Question 74. Social services for older citizens and disabled people.
Social services for elderly citizens and disabled people
Regulated by the Federal Law of August 2, 1995 On Social Services for Elderly and Disabled Citizens. this type social services is a set of social services that are provided to specified persons at home or in social service institutions, regardless of the form of ownership.
Activities in this area are based on the following principles:
1. Respect for human and civil rights
2. Providing state guarantees in the field of social services
3. Equality of opportunities to receive social services and their accessibility
4. Focus on the individual needs of these individuals
5. Priority of measures social adaptation
6. Continuity of all types of social services
7. Responsibility of state bodies. authorities and institutions, officials for ensuring the rights of these persons in the field of social services.
The right to social services has women over 55 years of age and men over 60 years of age, as well as disabled people (including disabled children) who need outside help temporarily or permanently due to the loss of the ability to independently satisfy their life needs (in whole or in part). ).
Social services for these persons are carried out by decision of the social welfare authorities in institutions subordinate to them or under agreements concluded by the authorities social protection with commercial organizations providing social services.
When receiving social services, elderly disabled citizens have the following rights:
1. respectful and humane treatment on the part of employees of a social service institution
2. the choice of institution and form of social services. service
3. for information about their rights and obligations, as well as about the conditions for the provision of social services.
4. Consent or refusal of social services
5. confidentiality of personal information
6. to protect your rights and interests
Social services are provided with the voluntary consent of the individuals themselves, with the exception of:
1. persons under 14 years of age
2. persons recognized as incompetent in accordance with the law
In this case, consent is given by the legal representative. Consent is expressed in a written statement, on the basis of which the person is placed in a social service institution.
The Law of the Russian Federation of July 2, 1992 On psychiatric care and guarantees of the rights of citizens during its provision provides for the possibility of placing an elderly citizen or disabled person in a social service institution without their consent.
As a general rule, these persons can refuse social services, while social service workers must explain to them the negative consequences decision taken. In this case, persons formalize their refusal of social services in writing.
Elderly citizens and disabled people may be provided with living quarters in social housing stock. At the same time, at the request of the individuals themselves, their social services can be provided both on a permanent and temporary basis.
Social services at home is aimed at maximizing the possible extension of the stay of elderly citizens and disabled people in their familiar environment in order to maintain their social status. The list of state-guaranteed social services includes home-based services:
1. catering, including home delivery of food
2. assistance in purchasing essential medicines, food and industrial goods.
3. assistance in obtaining medical care, including transfer to medical institutions.
4. maintaining living conditions in accordance with hygienic requirements
5. assistance in providing legal assistance and legal services
6. assistance in organizing funeral services.
7. If these persons live in residential premises without central heating and/or water supply, then the list of guaranteed services includes the provision of fuel or water.
In addition, these persons may be provided with other additional services on the condition of partial or full payment.
If senior citizens or disabled people suffer mental disorders, cancer, tuberculosis, sexually transmitted diseases, chronic alcoholism and other similar diseases requiring treatment, then they may be denied social services at home and they are sent to health care institutions.
Semi-stationary social services: includes social, medical and cultural services for elderly citizens and people with disabilities, organizing their meals, recreation, providing them with feasible labor activity and maintaining an active lifestyle. Semi-stationary social services accept persons who are capable of self-care and active movement and have no medical contraindications. Semi-stationary social services can be provided in day and night care homes. These social service institutions are created primarily for persons without a fixed place of residence. The night stay home accepts persons who apply both independently and those referred there by social services. protection or ATS. Some individuals may be provided with these services (listed above) according to inter-personal indications.
Inpatient social services is aimed at providing social and domestic assistance to citizens who have lost the ability to self-care or who need it for health reasons. This type of social service includes rehabilitation measures of a medical, social, therapeutic and labor nature, appropriate to age and health status, provision of care, medical assistance, organization of recreation and leisure. These persons have the following rights:
1. providing living conditions that meet sanitary and hygienic requirements
2. primary health care and dental care
3. socio-medical rehabilitation and social adaptation
4. voluntary participation in the medical and labor process
5. the right to a medical and social examination carried out for medical reasons
6. have the right to be freely visited by lawyers, notaries, representatives public associations, legal representatives, relatives and clergy.
7. have the right to free legal assistance in accordance with the Federal Law on Free legal assistance in the Russian Federation dated November 21, 2011.
8. the right to provide them with premises for the performance of religious rites for believers of all faiths.
9. the right to retain the residential premises they occupy under a rental or lease agreement for 6 months from the date of admission to social services, if these are state/municipal property houses. If family members remain in the premises, it is retained for the entire period.
10. participation in public commissions to protect the rights of citizens.
11. Disabled children in inpatient social service institutions have the right to receive education and vocational training.
12. Physically disabled children and mentally disabled children are placed in different social service institutions.
Elderly citizens and disabled people in inpatient social service institutions are given the right to be hired in accordance with their health status, and if an employment contract has been concluded with them, they have the right to a vacation of 30 calendar days.
Urgent social services carried out in order to provide emergency care of a one-time nature if they are in dire need of social support. Urgent social services include:
1. one-time provision of hot meals or food packages
2. provision of clothing, shoes and other essential goods
3. one-time provision of financial assistance
4. assistance in obtaining temporary housing
5. organization of legal assistance for the purpose of their protection
6. organization of emergency medical and psychological assistance with the involvement of psychologists and clergy.
Social advisory assistance is aimed at adaptation of the elderly and disabled, at easing social tension, creating favorable conditions in the family, ensuring interaction between the individual, family, society and the state. Social advisory assistance includes:
1. identification of persons in need of this assistance
2. prevention of socio-psychological deviations
3. work with families in which these citizens live
4. organization of leisure time,
5. consultation in training, career guidance and employment.
6. legal assistance within the competence of social authorities. service.
7. ensuring coordination of the activities of public associations and social service institutions.
Legal basis social assistance elderly and disabled
The main directions of social services for disabled people are enshrined in the Federal Law dated 08/02/1995, as amended on 08/22/2004 “On social services for elderly citizens and disabled people”. According to this law, disabled people who need permanent or temporary assistance due to partial or complete loss of the ability to independently satisfy their basic life needs due to limited ability for self-care and (or) movement have the right to social services provided in the state and non-state sectors of the system social services.
Social services for people with disabilities are provided by decision of social protection authorities in institutions under their jurisdiction or under agreements concluded by social protection authorities with social service institutions of other forms of ownership.
Social services are provided subject to the voluntary consent of disabled people to receive social services. Social services, at the request of disabled people, can be provided on a permanent or temporary basis.
Disabled people, as well as their legal representatives, have the right to refuse social services, with the exception of cases specifically provided for by the Federal Law of 08/02/1995, as amended on 08/22/2004 “On social services for elderly citizens and the disabled”. In case of refusal of social services, disabled people, as well as their legal representatives, are explained the possible consequences of their decision.
Refusal of disabled people from social services, which may lead to a deterioration in their health or a threat to their life, is formalized by a written statement from disabled people or their legal representatives, confirming receipt of information about the consequences of refusal.
Restrictions on the rights of people with disabilities when providing them with social services are allowed in cases where they are deprived of care and support from relatives or other legal representatives and at the same time are unable to independently satisfy their vital needs (loss of the ability for self-care and (or) active movement) or are recognized as legally incompetent. The issue of placing disabled people in inpatient social service institutions without their consent or without the consent of their legal representatives is decided by the court on the proposal of the social protection authorities.
Refusal from the services of inpatient social service institutions for disabled people who have lost the ability to satisfy their basic life needs or are recognized as incompetent in accordance with the procedure established by law is made upon a written application from their legal representatives if they undertake to provide these persons with care and the necessary living conditions.
