Home Prevention Social service institutions for the elderly and disabled. Inpatient social services for the elderly and disabled

Prevention

Social service institutions for the elderly and disabled. Inpatient social services for the elderly and disabled

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MINISTRY OF EDUCATION OF THE REPUBLIC OF BASHKORTOSTAN

STATE AUTONOMOUS EDUCATIONAL

INSTITUTION

SECONDARY VOCATIONAL EDUCATION

TUYMAZINSKY STATE LAW COLLEGE

DEPARTMENT OF LEGAL DISCIPLINES

Inpatient social services

elderly and disabled people

COURSE WORK

SHAPILOVA NATALIA ALEKSANDROVNA

040401.52 SOCIAL WORK

SCIENTIFIC ADVISER:

MINIKHANOVA N.I.

TEACHER

SOCIAL WORK WITH ELDERLY AND DISABLED PEOPLE

TUYMAZY 2012

Introduction

System of inpatient social services for the elderly and disabled

Institutions for inpatient social services for the elderly and disabled

Inpatient social services

Conclusion

List of sources and literature

Introduction

In modern socio-economic conditions, one of the most important tasks social policy is the support and social protection of disabled people, veterans, elderly citizens, as well as interrelated organizational, legal, socio-economic conditions for the implementation of measures to improve their situation and strengthen social security, taking into account the current demographic and socio-economic situation

Inpatient social services include measures to create living conditions for elderly citizens and people with disabilities that are most adequate to their age and health status, rehabilitation measures of a medical, social and medical-labor nature, provision of care and medical assistance, organization of their rest and leisure.

The problems of inpatient social services for elderly citizens and disabled people are very relevant in our time, because inpatient institutions for the elderly and disabled responds poorly to numerous reforms. Nursing homes perform their functions based on their own interests rather than the interests of the people using their services. The federal and local budgets are chronically short of funds; the number of people in need of placement in such institutions seriously exceeds the number of places that can accommodate those interested. Thus, the situation in boarding schools for the elderly and disabled remains very serious.

The degree of development and theoretical and methodological basis of the research. Various aspects of this problem were considered in the works of domestic scientists and authors: S.A. Filatova, S.A. Sushchenko E.I. Kholostova, R. S. Yatsemirskaya, etc.

The work of stationary social institutions is among the priority areas that determine modern state policy. This is evidenced by regulatory legal acts reflecting issues professional activity social work working with older people and people with disabilities:

Resolution of the Ministry of Labor and Social Affairs protection of the population of the Russian Federation dated 08.08.2002 No. 54;

“Federal List of State-Guaranteed Social Services Provided to Elderly Citizens and Disabled Persons by State and Municipal Social Service Institutions.”

The results of our analysis of scientific literature and regulatory documents showed that the measures taken on this problem are insufficient and require further development and research.

The problem and its relevance determined the topic of our research: “Social inpatient services for the elderly and disabled.”

The object of the study is the process of inpatient social services for the elderly and disabled.

The subject of the research is inpatient social services for the elderly and disabled.

The purpose of the study is to study the features of inpatient social services for the elderly and disabled.

The following tasks follow from this goal:

study the system and principles of inpatient social services for the elderly and disabled;

characterize inpatient social service institutions;

consider inpatient social services;

Research methods. To solve the problems and verify the starting points, a complex of complementary research methods was used: analysis, special, pedagogical, psychological, legal literature, and legal documents; praximetric (studying and summarizing the experience of professional activities of social work).

Theoretical significance of the study. The results of the study expand the scientific understanding of the basic principles of the work of a social worker. The essential characteristics of individual research concepts will form the basis for subsequent theoretical understanding of the problem under study. results theoretical research will expand scientific ideas about social work with the elderly and disabled.

The material for the theoretical study was systematized on the basis of legal documents of social workers, scientific, methodological and special literature.

The structure of the work corresponds to the logic of the study and consists of an introduction, a main part, which includes three independent paragraphs, a conclusion, and a list of references.

Inpatient social service system

Inpatient social services are aimed at providing comprehensive social and everyday assistance to elderly citizens and disabled people who have partially or completely lost the ability to self-care and who, for health reasons, require constant care and supervision.

Inpatient social services for elderly and disabled citizens are provided in inpatient social service institutions (departments) profiled in accordance with their age, health and social status.

Elderly citizens and disabled people who have partially or completely lost the ability to self-care and need constant outside care, from among particularly dangerous repeat offenders released from prison and other persons for whom administrative supervision is established in accordance with current legislation, as well as 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, who are sent from institutions of the internal affairs bodies, in the absence of medical contraindications and at their personal request, are accepted for social services in special inpatient social service institutions in the manner determined by the executive authorities of the subjects Russian Federation.

Elderly citizens and disabled people living in stationary social service institutions and constantly violating the procedure for living in them established by the Regulations on the social service institution may, at their request or by a court decision adopted on the basis of a proposal from the administration of these institutions, be transferred to special stationary social service institutions. service .

Citizens living in inpatient institutions receive the entire range of social services, from medical care to social and labor rehabilitation. Taking into account age, health status and some other factors, Various types institutions: boarding schools for the elderly and disabled, boarding houses for labor veterans, psychoneurological boarding schools, orphanages and shelters, etc.

Citizens are admitted to inpatient institutions for the elderly and disabled retirement age, as well as disabled people of the 1st and 2nd groups over 18 years of age who do not have able-bodied children or parents obligated by law to support them. Disabled people and participants of the Great Patriotic War are admitted to boarding houses as a matter of priority. Patriotic War, family members of deceased military personnel, as well as deceased disabled people and war participants. If there are available places, temporary residence of these persons is permitted for a period of 2 to 6 months.

One of the indispensable conditions for admission is voluntariness, therefore, documents are processed only with a written application from a citizen, and for persons under 14 years of age and persons recognized as legally incompetent - a written application from their legal representatives. At any time, a citizen can refuse inpatient care and leave it.

Bacterial or virus carriers, chronic alcoholics, patients with active forms of tuberculosis, severe mental disorders, sexually transmitted and other infectious diseases senior citizens and disabled people may be denied the provision of social services at home on the basis of a joint conclusion of the authority social protection(administration of the municipal social service center) and the medical advisory commission of the health care institution.

