older people in need of care, the various helping professions must develop and apply ethically sensitive methodological approaches in research and in the development and implementation of practises today and in the future. In alienated systems of care, many people lose their humanity. As social work professionals, we need to understand philosophies of care and people’s daily lives from multiple perspectives. A comprehensive insight into the lives of older people is only possible if we use participatory dialog, respect people’s autonomy, and understand life on the planet as inseparable from all forms of the environment. Research, as the main human strategy to understand life, is a tool to get in touch with people’s everyday knowledge and inner wisdom, which are indispensable sources for creating an ecologically and socially sustainable human society. It discusses in an exploratory manner the development of the global aging and sustainable development agendas, the concepts of intergenerational solidarity and human needs, and discuss the principles of human needs research from a social work perspective.

1. Introduction

With social work research, we strive to understand everyday life situations as the mission of social work is to develop the well-being of all people in pursuit of a socially just society that respects human dignity and autonomy [1, 2]. The most fundamental task of social work is to help and support people in moments of distress in their lives. As social work professionals, we are daily entering people’s lives and our interventions always have an impact on people’s futures. We cannot respond to any challenge without considering all the possible impacts of our intervention on people’s lives. Article 9.7 of the Global Statement of Ethical Principles of Social Work states, “Decisions should always be based on empirical evidence; practice wisdom, and ethical, legal, and cultural considerations. Social workers must be prepared to be transparent about the reasons for their decisions [1]. This ethical principle burdens social workers on a professional and personal level, causing our lives to be permeated with constant re-evaluation of our professional practice and endless self-questioning about the appropriateness of our decisions and motives. Social work, like other helping professions, is confronted with the immense human suffering in the world today. The world is in the midst of a deep and global political, environmental, and social crisis that threatens basic security conditions and is unable to meet the basic needs of its growing population [3, 4, 5]. Billions of people are struggling; hundreds of millions are at risk of hunger and even famine. People in the richest countries can expect to live up to 30 years longer than people in the poorest countries. Countries in the Global South are drowning in debt, and poverty and hunger are increasing, while they face the growing impacts of the climate crisis – a case study in inequality [5].

Period	Global aging policy documents	Global sustainable development policy documents
1948–1999	1948 (UN) Universal Declaration of Human Rights; 1982 (WHO) World Assembly on the Elderly; 1991 (UN) The United Nations Principles for Older Persons Resolution	1987 (WCED). Our Common Future: Brundtland Report
2000–2014	2002 (WHO) Active aging: a policy framework; 2002 (UN) Madrid International Plan of Action on Aging: Report of the Second World Assembly on Aging; 2002 (UNECE) Berlin Ministerial Declaration: A society for all ages in the UNECE region; 2002 (UNECE) Regional Implementation Strategy for the Madrid international plan of action on aging; 2007 (UNECE) León Ministerial Declaration: A society for all ages: challenges and opportunities 2007 (UNECE) Implementation of the Madrid International Plan of Action on Aging in the UNECE region: Review of the first 5 years; 2012 (UNECE) Vienna Ministerial Declaration: Ensuring a society for all ages: Promoting quality of life and active aging; 2012 (UNECE) Second Review and Appraisal of the Regional Implementation Strategy of the Madrid Plan of Action on Aging (MIPAA/RIS): Synthesis Report on the implementation of the Madrid International Plan of Action on Aging in the UNECE Region	2000 (UN) United Nations Millennium Declaration: Millennium Development Goals
2015–2030	2017 (WHO) Global strategy and action plan on aging and health; 2017 (UNECE). Lisbon Ministerial Declaration: A Sustainable Society for All Ages: Realizing the potential of living longer: Ensuring a society for all ages: Promoting quality of life and active aging; 2017 (UNECE). Synthesis Report on the implementation of the Madrid International Plan of Action on Aging in the ECE region between 2012 and 2017; 2017 (UNDP). Aging, Older Persons and the 2030 Agenda for Sustainable Development; 2017 (UNFPA). Aging in the Twenty-First Century: A Celebration and A Challenge; 2019 (WHO) Global campaign to combat ageism; 2020 (WHO) Decade of healthy aging: baseline report; 2022 (WHO) Aging and Health; 2022 (UN) Rome Ministerial Declaration: A Sustainable World for All Ages: Joining Forces for Solidarity and Equal Opportunities Throughout Life; 2022 (UNECE): Aging Policy in Europe, North America, and Central Asia in 2017–2022: Synthesis Report on the implementation of the Madrid International Plan of Action on Aging in the ECE region between 2017 and 2022; 2022: (UN) MIPAA/RIS + 20 20 years of action toward creating societies for all ages in the UNECE region	2015 (UN) Transforming our world: the 2030 Agenda for Sustainable Development; 2021 (UN) Our Common Agenda – Report of the Secretary-General; 2023 (UN) Global Sustainable Development Report 2023, Advance, United version

Table 1.

The chronology of WHO and UN aging and sustainable development policy documents adoption.

War conflicts, health crises, natural disasters, the violation of basic human rights, and the destruction of our planet’s ecosystem are interrelated and interdependent problems. We can observe the struggle for the remaining natural and human resources. Planet Earth is “shrinking” into a “glocal village”. The biophysical boundaries of the planet are being exceeded, and along with destructive human activities (imposed aggression, violence, exploitation), climate change is the most dangerous threat to the natural environment and societies [5]. In today’s context of ecological and humanitarian crises, humanity faces a double task: on the one hand, to ensure absolute respect for the human rights inherent in all people, and on the other hand, to respect the planet as an indisputable value in itself. The area where sustainable development issues and global security challenges are most relevant is the issue of population aging, as this phenomenon involves a range of changes that communities around the world are dealing with differently.