Disabled persons who are bacterial or virus carriers, or if they have chronic alcoholism, quarantine infectious diseases, active forms of tuberculosis, severe mental disorders, venereal and other diseases requiring treatment in specialized healthcare institutions, may be denied social services at home. Such a refusal is confirmed by a joint conclusion of the social protection body and the medical advisory commission of the health care institution.
Forms of social services:
1. social services at home (including social and medical services);
2. semi-stationary social services in day (night) departments of social service institutions;
3. stationary social services in stationary social service institutions (boarding homes, boarding houses and other social service institutions, regardless of their name);
4. urgent social services;
5. social and advisory assistance.
Disabled persons may be provided with living quarters in social housing stock.
Social services at home are one of the main forms of social services, aimed at maximizing the possible extension of the stay of disabled people in their usual social environment in order to maintain their social status, as well as to protect their rights and legitimate interests.
State under home care The following social services are guaranteed:
1. catering, including home delivery of food;
2. assistance in purchasing medicines, food and industrial goods of prime necessity;
3. assistance in obtaining medical care, including escort to medical institutions;
4. maintaining living conditions in accordance with hygienic requirements;
5. assistance in organizing legal assistance and other legal services;
6. assistance in organization funeral services;
7. other home-based social services.
When serving disabled people living in residential premises without central heating and (or) water supply, home-based social services included in the list of state-guaranteed social services include assistance in providing fuel and (or) water.
Disabled persons may be provided with other home-based services on full or partial payment terms.
Social and medical services at home are provided for disabled people in need of home-based social services, suffering from mental disorders (in remission), tuberculosis (except for the active form), serious diseases (including cancer) in late stages, with the exception of persons who are bacteria or virus carriers, or if they have chronic alcoholism, quarantine infectious diseases, active forms of tuberculosis, severe mental disorders, venereal and other diseases requiring treatment in specialized healthcare institutions.
Urgent social services are carried out in order to provide emergency one-time assistance to disabled people in dire need of social support. In this regard, the following services can be provided:
1. one-time provision of free hot meals or food packages to those in dire need;
2. provision of clothing, shoes and other basic necessities;
3. one-time provision of financial assistance;
4. assistance in obtaining temporary housing;
5. organization of legal assistance in order to protect the rights of persons served;
6. organization of emergency medical care psychological assistance with the involvement of psychologists and clergy for this work and the allocation of additional telephone numbers for these purposes;
7. other urgent social services.
Social advisory assistance to disabled people is aimed at their adaptation in society, easing social tension, creating favorable relationships in the family, as well as ensuring interaction between the individual, family, society and the state.
This assistance is focused on their psychological support, intensifying efforts in solving their own problems and includes:
1. identification of persons in need of social advisory assistance;
2. prevention various kinds socio-psychological deviations;
3. work with families in which disabled people live, organizing their leisure time;
4. advisory assistance in training, vocational guidance and employment of people with disabilities;
5. ensuring coordination of activities government agencies and public associations to solve problems of people with disabilities;
6. legal assistance within the competence of social service authorities;
7. other measures to form healthy relationships and create a favorable social environment for people with disabilities.
The procedure and conditions for the provision of free home-based, semi-stationary and stationary social services, as well as on the terms of full or partial payment, are established by the executive authorities of the constituent entities Russian Federation.
According to the Federal Law dated July 17. 1999, as amended on November 25, 2006, “On State Social Services,” disabled people can apply for the following set of services:
1. additional free medical care, including provision of necessary medicines according to doctor’s prescriptions, providing, if there are medical indications, vouchers for Spa treatment carried out in accordance with the legislation on mandatory social insurance;
2. free travel on suburban railway transport, as well as on intercity transport to and from the place of treatment.
When providing social services to disabled people with limited ability to work III degree, have the right to receive, under the same conditions, a second voucher for sanatorium-resort treatment and free travel on suburban railway transport, as well as on intercity transport to the place of treatment and back for the person accompanying them.
The list of medicines, as well as the list of sanatorium and resort institutions, are approved by the relevant orders of the Ministry of Health and Social Development.
Accounting for the right of citizens to receive social services is carried out at the citizen’s place of residence from the moment his monthly cash payment is established.
Social services are provided for a calendar year. If a disabled person acquired the right to receive social services during a calendar year, then the period for providing him with social services is the period from the moment of acquiring the right to receive social services until December 31 of the current year.
Payment for social services is made by deducting a certain amount from the monthly cash payment (MCA). For example, if a disabled person refuses free travel on railway transport, then 97.53 rubles will be withheld from his monthly cash payment, the amount of which depends on the degree of limitation of his ability to work.
2.1 Organization and methods of work of the Social Service Center
Social work is an activity carried out by a professionally trained specialist to provide assistance to people in need who are unable to solve their life problems without outside help.
Social work with elderly disabled people consists of providing practical assistance to those who have a low financial level, suffer from various diseases, have disabilities, as well as creating conditions conducive to their physical survival and maintaining their social activity. Social work with such a contingent can be considered at two levels:
Macro level. Work at this level involves measures taken at the state level, its attitude towards elderly people with disabilities as part of society. These include: the formation of social policy taking into account the interests of older people with disabilities; development of federal programs; Creation integrated system social services for the elderly and disabled, including medical, psychological, advisory and other types of social assistance; training of specialists to work with older people and people with disabilities.
Micro level. This work is considered at the level of each elderly person, namely: whether he lives in a family or alone, health status, ability to self-care, age, environment, support, whether he uses social services and even the identity of the social worker who works directly with him .
To ensure a decent life for elderly people with disabilities, Social Service Centers have proven themselves very positively in the social protection system, helping single elderly citizens and people with disabilities adapt to difficult life situations.
Social and medical services at home are provided to disabled people who need permanent or temporary (up to 6 months) outside assistance due to partial or complete loss of the ability to self-care. The staff of this department includes nurses who provide patronage to disabled people at home and provide the following services: monitoring the state of health, feeding weakened patients, sanitary and hygienic procedures (measuring body temperature, blood pressure, control of medication intake). Nurses carry out medical procedures in accordance with the prescription of the attending physician: subcutaneous and intramuscular administration medicines; application of compresses; dressings; treatment of bedsores and wound surfaces; collection of materials for laboratory research; provide assistance in using catheters and other medical products. Medical workers teach relatives of disabled people practical skills in general patient care.
The main directions of social and medical services are maintaining and improving the quality of life of clients, reflecting not only the functional, physical and psychological state of a person’s health, but also his social activity, ability to self-care, material support and living conditions, as well as satisfaction with the feeling of his own physical and psychological well-being.
Medically oriented functions of OSMO:
Organization of medical care and patient care;
Providing medical and social assistance to the family;
Medical and social patronage various groups population;
Providing medical and social assistance to chronically ill patients;
Organization of palliative care;
Prevention of relapse of the underlying disease, disability, mortality (secondary and tertiary prevention);
Health and hygiene education;
Informing the client about his rights to medical and social assistance and the procedure for its provision, taking into account the specifics of the problems, etc.
The activities of a social worker in OSMO, aimed at eliminating problems associated with loneliness of older people and disabled people, depend on the specifics of the legislation and the institution that cooperates with needy categories of the population. Social services for the elderly and senior citizens at the regional level has been carried out since 01/01/2015 in accordance with Federal Law No. 442 “On Social Services for Citizens in the Russian Federation”, but the activities of local authorities and local legislation in this area. In order to implement Federal Law No. 442, the Moscow Government decided: to approve the Procedure for the provision of social services in Moscow from 01/01/2015. Local legislation duplicates federal legislation in its basic principles, but adjusts it in accordance with the specifics and needs of Moscow.
The priority functions of the organization of social assistance at home related to the loneliness of elderly disabled people are the provision of services such as: socio-pedagogical, socio-psychological, services in order to increase the communicative potential of recipients of social services.
Social and pedagogical services play a leading role in overcoming loneliness. Their tasks:
Gaining new knowledge to help you respond flexibly to changes in life;
Creating opportunities for creative development and self-realization of experience and knowledge of elderly people with disabilities;
Realization of the need for communication.