Persons living in inpatient institutions have the right to: living conditions in accordance with sanitary and hygienic requirements; nursing, primary health care and dental care; free specialized medical and prosthetic and orthopedic care; voluntary participation in the medical and labor process, taking into account medical recommendations; free visits by a notary, lawyer, relatives and other persons; preservation of residential premises occupied under a rental or lease agreement in state, municipal and public housing stock for 6 months from the date of admission to the hospital, etc.

The hospital administration is obliged to: respect human and civil rights; ensure personal integrity and safety of citizens; allocate separate living quarters for spouses to live together; ensure the possibility of unhindered reception of visitors at any time; ensure the safety of things; provide the opportunity to use telephone and postal communications in accordance with established tariffs, etc.

According to the resolution “On the procedure for the participation of elderly citizens and disabled people living in inpatient social service institutions in treatment labor activity(approved by Decree of the Government of the Russian Federation of December 26, 1995 N 1285):

1. The main objectives of medical and labor activity of elderly citizens and disabled people living in inpatient social service institutions (hereinafter referred to as citizens, inpatient institutions, respectively) are occupational therapy and improvement of the general health of citizens, their labor training and retraining in order to master a new professions in accordance with their physical capabilities, medical indications and other circumstances.

2. The involvement of citizens in medical and labor activities is carried out on a voluntary basis, taking into account their state of health, interests, desires and on the basis of the conclusion of a doctor at a hospital institution (for disabled people - in accordance with the recommendations of the medical and labor expert commission).

3. In inpatient institutions, various types of medical and labor activities are organized, differing in nature and complexity and meeting the capabilities of citizens with different levels of intelligence, physical defects, and residual working capacity. Medical work activities can also be organized in the form of work in subsidiary rural farms of inpatient institutions.

4. Therapeutic work activities of citizens in inpatient institutions are carried out by labor instructors and worker training instructors in accordance with schedule plans and individual rehabilitation programs.

Specialists and workers may be involved to perform the work necessary to organize medical work activities.

5. The duration of medical and labor activity of citizens should not exceed 4 hours a day.

6. For each citizen participating in medical and labor activity, the doctor of the inpatient institution maintains an individual card of medical and labor activity.

7. The determination of the type and duration of medical and labor activity is carried out by a doctor at a hospital institution specifically for each citizen, taking into account his desire, about which a corresponding entry is made in the medical history and individual card medical and labor activities.

Inpatient social service institutions owned by federal or municipal authorities are financed from budgets at various levels.

The following categories of minors have the right to admission to the institution: those without parental care; in need of social rehabilitation and emergency medical and social assistance; experiencing difficulties in communicating with parents, peers, teachers and other persons; living in dysfunctional families; subjected to physical or psychological violence; those who refused to live in families or institutions for orphans and children left without parental care.

It is not allowed to place children with diseases that require active medical intervention, as well as those in a state of alcohol or drug intoxication, mentally ill people who have committed a crime.

The source of funding is the budgets of the constituent entities of the Russian Federation.

A new social service institution is women's crisis centers. Inpatient departments of the center are created for the stay of women for a period of no more than 2 months. Women who are in a crisis and a state dangerous to their physical and mental health, or who have been subjected to psychophysical violence, are provided with psychological, legal, pedagogical, social and other assistance at any time of the day. The centers are funded from the budget. Selected species assistance may be provided for a fee.

Elderly citizens and disabled people living in inpatient social service institutions have the right to:

providing them with living conditions that meet sanitary and hygienic requirements;

nursing, primary health care and dental care provided in a residential social service facility;

socio-medical rehabilitation and social adaptation;

voluntary participation in the medical and labor process, taking into account the state of health, interests, desires in accordance with the medical report and labor recommendations;

medical and social examination carried out for medical reasons to establish or change the disability group; free visits by a lawyer, notary, legal representatives, representatives of public associations and a clergyman, as well as relatives and other persons;

free assistance from a lawyer in the manner prescribed by current legislation;

providing them with premises for the performance of religious rites, creating appropriate conditions for this that do not contradict the internal regulations, taking into account the interests of believers of various faiths;

preservation of residential premises occupied by them under a rental or lease agreement in houses of state, municipal and public housing funds for six months from the date of admission to a stationary social service institution, and in cases where members of their families remained living in the residential premises - for the entire time spent in this institution.

In case of refusal of the services of a stationary social service institution after the expiration of the specified period, elderly citizens and disabled people who have vacated residential premises due to their placement in these institutions have the right to priority provision of residential premises if the previously occupied residential premises cannot be returned to them .

participation in public commissions to protect the rights of elderly citizens and people with disabilities, created, among other things, in social service institutions.

Disabled children living in stationary social service institutions, who are orphans or deprived of parental care, upon reaching 18 years of age, are subject to the provision of residential premises out of turn by local governments at the location of these institutions or at the place of their previous residence of their choice, if an individual rehabilitation program provides the ability to perform self-service;
Disabled children living in inpatient social service institutions have the right to receive education and vocational training in accordance with their physical capabilities and mental abilities. This right is ensured by organizing special educational institutions(classes and groups) and labor training workshops in the manner prescribed by current legislation.
Elderly citizens and disabled people living in state social service institutions and in need of specialized medical care are sent for examination and treatment to state health care institutions. Payment for treatment of elderly citizens and disabled people in these health care institutions is carried out in accordance with the established procedure at the expense of appropriate budgetary allocations and health insurance funds.

Elderly citizens and disabled people living in inpatient social service institutions have the right to freedom from punishment. For the purpose of punishing elderly and disabled citizens or creating convenience for the staff of these institutions, the use of medicines, means of physical restraint, as well as isolation of elderly and disabled citizens is not allowed. Persons guilty of violating this norm bear disciplinary, administrative or criminal liability established by the legislation of the Russian Federation.

Thus, studying the system of stationary social services, we can conclude that stationary social services are the provision of social services: assistance in housekeeping, temporary placement in a social protection institution, etc. In a broad sense, social services include other than cash payments, kinds social security, including: child protection, maternity protection, disabled people, medicine, education, etc.