The increasing aging of the population is a particular challenge in today’s uncertain world. According to the World Health Organization (WHO), by 2030, one in six people in the world will be 60 years of age or older. WHO predicts that the proportion of the world’s population over 60 will nearly double between 2015 and 2050, from 12–22%, and that by that time, two-thirds of those over 60 will live in low- and middle-income countries [6]. The interest of policymakers, civil society, scientists, and other relevant actors in observing and responding to the trend of population aging is not uniform but reflects different aspects. Debates on aging range from the more humanistic, cultural, and philosophical to the political, economic, health, and social, contributing to the creation of perspectives that influence society’s perception of the topic and legitimize various dimensions of aging. The topic is interesting for social work from many angles: from the individual personal life course as well as from the societal level. It is important for social work to understand the micro, mezzo, and macro frameworks within which the discipline itself develops theories and practices to address the needs of older people. To better understand the role of social work and social work research in aging and long-term care in the context of global policy agendas for aging and sustainability development, the following research questions are discussed in the chapter:

1. What are the characteristics of global policy agendas on aging and sustainable development, how have these global policies evolved, and how are the needs of older people and intergenerational solidarity addressed in these documents?

2. What research principles of social work are important to create a deeper knowledge about the needs of older people and to understand the everyday experiences of older people as an opportunity for the development of an ecologically and socially just society?

The methodology used to answer the research questions is a combination of literature review, textual analysis, and interpretive discussion. The results are presented in two parts:

The first part of the paper answers the first research question and presents the results of the review¹ of global policy documents and the results of the textual analysis of global documents on the occurrence and description of older people’s needs and intergenerational solidarity as themes or concepts in these documents.

The second part of the paper answers the second research question and presents a critical discussion of the findings of global policy document review, current perceptions of the needs of older people, and long-term care models in the context of social work research ethics and principles developed through practical research experience.²

2. Global agendas for aging and sustainable development as a policy framework for the daily lives of older people

The increasing aging of the population is considered one of the greatest global and sustainable challenges, and many questions arise about how society should adapt to this situation [3, 7, 8, 9, 10]. A general overview of global policy attention reveals a focus on questions such as: How should society meet the needs of the growing number of older people? How can sustainable public budgets and health and social security systems be created to meet the needs of older people? How can areas of daily life, work, financial markets, education, housing, long-term care, and transportation be adapted to prevent exploitation of the natural and human worlds? How can an adequate quality of life be provided for people living today without endangering future generations?

The growth of an aging population and the environmental crisis entered the public debate as separate issues, but since the early 1970s, they have frequently appeared together in legal and policy documents and in the research literature. In particular, the definition of sustainable development written in the “Brundtland Report” in 1987 [10] inevitably links the two issues: “Humanity has the ability to make development sustainable, that is, to ensure that it meets the needs of the present without compromising the ability of future generations to meet their own needs” [11, 12, 13, 14]. The most commonly cited classical definition of sustainable development, which focuses on needs-based approaches and intergenerational equity, provides common ground for both agendas. It established the principle of intergenerational justice in meeting human needs as the guiding principle of sustainable development and the promotion of intergenerational solidarity as one of the objectives of aging policies. In this way, intergenerational solidarity becomes a fundamental guarantee for meeting the needs of all generations, and meeting the needs of current and future generations becomes the central theme of the politics of aging and sustainable development [10]. Thus, intergenerational solidarity, as social cohesion between generations at the societal and community levels, and especially within families, has become, on the one hand, an important principle of integrated environmental, economic, and social strategies in the development agenda, and, on the other hand, a key objective of global aging policies.

Although the sustainable development definition is strong in its value perspective, it includes two elusive concepts, intergenerational solidarity, and human needs, opening up endless possibilities for interpretation. In particular, the concept of human needs has taken a self-evident deterministic position in people’s perceptions, as the satisfaction of human needs has become synonymous with well-being. Over the decades of welfare policy development, the concept of human needs has found its place in political, professional, and everyday language as a generalized concept [11, 12, 13, 14, 15]. It is, therefore, no exaggeration to say that meeting human needs is a stated professional goal in all social and health professions, that all policy programs identify meeting human needs as their goal, and that ordinary people would argue that meeting needs activates them in their daily lives [15, 16].

The concept of universal human needs is linked to the concept of human rights and is presented as such in the policy on aging [17, 18, 19, 20, 21]. The universality of needs is based on the belief that all people everywhere in the world, at all times, in the present and in the future, have certain basic needs and that these needs must be met in order to avoid serious harm to an objective nature, to participate in society, and to think critically about the conditions in which they find themselves [17, 18, 19, 20]. The recognition of universal human needs as human rights is associated with the adoption of the Declaration of Human Rights [21]. However, it took several decades for the needs and rights of older people to be concretely addressed at the global level. The decisive moment was a “World Assembly on the Elderly” organized in 1982 in Vienna on the initiative of the United Nations (UN) [21]. The Assembly was a milestone in the creation of a global policy instrument on aging. The Vienna International Plan of Action on Aging [22] became the most important document that raised awareness of the need for special protection of the human rights of older persons and of the responsibility of states to respond to the needs of older populations. This document recognized aging as one of the most important social, economic, and demographic phenomena of modern times. It included the following areas: health and nutrition, protection of older consumers, housing and environment, family, social assistance, income security and employment, and education. Its recommendations included preventing the segregation of older people, providing home-based care for older people, rejecting stereotypical concepts in government policy, and recognizing the value of age.

The next important milestone was the adaptation of the United Nations Principles for Older Persons in 1991 [23]. By defining human principles such as independence, participation, care, self-fulfillment, and dignity of older people as their fundamental rights, this document provides a guide for understanding the well-being of older people and becomes a global document in the development of aging policy. It influenced all further international and regional documents, including the Madrid International Plan of Action on Aging (MIPAA) which was adopted at the Second World Conference on Aging, in Madrid in 2002 [24]. The three priority areas identified in Madrid were development, health and well-being, and an enabling and supportive environment. In the same year, a Regional Implementation Strategy (RIS) [25] was also adopted at the United Nations Economy Commission for Europe (UNECE) Ministerial Conference on Aging in Berlin. The strategy contains a set of concrete actions in the form of 10 commitments.³ The MIPPA/RIS called for a change in attitudes, policies, and practices to ensure that older people are seen not just as welfare recipients but as active participants in the development process whose rights must be respected. The document, entitled “Building a Society for All Ages,” therefore offered a blueprint for responding to population aging in the 21st century [24].