The problem of older disabled people’s lack of opportunity to communicate with each other, have hobbies, hobbies, and organize their leisure time is also becoming more and more urgent. The absence of such opportunities contributes to the development subjective state loneliness.
Loneliness therapy is a set of actions, technological approaches and theories aimed at both preventing loneliness and eliminating its consequences. A social worker must be well versed in loneliness therapy methods in order to be able to choose the optimal model in each specific case that will contribute to practical results. Here we need to take into account the variety of factors leading to loneliness. Helping lonely people should be about changing the situation, not about the person's personality. The social worker is called upon to use methods that do not negatively affect a person’s loneliness.
In general, in the regions in the field of organizing social services for elderly people with disabilities, services are used at home and in inpatient conditions; provision of social services to older people on the basis of the implementation of the principle of an individual approach; development of a network of new types of social service organizations, primarily gerontological centers, small-capacity homes, temporary residence homes, gerontopsychiatric centers, mobile social services; development of a range of additional paid services in the state and non-state social service sector; providing older people with social medical services, including on the basis of hospice-type institutions, including hospices at home; interaction with public associations, charitable organizations, families and volunteers in providing social services to older people and people with disabilities.
Legislation at the regional level takes into account that different people require different services. Different pensioners need a different set of social services, not all of which are provided free of charge for everyone. The most popular existing forms remain semi-stationary. There are about 4.5 thousand of them across the country - they are in almost every city, serving about 20 million people. Social services at home are no less in demand.
The experience of the regions in social technologies for elderly disabled people, aimed, among other things, at overcoming the problem of loneliness is interesting - the example of the Kurgan region: “Dispensary at home.” This technology involves carrying out a complex of restorative therapy, rehabilitation measures, organizing meals, providing healthy leisure time, and creating psychological comfort for elderly disabled people at home. At the “preventoriums at home”, activities are carried out to carry out doctor’s prescriptions for vitamin therapy, herbal medicine, general developmental physical exercises, aerotherapy, massage courses, monitoring the health status of citizens, etc.
Enrollment in a “preventorium at home” is carried out by order of the director of the Social Service Center on the basis of a personal application from a citizen. Services in the “preventorium at home” are provided for 2-3 weeks, the work of which involves nurses, social workers, a psychologist, a massage therapist, an exercise therapy instructor, a rehabilitation specialist for the disabled, etc.
In Moscow, at the State Budgetary Institution TCSO “Alekseevsky” in the “Maryina Roshcha” branch, the technology of social patronage is widespread. It is carried out in stages: informing citizens about the activities of the social service center; conducting a survey of socio-economic living conditions; registration of needy citizens with the center; providing assistance in solving their problems. Social patronage uses interdepartmental interaction.
Social services in the form of social services at home, in volumes determined by established standards, are provided:
free of charge - to recipients of social services on the terms provided for by Federal Law No. 442 of December 28, 2013 “On the basics of social services for citizens in the Russian Federation” and categories of citizens included in the additional list for Moscow, PP No. 827 of December 26, 2014 .
For a partial payment (50% of the tariff for a full payment) - in cases where recipients have an average per capita income in the amount of 150 to 250% inclusive of the subsistence minimum established in the city of Moscow for the main socio-demographic groups of the population;
for full payment - in cases where recipients have an average per capita income of over 250% of the subsistence level established in Moscow for the main socio-demographic groups of the population.
The priority functions of organizing home care are:
Providing social and domestic assistance and pre-medical medical care in home conditions to disabled people and elderly citizens, and other needy categories of the population;
Social, cultural, medical pre-medical care for citizens, organizing their nutrition and recreation, maintaining an active lifestyle;
Rendering urgent help of a one-time nature for citizens in dire need of social support (clothing, food, psychological, legal, etc.);
Implementation of measures for social rehabilitation of disabled people;
Providing citizens in dire need, including people without a fixed place of residence, with hot meals in a charity canteen.
The main objectives of organizing home care: creating conditions for the maximum possible extension of citizens’ stay in their usual habitat and maintaining their social, psychological and physical status, providing sociocultural, socio-psychological, socio-medical services; carrying out preventive measures in order to improve the quality of life, maintain health, and adapt to changing conditions of society.
Home assistance for elderly disabled people is aimed at eliminating a set of existing problems in relation to pensioners who are not inclined to seek help on their own or avoid it, not wanting to personally collect documents, etc.
The priority of the work of specialists in in this case is:
Psychological support;
Coordinating socialization;
Adaptive - development of adaptive abilities;
Wellness;
Prevention of deviant behavior;
Monitoring the condition of the pensioner, the conditions of their stay and safety in the family.
Thus, at the Center for Social Services, technologies for working with elderly disabled people at home are based on scientifically based data on the differentiation of social activity of certain categories of citizens.
Social activity is represented by the ability of recipients of social services to self-service, participate in work activities, engage in leisure activities, and the ability and desire to communicate. These priorities help overcome social and psychological isolation. The assistance of a social worker is especially necessary for elderly disabled people in the social and medical care department.
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1. Social protection system for citizenselderlyand disabled people in the Russian Federation
Social protection includes a set of social services that are provided to elderly citizens and disabled people at home or in specialized state and municipal institutions.
Social protection of disabled people is a system of state-guaranteed economic, legal and social support measures that provide disabled people with conditions for overcoming, replacing (compensating) disabilities and aimed at creating equal opportunities for them to participate in the life of society with other citizens.
The legislation of the Russian Federation on social protection of disabled people consists of the relevant provisions of the Constitution of the Russian Federation, federal laws and other regulatory legal acts of the Russian Federation, as well as laws and other regulatory legal acts of the constituent entities of the Russian Federation.
Social protection of elderly citizens is considered as “the activity of social services and individual specialists in social support, provision of social, social, medical, psychological, pedagogical, social and legal services, implementation of social adaptation and rehabilitation of citizens in difficult life situations.”
Social protection is part of the social security system of the population and is carried out through the system of social services.
Currently, the development of the social protection system is in the network development stage social institutions and development of social protection technologies taking into account the specifics of various regions of the Russian Federation.
To form an effective social protection system, it is also necessary to create your own tools for understanding the surrounding reality and the person in need of social services. On modern stage a consistent process of modeling territorial (departmental) social services and technologies of their activities is carried out.
The social protection system of the population can act as a tool for correcting the work of self-organization and self-regulation mechanisms in society: one of the main tasks to satisfy the systemic need for adjusting the work of social mechanisms based on the principle of self-regulation and self-organization of “social organisms” is adjusting people’s behavior in accordance with their interests the “social organism” that includes them. The functions of solving these problems are borne by such institutions of society as the education and upbringing system, religion, family, etc. With the beginning of the formation and development of the social protection system, correction of the work of social mechanisms of self-organization and self-regulation became one of its most important tasks.
Social protection is provided through the social services system.
The concept of “social service” refers to the basic concepts in social services to the population and is defined as a system of state and non-state structures that carry out social work and include special institutions for the provision of social services and their management bodies.
The social service system includes state, municipal and non-state services.
The state social service includes institutions and enterprises of social protection, executive authorities of the Russian Federation and constituent entities of the Russian Federation, whose competence includes the organization and implementation of social protection.
