Nous nous sommes intéressés à l’analyse et à la mise à jour d’une typologie de l’aide reçue par les personnes âgées de 65 ans et plus vivant à domicile. Cette étude secondaire s’est basée sur les données recueuillies dans deux milieux francophones, Hochelaga-Maisonneuve (HM) et Moncton (MCT). La collecte de données avait été faite par l’entremise d’un questionnaire administré par entrevue face à face. Les deux objectifs, de cette thèse sont : 1) Établir une typologie des réseaux d’aide, résultant de la combinaison des sources d’aide et des tâches accomplies ; 2) Identifier les principaux déterminants d’appartenance aux réseaux. La typologie obtenue met en relation les ressources, formelles ou informelles, utilisées par les personnes âgées et l’aide instrumentale reçue. La capacité ou l’incapacité à effectuer neuf activités de la vie quotidienne et huit de la vie domestique ont servi à évaluer l’aide reçue. Six ressources formelles et dix informelles ont été examinées selon qu’elles étaient les 1ères, 2ièmes ou 3ièmes sources d’aide utilisées par les personnes âgées. L’approche privilégiée s’est inspirée de celle des réseaux sociaux et du modèle de Pescosolido. C’est l’influence des caractéristiques sociodémographiques des personnes âgées, de leurs états de santé, de leurs habitudes de vie sur leurs réseaux qui nous ont intéressés. Les résultats sont présentés à chaque fois pour nos deux milieux séparément. Nous commençons par un descriptif des sources d’aide utilisées et des aides reçues. Puis les profils des sources d’aide utilisées et des activités accomplies sont exposés pour l’ensemble des personnes âgées. Ces profils servent de base pour obtenir notre typologie. Elle comprend cinq catégories. Ces catégories sont toutes composées de personnes âgées faisant appel à de l’aide formelle, informelle ou mixte pour accomplir des tâches uniques ou multiples. La première catégorie « Transitoire », comprend 39% (HM) et 46% (MCT) des personnes âgées qui débute un processus d’incapacité. Elles font appel à des ressources informelles pour accomplir une tâche unique. La deuxième catégorie « Personnes âgées seules » en rassemble 14% (HM et MCT), majoritairement des femmes, avec peu d’incapacités. Ces dernières utilisent de l’aide formelle pour une tâche unique. La troisième catégorie « Familiale » regroupe 12% (HM et MCT) des personnes âgées bien entourées qui ont plusieurs incapacités. Ces gens font appel à des sources d’aide informelles pour réaliser des tâches multiples. La quatrième catégorie « Très fragile » rassemble 30% (HM) et 25% (MCT) des personnes âgées peu entourées ayant beaucoup d’incapacités. Elles utilisent des ressources d’aide mixtes pour effectuer des tâches multiples. La cinquième catégorie « Pré institutionnel » comprend 4% (HM et MCT) des personnes âgées qui ont le plus d’incapacités et qui sont seules. Ces gens font appel à de l’aide formelle pour des tâches multiples. Les déterminants d’appartenance à ces catégories proviennent des blocs sociodémographiques, état de santé et réseaux sociaux de notre modèle théorique. Une des contributions importantes de cette thèse a été de pouvoir identifier cinq catégories bien distinctes composant une typologie de l’aide reçue, indépendamment du milieu, par des personnes âgées vivant à domicile. MOTS CLÉS : Typologie, réseaux sociaux, personnes âgées, services de soins, formels, informels, aides reçues, sources d’aide, incapacités, déterminants d’appartenance, fragilité / We have been interested in the analysis and the elaboration of a typology concerned by elderlies’ support, 65 years and older living at home. This secondary study was based on data collected in two different francophone cities, Hochelaga-Maisonneuve (HM) and Moncton (MCT). Interviews “face to face” were conducted. The objectives were: 1) Establish a typology of supports networks putting in relation the support resources and the activities done by these resources, 2) Identify the belonging criteria for these networks. The typology puts into relation the resources, formal or informal, utilised by the elderlies and the instrumental aid received. The fact that elderlies were able or not able to perform, at least for one of the nine daily activities or of the eight domestic ones, was used to evaluate the support received. Six formal and ten informal resources utilized by the elderlies were looked at in terms of 1st, 2nd or 3rd resources. Social network approach and Pescosolido’s model were used. Sociodemographic characteristics, health status and way of life of the elderlies’ networks, were the main parameters in which we were concerned. The results are presented for the two environments separately. We start by describing the aid resources used and their different tasks done for the elderlies. Than, we show the different aid resources’ profiles associated to the activities’ profiles for the two populations. These profiles are the basis of our typology. It is composed of five categories. They refer to formal, informal or mixed help in order to do single or multiple activities. The first category “Transient” has 39% (HM) and 46% (MCT) of elderlies who start to have significant incapacity. They use informal support for a unique task. The second category “Singles” correspond to 14% of HM or MCT. They are mostly women with little incapacity. They use formal help for a unique task. The third category “Family” regroup 12% of HM or MCT with more incapacities. They are well supported by their family members. They use informal help for multiple activities. The fourth category “Fragile” has 30% (HM) and 25% (MCT) of elderlies with lots of incapacities. They have less family members to help them and they use mixed (informal – formal) support to be able to do multiple tasks. The fifth category “Pre-Institutional” is composed of 4% (HM or MCT) elderlies how are the most handicapped. They are by themselves and they use formal support to do multiple tasks. One of the most important goals of this thesis was to be able to construct a typology of the aid received by elderlies, living at home, in two different environments and to define five very distinct categories in relation with the type of resources. Key words: Typology, social networks, elderly, support, help, formal, informal, health services, frailty, incapacity