The tenth anniversary of the adoption of MIPAA/RIS was celebrated in Vienna in 2012 under the theme ”Ensuring a society for all ages: promoting quality of life and active aging [26]. The conference adopted four priority goals: (1) promoting long working lives and maintaining working capacity; (2) promoting participation, non-discrimination, and social inclusion of older people; (3) promoting and protecting dignity, health, and independence in old age; (4) maintaining and strengthening intergenerational solidarity. Five years later, the 2017 Lisbon Ministerial Declaration on Aging, under the theme “Realizing the potential of living longer to achieve a sustainable society for all ages,” reaffirmed three priority goals in slightly reverse order: (1) recognizing the potential of older people; (2) promoting longer working lives and ability to work; (3) ensuring aging with dignity [27]. In 2022, the Ministerial Conference was held in Rome under the title “A Sustainable World for All Ages.” Joining Forces for Solidarity and Equal Opportunities Throughout Life” adjust the priority goals in the following order: (1). promoting active and healthy aging throughout life; (2). ensuring access to long-term care and support for family and family caregivers; (3). mainstreaming aging to advance society for all ages [7].

In the meantime, international sustainable development policies have gradually taken into account the issue of aging populations, starting with “Our Common Future” [10] and at the turn of the millennium from the 20th to the 21st century with the Millennium Development Goals in 2000 [28] and in 2015 with the adaptation of the 2030 Agenda for Sustainable Development – “Transforming our world” [29]. At the heart of the sustainable development perspective is the consideration of older people and their needs in terms of their contribution to society in order to achieve sustainable development in a balanced way [28, 29]. The 2030 Agenda calls for ‘leaving no one behind’ and recognizes that older people are among the most vulnerable and need special attention. It calls for the aging agenda to be mainstreamed into all policies and programs, as all segments of society should be involved in achieving the Sustainable Development Goals (SDGs)⁴ [29].

From a sustainable development perspective, aging is likely to have far-reaching impacts on all sectors of society, including labor markets, financial and health systems, political participation, demand for goods and services, urban planning and infrastructure development, and family structures and intergenerational relations [30]. The implementation of the SDGs is consistent with the implementation of aging policies: in order to prepare society for the economic and social changes associated with aging and old age, the necessary conditions must be created to enable older people to lead self-determined, healthy, and productive lives and to enable them to exercise their right to make decisions and choices in all areas that affect their lives [30].

2.1 The political narrative on aging and intergenerational solidarity

The concept of intergenerational solidarity links the issues of sustainability and aging, particularly in the area of the social and economic impact of population aging on sustainable development, in order to protect the rights and needs of future generations while meeting the needs of today’s older people. Intergenerational solidarity is directly related to society’s current attempt to act and develop under the paradigm of sustainability. Sustainability itself has a moral core that relates to equity and points to the intergenerational obligation of today’s people to “strive for development that meets the needs of the present without compromising the ability of future generations to meet their own needs” [10].

At the turn of the millennium, younger and older generations had reciprocal relationships in aging policy documents, both responsible for caring for each other, e.g., the opening paragraph of the 2002 Madrid Report of the Second World Assembly on Aging states, “We recognize the need to strengthen intergenerational solidarity and partnerships, taking into account the special needs of both older and younger people, and to promote intergenerational relationships based on reciprocity” [24].

The rhetoric in sustainable development documents is less conciliatory toward current generations, emphasizing the rights of unborn generations under the threat of “profligacy “by living generations that are “rapidly closing options for future generations”. In particular, there is a frustration on the side of sustainable development and environmental protection that has persisted since 1987 when the World Commission on Environment and Development determined that drastic action was needed [31]. Current sustainability documents emphasize that there is no sign of major improvements and that the world must think about future generations who, by definition, are not represented in today’s decision-making and cannot articulate their needs [31].

From the perspective of old-age policy, it is interesting to note how intergenerational solidarity has become an important policy objective over the decades. For example, analysis of the MIPAA/RIS synthesis reports shows how intergenerational solidarity became a focus of aging policy and a goal in itself. In the first two implementation cycles (2002–2012), intergenerational solidarity activities can be found mainly in the areas of activities against age discrimination, promoting the integration of older people into society, and supporting families in caring for older people [26, 31]. Especially in 2007–2012, during the global financial and economic crisis, the issue of intergenerational solidarity was mainly addressed in the areas of social security system transformation, health care improvement, mainstreaming of aging, and labor market adjustment [32, 33, 34].

Older generations were seen at the time as an economically strong cohort that could contribute to economic growth after the years of the global financial crisis. Intensive policy efforts were made at the time to refute the notion that older people were a burden on society: “As Europeans live longer and healthier lives, governments are looking for ways to increase older people’s involvement in society and keep them active; these changes could lead to economic benefits for society as a whole” [29]. For example, the United Nations Population Fund (UNFPA) report states, “Our collective future is one in which there will be more older people than children […] Political will is needed to ensure that aging is a time of opportunity for all” [35]. In the last decade (2012–2022), intergenerational solidarity has been established as a specific goal of aging policy and has become the focus of action plans [3, 4, 7, 8, 34, 36].

In the political rhetoric of aging, intergenerational solidarity has recently been more closely linked to the sustainable development agenda, and current generations are expected to protect natural and economic conditions for future generations. It is recognized that older people can participate in society not only financially, but also through their voluntary contribution to caring for younger generations or through other forms of active participation in all areas of life (e.g., culture, education, family care, etc.). The intergenerational solidarity as an influential principle had an important impact on economic development and the development of alternatives in the field of welfare and health care. The importance of intergenerational solidarity is particularly seen in the area of financially sustainable social protection and welfare systems, active engagement of older people in society, promotion of healthy aging and independent living, and promotion of a positive image of aging. The last MIPPA/RIS decade has promoted deinstitutionalization and ‘aging in place’ (various forms, such as intergenerational or assisted living), as well as the use of technology and digitization as a means for older people to live independently in the community [7].

2.1.1 Shift from active aging toward healthy aging policy agenda

Currently, the most important document in the field of aging policy is the Decade of Healthy Aging (2021–2030)⁵ [9]. The Decade of Healthy Aging is in line with all major global documents on aging and sustainable development. Healthy aging is defined as “the process of developing and maintaining the functional capabilities that enable well-being in older age” [9], This document introduces the “ policy agenda of ‘healthy aging’ as a new conceptual model in the field of aging policy. ‘Healthy aging’ replaces the World Health Organization’s previous focus on ‘active aging,’ a policy framework developed in 2002 [19]. The concept of active aging was primarily about expecting physically active older people to participate not only in working life but also in social, economic, cultural, spiritual, and civic affairs. Like active aging, healthy aging emphasizes the expectation that older people remain a resource for their families, communities, and the economy, but now the focus is on older people’s abilities to meet their basic needs in order to realize their visions of living with dignity [9].