The jurisdiction of federal government bodies in the field of social protection includes:
1) determination of state policy regarding persons with disabilities;
2) adoption of federal laws and other regulatory legal acts of the Russian Federation on social protection of disabled people (including those regulating the procedure and conditions for providing disabled people with a single federal minimum of social protection measures); control over the implementation of the legislation of the Russian Federation on social protection of disabled people;
3) conclusion of international treaties (agreements) of the Russian Federation on issues of social protection of disabled people;
4) establishment of general principles of organization and implementation of medical and social examination and rehabilitation of disabled people;
5) defining criteria, establishing conditions for recognizing a person as disabled;
6) establishing standards for technical means of rehabilitation, means of communication and computer science, establishing norms and rules that ensure accessibility of the living environment for disabled people; determining appropriate certification requirements;
7) establishing a procedure for accreditation of organizations, regardless of organizational and legal forms and forms of ownership, carrying out activities in the field of rehabilitation of disabled people;
9) development and implementation of federal target programs in the field of social protection of disabled people, monitoring their implementation;
10) approval and financing of the federal list of rehabilitation measures, technical means of rehabilitation and services provided to a disabled person;
16) assistance in the work of all-Russian public associations of disabled people and providing them with assistance;
19) formation of federal budget indicators for expenditures on social protection of disabled people;
20) establishment of a unified system for registering disabled people in the Russian Federation, including disabled children, and organization based on this system statistical observation the socio-economic status of people with disabilities and their demographic composition.
The municipal social service includes institutions and enterprises for the social protection of the population operating on the territory of the constituent entities of the Russian Federation, as well as local government bodies, whose competence includes the organization and implementation of social protection.
State authorities of the constituent entities of the Russian Federation in the field of social protection and social support for disabled people have the right:
1) participation in the implementation of state policy regarding people with disabilities in the territories of the constituent entities of the Russian Federation;
2) acceptance in accordance with federal laws laws and other regulatory legal acts of the constituent entities of the Russian Federation;
3) participation in determining priorities in the implementation of social policy regarding people with disabilities in the territories of the constituent entities of the Russian Federation, taking into account the level of socio-economic development of these territories;
4) development, approval and implementation of regional programs in the field of social protection of disabled people in order to provide them with equal opportunities and social integration into society, as well as the right to control their implementation;
5) exchange with authorized federal executive authorities information on the social protection of disabled people and on the provision of social support to them;
6) providing additional measures of social support to people with disabilities from the budgets of the constituent entities of the Russian Federation;
7) promoting the employment of disabled people, including stimulating the creation of special jobs for their employment;
8) carrying out activities for training personnel in the field of social protection of disabled people;
9) financing scientific research, research and development work in the field of social protection of disabled people;
10) assistance to public associations of disabled people;
Non-state social service includes institutions and social protection enterprises created by charitable, public, religious and other non-governmental organizations and individuals.
For example, the All-Russian Society of Disabled People is a voluntary public organization of disabled people, operating on the basis of its own Charter, in accordance with the Constitution of the Russian Federation and current legislation throughout the Russian Federation. VOI carries out its activities under the leadership of its elected bodies, regardless of political and public organizations, and is neutral in religious terms. VOI builds its work on the basis of the Program of the All-Russian Society of Disabled People.
VOI goals: protection of the rights and interests of people with disabilities in the Russian Federation; creating conditions for people with disabilities that provide equal opportunities for participation in all spheres of society with other citizens of the Russian Federation; integration of disabled people into society.
The tasks of the VOI are: to express and protect the legitimate interests and rights of people with disabilities in central and local government bodies and administration, using for these purposes the right of legislative initiative; participate in the formation of government and management bodies, the development of decisions made by them, in cases and in the manner provided for by law; to assist people with disabilities in the implementation of benefits and advantages established by law, in obtaining medical care, education, employment, improving their financial situation, housing and living conditions, and in fulfilling spiritual needs; to involve disabled people into members of the Society, to widely promote the activities of VOI, etc.
Thus, a client who finds himself in a difficult life situation can receive the following support based on his requests.
socially disabled citizen
Main directions of social protection of the population:
Providing material assistance to citizens in difficult life situations, in the form of cash, food, etc., as well as special vehicles, technical means for the rehabilitation of disabled people and people in need of care;
Social protection at home, which is carried out by providing social services to citizens in need of permanent or temporary non-stationary social services;
Social protection in inpatient institutions, carried out by providing social services to citizens who have partially or completely lost the ability to self-care and need constant outside care, and ensuring the creation of living conditions appropriate to their age and health status, carrying out medical, psychological, social nature, nutrition, care, as well as organization of feasible work, rest and leisure;
Providing temporary shelter in specialized social protection institutions for orphans, neglected minors, citizens in difficult life situations, citizens without a fixed place of residence, victims of mental or physical violence and other clients social service those in need of temporary shelter;
Organization of day stay in social protection institutions with the provision of social, social, medical and other services to elderly citizens and disabled people who have retained the ability for self-care and active movement, as well as other persons, including minors, in difficult life situations;
Advisory assistance on social, social and medical support of life, psychological and pedagogical assistance, social and legal protection;
Rehabilitation services for persons with disabilities, juvenile offenders, and other citizens who find themselves in difficult life situations and in need of professional, psychological, and social rehabilitation.
In modern conditions, institutions for social protection of pensioners and interdepartmental work on organizing social support for older people are becoming important. This is due to the increase specific gravity elderly citizens and disabled people in the population, changes in a person’s social status, cessation or restriction of work activity, transformation of value guidelines, the very way of life and communication, as well as the emergence of various difficulties, both in social and everyday life, and in psychological adaptation to new conditions. All this dictates the need to develop and implement specific approaches, forms and methods of social work with pensioners and older people. Social protection of elderly citizens and people with disabilities is carried out in accordance with the ethical principles of the International Labor Organization:
Personal dignity is the right to decent treatment, treatment, social assistance and support.
Freedom of choice - every elderly person has the right to choose between being kept at home and living in a shelter, temporary or permanent.
Coordination of assistance - assistance provided by various social bodies must be proactive, coordinated and consistent.
Individualization of assistance - assistance is provided, first of all, to the elderly citizen himself, taking into account his environment.
Bridging the gap between sanitary and social care- given the priority nature of the health criterion, the level of financial assistance cannot depend on the standard of living and place of residence.
At the initial stages of the development of the system of social assistance to elderly citizens and people with disabilities, such urgent problems as the organization of nutrition, medical services, housing, and material support were solved in order to create for them normal conditions life.
At the present stage, organizing assistance to elderly citizens and the disabled, along with solving these traditional social problems, involves the development social technologies, the implementation of which will help resolve issues related to psychological difficulties arising in the process of communication or from loneliness. It is also necessary to take into account other age groups, what are the social problems of those who live to old age, their relationships with people around them, the role and status of the elderly in the family and society, etc. It should be noted that there are different categories of elderly citizens and people with disabilities. Among them there are people:
Not in need of help
Partially disabled
In need of service
Requiring constant care, etc.
Assistance to elderly citizens and disabled people is provided by social protection authorities through their departments, which identify and maintain records, provide various types of social support, offer and provide paid services.
Social protection is carried out by decision of social protection bodies in institutions subordinate to them or under agreements concluded by social protection bodies with social protection institutions of other forms of ownership.
The following institutions also perform the function of social protection and assistance:
Boarding houses;
Day and night departments;
Special homes for single elderly people;
Hospitals and departments for chronically ill patients;
Hospitals of various types;
Territorial centers of social protection;
Social assistance departments at home;
Gerontological centers, etc.
Main functional diagram social protection of elderly citizens and disabled people can be presented in the following form.
Social protection includes everything that an elderly and disabled person receives from public consumption funds in addition to their pension. In this case, the company assumes all or part of the costs associated with paying for the cost of services provided to the elderly and disabled citizens those in need of certain types of social assistance. At the same time, in order to provide social protection, the specific needs that are characteristic of this particular category of citizens are satisfied.
The development of social protection for the elderly and disabled is given increasing importance in our country every year; it is considered as an extremely necessary addition to cash payments, which significantly increases the efficiency of the entire state social security system.
System (Greek: composed of parts, connected) is a set of objects that are in relationships and connections with each other and form a certain integrity, unity.