L’importance accordée à la reconnaissance des droits fondamentaux des personnes en matière d’intégrité physique et de consentement aux soins dans notre société fait que le travailleur social appelé à participer à l’ouverture de régimes de protection du majeur doit développer une expertise multidimensionnelle. De plus, le travailleur social se retrouve à confronté à différentes logiques d’action (juridique et procédurale, médicale, psychosociale, pragmatique) dont il doit tenir compte dans le processus d’évaluation. Ceci nous amène à aborder la position difficile dans laquelle se trouve généralement le travailleur social qui oscille entre la possibilité de favoriser l’autonomie de la personne et la volonté de protéger celle-ci. L’objectif de ce mémoire est donc d’accroître notre compréhension du processus de prise de décision du travailleur social dans la détermination de l’inaptitude d’une personne âgée, dans le cadre des régimes de protection du majeur. D’une manière plus spécifique, cette étude consiste à retracer et à théoriser, par l’analyse de sa logique d’action, le processus à travers lequel le travailleur social se positionne lorsqu’il se retrouve confronté à des dilemmes éthiques par rapport à la détermination de l’inaptitude d’une personne âgée. L’analyse de l’expérience du travailleur social a été réalisée à travers le paradigme de l’individualisme méthodologique tel que définit par Raymond Boudon. Les données furent recueillies lors d’entrevues semi-dirigées réalisées auprès de sept intervenants. Les témoignages recueillis par le biais de cette recherche exploratoire montrent à quel point il peut être difficile et éprouvant pour le travailleur social de devoir se positionner dans la détermination de l’inaptitude d’une personne âgée, dans le cadre des régimes de protection du majeur et comment ces interventions s’inscrivent dans un jeu infiniment complexe d’interactions multiples entre acteurs et actants. Les principaux obstacles à la prise de décision éthique dont ont fait part les travailleurs sociaux interrogés sont liés au contexte de pratique. Il s’agit du manque de ressources financières et humaines disponibles ainsi que le fait que les décisions ne soient pas toujours prises en équipe interdisciplinaire et dans un climat qui soit non menaçant. La reconnaissance de l’expertise des travailleurs sociaux en matière d’ouverture de régimes protection est d’ailleurs ressortie comme un enjeu important. / In our society, the emphasis on recognition of the fundamental rights of a person regarding his\her physical integrity and consent for care requires social workers to develop a multidimensional expertise in order to participate in the instituting of protective supervision for persons of full age. Moreover, social workers are confronted with various dimensions (legal and procedural, medical, psychosocial and pragmatic) which should be considered in the process of evaluation. This brings us to consider delicate position of the social worker who must make a difficult choice between promoting the service user’s individual autonomy or protecting him or her from harm, courses of action that are not always compatible. The objective of this research is to increase our understanding of social workers ‘decision-making process when determining the incapacity of an elderly person within the framework of protective supervision for persons of full age. More specifically, this study aims to review and theorize, by analyzing its logic of action, the process through which the social worker is making a decision when confronted with ethical dilemmas in relation to determining incapacity of an elderly person. The framework of this research is based on the methodological individualism of Raymond Boudon. The data were collected using semi-directed interviews with seven participants. The result of the study has shown how it can be difficult and challenging for the social workers to have to position themselves in determining incapacity of an elderly person. In fact, the interventions are part of an infinitely complex interaction between multiple actors and agents. The main obstacles to ethical decision-making are related to the context of practice, i.e. the lack of financial and human resources, and the lack an interdisciplinary team approach in a non-threatening climate. The non-recognition of the expertise of social workers regards to protective supervision was also identified as an issue.

Le dessaisissement est une notion aux contours incertains, comme en témoignent la diversité de ses occurrences et les domaines variés dans lesquels il évolue. A l’étude, il semble qu’il puisse être conçu de manière autonome comme étant la mesure, judiciaire ou contractuelle, par laquelle le titulaire d’un droit voit celui-ci amputé de tout ou partie des pouvoirs qui y sont attachés, ceux qui lui sont ainsi retirés étant transférés à une autre personne, le saisi, qui les exerce seul ou conjointement avec lui, le dessaisi. Le dessaisissement est principalement mis en œuvre par deux techniques : la représentation judiciaire et le transfert fiduciaire. Il y est chaque fois animé par une double idée. D’un côté, la réponse à un souci de compétence et d’efficacité juridique, qui impose de circonscrire les cas dans lesquels le dessaisissement peut être judiciairement imposé ou contractuellement consenti. D’un autre côté, la protection du dessaisi. La mesure confère au saisi des pouvoirs attachés à des droits dont il n’est pas titulaire. Ce transfert présente le risque de permettre au saisi de conclure des actes qui engagent le dessaisi, sans que ce dernier ne puisse en être, seul, valablement l'auteur. Tout cela mérite de prêter attention à la manière dont le dessaisissement est mis en œuvre, exécuté, contrôlé et cesse. Mais la dualité de la notion de dessaisissement empêche l’unification parfaite de son régime. / Divestment is a concept with uncertain contours, as evidenced by the diversity of its examples and the various fields in which it evolves. In the study, it seems that an autonomous notion of divestment emerges as the measure, judicial or contractual, by which the holder of a right sees that right removed of all or part of the powers attached to it. Those powers being transferred to another person, the granted person, who exercises them alone or jointly with the divested. Divestment is mainly implemented by two techniques: judicial representation and fiduciary assignment. It is always driven by a double idea. On the one hand, the concern for competence and legal efficiency which requires that the cases in which divestment may be judicially imposed or contractually consented be limited. On the other hand, the protection of the divested of his powers. This measure confers on a person, the person granted, the powers attached to the rights of which he or she is not the holder. This transfer presents the risk of allowing the person to whom the powers are granted to act in a way which binds the divested, without the latter being the sole and valid author. All this merits attention to the way in which divestment is implemented, executed, controlled and terminated. The duality of the notion of prevents a one-size-fits-all solution to its implementation.