Inpatient social service institutions

Inpatient social service institutions include: psychoneurological boarding schools; boarding houses; nursing homes (gerontological centers); orphanages for the disabled.

Let's look at some of them:

Psychoneurological boarding school (abbreviated PNI) is a stationary institution for social services persons suffering from mental disorders, who have partially or completely lost the ability to self-care and who are in need due to a mental state, and often physical health in constant care and supervision. Psychoneurological boarding schools are included in common system psychiatric care V Russian Federation and at the same time are institutions social protection population.

The main function currently performed by psychoneurological boarding schools is to provide accommodation for patients and their social and living arrangements. Usually a person stays in a PNI for 15-20 years or more; the concept of discharge is practically absent. This determines the special organization of life for patients, combining elements of a hospital facility and dormitories, as well as patient involvement in work activities.

Labor activity. For organization occupational therapy PNI traditionally has a material and technical base, represented by labor therapy workshops (TMW), subsidiary agriculture and special workshops. The most common types of work in LTM are sewing, carpentry and cardboard; There are also assembly and shoemaking types of work, basket weaving, etc. After 1992 changes in the socio-economic situation in the country led to the fact that LTMs stopped receiving orders and raw materials from the local industry, which resulted in a violation of the right to work of many residents.

In addition, the work activity of PNI patients is often carried out in the following forms:

economic and household activities for maintaining the institution (maintaining cleanliness and order in the premises, caring for the seriously ill, unloading food, etc. - this work is not paid and is often forced, in violation of workers' rights);

activities as part of visiting teams on field work and construction projects;

activities in regular positions in the boarding school and beyond;

Educational activities in PNI should be carried out according to specially developed training programs for socially significant professions, taking into account the degree of intellectual defect. Most often, there is a need to train young PNI patients in the professional skills of a plasterer-painter, carpenter, shoemaker, seamstress, etc., since in institutions of the social protection system there is a need to carry out repairs of buildings, furniture, kitchen utensils, linen, and shoes.

Living conditions in a PNI are usually characterized by monotony of the environment, monotony of everyday life, lack of interesting employment, lack of communication with a healthy environment, dependence on personnel. In many boarding schools, patients live eight to ten people per room; The sanitary area per patient is often 4-5 m², contrary to the standards (7 m²).

Persons living in psychoneurological boarding schools are subject to the general rights of persons suffering from mental disorders. Thus, PNI patients should be informed of their rights, they should be treated humanely and with respect for their human dignity, the conditions of their detention should be as less restrictive as possible, etc. It is also necessary to take into account the rules on consent to treatment, the right to refuse from treatment, the right to keep medical information confidential and other so-called medical rights provided for in Psychiatric Care Act .

contact the PNI administration on issues of treatment, examination, discharge, compliance with rights provided for by the legislation on psychiatric care;

submit uncensored complaints and applications to authorities representative And executive authorities, prosecutor's office, court and lawyer;

meet with a lawyer and a clergyman alone;

perform religious rituals, observe religious canons, including fast, in agreement with the administration, have religious paraphernalia and literature;

subscribe to newspapers and magazines;

receive education according to the program secondary school or special school for children with intellectual disabilities, if the person is under 18 years of age;

receive, on an equal basis with other citizens, remuneration for work in accordance with its quantity and quality, if the citizen participates in productive labor.

Authoritative publications note massive violations of the rights of citizens living in psychoneurological boarding schools. State control enforcement of their rights is often insufficient, and public protection is almost completely absent. Characterized by widespread violations of the rights to employment and labor rehabilitation, to systematic training, to integration into society, independent living, own family. Violation of rights is such a common situation in which a person with mental disorders, according to the conclusion of doctors, could be discharged from a psychoneurological institution, but is denied discharge. The most common reason for refusal is lack of housing and the inability to solve the housing problem; other common reasons- inconsistency of available legal norms in relation to incapacitated persons, the difficulty of obtaining a decision from a medical commission on the possibility of independent living. Cases of discharge from psychoneurological institutions turn out to be isolated; Once in a psychoneurological boarding school, patients usually live there all their lives.

According to human rights activists, in relation to PNI patients, employees often take illegal real estate and misappropriate pensions by illegal means.

The Gerontological Center is designed to provide social services to citizens of older age groups, the purpose of which is to extend active longevity and maintain satisfactory life potential for this category of citizens.

The main objectives of the Gerontological Center are:

provision of social services to citizens of older age groups (care, catering, assistance in obtaining medical, legal, socio-psychological and natural types of assistance, assistance in vocational training, employment, leisure activities, funeral services, etc.

monitoring the social status of citizens of older age groups living in the service area of the Gerontological Center, their age structure, health status, functional abilities and income level in order to timely prepare a forecast and further plan the organization and improve the effectiveness of social services for citizens of older age groups;

implementation of the results of scientific research in the field of social gerontology and geriatrics into the practice of the Gerontological Center;

interaction with bodies and organizations, including research organizations, social service institutions, on issues of organizing social services for citizens of older age groups, including issues of the practical application of social gerontology and geriatrics in social services for citizens of older age groups.

The following structural units can be created in the Gerontological Center:

for the provision of social services in stationary, semi-stationary and home-based conditions (mercy department, department for providing social services to socially and physically active citizens of older age groups, day (night) stay department, specialized home care department, emergency social assistance department and others);

organizational and methodological department;

social rehabilitation department;

gerontopsychiatric department;

socio-psychological department;

social and medical department;

other divisions and services corresponding to the goals and objectives of the Gerontological Center.