The social protection system covers, in particular, geriatric medical care, both inpatient and outpatient; maintenance and service in boarding homes, home care for those in need of outside care; prosthetic assistance, provision vehicles employment of those wishing to continue passive labor activity and their professional retraining; organization of labor in specially created enterprises and workshops; housing and communal services; organization of leisure activities, etc.
At the same time, in the field of social protection, the possibility of exercising the right to receive it often depends on the decision of the competent authority, since a number of social services provided in this area are still among the scarce ones, not guaranteed to absolutely every old and disabled person. This is evidenced, in particular, by the excess of the number of people in need of services placed in boarding homes compared to the total number of places in these institutions; in social assistance at home and the capabilities of this service, etc.
Thus, the modern social protection system provides a fairly large range of services. Which in turn are guaranteed by the laws of the Russian Federation. In the technology of social protection of the population of the Russian Federation, three main areas of social protection of older people are distinguished:
Pension provision;
System of benefits and benefits for older people;
Social protection of older people in standard and non-standard conditions.
2. Forms of social services
Social services for elderly and disabled citizens include:
1) social services at home (including social and medical services);
2) semi-stationary social services in day (night) departments of social service institutions;
3) stationary social services in stationary social service institutions (boarding homes, boarding houses and other social service institutions, regardless of their name);
4) urgent social services;
5) social advisory assistance.
Elderly citizens and disabled people may be provided with living quarters in social housing stock.
Services provided at home to elderly citizens and disabled people who need outside help due to partial loss of self-care ability:
1) services for organizing catering, everyday life and leisure: purchase and home delivery of food products, hot lunches; assistance in cooking; purchase and home delivery of essential industrial goods; delivery of water, heating of stoves, assistance in providing fuel (for those living in residential premises without central heating and (or) water supply); handing over items for washing, dry cleaning, repairs and their return delivery; assistance in organizing repairs and cleaning of residential premises; assistance in paying for housing and utilities; assistance in organizing the provision of services by trade, public utilities, communications and other enterprises providing services to the population; providing assistance in writing letters; assistance in providing books, magazines, newspapers; assistance in visiting theaters, exhibitions and other cultural events;
2) socio-medical and sanitary-hygienic services: providing care taking into account the state of health; assistance in providing medical care; assistance in conducting medical and social examination; assistance in conducting rehabilitation; assistance in providing medicines and products based on doctors’ opinions medical purposes; providing psychological assistance; assistance in hospitalization, accompanying those in need to medical institutions; visits to inpatient healthcare facilities to provide moral and psychological support; assistance in obtaining vouchers for sanatorium and resort treatment, including preferential ones; assistance in obtaining dental and prosthetic and orthopedic care, as well as in providing technical means of care and rehabilitation;
4) assistance in employment;
5) legal services: assistance in preparing documents; assistance in obtaining benefits and advantages established by current legislation; providing assistance on pension issues and other social payments; assistance in obtaining legal assistance and other legal services;
6) assistance in organizing funeral services.
Social and medical services at home are provided for elderly citizens and people with disabilities who need home-based social services and suffer from mental disorders (in remission), tuberculosis (except for the active form), and serious diseases (including cancer) in late stages.
Semi-stationary social services. Services provided in semi-stationary conditions (day (night) departments created in municipal social service centers or under social protection authorities), including for persons without a fixed place of residence, include the following:
1) catering, everyday life and leisure services: provision of hot meals; provision bedding and a sleeping place in a special room that meets sanitary and hygienic requirements; provision of books, magazines, newspapers, board games and others;
2) social and medical services;
3) assistance in obtaining education and (or) profession for disabled people in accordance with their physical capabilities and mental abilities;
4) legal services;
Institutions (departments) of semi-stationary social services for elderly citizens and disabled people are:
Night stay house;
Social shelter;
Social hotel;
Center (department) for social adaptation;
Social rehabilitation department for elderly and disabled citizens;
Day care center (department) for elderly citizens and disabled people;
Center (department) for temporary residence of elderly citizens and disabled people;
Social canteen, department of trade services for low-income citizens, medical and industrial labor workshops, subsidiary farms at social service institutions for elderly and disabled citizens and others.
Inpatient social services. Services provided to elderly citizens and disabled people living in inpatient social service institutions:
1) material and household services:
Providing living space, premises for organizing rehabilitation activities, medical and labor activities, cultural and social services in a stationary social service institution;
Providing furniture for use in accordance with approved standards;
Assistance in organizing the provision of services by trade and communication enterprises;
Compensation for travel expenses for training, treatment, consultations;
2) services for organizing catering, everyday life, leisure:
Preparation and serving of food, including dietary nutrition;
Providing soft equipment (clothes, shoes, underwear and bedding) in accordance with approved standards;
Providing leisure time (books, magazines, newspapers, board games, excursions, etc.);
Providing assistance in writing letters;
Providing clothing, footwear and cash benefits upon discharge from the institution according to approved standards;
Ensuring the safety of personal belongings and valuables;
Creation of conditions for the performance of religious rites;
3) socio-medical and sanitary-hygienic services:
Free medical care;
Providing care based on health status;
Assistance in conducting medical and social examination;
Carrying out rehabilitation measures (medical, social), including for people with disabilities based on individual rehabilitation programs;
Providing primary health care and dental care;
Organization of medical examination;
Hospitalization of those in need in medical institutions, assistance in referral, based on doctors’ conclusions, for sanatorium-resort treatment (including on preferential terms);
Providing psychological support, conducting psychocorrectional work;
Assistance in obtaining free dentures (with the exception of dentures made from precious metals and other expensive materials) and prosthetic and orthopedic care;
Providing technical means of care and rehabilitation;
Ensuring sanitary and hygienic requirements in residential premises and common areas;
4) organization of education for disabled people, taking into account their physical capabilities and mental abilities:
5) services related to social and labor rehabilitation;
6) legal services;
7) assistance in organizing funeral services.
Types of inpatient institutions (departments) of social services for elderly citizens and disabled people:
Boarding house (boarding house) for the elderly and disabled;
Boarding house (boarding house) for war and labor veterans;
Special boarding house (department) for the elderly and disabled;
Psychoneurological boarding school;
Rehabilitation center (department) for disabled people young;
Boarding house (department) of mercy;
Gerontological Center;
Gerontopsychiatric Center;
Small-capacity boarding house;
Social and health center.
Institutions (departments) of social services for elderly citizens and disabled people, providing services for the provision of living quarters in houses of the housing stock for social use:
Special home for lonely elderly people;
Social apartments.
An independent social service institution for elderly and disabled citizens may have one of the following names:
Boarding house;
Boarding school;
Pension;
Hotel.
A boarding house (boarding house) for the elderly and disabled is a social and medical institution intended for permanent, temporary (up to 6 months) and five-day a week accommodation for those who have partially or completely lost the ability to self-care and require constant outside care, ensures the creation of appropriate their age and health status, living conditions, carrying out medical, psychological, social activities, nutrition and care, as well as organizing feasible work, rest and leisure.
A boarding house (boarding house) for war and labor veterans is a social and medical institution intended for permanent, temporary (up to 6 months) and five-day a week accommodation of war and labor veterans who have partially or completely lost the ability to self-care and need constant outside assistance care, ensures the creation of living conditions appropriate to their age and health status.
A special boarding house (special department) for the elderly and disabled is a social and medical institution intended for citizens in need of constant outside care, from among those released from places of imprisonment and other persons for whom, in accordance with the current legislation, administrative supervision is established, and also elderly citizens and disabled people who have previously been convicted or have been repeatedly brought to administrative responsibility for violating public order, engaged in vagrancy and begging.
A psychoneurological boarding school is a social and medical institution intended for those suffering from chronic mental illnesses and in need of constant outside care, ensuring the creation of living conditions appropriate to their age and state of health, carrying out medical, psychological, social activities, food and care, as well as organizing feasible labor activities, recreation and leisure.