Made available in DSpace on 2016-04-28T20:39:23Z (GMT). No. of bitstreams: 1 Fernanda A C Gouveia Paulino.pdf: 1360933 bytes, checksum: d5b99823bc5f00a57167c68b294f0035 (MD5) Previous issue date: 2006-10-01 / Due to the increase of the chronic illness and the medical resources that generate survivors of acute physical illness, the purpose of this research is to understand the impact of chronic illness situations on middle-age, especially in cases of incapacitation that requires a familiar functioning reorganization. Because of the complexity of these cases, the choice of this work was to specially approach families with dependent children and that the carrier of the chronic illness is the member who supports the family. A qualitative inquiry was carried through on eight families. The data included interview , familiar genogram and part of the test Entrevista Familiar Estruturada (EFE). This data were discussed based on the systemic theory under a biopsycossocial perspective, with the survey of the main aspects that had allowed understanding of the interconnection among the biological, psychological and social sphere. Under the point of view of a familiar event, the results of this research allowed an understanding about the transformations that suffer a family with a middle-age adult with a chronic incapacity. The incapacity cases demands changes that reach the individual and familiar cycles of life and than alter insidiously in family s organization, relationship and functioning. Substitutions are required and changes are imposed that involves losses, with concomitant offering of care. When who fall ill is in middle age and centers the familiar responsibilities, the run down of the familiar system is intense and extensive. It involves post-pone, anticipation and cancellation of plans, intervenes on financial statements and it rearranges the relationships, being able to modify some familiar rules, leadership, hierarchies and cohesion between members. In this research, although the incapacity characteristics have been sufficiently notable to the configuration of the familiar organization, the quality of the previous relationship revealed the most significant factor for familiar flexibility and adaptation to the (new) condition. The characteristics of the familiar functioning and repercussions in the member who supports the family under a desenvolvimental approach had been argued. The results discussion pointed out to the necessity of psychological attention to the families with a chronic illness situation (member), considering the familiar structure and dynamics and still its vital cycle moment. The deeper understanding of each case with the apprehension of the meanings and beliefs, as well as the approach of the suffering of the families allowed the elaboration of a reflection about professional position, criterion for the clinical inquiry and the reach of the health psychology for providing interventions in the families that are living illness situations / Em razão do aumento da incidência de adoecimentos crônicos e dos recursos da área médica que geram sobreviventes de afecções físicas agudas, este trabalho teve por objetivo compreender o impacto das situações de cronicidade na meiaidade, especialmente nos quadros de incapacitação com necessidade de reorganização do funcionamento familiar. Optou-se por abordar especificamente famílias em que houvesse filhos dependentes e cujo portador de condição crônica desempenhasse previamente o papel de provedor e/ou cuidador familiar, dada a complexidade da substituição desses papéis. Foi realizada investigação qualitativa da qual participaram oito famílias. A coleta de dados incluiu entrevista semi-estruturada, genograma familiar e parte do instrumento Entrevista Familiar Estruturada (EFE). Os dados obtidos foram discutidos a partir da teoria sistêmica sob uma perspectiva biopsicossocial, com o levantamento dos principais aspectos que permitiram a leitura da interligação entre as esferas biológica, psicológica e social. Os resultados favoreceram a compreensão das transformações familiares diante de condições crônicas incapacitantes em adulto de meia-idade, sob o prisma de um evento familiar. Os quadros de incapacitação exigem transformações que atingem os ciclos de vida individuais e familiares e assim interferem de forma insidiosa na organização, relacionamentos e funcionamento da família. São requeridas substituições e impostas mudanças que envolvem perdas, com concomitante oferecimento de cuidado. Quando quem adoece está na meia-idade e centraliza as responsabilidades na família, a desestabilização do sistema é intensa e extensa. Envolve adiamento, antecipação ou cancelamento de planos, interfere no balanço financeiro e rearranja os relacionamentos, podendo modificar características como as regras, lideranças, hierarquias e coesão entre os membros. Neste estudo, embora as características da incapacitação tenham sido bastante relevantes para a configuração da organização familiar, a qualidade de relacionamento prévio mostrou-se o fator mais significativo para a flexibilidade familiar e adaptação à condição. Foram discutidas as características do funcionamento familiar e repercussões nos cuidadores sob um enfoque desenvolvimental. A discussão dos resultados apontou para a necessidade de atenção psicológica às famílias em situação de adoecimento crônico com a consideração da estrutura e dinâmica familiar e do momento de ciclo vital. A compreensão aprofundada de cada caso com a apreensão dos significados e crenças, bem como a aproximação do sofrimento das famílias permitiu a elaboração de reflexão sobre postura profissional, critérios para a investigação clínica e o alcance da psicologia da saúde no oferecimento de intervenções a famílias em situações de adoecimento