The organizational and methodological department is created for:

monitoring the social status of citizens of older age groups, determining their need for social services, taking into account the demographic situation (age composition, population ratio, life expectancy, mortality, birth rate), health status, trends and causes of aging ( general state health, the level of medical care provided and the decline physical activity) and other criteria;

drawing up technologies for social services for citizens of older age groups, taking into account scientific developments in social gerontology and geriatrics and organizing work on their implementation in the practice of the Gerontological Center;

tracking and analysis of scientific developments in social gerontology and geriatrics;

developing directions (forecasts, programs, concepts, strategies, technologies) for the activities of the Gerontological Center for the application of social gerontology and geriatrics in the provision of social services, taking into account the preservation of national traditions of social work; determining directions for the development of additional social services provided by the Gerontological Center to citizens of older age groups;

assessing the effectiveness and quality of social services provided by the Gerontological Center to citizens of older age groups;

interaction with authorities and organizations on issues of social services, as well as social gerontology and geriatrics.

The social rehabilitation department is created for:

carrying out rehabilitation of citizens of older age groups living in the Gerontological Center, including reactivation, resocialization and reintegration;

carrying out activities aimed at extending the active longevity of citizens of older age groups;

4) development and implementation of measures aimed at preserving the vital functions of citizens of older age groups at their place of residence and developing their abilities for everyday self-service and organizing feasible work activities;

developing recommendations and providing assistance to citizens of older age groups in the formation of behavioral forms, including labor rehabilitation and expansion of individual abilities and capabilities: physical activity, acquisition, restoration and maintenance of work skills, reducing the level of dependence on outside help, etc.

The gerontopsychiatric department is being created for:

providing social services to citizens of older age groups suffering from mental disorders in combination with multiple somatic pathologies;

carrying out medical and social rehabilitation in order to prolong active life and preserve the satisfactory life potential of citizens of older age groups with personality changes, intellectual-mnestic and mental disorders;

implementation of modern and effective methods social services for citizens of older age groups with personality changes, intellectual-mnestic and mental disorders who do not have established medical contraindications for the provision of social services;

The socio-psychological department is created for:

development of socio-psychological methods aimed at preserving the satisfactory life potential of citizens of older age groups;

identifying the need of citizens of older age groups served in the Gerontological Center for socio-psychological assistance and developing recommendations for the formation of a microclimate in the team of citizens of older age groups, placing them taking into account psychological compatibility;

organizing a “helpline for older people” service;

carrying out activities to develop social tourism and recreation for citizens of older age groups;

The social and medical department is intended for:

interaction with treatment-and-prophylactic, sanitary-epidemiological and other healthcare institutions on issues of organizing the provision of social medical services citizens of older age groups;

monitoring the provision of social and medical care and medications to citizens of older age groups who receive social services;

developing a list and procedure for providing additional social and medical services to citizens of older age groups.

Social services in the Gerontological Center are provided to citizens of older age groups who need outside help due to partial or complete loss of the ability to independently satisfy their life needs due to limited ability for self-care and (or) movement and who do not have medical contraindications to service in social service institutions.

Contraindications for admission to the Gerontological Center for citizens of older age groups may include active forms of tuberculosis, chronic alcoholism, quarantine infectious diseases, severe mental disorders, sexually transmitted and other diseases requiring treatment in specialized healthcare institutions in accordance with the legislation of the Russian Federation.

Social services can be provided to citizens of older age groups at the Gerontological Center on the basis of:

a personal written statement, and for persons recognized as legally incompetent in the established manner - a written statement from their legal representatives, submitted to the social protection body in charge of the Gerontological Center;

referral for social services issued by the social protection authority in charge of the Gerontological Center;

an agreement on the provision of social services concluded between citizens of older age groups or their legal representatives and the Gerontological Center, in cases established by the legislation of the Russian Federation.

Admission to social services for citizens of older age groups is formalized by order of the Gerontological Center.

Boarding house. In Bashkortostan, inpatient social services for elderly citizens and disabled people are provided by 5 nursing homes for the elderly and disabled, 15 psychoneurological boarding schools and 44 temporary departments within the structure of comprehensive centers for social services for the population of districts and cities. More than 7 thousand elderly and disabled people (7,100 beds) permanently live in these social service institutions.

A boarding house for the elderly and disabled is intended for the residence of appropriate persons over the age of 45, regardless of the ability to care for themselves or the need for constant outside care; boarding house for the disabled - only for disabled people aged 18 to 45 years, regardless of the ability to care for themselves; psychoneurological boarding school (separate for men and women) - for disabled people suffering from mental illness; orphanage boarding school - for children with physical disabilities, blind, deaf-mute, deaf-blind, deaf-blind, sick with some persistent mental illnesses, severely mentally retarded children who are capable of learning special programs and methods, as well as for severely mentally retarded children who require only constant care and supervision.

The official website of the Ministry of Labor and Social Protection of the Population provides information about consumers of boarding house services:

Consumers of the state service for social services for elderly citizens and disabled people in inpatient conditions are:

elderly citizens and disabled people who have partially or completely lost the ability to self-care and who, for health reasons, require constant outside care and supervision;

elderly citizens and disabled people suffering from chronic mental illnesses, who have partially or completely lost the ability to self-care and who need constant care and supervision for health reasons;

disabled children with mental development abnormalities, who have partially or completely lost the ability to self-care and who, for health reasons, need care, household and medical services, as well as social and labor adaptation;

disabled children with physical disabilities who have partially or completely lost the ability to self-care and who, for health reasons, need care, household and medical services, as well as social and labor adaptation [ 8 ].

Boarding houses (Boarding Homes) are maintained at the expense of the state, enterprises, collective farms or public organizations. Their activities are coordinated by social security authorities regardless of departmental subordination. The main purpose of D.-i. -- create normal living conditions for lonely disabled people and the elderly. All persons in them are fully provided with food, clothing, shoes, bedding, and adults retain 10% of their pension.

Boarding houses have subsidiary farms, through which they can provide fresh vegetables, fruits, berries, dairy products, honey, etc. Medical care, including regular preventive examinations, in D.-i. is organized taking into account its profile and the population of residents. Monitoring the quality of medical care, compliance with the sanitary and epidemiological regime in these institutions, as well as the provision of specialized medical care is carried out by health authorities. According to indications, occupational therapy is organized, and for young disabled people - general and vocational training; Various cultural events are held. social services elderly gerontological

Admission to a boarding home and a change in usual life activities is a critical moment in the life of an elderly person. Unforeseen situations, new people, unusual surroundings, unclear social status - these life circumstances force a person not only to adapt to the external environment, but also to respond to changes occurring in themselves. Elderly people are faced with the question of assessing themselves and their capabilities in a changed situation.