Rehabilitation center (department) for disabled young people is a social and medical institution intended for young disabled people who have partially or completely lost the ability to self-care, and carries out the process of rehabilitation of disabled people in accordance with rehabilitation programs, ensures the creation of living conditions appropriate to their age and health status .
A boarding house (department) of mercy for the elderly and disabled is a social and medical institution intended for those on bed rest or moving within the ward with outside help, ensuring the creation of living conditions appropriate to their age and health status.
A gerontological center is a social and medical institution intended for those who have partially or completely lost the ability to self-care and need constant outside care, ensures the creation of living conditions appropriate to their age and state of health, conducts medical, psychological, social activities, nutrition and care, and organizes feasible work, recreation and leisure, carries out scientific-practical and organizational-methodological work in the fields of gerontology and geriatrics, and also carries out work to improve the qualifications of staff in inpatient social service institutions.
The gerontopsychiatric center is a social and medical institution intended for those suffering from chronic mental illnesses and in need of constant outside care, ensures the creation of living conditions appropriate to their age and state of health, as well as the organization of feasible work activity, rest and leisure, carries out scientific and practical work in the field psychiatry for people of older age groups and carries out work to improve the qualifications of workers in psychoneurological boarding homes.
A small-capacity boarding house for the elderly and disabled is a social and medical institution for no more than 50 people, intended for those who have partially or completely lost the ability to self-care and need constant outside care, ensuring the creation of living conditions appropriate to their age and health status.
Social health center - a social service institution designed to carry out social health and preventive measures to extend the possibility of self-realization by citizens who have retained the ability for self-care and active movement, their vital needs by promoting health, increasing physical activity, as well as normalization of mental status.
Special home for single elderly people (social apartment) - a specialized house or apartment, part of the housing stock for social use, created for the permanent residence of single citizens retirement age, as well as married couples from among them who have retained full or partial ability for self-care in everyday life and need to create conditions for self-realization of basic life needs.
Night stay home, social shelter, social hotel, social adaptation center (department) are social assistance institutions (departments) created in the system of social protection bodies to provide social assistance to persons without a specific place of residence and occupation. These institutions (departments) are intended for temporary residence or overnight accommodation for persons who find themselves without a specific place of residence and occupation, as well as assistance in the implementation of measures for the social adaptation of persons who have lost socially useful connections (primarily persons released from prison), to living conditions in society.
Social rehabilitation department for elderly citizens and disabled people - structural subdivision social service institutions designed to carry out health and social rehabilitation activities with citizens who have retained the ability to self-service or have partially lost it.
Day care center (department) for elderly citizens and disabled people - an institution (department) designed to provide social, everyday, cultural services to citizens who have retained the ability for self-care and active movement, providing them with medical care, organizing meals and recreation, attracting them to feasible labor activities and maintaining an active lifestyle.
Center (department) for temporary residence of elderly citizens and disabled people - an institution (department) designed to provide elderly citizens and disabled people with comfortable housing for a period of up to 6 months, provision of household, sanitary and hygienic services, medical care if necessary, as well as the organization of their food and leisure.
Center (department) for social services at home for elderly citizens and people with disabilities - an institution (department) intended for temporary (up to 6 months) or permanent provision of social and domestic assistance to citizens who have partially lost the ability to self-care and need outside support. .
A center (department) for urgent social services is an institution (department) designed to provide citizens, regardless of their age, who are in dire need of social support, with one-time assistance aimed at maintaining their livelihoods.
Advisory center (department ) - an institution (department) designed to protect the rights and interests of citizens, their adaptation in society by assisting in solving social, psychological and legal issues.
The Center for Social Services for Elderly Citizens and Disabled Persons is a social service institution that is under the jurisdiction of social protection bodies of the constituent entities of the Russian Federation or municipal social protection bodies and carries out organizational, practical and coordination activities to provide social services to elderly citizens and people with disabilities.
A comprehensive social center for providing assistance to persons without a fixed place of residence is a social service institution that provides assistance to persons in difficult life situations - without a fixed place of residence, in providing them with social, medical and other services.
A social canteen is a structural unit of a social service institution designed to provide assistance to citizens who are in dire need of social support due to low income or due to the loss of the ability to self-care, by providing them with hot meals, semi-finished products or food packages.
Social advisory assistance provided to elderly citizens and people with disabilities is the only form of social assistance that is more of a preventive nature in certain risk groups. Such assistance is provided to the population for the purpose of psychological support for disabled people and elderly citizens. However, it affects not only the elderly citizens and disabled people themselves, but also all members of their families, since, first of all, problems with adaptation and getting used to new living conditions begin in a disabled person or a senior citizen precisely because of the unhealthy perception in the family of such a person who is being tried not notice, and in some cases even show aggression towards him. Therefore, a certain psychological attitude here must be created not so much among the disabled person or senior citizen himself, but among his family members.
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8.2. Social services for the elderly and old people
Social service is a set of social services that are provided to elderly and senile citizens at home or in specialized state and municipal institutions. It includes social and domestic assistance, social and environmental influence and moral and psychological support.
The basic principles of activity in the field of social services for old people are as follows:
respect for human and civil rights;
provision of state guarantees;
ensuring equal opportunities in receiving social services and their accessibility for older people;
continuity of all types of social services;
orientation of social services to individual needs;
priority of measures for social adaptation of elderly citizens.
The state guarantees elderly and elderly people the opportunity to receive social services based on the principle of social justice, regardless of gender, race, nationality, language, origin, property and official status, place of residence, or attitude to religion.
By mid-1993, several models of social services had developed in the Russian Federation, which were legislated by the Law of the Russian Federation of August 2, 1995 “On Social Services for Elderly Citizens and Disabled People.” According to this Law, the social service system is based on the use and development of all forms of property and consists of the state, municipal and non-state social service sectors.
Public sector social services consists of social service management bodies of the Russian Federation, social service bodies of the constituent entities of the Russian Federation, as well as social service institutions that are federally owned and owned by the constituent entities of the Russian Federation.
Municipal social service sector includes social service management bodies and municipal institutions providing social services.
Municipal social service centers are the main form of the municipal sector, they are created by local governments in their subordinate territories and are under their jurisdiction. Municipal social service centers carry out organizational, practical and coordination activities to provide various types of social services.
The tasks of the municipal social service center includes identifying old people in need of social support; provision of various social services of a one-time or permanent nature; analysis of social services for elderly people; involvement of various state and non-state structures in resolving issues of providing social, medical, social, psychological and legal assistance to elderly and elderly people.
An analysis of the main activities of municipal social service centers indicates that this model of social service, focused on working with elderly and elderly people, has become most widespread and recognized and is the most typical.
Non-state social service sector unites social service institutions whose activities are based on forms of ownership that are not state and municipal, as well as persons engaged in private activities in the field of social services. This includes public associations, professional associations, charitable and religious organizations whose activities are related to social services for old people. Federal and territorial lists of state-guaranteed social services have been developed.
The federal list of state-guaranteed social services is basic, determined by the Government of the Russian Federation and revised annually; At the same time, a reduction in the volume of social services guaranteed by the state is not allowed. Based on the federal list of social services, a territorial list is established, also guaranteed by the state. This list is approved by the executive authority of the constituent entity of the Russian Federation, taking into account the needs of the population living on the territory of this constituent entity of the Russian Federation.
The right to social services is available to women over 55 years of age and men over 60 years of age who need permanent or temporary assistance due to partial or complete loss of the ability to independently satisfy their life needs.
When receiving social services, elderly and old people have the right to:
respectful and humane attitude on the part of employees of social service institutions;
selection of an institution and form of social services in the manner established by the federal social protection body and social protection bodies of the constituent entities of the Russian Federation;
information about your rights, obligations and conditions for the provision of social services;
consent to social services;
refusal of social services;
confidentiality of personal information;
protection of your rights and legitimate interests, including in court;
obtaining information about the types and forms of social services;
indications for receiving social services and the terms of their payment and other conditions for the provision of social services.