Estudo dos benefícios previdenciários por incapacidade sob o prisma dos direitos humanos fundamentais sociais, com enfoque na garantia de sua máxima efetividade possível em termos de concretização, como princípio jurídico. Importância cada vez maior do tema, tendo em vista o aumento de sua litigiosidade, atualmente responsável pelo maior número de ações ajuizadas e em trâmite junto aos Juizados Especiais Federais da Terceira Região. Utilização dos métodos dedutivo e interdisciplinar de estudo, com ênfase nos enfoques histórico, político, filosófico, social e jurídico. Análise dos direitos humanos fundamentais sob o prisma da Teoria Crítica (Escola de Frankfurt) e do pós-positivismo (neoconstitucionalismo concretista; força normativa da constituição), levando-se em conta sua evolução histórica, bem como a evolução dos modelos de Estado, dos ordenamentos jurídicos e da própria sociedade ao longo dos séculos. Conclusão pela existência de um regime jurídico único de proteção de todos os direitos humanos fundamentais, de nível constitucional, bem como de seu caráter universalizante, fruto de longo processo de lutas pelo reconhecimento do ser humano como sujeito de direitos e da sacralização da pessoa humana, alçada ao centro dos ordenamentos jurídicos estatais. Reflexos de tais constatações na via jurisdicional, mediante a garantia de plena justiciabilidade dos direitos humanos fundamentais, com ênfase nos direitos sociais. Inserção do direito a previdência social dentre os direitos humanos fundamentais sociais, com assento constitucional (art. 201 , I). Necessidade de seu estudo a partir da análise das contingências sociais elencadas constitucionalmente e em lei como objeto de proteção estatal. Aglutinação das prestações previdenciárias em torno de cada contingência social , com a formação de um regime jurídico único de proteção. Enfoque na continggência social da incapacidade laboral. incapacidade laboral decorrente de doença e/ou acidente, objeto do presente estudo. Aglutinação dos três benefícios previdenciários por incapacidade (aposentadoria por invalidez, auxílio-doença e auxílio-acidente) em um regime jurídico protetivo único, caracterizado pela fungibilidade ontológica entre eles. Necessidade de garantia da prestação adequada ao caso concreto, sem exigências de prévia definição acerca do grau e alcance da incapacidade laboral do trabalhador segurado. Reflexos de tais constatações sobre as demandas previdenciárias por incapacidade laboral, com ênfase na garantia da proteção jurisdicional ao direito humano fundamental social. Escopo principal de desenvolvimento de uma teoria geral voltada à proteção dos benefícios previdenciários por incapacidade, notadamente pela via jurisdicional , como medida de estímulo ao debate acadêmico e desenvolvimento destes estudos, com ganhos em termos de fundamentação e coerência. Fomento, outrossim, a uma análise sistemática e coerente de tais benefícios pelo Poder Judiciário, com o abandono da análise casuística e pontual levada a efeito até hoje Direito do Trabalho e da Seguridade Social. / Study of the incapacity benefits through the prism of social fundamental human rights, with a focus on ensuring the maximum possible effectiveness in their implementation, as a legal principle. Growing importance of the issue, given the increase in their litigation, currently responsible for the largest number of lawsuits fi1ed and pending with the Federal Special Courts of the Third Region. Use of deductive and interdisciplinary study methods, emphasizing the historical, political, philosophical, social and legal approaches. Analysis of fundamental human rights from the perspective of Critical Theory (Frankfurt School) and post-positivism (concretist neoconstitutionalism; normative force of the constitution), taking into account its historical evolution and the evolution of state models, of legal system and society itself over the centuries. Conclusion by the existence of a unified legal regime for the protection of all fundamental human rights, at constitutional level, as well as its universalizing character, as a result of long process of struggles for recognition ofthe human being as a subject ofrights and the sacredness ofthe human person, raised to the center of state legal systems. Reflections of those findings in the judicial process, by ensuring full justiciability of fundamental human rights, with emphasis on social rights. Insertion of the right to social security among the social fundamental human rights, with constitutional provision (art. 201, 1). Need for their study from the analysis of social contingencies listed constitutionalIy and in law as state protection object. Agglutination of social security benefits around each social contingency, with the formation of a unified legal regime of protection. Focus on social contingency of incapacity due to illness and/or accident, the present study object. Agglutination of the three incapacity benefits (disability retirement, sickness and accident alIowance) in a unified protective legal regime, characterized by ontological fungibility between them. Need to ensure the appropriate benefit to the case, without requiring prior definition of the extent and scope of the incapacity of the insured worker. Reflections of such findings on the judicial claims for incapacity, emphasizing the guarantee of judicial protection to the social fundamental human right. Principal aim of developing a general theory focused on the protection of incapacity benefits, notably by judicial process, as a stimulus to the academic debate and development of these studies, with gains in terms of reasoning and coherence. Promoting, moreover, a systematic and coherent analysis of such benefits by the judiciary, with the abandonment of the casuistic and punctual analysis carried out to date.