According to the Resolution of the Ministry of Labor and Social Protection of the Population of the Russian Federation dated 08.08.2002 No. 54 “On approval of methodological recommendations for organizing the activities of a state (municipal) institution “boarding home for mentally retarded children”:

The activities of the Institution are aimed at social services for disabled children, in connection with which the Institution carries out:

providing social services to disabled children in order to create favorable living conditions for them;

implementation of individual rehabilitation programs for disabled people, developed by institutions of the state medical and social examination service;

measures for social and labor rehabilitation of children with disabilities for the purpose of restoring or compensating for lost or impaired abilities for everyday, social and professional activities, and integrating them into society;

organizing care for disabled children, leisure activities, carrying out therapeutic and health-improving and preventive measures;

organization of physical education for disabled children, taking into account age and health status, allowing them to develop their abilities within the limits of maximum capabilities;

social, psychological or other assistance to parents (legal representatives) of disabled children to eliminate a difficult life situation;

protection of the rights and legitimate interests of disabled children in the manner prescribed by the legislation of the Russian Federation;

organization of education for disabled children, taking into account their physical capabilities and mental abilities in accordance with the legislation of the Russian Federation.

When providing social services to disabled children, it is recommended to use small-scale mechanization and self-service tools that will allow:

improve the quality of service, maintenance and care for disabled children;

use progressive forms and methods of work on social services for disabled children;

to facilitate the work of staff in caring for seriously ill children and to instill self-care skills in disabled children;

use new rehabilitation technologies that increase the effectiveness of the rehabilitation process for disabled children.

The following structural units may be created in the Institution: admissions department, medical and social rehabilitation department, psychological and pedagogical assistance department, social and labor rehabilitation department, social counseling department, mercy department, day care group and other departments that meet the goals and objectives of the Institution .

The reception department of the Institution is intended for:

carrying out the initial and, if necessary, subsequent admission of disabled children to the Institution, identifying their needs in social services, referrals to the relevant functional divisions of the Institution;

creating a data bank about disabled children who have applied to the Institution for help, exchanging the necessary information with interested state and public organizations and institutions;

carrying out analysis and forecasting of social processes in the territory served by the Institution.

The medical and social rehabilitation department of the Institution is intended for:

development and use of traditional and new effective techniques and technologies in carrying out rehabilitation activities;

referral of disabled children, if necessary and in agreement with health authorities, to medical institutions to receive specialized medical care;

ensuring interaction between department specialists and parents (legal representatives) of disabled children to achieve continuity of rehabilitation activities and social adaptation disabled children in the family, teaching them the basics of medical-psychological and medical-social knowledge, skills and abilities to carry out rehabilitation activities at home;

carrying out therapeutic and physical education activities with disabled children.

The Department of Psychological and Pedagogical Assistance of the Institution is intended for:

providing practical assistance in organizing the education of disabled children, developing educational programs based on the characteristics of the psychophysical development and individual capabilities of disabled children;

conducting psychological and correctional work with disabled children;

preparing and conducting activities to organize leisure time for disabled children together with their parents (legal representatives), conducting medical and social patronage for families with disabled children;

teaching disabled children self-care skills, behavior in everyday life and public places, self-control, as well as communication skills and other methods of everyday adaptation;

organizing play therapy for disabled children;

conducting a detailed diagnosis of the mental development of disabled children in order to determine the forms and methods of psychocorrectional work.

The Department of Social and Labor Rehabilitation of the Institution is intended for:

carrying out activities to provide psychological and career guidance services to disabled children;

carrying out activities that promote the development and acquisition of professional skills and abilities by disabled children;

organization of occupational therapy and pre-vocational labor training for disabled children on the basis of training and production workshops of the Institution based on local conditions;

resolving issues of future employment of disabled children in specialized enterprises for disabled people in the prescribed manner.

The Social Advisory Assistance Department of the Institution is intended for:

consulting parents (legal representatives) on psychological and pedagogical issues of family education and personality development of disabled children with developmental limitations;

providing social and advisory assistance to families raising disabled children on issues of social and legal protection and ensuring their livelihoods.

The charity department of the Institution is intended for:

organizing rehabilitation groups that unite disabled children, taking into account their age and severity of the disease;

implementation of activities of rehabilitation groups based on individual rehabilitation programs for disabled children.

The day care group of the Institution is intended for:

implementation of individual programs for medical-social, psychological-social, socio-pedagogical rehabilitation of disabled children;

ensuring a temporary detention regime for disabled children, taking into account family circumstances and the interests of disabled children.

The institution accepts disabled children from 4 to 18 years old with disabilities mental development who, for health reasons, need outside care, consumer services, medical care, social and labor rehabilitation, training and education, and who are in another difficult life situation.

Disabled children who, according to the conclusion of medical institutions, suffer from mental, oncological, skin-venereological and other forms of infectious diseases requiring treatment in specialized inpatient medical institutions are not admitted to the Institution.

Disabled children are admitted to the Institution for permanent, temporary (for up to 6 months), five-day a week accommodation and day stay. Social rehabilitation work with parents (legal representatives) is carried out during the entire period of residence or stay of disabled children in the Institution.

The basis for placement in the Institution is a voucher issued by the social protection body of the population of a constituent entity of the Russian Federation or a local government body. A permit for the placement of a disabled child may be issued on the basis of an application from his parents (legal representatives).

A personal file is opened for each resident of the Institution, which contains: a voucher; medical history, to which a medical card is attached; a certificate from the institution of the state medical and social examination service; individual rehabilitation program, outpatient card, received from a medical institution, all medical and other documents from the time the disabled child was in the Institution

Thus, studying inpatient social service institutions, we can conclude that inpatient social service institutions are psychoneurological boarding schools, gerontological centers, boarding homes, orphanages for disabled children.