Social services for old people include stationary, semi-stationary and non-stationary forms. To stationary forms of social services
These include boarding houses for labor veterans and disabled people, boarding houses for WWII veterans, boarding houses for certain professional categories of the elderly (artists, etc.), special houses for single and childless couples with a range of social and welfare services; specialized boarding houses for former prisoners who have reached old age. Towards semi-stationary forms of social services
include day and night departments; rehabilitation centers; medical and social departments. Towards non-stationary forms of social services
include social services at home; urgent social services; social advisory assistance; socio-psychological assistance.
Inpatient social services Social services for old people can be permanent or temporary depending on their wishes. It can be completely free, partially paid or paid.
is aimed at providing comprehensive social and domestic assistance to elderly and senile citizens who have partially or completely lost the ability to self-care and who, for health reasons, require constant care and supervision. This service includes measures to create the most appropriate living conditions for age and health status, rehabilitation measures of a medical, social and therapeutic-labor nature, provision of care and medical assistance, organization of recreation and leisure for elderly and elderly people. are not a product of our time. For the first time, special houses for old people appeared in ancient times in China and India, and then in Byzantium and Arab countries. Around 370 AD, Bishop Basil opened the first department for the elderly in the hospital of Caesarea Cappadia. In the 6th century, Pope Pelagius established the first home for the elderly in Rome. From that time on, special premises and rooms for the elderly poor began to be opened in all monasteries. Large asylums for old sailors were first opened in London in 1454 and in Venice in 1474. The first law on state responsibility for poor and infirm old people was passed in England in 1601.
In Rus', the first mentions of the creation of almshouses are found in the reign of Prince Vladimir in 996. During the years of Mongol enslavement, the church and Orthodox monasteries were the builders of premises for almshouses and old charity. In 1551, during the reign of Ivan the Terrible, an Appeal was adopted to the Stoglavy Cathedral, where in Chapter 73 “On Alms” the task was set as urgent measures to identify “elderly and lepers” in all cities, build almshouses for them, men’s and women’s, and keep them there. , providing food and clothing at the expense of the treasury.
During the reign of Alexei Mikhailovich, by his order, Kondinsky was built 760 versts from Tobolsk monastery especially for the charity of the old, crippled, homeless and helpless.
Metropolitan Nikon at the same time opened 4 houses for the care of poor widows, orphans and the elderly in Novgorod. In 1722, Peter I issued an order to fill the vacant places in monasteries with retired soldiers. Service in the army in those days lasted more than 25 years and, it is clear that these retired soldiers were already elderly. With this order, the king pursued the goal of providing shelter and food for old and wounded officials who had no means of subsistence.
In the 30s of the 19th century, “houses of industriousness” were opened in Moscow, where the poor and old people lived. In the 60s of the same century, parish trustees were created, which were also involved in the construction of elderly shelters. Admission to these shelters was very strict - only lonely and frail old people. These same councils obliged relatives to take care of their parents in old age.
In 1892, there were 84 almshouses at Orthodox monasteries, of which 56 were at the expense of the state and monasteries, 28 - at the expense of individuals and societies.
In Soviet times, the stationary social service system was decisive in providing social assistance to old people. As a rule, old people who, due to their physical helplessness, were unable to maintain their usual way of life were admitted to boarding homes for the elderly and disabled. These boarding houses were practically hospitals for chronically ill and helpless old people. The main principle of organizing the activities of boarding homes was the provision of medical care; all work was based on the principle of hospital departments and was entrusted to medical personnel: doctor - nurse- nurse. The structure and activities of these social security institutions have remained without significant changes to this day.
At the beginning of 1994, there were 352 boarding houses for labor veterans in Russia; 37 - specialized boarding homes for old people who spent their entire adult lives in places of detention and remained in their old age without shelter, family, home, or loved ones.
Currently, 1061 inpatient social security institutions are open in the Russian Federation. The total number is 258,500 places, with a population of 234,450 people. Unfortunately, in our time there is not a single boarding house for the elderly that is fully supported by private individuals or any charitable societies.
Boarding houses for labor veterans are available everywhere, but most of them are in the Nizhny Novgorod region - 40; in Sverdlovskaya - 30. Until 1992, there was 1 paid boarding house in Moscow, accommodation in a single room cost 116 rubles per month, in a double room - 79 rubles. In 1992, the state was forced to take it over, leaving 30 paid places, but even these places there were no takers. In 1995, only 3 paid places were occupied. This fact especially clearly demonstrates the impoverishment of the residents of Moscow and all of Russia.
According to N.F. Dementieva and E.V. Ustinova, 38.8% of elderly people live in boarding houses for labor veterans; 56.9% - old age; 6.3% are long-livers. The overwhelming majority of very old people (63.2%) in inpatient institutions of the social security system is characteristic not only of Russia, but is observed in all countries.
The basic rule for applicants is that 75% of the pension goes to the Pension Fund, and 25% remains for the old people themselves. The cost of maintaining a boarding house is from 3.6 to 6 million rubles (excluding denomination).
Since 1954, all homes for the elderly and disabled had benefits, could develop their estate plots, have subsidiary farm in rural areas, labor workshops. However, after social reforms were carried out, taxes were established even on these social service institutions, including road taxes. This led to the abandonment of labor workshops and subsidiary farms in many houses. Currently, boarding houses for labor veterans have only 3 protected items: food, employee salaries and partially medicines.
According to the Federal Law, in boarding houses for labor veterans, old people living have the right to:
providing them with living conditions that meet sanitary and hygienic requirements;
nursing, primary health care and dental care;
free specialized care, dental and prosthetic and orthopedic;
socio-medical rehabilitation and social adaptation;
voluntary participation in the medical and labor process, taking into account the state of health;
medical and social examination to establish or change the disability group;
free visitation by their lawyer, notary, clergyman, relatives, representatives legislative bodies and public associations;
provision of premises for religious ceremonies;
if necessary, referral for examination and treatment to state or municipal health care institutions.
If desired and necessary for work, residents of boarding houses for labor veterans can be hired for work available to them due to health reasons, under the terms of an employment contract. They have the right to annual paid leave of 30 calendar days.
Special residential buildings for old people is a completely new form of inpatient social service. It is intended for singles and married couples. These houses and their conditions are designed for old people who have retained full or partial ability for self-care in everyday life and who need to create easier conditions for the self-realization of their basic life needs.
The main goal of these social institutions is to provide favorable living conditions and self-service, provide social and medical assistance; creating conditions for an active lifestyle, including feasible work. The pensions of those living in these houses are paid in full, in addition, they receive a certain amount of additional payment. A prerequisite for admission to residence is for old people to transfer their home to the municipal housing stock city, region, etc. in which they live.
Specialized boarding homes for the elderly are intended for permanent residence of citizens who have partially or completely lost the ability to self-care and need constant outside care, from among those released from prison, especially dangerous repeat offenders and other persons for whom administrative supervision is established in accordance with current legislation. Elderly people who have previously been convicted or have been repeatedly brought to administrative responsibility for violating public order, engaged in vagrancy and begging, and sent from internal affairs agencies are also sent here. Old people living in boarding houses for labor veterans and constantly violating the rules of living in them established by the Regulations on Social Service Institutions may, at their request or by a court decision made on the basis of the provision of documents by the administration of these institutions, be transferred to specialized boarding houses.
Old people enter a nursing home for various reasons, but the main one, without a doubt, is helplessness or fear of impending physical helplessness. Almost all old people suffer from various somatic diseases that are chronic and usually no longer amenable to active therapy.
At the same time, these old people carry with them various moral, social and family losses, which ultimately become the reason for voluntary or forced abandonment of their usual way of life. An old person makes the decision to move to a nursing home as a result of difficulties in self-care. Fear of even greater physical weakness, impending blindness and deafness contribute to such a decision.