Nous nous sommes intéressés à l’analyse et à la mise à jour d’une typologie de l’aide reçue par les personnes âgées de 65 ans et plus vivant à domicile. Cette étude secondaire s’est basée sur les données recueuillies dans deux milieux francophones, Hochelaga-Maisonneuve (HM) et Moncton (MCT). La collecte de données avait été faite par l’entremise d’un questionnaire administré par entrevue face à face. Les deux objectifs, de cette thèse sont : 1) Établir une typologie des réseaux d’aide, résultant de la combinaison des sources d’aide et des tâches accomplies ; 2) Identifier les principaux déterminants d’appartenance aux réseaux. La typologie obtenue met en relation les ressources, formelles ou informelles, utilisées par les personnes âgées et l’aide instrumentale reçue. La capacité ou l’incapacité à effectuer neuf activités de la vie quotidienne et huit de la vie domestique ont servi à évaluer l’aide reçue. Six ressources formelles et dix informelles ont été examinées selon qu’elles étaient les 1ères, 2ièmes ou 3ièmes sources d’aide utilisées par les personnes âgées. L’approche privilégiée s’est inspirée de celle des réseaux sociaux et du modèle de Pescosolido. C’est l’influence des caractéristiques sociodémographiques des personnes âgées, de leurs états de santé, de leurs habitudes de vie sur leurs réseaux qui nous ont intéressés. Les résultats sont présentés à chaque fois pour nos deux milieux séparément. Nous commençons par un descriptif des sources d’aide utilisées et des aides reçues. Puis les profils des sources d’aide utilisées et des activités accomplies sont exposés pour l’ensemble des personnes âgées. Ces profils servent de base pour obtenir notre typologie. Elle comprend cinq catégories. Ces catégories sont toutes composées de personnes âgées faisant appel à de l’aide formelle, informelle ou mixte pour accomplir des tâches uniques ou multiples. La première catégorie « Transitoire », comprend 39% (HM) et 46% (MCT) des personnes âgées qui débute un processus d’incapacité. Elles font appel à des ressources informelles pour accomplir une tâche unique. La deuxième catégorie « Personnes âgées seules » en rassemble 14% (HM et MCT), majoritairement des femmes, avec peu d’incapacités. Ces dernières utilisent de l’aide formelle pour une tâche unique. La troisième catégorie « Familiale » regroupe 12% (HM et MCT) des personnes âgées bien entourées qui ont plusieurs incapacités. Ces gens font appel à des sources d’aide informelles pour réaliser des tâches multiples. La quatrième catégorie « Très fragile » rassemble 30% (HM) et 25% (MCT) des personnes âgées peu entourées ayant beaucoup d’incapacités. Elles utilisent des ressources d’aide mixtes pour effectuer des tâches multiples. La cinquième catégorie « Pré institutionnel » comprend 4% (HM et MCT) des personnes âgées qui ont le plus d’incapacités et qui sont seules. Ces gens font appel à de l’aide formelle pour des tâches multiples. Les déterminants d’appartenance à ces catégories proviennent des blocs sociodémographiques, état de santé et réseaux sociaux de notre modèle théorique. Une des contributions importantes de cette thèse a été de pouvoir identifier cinq catégories bien distinctes composant une typologie de l’aide reçue, indépendamment du milieu, par des personnes âgées vivant à domicile. MOTS CLÉS : Typologie, réseaux sociaux, personnes âgées, services de soins, formels, informels, aides reçues, sources d’aide, incapacités, déterminants d’appartenance, fragilité / We have been interested in the analysis and the elaboration of a typology concerned by elderlies’ support, 65 years and older living at home. This secondary study was based on data collected in two different francophone cities, Hochelaga-Maisonneuve (HM) and Moncton (MCT). Interviews “face to face” were conducted. The objectives were: 1) Establish a typology of supports networks putting in relation the support resources and the activities done by these resources, 2) Identify the belonging criteria for these networks. The typology puts into relation the resources, formal or informal, utilised by the elderlies and the instrumental aid received. The fact that elderlies were able or not able to perform, at least for one of the nine daily activities or of the eight domestic ones, was used to evaluate the support received. Six formal and ten informal resources utilized by the elderlies were looked at in terms of 1st, 2nd or 3rd resources. Social network approach and Pescosolido’s model were used. Sociodemographic characteristics, health status and way of life of the elderlies’ networks, were the main parameters in which we were concerned. The results are presented for the two environments separately. We start by describing the aid resources used and their different tasks done for the elderlies. Than, we show the different aid resources’ profiles associated to the activities’ profiles for the two populations. These profiles are the basis of our typology. It is composed of five categories. They refer to formal, informal or mixed help in order to do single or multiple activities. The first category “Transient” has 39% (HM) and 46% (MCT) of elderlies who start to have significant incapacity. They use informal support for a unique task. The second category “Singles” correspond to 14% of HM or MCT. They are mostly women with little incapacity. They use formal help for a unique task. The third