Services of stationary social institutions

According to the “Federal List of State-Guaranteed Social Services Provided to Elderly Citizens and Disabled Persons by State and Municipal Social Service Institutions”

Services provided to elderly citizens and disabled people living in inpatient social service institutions:

1. Material and household services:

provision of living space, premises for organizing rehabilitation activities, medical and labor activities, cultural and social services in a stationary social service institution;

provision of 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, and leisure:

preparing and serving food, including dietary nutrition;

provision of soft equipment (clothes, shoes, underwear and bedding) in accordance with approved standards;

providing assistance in writing letters;

provision upon discharge from the institution with clothing, shoes and cash benefits according to approved standards;

ensuring the safety of personal belongings and valuables;

creating conditions for the performance of religious rites.

(as amended by Decree of the Government of the Russian Federation dated April 17, 2002 N 244)

3. Social, medical and sanitary services:

free provision of medical care in the scope of the basic program of compulsory health insurance for citizens of the Russian Federation, targeted programs and territorial programs of compulsory health insurance in state and municipal medical institutions;

providing health-sensitive care;

assistance in conducting medical and social examination; carrying out rehabilitation measures (medical, social), including for people with disabilities, based on individual rehabilitation programs;

provision of 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;

provision of 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:

creating conditions for preschool education children and education under special programs; creating conditions for receiving school education under special programs.

5. Services related to social and labor rehabilitation:

creating conditions for the use of residual labor opportunities, participation in medical and labor activities;

carrying out activities to teach accessible professional skills, restore personal and social status.

6. Legal services:

assistance in paperwork; providing assistance with questions pension provision and provision of other social benefits;

assistance in obtaining benefits and advantages established by current legislation;

assistance in obtaining advisory assistance;

ensuring representation in court to protect rights and interests;

assistance in obtaining free help a lawyer in the manner prescribed by current legislation;

assistance in preserving residential premises previously occupied under a rental or lease agreement in state, municipal and public housing funds for six months from the date of admission to a stationary social service institution, as well as in emergency provision of residential premises in case of refusal of the services of a stationary social service institution upon expiration of the specified period, if the previously occupied premises cannot be returned.

7. Assistance in organizing funeral services.

Having examined the services of social inpatient institutions, we came to the conclusion that these are material and household services for organizing meals, everyday life, and leisure; socio-medical and sanitary-hygienic services; organization of education for disabled people, taking into account their physical capabilities and mental abilities; legal services; assistance in organizing funeral services provided by inpatient social service institutions.

Conclusion

Having considered the first section of the study “System of inpatient social services for the elderly and disabled,” the following conclusions can be drawn:

Inpatient social services are the provision of social services: assistance in housekeeping, temporary placement in a social protection institution, etc. In a broad sense, social services include other types of social security in addition to cash payments, including: child protection, maternity protection, disabled people, medicine, education, etc.

Elderly and disabled people living in inpatient institutions have their own rights, for example: living conditions in accordance with sanitary and hygienic requirements; nursing, primary health care and dental care; free specialized medical and prosthetic and orthopedic care; voluntary participation in the medical and labor process, taking into account medical recommendations; free visits by a notary, lawyer, relatives and other persons; preservation of residential premises occupied under a rental or lease agreement in state, municipal and public housing stock for 6 months from the date of admission to the hospital, etc.

Principles of social services for older people

The activities of social service institutions are based on such important provisions as:

the need for strict observance of the freedoms and rights of wards;

continuity between social organizations providing special services to the elderly;

mandatory consideration of the needs and wishes of every elderly person, without exception;

strict adherence to guarantees provided by the state;

equalization of opportunities for all applicants for social services;

appeal special attention for the adaptation of the elderly in society.

On the basis of state guarantees, social services are provided to relevant groups of people. They must be provided regardless of nationality, race, religion, financial status, gender and other characteristics.

What conditions must be observed for social services for older people?

Social services are considered necessary for persons in whose life there are circumstances that sharply worsen its quality:

inability to carry out simple actions around the house, take care of oneself, independently change body position and move due to serious illnesses or receiving traumatic injuries;

the presence in the family of a person with a disability group who needs daily care and concern;

the presence in the family of children who have difficulties adapting to society;

impossibility of daily supervision and care and lack of care for disabled people and children;

conflict within the family due to violence or with people who suffer from severe mental illness or have alcohol or drug addiction;

the person does not have a permanent place of residence, including those who have not yet reached the age of 23 and have already completed their stay in homes for orphans;

a person’s lack of a place to work and financial resources for subsistence.

But the presence in life of one or more of the above circumstances only confirms the difficult situation in life this person, but does not guarantee receipt of free social services. It is also worth noting that due to the introduction of fees for social services for the elderly and disabled, the meaning of the concept of “social services” has become very controversial. And all because this activity has lost touch with the traditional meaning of the concept of social assistance.

How social services for older people are organized

Citizens of the elderly age group require care and care from strangers constantly or for a certain period of time due to the inability to independently change body position, move and satisfy vital needs. This social group has the right to social services. Its provision is possible at the state, local and non-state levels. This activity is carried out in accordance with the decision of the social security authorities in subordinate organizations or in accordance with the concluded agreement between these authorities and non-departmental institutions.

People demanding various reasons and social service circumstances, have rights to:

Polite and sensitive attitude of social workers towards their clients.

Independent choice of establishment and type of service in a certain order. It is established by social protection authorities at the federal and local levels.

Familiarization with information material about your own rights, as well as the conditions for receiving services.

Refusal to provide these services.

Keeping confidential personal information that a social worker may learn in the course of his work.

Protection of rights, if necessary, can be carried out through judicial proceedings.

Access to information material about existing types and types of social services, the reasons for which they are provided, and the conditions for paying for them.

Social services for the elderly and disabled are based on the wishes of the person and are provided either permanently or for a short period of time.

At the legislative level it is provided five types of services for the elderly population and citizens with disabilities:

Semi-stationary in nature, with accommodation of people on the basis of day or night departments of specialized organizations.

Stationary in nature on the basis of specialized institutions. These can be various boarding houses, sanatoriums, boarding schools, etc.

Urgent nature.

Advisory nature.