The capabilities model used in the current aging policy combines three components of healthy aging: the intrinsic capabilities of the individual, the environment in which a person lives, and the way people interact with their environment [9]. This concept of aging introduces a functioning-based approach to aging policy. The functioning-based approach, as the most basic ability of older people to manage and meet their immediate and future needs, determines their ability to provide an adequate standard of living. This ability includes ensuring that older people can afford adequate food, clothing, suitable housing, and health and care services. The concept of healthy aging focuses on the ability of older people to meet their basic needs and assumes that older people have the desire to contribute to society and are willing to achieve their personal goals for well-being. Functioning is understood as the set of capabilities that enable all people to be and do what they rightly value. Because people’s abilities change over the life course, the capabilities approach focuses on the abilities of older people to minimize the impact of changes that may be associated with illness, disability, loss of financial or social networks, or livelihood.

2.1.2 Normative and economistic view of older people needs

Analysis of selected documents reveals a trend of customization of goals from one implementation cycle to the next, following changes in the global socioeconomic situation (e.g., the world has gone through a deep financial and health crisis and faces global security, political, and environmental crises) and instrumentalizing global policy documents for adaptation in regional and national policies. The needs of older people are placed in the context of broader and mostly pragmatic issues, such as the sustainability of social security systems, the challenges of an aging workforce and a declining number of working-age people, higher demand for health and social care services, and long-term care, and thus the need for more trained health and social care professionals. All of these issues have become common topics of public and private discussion in more than 50 years of global aging policies and sustainable development, and as such have influenced the rhetoric of human needs and intergenerational solidarity. Older people have an image as a consumer cohort that is both attractive to the care industry and a constant threat to future generations due to their growing needs.

Human needs are argued in the global policy agenda as an ethical imperative based on human rights. This policy advocates the model of universal human needs and that there is a collective responsibility for the optimal use of natural and human resources to meet human needs. Human needs are addressed in the Decade of Healthy Aging through a capability approach. The capability approach understands human well-being in terms of essential freedoms and opportunities that people possess [13]. The freedom to achieve well-being is a matter of what people can do and be and thus creates a moral framework for assessing whether a person has certain competencies and whether there are opportunities in their environment to live well [18]. However, the rhetoric of universal human needs in this policy overlaps with economic and moral rhetoric. The current politics of aging implies an exclusively economistic view of human need satisfaction, as the “subject” should tend to be self-sufficient in meeting his or her needs through participation in the economy and the free market.

The capacity approach to human functioning is based on the assumption that people will do whatever it takes to fulfill their identity project and does not allow for critical reflection on the consumerist nature of contemporary identity formation. Consequently, the function-based approach neglects the limits of sustainability by failing to provide much-needed critical reflection on non-finite consumption, and by providing little space for reflection on preferred choices for satisfying needs. Using the capability model as a counterpart to the deficit model, an aging policy cannot move beyond “repeating the same”. Although the ability concept advocates autonomy and the freedom of individuals to make their own decisions about their lives, it establishes a normative logic of standardized abilities that a person must have in order to be recognized as capable of participating successfully in society.

2.1.3 Politicization of intergenerational responsibility

Healthy aging as a political concept is an economic and moral justification for enacting policies and seeking programs to promote how to age well. By avoiding harmful behaviors, people demonstrate their commitment to taking responsibility for their own health and the health of others. The concept of healthy aging places the responsibility on people to strive to make healthy choices throughout their lives and, if they are in good health, helps to reduce the cost of health care in old age [37, 38]. The older generation is portrayed as a large group that can be a strong economic force in society: ”The available evidence suggests that caring for older people is not as costly to finance and that older people, especially when healthy and active, provide significant economic and societal benefits, e.g., through direct participation in the formal and informal labour force, through taxes and consumption, social security contributions, through transfers of money and assets to younger generations, volunteering, etc. [18]. Key issues in the development of long-term care are therefore accompanied by an emphasis on opportunities for the economy. ‘Opportunity’ is a magic word used in the politics of aging and sustainability.

Intergenerational solidarity is a cultural and religious value that has been present in the relationships between family and community members since the existence of humanity. It is a basic requirement for communities to survive at all. The analysis of the main international documents on aging and sustainable development shows the politicization of the principle of intergenerational solidarity. In international strategies and action plans, it has become an alienated political goal over the last 50 years. For example, the documents analyzed report the exclusion and vulnerability of older people during the COVID-19 pandemic, although intergenerational solidarity is a catchword in policy documents. Declared goals are not a guarantee of their implementation. However, on the sustainable development side of global politics, the search for a response to implement intergenerational solidarity as a sentiment and value of humanity is evident: “A new global contract to provide global public goods and address major risks” is needed: “A renewed social contract at the national level and greater intergenerational solidarity must find expression in a new contract at the global level” [31].

The political rhetoric of international declarations is based on the principle of intergenerational justice – the recognition of responsibility toward future generations. Under phrases such as “ensuring a society for all ages”, “a sustainable world for all ages,” or “our common future”, “leaving no one behind,” or “transforming our future,” features of shared responsibility and a moral duty of all people can be discerned. At the same time, however, the strategies and goals in these documents reveal a continued individualization of health or social risks and a moral panic about older people who might not benefit society in old age because of their economic or health impairments. The politics of aging and sustainable development are inherently contradictory because there is an expectation of a more modest life while at the same time, there is constant pressure on people to participate in the economic race. The moral appeal to all people of all generations is presented as an individual ”debt“ to future generations, with no thought given to how consumer culture is sustained in a forced global market economy.