category “Family” regroup 12% of HM or MCT with more incapacities. They are well supported by their family members. They use informal help for multiple activities. The fourth category “Fragile” has 30% (HM) and 25% (MCT) of elderlies with lots of incapacities. They have less family members to help them and they use mixed (informal – formal) support to be able to do multiple tasks. The fifth category “Pre-Institutional” is composed of 4% (HM or MCT) elderlies how are the most handicapped. They are by themselves and they use formal support to do multiple tasks. One of the most important goals of this thesis was to be able to construct a typology of the aid received by elderlies, living at home, in two different environments and to define five very distinct categories in relation with the type of resources. Key words: Typology, social networks, elderly, support, help, formal, informal, health services, frailty, incapacity

L’importance accordée à la reconnaissance des droits fondamentaux des personnes en matière d’intégrité physique et de consentement aux soins dans notre société fait que le travailleur social appelé à participer à l’ouverture de régimes de protection du majeur doit développer une expertise multidimensionnelle. De plus, le travailleur social se retrouve à confronté à différentes logiques d’action (juridique et procédurale, médicale, psychosociale, pragmatique) dont il doit tenir compte dans le processus d’évaluation. Ceci nous amène à aborder la position difficile dans laquelle se trouve généralement le travailleur social qui oscille entre la possibilité de favoriser l’autonomie de la personne et la volonté de protéger celle-ci. L’objectif de ce mémoire est donc d’accroître notre compréhension du processus de prise de décision du travailleur social dans la détermination de l’inaptitude d’une personne âgée, dans le cadre des régimes de protection du majeur. D’une manière plus spécifique, cette étude consiste à retracer et à théoriser, par l’analyse de sa logique d’action, le processus à travers lequel le travailleur social se positionne lorsqu’il se retrouve confronté à des dilemmes éthiques par rapport à la détermination de l’inaptitude d’une personne âgée. L’analyse de l’expérience du travailleur social a été réalisée à travers le paradigme de l’individualisme méthodologique tel que définit par Raymond Boudon. Les données furent recueillies lors d’entrevues semi-dirigées réalisées auprès de sept intervenants. Les témoignages recueillis par le biais de cette recherche exploratoire montrent à quel point il peut être difficile et éprouvant pour le travailleur social de devoir se positionner dans la détermination de l’inaptitude d’une personne âgée, dans le cadre des régimes de protection du majeur et comment ces interventions s’inscrivent dans un jeu infiniment complexe d’interactions multiples entre acteurs et actants. Les principaux obstacles à la prise de décision éthique dont ont fait part les travailleurs sociaux interrogés sont liés au contexte de pratique. Il s’agit du manque de ressources financières et humaines disponibles ainsi que le fait que les décisions ne soient pas toujours prises en équipe interdisciplinaire et dans un climat qui soit non menaçant. La reconnaissance de l’expertise des travailleurs sociaux en matière d’ouverture de régimes protection est d’ailleurs ressortie comme un enjeu important. / In our society, the emphasis on recognition of the fundamental rights of a person regarding his\her physical integrity and consent for care requires social workers to develop a multidimensional expertise in order to participate in the instituting of protective supervision for persons of full age. Moreover, social workers are confronted with various dimensions (legal and procedural, medical, psychosocial and pragmatic) which should be considered in the process of evaluation. This brings us to consider delicate position of the social worker who must make a difficult choice between promoting the service user’s individual autonomy or protecting him or her from harm, courses of action that are not always compatible. The objective of this research is to increase our understanding of social workers ‘decision-making process when determining the incapacity of an elderly person within the framework of protective supervision for persons of full age. More specifically, this study aims to review and theorize, by analyzing its logic of action, the process through which the social worker is making a decision when confronted with ethical dilemmas in relation to determining incapacity of an elderly person. The framework of this research is based on the methodological individualism of Raymond Boudon. The data were collected using semi-directed interviews with seven participants. The result of the study has shown how it can be difficult and challenging for the social workers to have to position themselves in determining incapacity of an elderly person. In fact, the interventions are part of an infinitely complex interaction between multiple actors and agents. The main obstacles to ethical decision-making are related to the context of practice, i.e. the lack of financial and human resources, and the lack an interdisciplinary team approach in a non-threatening climate. The non-recognition of the expertise of social workers regards to protective supervision was also identified as an issue.