The first type of social service can be considered the provision of services at home. It is focused on keeping people in a familiar and comfortable environment for as long as possible, in order to maintain their status in society.

The list of services performed at home includes:

supply of necessary products and ready-made hot meals;

maintaining cleanliness of housing in accordance with sanitary standards;

delivery of necessary medicines and household goods;

accompanying patients to health care facilities to receive the necessary medical care;

organization of legal, ritual and any other necessary services;

a number of other services.

This list may also include the supply of the elderly population and people with disabilities with clean drinking water and fuel resources in situations where they live in premises where there is no centralized water supply and heating.

Also, in addition to all the above services, additional ones may be provided, but for an appropriate fee.

Social services for older people at home can be provided to those who suffer from serious illnesses terminal stages, mental illnesses (beyond exacerbation), inactive tuberculosis. Social assistance is not provided to patients with chronic alcoholism and infectious diseases. This type of service is implemented under certain conditions and in the established regional executive branch ok.

A semi-stationary type of care for elderly citizens is provided to those who are able to independently change their body position, move and perform simple actions aimed at meeting the needs of life. This includes medical, social, consumer and cultural services, the purpose of which is to organize ready-made food for people, a variety of recreation and leisure, and ensure the participation of people in feasible work.

Elderly people are enrolled in this type of service according to the decision of the management of the relevant organization, which is made after considering the citizen’s application and a certificate of his state of health. The procedure and conditions for the provision of services are established by the local executive authority.

The inpatient type is focused on providing multidirectional assistance to elderly people who have lost the ability to care for themselves, as well as those who, for health reasons, require daily monitoring and care.

This includes measures to ensure the creation of living conditions that are most appropriate for age and health, medical and social rehabilitation, provision of active and varied recreation, as well as the organization of highly qualified medical care and adequate care.

This type of service for older people is implemented on the basis of inpatient departments of specialized organizations.

People who live in such institutions have the right to:

Undergoing rehabilitation and adaptation to society.

Participation on a voluntary basis in feasible work, taking into account their interests and wishes.

Receiving daily care and attention, timely and qualified medical assistance.

Conducting a medical examination that is necessary to change or confirm the disability group.

Free meetings with relatives and friends.

Arranging visits, if necessary, by lawyers, notaries, priests, etc.

Obtaining free premises with suitable conditions for conducting religious ceremonies. It is important that the created conditions do not contradict the routine within the organization.

Retaining housing that was rented before entering a social institution for six months if you lived there alone. If relatives of an elderly person also live in this place, then the housing is maintained throughout the entire period of the pensioner’s stay in the hospital.

Obtaining new housing out of turn in the case when old man wrote a refusal of special social services after 6 months of being in the relevant institution and has already lost his previous housing.

Participation in public commissions, the main goal of which is to protect the rights of people in the elderly age group.

Social services for older people in Russia, provided on an urgent basis, are one-time emergency and emergency assistance.

This includes a number of services:

food delivery and provision of food packages to wards;

supply of necessary wardrobe items and household goods;

finding a place for temporary residence;

one-time cash payment;

organization of legal assistance, the main goal of which is to protect the interests and rights of wards;

high-quality assistance from doctors and psychologists in urgent circumstances.

In order to adapt the elderly to society, reduce social tension and improve relationships between family members, such a form of assistance as consultations is provided.

Social service institutions for older people

Nowadays social service centers for older people occupy fairly high positions in the structure of gerontological services. They are based in institutions that, due to various circumstances, have changed the focus of their work. Such organizations are usually former boarding houses, sanatoriums, camps and other similar institutions.

In addition to all of the above, the list of social services for older people may include the organization of ready meals and the supply of necessary goods at the lowest possible cost.

Persons living alone are provided with assistance through a system of specialized homes, which have a controversial organizational and legal status. These institutions are taken into account in the state statistical report together with non-stationary and semi-stationary organizations. Moreover, such houses should not even be called specialized institutions, but rather a type of housing in which elderly people are located under certain conditions. A service for social purposes is often created in houses, and branches of social centers are also opened.
There are many pensioners living in the country who are not only lonely, but also have certain health problems. Specialized boarding houses can be a good solution for them. The 1990s significantly damaged the reputation of such establishments. But now everything has changed in better side– and first of all the quality of service.

Elderly people are offered several service options:

staying in a boarding house for some time while family members are on vacation or on a business trip;

stay during the rehabilitation period;

permanent residence.

Branches of our network of private boarding houses "Autumn of Life" are located in the Istra and Odintsovo districts of the Moscow region.

If you visit our boarding houses in person, you will be able to choose the most suitable institution for your elderly relatives. Visiting hours are from 9.00 to 21.00 daily. The location map can be found in the section on the official website.

In accordance with the Constitution of the Russian Federation, citizens of the Russian Federation have the right to social security, including pensions, in old age.

A pension is a cash benefit received by citizens from public consumption funds for old age, loss of ability to work, length of service, or loss of a breadwinner, which is the basis for calculating a pension. Payments are made monthly upon reaching retirement age.

In accordance with the law, pensions are divided into state and non-state. The law establishes labor and social pensions. In connection with labor and other socially useful activities, pensions are awarded: old age (age), disability, loss of a breadwinner, and long service. Citizens who for some reason do not have the right to a pension in connection with labor and other socially useful activities are provided with a social pension.

The pension is granted for life. Pension provision in accordance with current legislation is carried out by state social security authorities.

Men have the right to an old-age pension upon reaching 60 years of age with at least 25 years of work experience, and women upon reaching 55 years of age with at least 20 years of work experience. Certain categories of citizens are granted pensions on preferential terms (that is, with a lower age and length of service).

Pension legislation ensures the right of citizens to choose one of the types of state pension. An exception is established only for persons who have become disabled as a result of a military injury, who can simultaneously receive two types of state pension: old age (or service) and a disability pension.

They become important in modern conditions institutions for social services for pensioners, interdepartmental work on organizing social support for older people. This is due to the increase specific gravity elderly people in the population, changes in the social status of a person in old age, cessation or limitation of work, transformation of value orientations, 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 services for older people are 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- at priority criterion of health status, the level of financial assistance cannot depend on the standard of living and place of residence.