3. Principles of social work research to deepen knowledge of understanding the needs of older people

Political statements about older people have a strong influence on the perception of older people in society. The dominant discourses of science, if they do not critically engage with their own production of knowledge, might also remain trapped in the dominant forms of objectifying knowledge and political ideologies [39, 40, 41, 42, 43]. Social work research faces the challenge of creating critical reference points to taken-for-granted constructions of reality and deciphering given meanings. Generalized political discourse is an interpretatively narrow and regulated language [40, 42]. Objectifying reality in a generalized, universalistic, and technical political language facilitates an easy adaptation into mainstream public narratives. Indeed, global political documents exhibit all the attributes of metanarratives that create a comprehensive and universal truth as a grand theory [39, 41]. This kind of political language creeps into everyday language and triggers a “looping effect” of self-referential descriptions of reality [42]. Generalized language in global policy documents influences not only the attitudes and opinions of ordinary people but also the discourses of academia and experts [41]. Expert texts tend to translate lived human experience into a linguistic form acceptable to relations of domination [44]. The production of knowledge is always a political act and a manifestation of a privileged position in society. The words of the dominant narrative have immense power in people’s lives and ‘leave their mark everywhere’ [39, 41]. Influencing the interpretation of reality is indeed the most powerful position in society.

Critical theories in social work point to the problem of traditional ‘universal truth’ [45, 46]. There are ‘voices that are traditionally silenced’ [45, 46, 47]. Correcting deficient forms of interpretation can only be done by recognizing people’s particular knowledge and using language that is sensitive to lived experience [44, 47, 48]. The lack of interpretive schemes is not only related to taboo subjects (not talked about out loud) but part of the silence is related to maintaining the status quo in a society [47, 49, 50, 51]. For example, the political metarhetoric of integrating older people into society by emphasizing happy and healthy aging silences the voices of the less happy and less affluent older people as ‘social problems’.

Social work as a value-based profession derives entirely from the principles of human rights and the improvement of social well-being and quality of life for all people [48, 49, 51]. The global definition of social work explains in detail the mission of social work, “Social work is a practise-based profession and an academic discipline that promotes social change and development, social cohesion, and human empowerment and liberation. The principles of social justice, human rights, collective responsibility, and respect for diversity are central to social work. Drawing on theories of social work, social sciences, humanities, and indigenous knowledge, social work engages people and structures to address life’s challenges and improve well-being” [2].

The definition of social work promotes a holistic person-in-environment approach to social work, and in order to accomplish the complex task, social workers must grasp people’s real-life situations from all possible angles [44, 51, 52]. Social work research is an inevitable part and the first step in the social work mission for improving the well-being of people. Therefore, the premise of social work research is that social work, as theory and practise, must explore the specifics of people’s everyday lives and incorporate the findings into social work interventions (transform the findings into knowledge for “doing”). The challenge for social work is to take up this premise and create the conditions for research-opportunities, methods, knowledge, and expertise-that enable, first, dialog with people and, second, ongoing reflexive dialog between social work theory and practice as both provide a conceptual framework for understanding people’s realities. In conducting research and planning interventions, therefore, social workers face the practical challenge of how to create opportunities for dialog with people and how to learn as much as possible about people’s everyday lives in order to authentically capture their conceptions of their reality.

3.1 Principle 1 of social work research: critical perspective on scientific and political generalizations

Political narratives in global documents create an influential framework for a simplified generalization of reality. Images of people and definitions of needs will always contain the assumptions that researchers and experts make about people and realities. The anthropological and ethnographic research tradition warns us of the pitfalls of creating colonizing knowledge [16, 53, 54]. The pitfalls of patronizing objectification of reality into which researchers concerned with the needs of older people and planners of social welfare interventions can easily fall are precisely those of selectivity and generalization [37, 44, 55]. Analyzing and collating information inevitably leads to generalization, selection, and grouping of information, while the demands of the feasibility of ideas and the pragmatics of human life lead to the reduction of people’s expectations, desires, and needs. If we ignore narrative and language, which is a powerful transmitter of cultural and social patterns, we can quickly get caught up in stereotypes when exploring needs and, in fact, help to perpetuate simplistic, stereotypical ideas about people’s everyday lives [56].

In the 21st century, criticism of prevailing social, political, or moral discourses is no longer enough. In social science research, and especially in social work research, there is a long tradition of radical and transformative research practice and knowledge [44, 49, 51, 57, 58, 59]. The intention for research to move beyond tokenistic, self-referential scholarship is evident in various research activities (action research, citizen science, participatory user research, ethnographic research, etc.) in which researchers have been intensively involved in community and institutional transformation processes [44, 49, 51, 60, 61, 62, 63, 64, 65].

When researching the lives of older people and their needs from a social work perspective, we must be aware of the importance of research procedures in creating emancipatory knowledge about life. As holders of privileged knowledge in contemporary society, professionals have a great responsibility to critically evaluate their own knowledge [53]. The self-sufficiency of expert knowledge and the self-confidence of professionals in their own “omniscience” are today the greatest obstacles to creating a dialog with people. In this respect, social work, which is in direct contact with people every day, is a discipline that should take advantage of this possibility of infinite dialog with people to constantly reflect on the knowledge of life [43, 44, 53]. Complementarity of knowledge is only possible when we express different experiences and perspectives. By exploring particular life experiences, exploring individual survival strategies, comparing different life contexts, and testing alternatives, we discovered not only individual particular life strategies but also situations of collective activation in developing responses [44, 49, 51, 60, 61, 62, 63, 64, 65].

Social work research is therefore always complex and involves multiple knowledge holders (people from the community, professionals, service users, and other knowledgeable people). Multiple perspectives and interpretations of interrelated situations help find the “blind spots” and identify the ideologies that underlie different bodies of knowledge. In this way, we can systematically and continuously correct social work theories and practices. Research, then, is always a critical look at the established cultural and civilizational forms of a society [16, 38, 43, 44]. By “dissecting” the features of people’s everyday lives, we also “dissect” the self-evident and invisible social forms. It is therefore not irrelevant who studies everyday life and how, and on the basis of which theoretical and value-related assumptions they make statements about life [16, 43, 44, 53, 63].