Made available in DSpace on 2016-06-02T20:44:16Z (GMT). No. of bitstreams: 1 6603.pdf: 1107602 bytes, checksum: f1fd43079c8ff9036b6e8cde5701d313 (MD5) Previous issue date: 2015-02-06 / Currently, in Brazil, the assistance geared to workers who were affected by disease or accident, who find themselves unable to return to their original function, but have the potential to exercise other labor activities, is provided by the National Institute of Social Security (INSS) to taxpayers, through the Vocational Rehabilitation Program (PRP). Vocational rehabilitation aims to provide the necessary means for the worker s re-entry into the labor market. This research aimed to understand the INSS PRP s contribution to the employee s reintegration in the market and, as specific objectives, identify the profile of the population served by the program of the Social Security Agency (APS) of the Southeast, between 2007-2012; we investigated the means used within the program to reintegrate workers into the labor market; trace the professional profile of users who visited the PRP; and characterize, in the view of the rehabilitated workers, how the program interfered with their reintegration into the market. This is a case study because it was focused on a single APS among a vast universe, transversal and descriptive, which had as data collection 592 records of people referred to the PRP on the above period; besides having been performed eight in-depth interviews with workers considered rehabilitated. The results showed that the profile of the people served corresponds to 76.5% male, 61.15% of those aged between 30-44 years, the most natural of the host city of the Program or the same state, about 62 % are married or living in a stable relationship, 15% have some form of disability, 42% had not finished elementary school, 74.5% are affiliated to the INSS as employees, 99.5% receive social security benefits, and of these, 77,2% receive common sickness assistance. About 48.5% of people referred were eligible to join the program. As for the resources used in the rehabilitation process, in 5.33% of cases was fitting, 23.33% in the provision of courses, and 25% training in the bond company; no resource were used with the remainder. Workers considered rehabilitated by the organization totaled 34%; currently, according to information from corporate systems of the institution, of these, 49.02% are employed or are self-employed, Social Security contributors, and 26.5% are without bond. The in-depth interviews allowed us observe that the rehabilitated workers do not show a direct relationship between the program and their reintegration into the labor market, but they claim that the resources used in the rehabilitation process are important means to win, if not a job, at least recognition personal and The study points to the need for coordination between the INSS and companies to be forwarded to the rehabilitated internship or a job vacancy by the Institute; this, while federal agency, would have, in their view, the power to promote this articulation and guarantee them a job. The PRP requires changes, a more active attitude of the body at the end of the rehabilitation process, and fundamentally have not ceased their responsibility at the time the rehabilitation of the certificate is sent out. / Atualmente, no Brasil, a assistência voltada aos trabalhadores que foram acometidos por alguma doença ou acidente, que se encontram incapazes para retornar à sua função de origem, mas possuem potencial laborativo para exercer outras atividades laborativas, é prestada pelo Instituto Nacional do Seguro Social (INSS) aos contribuintes, por meio do Programa de Reabilitação Profissional (PRP). A reabilitação profissional visa proporcionar os meios necessários para o reingresso do trabalhador no mercado de trabalho. Esta pesquisa teve como objetivo geral compreender a contribuição do PRP do INSS para a reinserção do trabalhador no mercado e, como objetivos específicos, identificar o perfil da população atendida pelo Programa de uma Agência da Previdência Social (APS) da região Sudeste, entre os anos de 2007 e 2012; investigar os meios utilizados dentro do Programa para reinserir o trabalhador no mercado de trabalho; traçar o perfil profissional dos usuários elegíveis para o PRP; caracterizar, na visão dos trabalhadores reabilitados, como o Programa interferiu na sua reinserção no mercado. Trata-se de um estudo de caso, pois foi enfocada uma única APS entre um vasto universo, transversal e descritivo, que teve como fonte de coleta de dados 592 prontuários das pessoas encaminhadas ao PRP no período exposto, além de terem sido realizadas oito entrevistas em profundidade com trabalhadores considerados reabilitados. Os resultados mostraram que o perfil das pessoas atendidas corresponde a 76,5% do sexo masculino, 61,15% na faixa etária entre 30 e 44 anos, a maioria natural da cidade-sede do Programa ou do mesmo estado deste, cerca de 62% são casados ou vivem em união estável; 15% apresentam algum tipo de deficiência; 42% não concluíram o Ensino Fundamental; 74,5% estão filiados ao INSS como empregados; 99,5% recebem benefício previdenciário, destes, 77,2% recebem auxílio-doença comum. Cerca de 48,5% das pessoas encaminhadas foram consideradas elegíveis para integrarem o Programa. Quanto aos recursos utilizados no processo de reabilitação, em 5,33% dos casos foi a protetização, em 23,33% a oferta de cursos e, em 25%, o treinamento na empresa de vínculo; com o restante não chegou ser utilizado nenhum recurso. Os trabalhadores considerados reabilitados pelo órgão somaram 34%; atualmente, de acordo com informações dos sistemas corporativos da instituição, destes, 49,02% estão empregados ou são autônomos, contribuintes da Previdência, e 26,5% estão sem vínculo. As entrevistas em profundidade permitiram observar que os trabalhadores reabilitados não apontam uma relação direta entre o Programa e sua reinserção no mercado de trabalho, mas afirmam que os recursos utilizados no processo de reabilitação são meios importantes para conquistarem, senão um emprego, ao menos reconhecimento pessoal e profissional. O treinamento na empresa de vínculo se mostrou um recurso ineficaz para os dois entrevistados nesta categoria, desviados de função e demitidos após seu retorno, já os cursos, técnicos ou de qualificação, são vistos como uma oportunidade de aprendizado e satisfação, porém não garantem um emprego; as próteses foram consideradas de ótima qualidade e imprescindíveis ao exercício de uma atividade laborativa. Foi apontada a necessidade de articulação entre o INSS e as empresas para que os reabilitados sejam encaminhados para estágio ou a uma vaga de emprego pelo Instituto. Este, como órgão federal, teria, na visão deles, o poder de promover essa articulação e garantir-lhes um emprego. O PRP requer mudanças, uma postura mais ativa do órgão ao término do processo de reabilitação, e, fundamentalmente, não ter cessada sua responsabilidade no momento em que o certificado da reabilitação é emitido.