The composition of nursing homes is very heterogeneous. And this is understandable. In a certain (decreasing every year) part, old people come here who are able to take care of themselves and have sufficient physical health. In another case, entering a nursing home is a manifestation of the altruism of an old person, a desire to free younger family members from the burdens associated with guardianship and care for a helpless elderly family member. In the third, this is a consequence of unfulfilled relationships with children or other relatives. However, this is always the result of the inability of old people to adapt to new living conditions in the family and in the familiar home environment. These old people choose social assistance and social services as a new way of life.
And yet, in any case, it is not easy for an old person to radically change his previous lifestyle by settling in a nursing home. 2/3 of old people move here extremely reluctantly, yielding to the pressure of external circumstances. The organization of these social institutions essentially copies the organization of medical institutions, which often leads to an undesirable and painful fixation on the purely painful side of senile infirmity. The results of a sociological study conducted in 1993 in Moscow showed that the overwhelming majority of those surveyed - 92.3% - had an extremely negative attitude towards the prospect of a possible move to a nursing home, including those living in communal apartments. The number of people wishing to move to a nursing home has decreased especially noticeably after the creation of social service departments at home. Currently, in various regions and cities, this queue is no more than 10-15 people, mostly people of particularly advanced age, completely helpless and often alone.
88% of those in nursing homes suffer from various mental pathology; 62.9% had limited physical activity; 61.3% are unable to even partially take care of themselves. 25% of residents die every year.
Serious concern, especially in the last 5 years, has been the unsatisfactory budget funding of boarding houses for labor veterans and disabled people. For this reason, many nursing homes cannot carry out major renovations of their buildings or purchase shoes, clothing, and technological equipment for elderly citizens. Currently, the pace of construction of special houses is sharply decreasing due to limited funds from local budgets. An equally pressing problem is the staffing of nursing homes.
Semi-stationary social services includes social, medical and cultural services for elderly and elderly people, organizing their meals, recreation, ensuring their participation in feasible work activities and maintaining an active lifestyle.
Semi-stationary social services are accepted for elderly and senile citizens who need it, who have retained the ability for self-care and active movement, and who do not have medical contraindications for enrollment in social services.
Day care department Designed to support the active lifestyle of older people. Old people are enrolled in these departments, regardless of their marital status, who retain the ability for self-care and active movement, on the basis of a personal application and a certificate from a medical institution about the absence of contraindications for admission to social services.
The length of stay in the department is usually a month. Visitors to the department can, with voluntary consent, participate in occupational therapy in specially equipped workshops. Work activities are carried out under the guidance of an occupational therapy instructor and under the supervision of a medical professional. Meals in the department can be free or for a fee; by decision of the management of the social service center and the local administration, certain services can be provided for a fee (massage, manual therapy, cosmetic procedures, etc.). These departments are created to serve at least 30 people.
Medical and social department is intended for those who experience serious difficulties in organizing their lives and running their own households, but for one reason or another do not want to live in nursing homes. Special departments and wards have been opened on the basis of healthcare institutions, where frail old-age pensioners living alone, who have lost mobility and the ability to self-care, are hospitalized first of all. In this case, a referral to a medical and social bed is given by social service centers in agreement with the local doctor. In recent years, the experience of organizing wards for routine treatment of old people, where all types of medical procedures are carried out, has become increasingly widespread.
In medical and social departments and wards, lonely, frail old people are on full social security for a long time, and their pensions, as a rule, are received by their loved ones and relatives, who often do not even visit the old people. In many regions, attempts are being made to at least partially reimburse the costs of maintaining elderly and senile people. This is done with the personal consent of the old people by order of the local authorities. These funds are used to purchase clothes and shoes, organize additional meals, and part of the funds goes to improve the wards and departments.
Medical and social departments have become widespread in rural areas. In winter, old people live here, and in spring they return to their homes.
Mercy Trains is a new form of service for old people living in remote, sparsely populated areas by teams that include doctors of various specialties and employees of social protection agencies. These mercy trains make stops at small stations and sidings, during which members of the brigade visit local residents, including the elderly, at home, provide them with all types of medical care, as well as financial assistance, give out medicines, food packages, and industrial kits. goods, etc.
Non-stationary forms of social services created to provide social assistance and services to older people who prefer to remain in their familiar home environment. Among non-stationary forms of social services, first place should be given to social services at home.
This form of social service was first organized in 1987 and immediately received wide acceptance from old people. Currently, this is one of the main types of social services, the main goal of which is to maximally prolong the stay of old people in their usual habitat, support their personal and social status, and protect their rights and legitimate interests.
Basic social services provided at home:
catering and home delivery of food;
assistance in purchasing medicines, food and industrial goods of prime necessity;
assistance in obtaining medical care, escort to medical institutions, clinics, hospitals;
assistance in organizing legal assistance and other legal forms of assistance;
assistance in maintaining living conditions in accordance with hygienic requirements;
assistance in organizing funeral services and burying lonely dead;
organization of various social services depending on living conditions in a city or village;
assistance in preparing documents, including for establishing guardianship and trusteeship;
placement in inpatient social service institutions.
In addition to home-based social services provided for by the federal or territorial lists of state-guaranteed social services, older people may be provided with additional services on a full or partial payment basis.
Social assistance departments at home are organized at municipal social service centers or local social welfare authorities. Social services at home can be provided permanently or temporarily for up to 6 months. The department is created to serve at least 60 people in rural areas and at least 120 people in the city.
Social services at home are provided free of charge:
for lonely old people;
for those living in families whose per capita income is below the minimum level established for the given region;
for old people who have relatives who live separately.
As studies have shown, of all types of services, the most significant for old people are:
care during illness - 83.9%;
grocery delivery - 80.9%;
drug delivery - 72.9%;
laundry services - 56.4%.
The list of services provided by social workers at home is regulated by special regulations, in particular the Order of the Ministry of Social Security of the RSFSR dated July 24, 1987. By the beginning of 1993, 8,000 social service departments at home were created in the Russian Federation, and the total number of persons served reached more than 700,000 people.
Additional services services provided by the department of social services at home:
health monitoring;
provision of emergency first aid;
performing medical procedures as prescribed by the attending physician;
provision of sanitary and hygienic services;
feeding weakened patients.
Procedure and conditions for enrollment for home-based social services: an application addressed to the head of the social protection agency; the application is reviewed within a week; An examination of the applicant’s living conditions is carried out. Based on the results of the examination, an act is drawn up, information is requested on the amount of the pension, a conclusion on the state of health and the absence of medical contraindications, a decision is made on enrollment for permanent or temporary service, and the types of services required.
Removal from social services is carried out on the basis of an order from the director of the social service center at the request of an old person, upon expiration of the service period, in case of violation of contractual terms of payment for services, identification of medical contraindications, malicious violations of the rules of behavior by old people served by social workers.
Social and medical care for old people at home is carried out in relation to people in need of home-based social services, suffering from mental disorders in remission, tuberculosis, with the exception of the active form, and severe somatic diseases, including cancer.
The staff of social and medical services includes medical workers whose professional activities are regulated by the legislation of the Russian Federation on protecting the health of citizens.
Social advisory services (assistance) for elderly and senile citizens is aimed at their adaptation in society, easing social tension, creating favorable relationships in the family, as well as ensuring interaction between the individual, family, society and the state. Social advisory assistance for elderly people is focused on their psychological support, increased efforts in solving their own problems and provides for:
identification of persons in need of social advisory assistance;
prevention of various kinds of socio-psychological deviations;
working with families in which old people live, organizing their leisure time;
advisory assistance in training, vocational guidance and employment;
ensuring coordination of the activities of government agencies and public associations to solve the problems of older citizens;
legal assistance within the competence of social service authorities;
other activities to form healthy relationships and create a favorable social environment for old people.