Exploring needs from a critical social work perspective is therefore always an exploration of traditions of thought and systems of constructing and justifying knowledge about the world. Adding to or correcting the stereotypical political and scientific narrative of people in need of care can only be done through an analysis of the language and constructions of one’s experience [44, 49]. Exploring needs requires looking beyond the ‘similarly sad or similarly successful story’ as well as beyond the ‘binding identity project” [37]. Improved interpretive schemes for explaining the world (new ideas and language) can only emerge in dialogic encounters with the “other” and otherness (helping us to see our invisible selves) and in the dialectical process of shaping personal theories and practices of everyday life [37, 43, 62]. Social work research is therefore constantly searching for unknown to correct conclusions about reality in order to correct and improve limited or inadequate interpretive schemes.

3.2 Principle 2 of social work research: transformation of mechanistic models of long-term care

Policy documents have a strong influence on the perception of what should be under the radar of science and the professions. For example, the concept of healthy aging and the associated capability model create a specific perspective on the needs of older people and the ideas of long-term care that should meet those needs. Today, we can state that long-term care for older people is a complex system of activities and services for people in institutions or in the community [48, 49, 51, 52, 60]. The complex organization in systems of care is trapped in the people processing management. The long-term care industry, organized on the model of sequential care on an assembly line, with different caregivers providing fragments of care, uses categorization tools as input information for organizing work [44, 55]. The tendency to develop mechanistic tools for managing people is therefore pervasive, as care providers and care institutions must adapt to the rules of the corporate business. In an effort to simplify management, capability information, as basic deficit information, introduces the immediate and causal logic of imposed or assumed needs. The procedural model of work does not go beyond an alienated form of care. Assistance is not about dialogically co-creating responses in the context of people’s lives, but about finding arguments about how to adapt a person’s situation to the system of care. Standardized needs are not something personal, inherent in the individual as part of their life experience, but become part of the imposed reality enforced by the service system and standard forms of assistance [44].

Therefore, the assessment of abilities in their selected categories can be very reductionist. Measuring people’s abilities can be a moment of depersonalization of human life. Together with the selection of indicators of basic needs, this can be a moment of total reduction of human existence to a few measurable categories (e.g., the ability to dress, take medication, and handle money) [9]. There is an illusion of ‘objectivity’ in the ability to measure because all measurement instruments are arbitrarily determined. By using standardized assessment tools, professionals attempt to create the impression of equality in decision-making processes about people’s social and health rights [44]. However, the models used to assess people’s abilities are selective and arbitrary, depending on who sets the criteria and what the model measures. Psychophysical ability assessment scales are an example. Although these assessment scales (e.g., disease progression scales, physical mobility assessment) are practical, transparent, and provide a relatively quick indication of a person’s basic psychophysical abilities, they are generally an “ability set” that does not contribute to an understanding of personal needs or support operationalization of need satisfaction [44].

In everyday professional practice, there are many examples of attribution of needs where professionals do not recognize people’s needs but argue that users need a particular service. Example: When someone is homeless, professionals conclude that they need to be placed in a group home (perhaps they need their own place to live in the first place); when a person with dementia loses orientation to the environment, the conclusion is that they need to be placed in a safe facility (perhaps they just need companionship to go for a walk); when an older woman experiences violence, the conclusion is that she needs to be placed in a safe house (in reality, she may want the perpetrator of violence to stop harassing her) [44]. In the person-processing logic of work, causal logic and standardized offers trigger a scenario in which “an older person with a chronic illness needs to be placed in a nursing home,” “the dementia patient needs a day centre,” “people living alone need volunteers”,” “a person who cannot prepare her own meals needs a home delivery service,” “the unemployed person needs a course on how to write a job application,” and so on. If one understands needs as purely administrative categories, one quickly falls into a cause-and-effect logic, similar to the way diagnoses are made in medicine. Needs are a “disease” to be diagnosed and services are a “prescription” If we as professionals focus only on the services we can provide, the actual circumstances of need and sources of power (capabilities) become irrelevant. A person in the role of ‘user/client’ is in a take-it-or-leave-it situation” [39, 44, 55].

Understanding needs must overcome the simplistic causal logic. However, people do not want to question the taken-for-granted, ‘natural obviousness’ of everyday life [66]. Human beings physical appearance in the world and awareness of physical vulnerability and transience of human being life bring feelings of uncertainty and unpredictability to our existence. Truths and ideas about the world help us make sense of existence and support the belief that all is well with life [66, 67, 68]. There is a link between routines and understanding needs. Many needs relate to daily rhythms and activities, but also to the predictability of the future. A sudden disruption in the familiar scenario causes people to find ways to restore the previous routine (needs expressed as repair tactics) or to adapt to a new situation (needs expressed as adaptation tactics) [69]. These behaviors are adapted to daily rhythms that are part of the daily routine (e.g., taking care of hygiene, preparing a meal, contacting relatives, visiting friends, etc.), as well as to life rhythms associated with turning points in life (e.g., moving to an institution, retirement, death of a partner, moving to another town, serious illness, etc.).

From a purely practical perspective of daily routines and activities, needs can be identified as anchor points for creating plans to operationalize strategies for daily living [44, 48, 49, 50, 51, 52]. Images of human needs, in their basic nature and universality, provide a sense of a shared world and support individual feelings of ontological security [66]. One could say that in the modern era, the concept of human needs has provided codified knowledge about daily life [44]. Therefore, we constantly create more or less reliable and credible conceptions of the world as we try to understand ourselves and the world in which we live [66, 69]. Social work research should incorporate sensitivity to the unique life of every person. Older people want a tranquil life and not a constant intrusion into their everyday life. They want to be cared for and nurtured in a home environment; under the conditions they find meaningful for them. Most of their needs can be grouped around three axes: the activity axis (activities of daily living), the integration axis (connectedness with other people, relationships, sociability, and contacts), and the social power axis, which is about society’s attitude toward older people and its influence on planning their future [44]. These three axes are crucial for the creation of long-term care focused on the overall security not only of old people but also of younger generations (because the experience of security is an individual balance of health, respect, satisfactory material conditions, and decision-making opportunities) [44].