Estudo dos benefícios previdenciários por incapacidade sob o prisma dos direitos humanos fundamentais sociais, com enfoque na garantia de sua máxima efetividade possível em termos de concretização, como princípio jurídico. Importância cada vez maior do tema, tendo em vista o aumento de sua litigiosidade, atualmente responsável pelo maior número de ações ajuizadas e em trâmite junto aos Juizados Especiais Federais da Terceira Região. Utilização dos métodos dedutivo e interdisciplinar de estudo, com ênfase nos enfoques histórico, político, filosófico, social e jurídico. Análise dos direitos humanos fundamentais sob o prisma da Teoria Crítica (Escola de Frankfurt) e do pós-positivismo (neoconstitucionalismo concretista; força normativa da constituição), levando-se em conta sua evolução histórica, bem como a evolução dos modelos de Estado, dos ordenamentos jurídicos e da própria sociedade ao longo dos séculos. Conclusão pela existência de um regime jurídico único de proteção de todos os direitos humanos fundamentais, de nível constitucional, bem como de seu caráter universalizante, fruto de longo processo de lutas pelo reconhecimento do ser humano como sujeito de direitos e da sacralização da pessoa humana, alçada ao centro dos ordenamentos jurídicos estatais. Reflexos de tais constatações na via jurisdicional, mediante a garantia de plena justiciabilidade dos direitos humanos fundamentais, com ênfase nos direitos sociais. Inserção do direito a previdência social dentre os direitos humanos fundamentais sociais, com assento constitucional (art. 201 , I). Necessidade de seu estudo a partir da análise das contingências sociais elencadas constitucionalmente e em lei como objeto de proteção estatal. Aglutinação das prestações previdenciárias em torno de cada contingência social , com a formação de um regime jurídico único de proteção. Enfoque na continggência social da incapacidade laboral. incapacidade laboral decorrente de doença e/ou acidente, objeto do presente estudo. Aglutinação dos três benefícios previdenciários por incapacidade (aposentadoria por invalidez, auxílio-doença e auxílio-acidente) em um regime jurídico protetivo único, caracterizado pela fungibilidade ontológica entre eles. Necessidade de garantia da prestação adequada ao caso concreto, sem exigências de prévia definição acerca do grau e alcance da incapacidade laboral do trabalhador segurado. Reflexos de tais constatações sobre as demandas previdenciárias por incapacidade laboral, com ênfase na garantia da proteção jurisdicional ao direito humano fundamental social. Escopo principal de desenvolvimento de uma teoria geral voltada à proteção dos benefícios previdenciários por incapacidade, notadamente pela via jurisdicional , como medida de estímulo ao debate acadêmico e desenvolvimento destes estudos, com ganhos em termos de fundamentação e coerência. Fomento, outrossim, a uma análise sistemática e coerente de tais benefícios pelo Poder Judiciário, com o abandono da análise casuística e pontual levada a efeito até hoje Direito do Trabalho e da Seguridade Social. / Study of the incapacity benefits through the prism of social fundamental human rights, with a focus on ensuring the maximum possible effectiveness in their implementation, as a legal principle. Growing importance of the issue, given the increase in their litigation, currently responsible for the largest number of lawsuits fi1ed and pending with the Federal Special Courts of the Third Region. Use of deductive and interdisciplinary study methods, emphasizing the historical, political, philosophical, social and legal approaches. Analysis of fundamental human rights from the perspective of Critical Theory (Frankfurt School) and post-positivism (concretist neoconstitutionalism; normative force of the constitution), taking into account its historical evolution and the evolution of state models, of legal system and society itself over the centuries. Conclusion by the existence of a unified legal regime for the protection of all fundamental human rights, at constitutional level, as well as its universalizing character, as a result of long process of struggles for recognition ofthe human being as a subject ofrights and the sacredness ofthe human person, raised to the center of state legal systems. Reflections of those findings in the judicial process, by ensuring full justiciability of fundamental human rights, with emphasis on social rights. Insertion of the right to social security among the social fundamental human rights, with constitutional provision (art. 201, 1). Need for their study from the analysis of social contingencies listed constitutionalIy and in law as state protection object. Agglutination of social security benefits around each social contingency, with the formation of a unified legal regime of protection. Focus on social contingency of incapacity due to illness and/or accident, the present study object. Agglutination of the three incapacity benefits (disability retirement, sickness and accident alIowance) in a unified protective legal regime, characterized by ontological fungibility between them. Need to ensure the appropriate benefit to the case, without requiring prior definition of the extent and scope of the incapacity of the insured worker. Reflections of such findings on the judicial claims for incapacity, emphasizing the guarantee of judicial protection to the social fundamental human right. Principal aim of developing a general theory focused on the protection of incapacity benefits, notably by judicial process, as a stimulus to the academic debate and development of these studies, with gains in terms of reasoning and coherence. Promoting, moreover, a systematic and coherent analysis of such benefits by the judiciary, with the abandonment of the casuistic and punctual analysis carried out to date.

A substantial number of employees in South Africa may soon be out of work as the result of their HIV-positive status. The dismissal of an infected employee may be motivated by the fact that he is considered to be incompetent or incapable of doing the work for which he was employed. Customers and fellow employees may refuse to deal with an infected employee, with the result that the employee is dismissed for economic reasons. The nature of the undertaking's activities may be such that the presence of an infected employee constitutes a health risk. For the purposes of carrying out his duty to create and maintain safe working conditions, the employer dismisses the employee. The employer may even force the infected employee to resign. Measures should be taken to improve the situation of infected employees. They include educating employers and employees about the transmission of the human immunodeficiency virus. / Mercentile Law / LL. M.