The advantage of social work research oriented to personal everyday scenarios and contexts is that it offers the opportunity to understand that people have very different ideas about what they need, how urgently they need something, and to what extent. By talking about people’s lives, researchers learn more about people’s personal desires, what is important to them, and what the important goals are in their lives [44, 45, 48, 49, 50, 51, 52]. Therefore, in order to understand the needs of older people, the needs of other generations must also be explored and understood, because intergenerational solidarity is about the values of all people - what people want for themselves and for those around them, what they value, and what they consider important in life. Forcing institutionalized solutions to people’s everyday needs creates discomfort, paralyzes people’s resilience, and disempowers them to develop their own capacities [44].

3.3 Principle 3 of social work research: the exploration of needs as a moment of profound reflection of reality

Human existence is embedded in an ever-changing reality to which individuals seek to adapt or change. We must understand needs as part of this ever-changing reality. People today are confronted with two definitive facts: First, unlimited satisfaction of human needs is not possible on a finite planet, and second, intergenerational ethics have reinforced the realization that the effects of our ecological actions today will negatively impact those who come after us [70]. As awareness of the devastating effects of human exploitation of the planet’s resources emerged, the concept of human needs became the subject of critical and reflective discussion [71]. The interaction between planetary boundaries and human well-being is seen as an important framework for shaping sustainable socioeconomic and other policies [71, 72]. Human well-being and planetary well-being become dual and inseparable goals for any human activity. The anthropocentric vision of social justice is reflected in the demands for environmental justice to preserve the planet [14, 71, 72, 73]. Understanding basic human needs within planetary boundaries means that creating a safe, fair, and equitable space for humanity requires greater global equity in the transfer of natural resources to meet human needs and absolute efficiency to return to planetary boundaries [71, 73].

Exploring needs is a moment of critical reflection on everyday life scenarios and as such can become transformative in the process of developing alternative solutions for practical (and ecological) change [43]. Ecological awareness of the urgent task of changing our habits confronts us with the task of overcoming entrenched ideas about our perception of needs and rethinking our value systems. Exploring human needs is an act that directly clashes with our established patterns of behavior [16]. It is the issue of the perception of human needs that confronts us with the inner tendency of humans to control and influence the future in order to suppress feelings of insecurity [66, 67]. But life on earth and the future as such remain unpredictable, despite our constant efforts to create knowledge to control and direct all aspects of life [66, 67, 68]. The future is “available” only at the level of assumptions. The profound discrepancy between perceptions of ecological and social needs confronts the human sciences and helps practice with the ethical demand and inescapable task of moving beyond ecologically blind studies of the social world and human needs. It is not possible to discuss the social dimensions of well-being without considering ecological issues. Climate change and other environmental issues remind us that human well-being depends on the well-being of the entire planet. Like all helping professions, social work is at a crossroads to rethink its ethical human rights foundations and professional mandate. The ethical and moral question is how professional knowledge can contribute to a socially and environmentally just society [72, 74].

Exploring and discussing people’s needs is a powerful force that encourages people to think about their lives. By exploring needs, we are constantly questioning the seemingly obvious and taken for granted, reflecting and articulating everyday routines [60, 69]. Talking about people’s everyday lives and their personal stories is always a moment of reflection of the world in which we live [66, 68]. The question about needs stimulates thinking about the future. People think about needs in terms of situations in the present, but they connect the ideas to the future. The concept of risk has an important influence on the question of needs. Risk refers to future events where it is not certain what will happen in the future [67]. People rely on experience, knowledge, and available resources to manage risk and hope that the desired scenario will occur. Needs thus become part of the scenario plan (they are an idea of what they need to achieve the desired outcome). As such, needs have the property of having a response and a path to the response. Exploring the situation of older people, which includes a contextual consideration (e.g., characteristics of place, time, social network, etc.), allows the practical ideas to be integrated into an operationalized plan (as a path to a desired outcome) [44, 45, 48, 49, 50, 51, 52]. When assessing needs by how certain it is that people’s expectations will be met, understanding the context makes it easier to imagine how events (situations that follow in response to needs) might occur.

Social work research aims to identify people’s individual, intimate plans regarding their desires for need satisfaction. In an ideal research situation, it would therefore be necessary to include action elements and testing of solutions (proposals and ideas) in any social work research [44, 45, 48, 49, 50, 51, 52, 53, 75]. In this case, it always turns out that solutions are never final, because only when we test the solution or idea can gaps in the plan be discovered and the plan be revised (or the idea can be reversed based on new understanding) [44, 48, 49, 50, 51, 52]. By exploring and recording everyday life and the needs articulated in it, we become attentive to the question of what knowledge individuals and communities have created as meaningful [43, 49, 56]. Therefore, sharing visions of needs can also be understood as a dynamic force for connecting communities and building social fabric [61].

3.4 Principle 4 of social work research: understanding needs as a changing concept

Science usually creates objectified factual knowledge. The challenging task of changing a limited anthropocentric and colonizing view of human needs so that it becomes more relevant in the context of a socially and ecologically just society is a demanding one and involves the reconstruction of scientific knowledge creation. The guiding principle of social work research for the possibility of creating transformative knowledge and values is rooted in human wisdom. There is a constant dialog and dialectic that takes place in people’s everyday lives and is reflected in the development of intimate knowledge formation. We can say that when we theorize about everyday life, we select and observe certain situations, attribute certain features to them, identify certain relationships between those features, and then see if the thing as we understand it stands up to comparison with other theories of everyday life, works in practice, and helps us achieve or understand what we want to achieve or understand [59].

When the political agenda gives preference to certain solutions, it sets the normative framework for interpreting reality and underscores the perception of needs. However, like any small or large personal theory about life, people develop their own personal theories about needs. Social work research can identify both how curtain concepts creep into everyday knowledge and how certain people’s values and beliefs live beyond popular and dominant concepts of life. Social work needs research, then, is first and foremost hermeneutic research because it is concerned with interpretation in knowledge formation. Secondly, social work research follows the heuristic approach in research design, as it is based on dialog as a specific form of dialectic that reflects and contradicts stereotypical public, scientific, and political beliefs.

We can conclude that social work research works under the paradigm of maximum structural variation of perspectives, while its analysis is focused on the discovery of similarities and differences in their temporal validity, as long as new and better explanations are created [76]. The complex exploration of the everyday world of older people leads to explanations of the contexts, and the circumstances in which their needs arise. It can help to gain insights into the specifics of different people’s lives and their environments [44, 48, 49, 50, 51, 52]. Social work research connects the different actors in shaping the idea of a common future based on concrete life situations [44, 45, 75]. The ideal outcome of a dialogical study of needs is an agreement negotiated between different actors in the community (residents, professionals, local policy representatives, the public, etc.) on the design of responses to the assumed needs. Therefore, the study of the needs of older people and the development of solutions to their needs is a strategy for creating knowledge about the characteristics of a particular place and time.

Exploring the needs of older people is a search for a delicate balance between individual freedom and respect for others, between autonomy and connectedness [44, 48, 49, 50, 51, 52]. “Thus, solving problems in the domain of wisdom requires more than the domain-relevant knowledge identified in research on other types of expertise; it requires qualities unique to the domain of wisdom. In addition to factual and procedural knowledge (heuristics) about the human condition and how to live a good life, competence in the domain of wisdom requires, in particular, consideration of context, tolerance of differing values, and the ability to deal with uncertainty” [77]. The satisfaction of needs is a creative act of human beings. It is a dialectic that takes place between experience, the interpretation of experience, and a new idea. The possibility of forming one’s own opinion is the basis for individual freedom and the meaning of life. In this way, social work research directly implements the goal of the Global Strategy on Aging: “The strategy aims to foster the ability of older people themselves to invent the future in ways that we and previous generations might never have imagined” [18].

Lived human experience teaches us that wisdom comes from gaining deep insights into oneself and one’s life based on procedural knowledge (strategies and heuristics for dealing with life and its meaning and for making life choices), contextualism across the lifespan (knowledge of the many contexts of life), consideration of value relativism (recognition of and tolerance for different values held by other people and other societies), and tolerance of ambiguity: the ability to recognize and cope with the uncertainties in one’s life that arise from uncertainty [75, 76, 77, 78, 79, 80]. Therefore, social work is always in search of understanding an ever-changing context of reality and striving for the necessary stability in people’s lives. Social work research is a never-ending story.

4. Conclusions

The world today has to cope with humanitarian and environmental problems. Social work research can help to discover the creative inner wisdom of people, as we need transformative ideas for sustainable and humane solutions. Global political agendas determine the priorities of research topics and shape the dominant narratives. A careful look at the international documents studied showed us the content and areas of interest pursued by different global and regional actors. Although terminology and rhetoric have changed slightly and priorities shift, the focus of aging policy has remained the same over the past 50 years: Recognition of the potential of older people (the potential of longevity for the economy and society), health promotion (functioning-based approaches in maintaining the ability of older people), and long-term care (sustainable and equitable systems of care for older people with significant declines in the physical and mental capacity that limit their ability to care for themselves and participate in society).

Current global aging policies are based on the healthy aging agenda, which justifies economic and moral reasons for promoting quality of life in old age by maintaining good health throughout the life course. In conjunction with the concept of intergenerational solidarity, the guarantee of meeting the needs of all generations lies in the reciprocity between the younger and older generations. Universal human needs and human rights are presented almost as synonyms in global policy documents, so we should not confuse the universality of human rights with the idea of universal needs. While human rights are considered universal by definition - they apply equally to all human beings - the universality of human needs should be understood as an interconnected and interactive system of basic human needs that are satisfied in an infinite and insatiable context of life.

The healthy aging agenda’s concept of capability advocates for the autonomy and freedom of individuals to make their own decisions about their lives, creating a normative logic of standardized capabilities that a person must have in order to be recognized as capable of participating successfully in society. It is important for helping professions to be alert to alienating, people-processing practices in long-term care systems, as the organization of work, and categorization of people can lead to mechanistic work with people. Social work as theory and practice is critical of generalized conceptions of older people and promotes those research strategies that allow for the discovery of the diversity of life experiences and the correction of different kinds of knowledge (especially hidden, ignored knowledge).

The experience of exclusion is the experience of invisibility. In today’s society, older people are marginalized unless they have economic power, but within this group, older women, people with dementia, and poor older people are even more marginalized. By exploring the everyday lives of older people and understanding their needs beyond socially dictated identities, we create narratives and a language that provides the opportunity to address experiences and issues that are otherwise outside of mainstream lifestyles. The hidden, the unspoken, are not only illness, death, and loneliness, but also the experience of systematic neglect and abuse, and depersonalization, especially among people living in institutions.

The overarching idea of social work theory and practice is a socially and environmentally just society. Starting from the anti-oppressive and radical scholars of social work, there is a social work knowledge and experience of critical research. Thus, social work research is not only about collecting data and interpreting information but also about finding concrete and useful practical solutions for people. In its pragmatic objective, social work should always benefit people. It can be said that needs have assumed a representative and symbolic function in the interpretation of what should be fulfilled in the life of each person. In a generalized and stereotyped way, human needs have become ideas that people exchange among themselves to explain the characteristics of individual and collective life situations. Survival itself requires a constant process of articulating the experience of reality between people, and by describing needs we can create a universal system of exchanging practical and concrete information. Needs as schemas, codes, symbols, and concepts are there to explain to each other what we need in life to live at all, and what we aspire to in order to feel fulfilled. Identifying and naming needs is how we co-create the truths of reality and agree to represent our position in this world. Or, to put it another way, needs have their place in daily life as common markers of reality, and as ideas, they help us generalize the basic human experience of being.

All people need a basic sense of security to make their lives predictable and manageable. An empowering social work research is that which allows people to develop their own theories of life, their personal models of knowing how the world works, and how to make sense of life. Freedom comes from the personal inner power of judgment [81]. The ability to independently decide what is good for us and the ability to make choices are linked to an autonomous sense of knowing what we need and want. Thus, each of us spends a lifetime developing and testing our own theories about the world and ourselves. We cannot escape this theorizing because life experience forces us to constantly adapt to life’s challenges. Social science, and social work science in particular, has a unique opportunity to open up to the excluded, ignored, and neglected experiences of human existence. Older people are the ones who can contribute to providing the necessary reference points for reflecting on reality since their world has changed several times during their own lives.

Acknowledgments

This paper is related to research that is financially supported by the Slovenian Research Agency within the research project (J5-2567) Long-term Care of People with Dementia in Social Work Theory and Practice.

Conflict of interest

“The authors declare no conflict of interest.”