The scope of social services provided to older people includes: social, social, medical, psychological, pedagogical, social and legal services; material assistance and social adaptation and rehabilitation of older people.

At the initial stages of the development of the social assistance system for older people, such urgent problems as the organization of nutrition, medical services, housing, and material support were solved in order to create standard living conditions for them.

On modern stage organizing assistance for older people, along with solving these traditional social problems, involves the development of social technologies, the introduction of which will help resolve issues related to psychological difficulties that older people experience in the process of communication or from loneliness. It is also necessary to consider how older people will perceive others 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, and others.

As a rule, social assistance, rehabilitation, and correction programs are developed depending on the membership of a particular category of older people. This is also related to the use of various principles, methods, and techniques for working with clients.

The basic principles of working with older people are respect and interest in the client’s personality, emphasis on the need and usefulness of his experience and knowledge to the people around him. It is important to perceive an elderly person not only as an object, but also as a subject of social work. This should help find and develop their internal reserves that promote self-realization, self-support and self-defense. An important role is played by the professional competence of the social worker, which includes knowledge of gerontological and psychological characteristics age, taking into account the client’s membership in a particular social group.

Assistance to the elderly is carried out by social protection authorities through their departments, which identify and keep records, carry out different kinds social support, offer and provide paid services. Social services are provided by decision of social protection bodies in institutions subordinate to them or under agreements concluded by social protection bodies with social service 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 lonely elderly people;
- hospitals and departments for chronic patients;
- hospitals of various types;
- territorial social service centers;
- social assistance departments at home;
- gerontological centers, etc.

Main functional diagram Social services for the elderly can be presented as follows:

In the system of inpatient institutions of the Russian Federation, a relatively new element is special houses for the permanent residence of single elderly people and married couples who have retained full or partial ability for self-care in everyday life and need appropriate conditions for self-realization of basic life needs.

The approximate Regulations on a special house for such pensioners lists its functions:

- providing favorable conditions for living and self-service;
- provision of permanent social, domestic and medical assistance to living elderly citizens;
- creating conditions for maintaining an active lifestyle, including feasible work activity.

Architectural and planning solutions for a special house must comply age characteristics living population of citizens. Such a house consists of one - two-room apartments and includes a range of social and domestic services: medical office, a library and a room for club work, a dining room (buffet), points for ordering food products, handing over items to the laundry and dry cleaning, as well as premises for work activities and others.

The special house is equipped with small-scale mechanization equipment that facilitates the self-care of elderly citizens living in it. It should have a 24-hour control center, provided with internal communications with all residential premises and external telephone communications.

Medical care for citizens is provided medical personnel territorial treatment and preventive institutions.

Based on current legislation, citizens living in such houses are paid a full pension. They have the right to priority referral to inpatient institutions of social protection authorities.

The organization of special homes for single elderly people and elderly couples is one of the promising ways to solve a whole range of social problems of pensioners and senior citizens.

In the Russian Federation, as throughout the world, there is a trend of population aging. According to the UN Population Division, in developed countries the proportion of older people will increase from 21 to 28% by 2050. In Russia, by 2010, the share of people of retirement age already exceeds one third.

In this regard, in modern conditions important institutions for social services for older people and interdepartmental work to organize social support for this group of the population are being acquired. This is due not only to an increase in the proportion of older people in the population, but also to the solution of problems arising from this phenomenon: changes in the social status of a person in old age, cessation or limitation of work, 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, which dictates the need to develop and implement specific approaches, forms and methods of social work with pensioners and older people.

Social services for older people are 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.

Eliminating 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.

The regulatory framework for social work with older people in the Russian Federation is the Federal Law “On the Fundamentals of Social Services for the Population in the Russian Federation” (dated December 10, 1995), according to which the scope of social services provided to older people includes: social household, social-medical, psychological-pedagogical, social-legal services; material assistance and social adaptation and rehabilitation of older people.

At the initial stages of the development of the system of social assistance to older people, social workers focused on solving such urgent problems as organizing nutrition, medical services, housing, and material support in order to create for them normal conditions life.

At the present stage, the organization of assistance to older people, along with the solution of these traditional social problems, involves the development of social technologies, the introduction of which will help resolve issues related to psychological difficulties that arise in older people in the process of communication or due to loneliness, as well as socio-psychological problems - how older people perceive other age groups, what are their social problems, their relationships with people around them, the role and status of older people in the family and society, etc.

It should be noted that there are different categories of older people. Among them there are people:

Not in need of help;

Partially disabled;

In need of service;

Requiring constant care, etc.

The basic principles of working with older people are respect and interest in the client’s personality, emphasis on the need and usefulness of his experience and knowledge to the people around him. It is important to perceive an elderly person not only as an object, but also as a subject of social work. This should help find and develop their internal reserves that promote self-realization, self-support and self-defense. An important role is played by the professional competence of the social worker, which includes knowledge of the gerontological and psychological characteristics of age, taking into account the client’s belonging to a particular social group.

Help for the elderly is provided by social protection authorities through their departments, which identify and monitor, provide various types of social support, offer and provide paid services. Social services are provided by decision of social protection bodies in institutions subordinate to them or under agreements concluded by social protection bodies with social service institutions of other forms of ownership.

The following institutions 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 social service centers;

Social assistance departments at home;

Gerontological centers, etc.

The basic scheme for the functioning of social services for the elderly can be presented as follows:

The approximate Regulations on a special house for such pensioners (approved by order of the Ministry of Social Protection of Russia dated April 14, 1994 No. 47) lists its functions:

Providing favorable conditions for living and self-service;

Providing permanent social, domestic and medical care to elderly residents;

Creating conditions for maintaining an active lifestyle, including feasible work activity.

From the point of view of architecture and layout, special houses must correspond to the age characteristics of the living population of citizens. Such a house consists of one - two-room apartments, includes a complex of social services: a medical office, a library and a room for club work, a dining room (buffet), points for ordering food products, handing over things to the laundry and dry cleaning, as well as premises for work, etc.

The special house is equipped with small-scale mechanization facilities that facilitate self-service for the elderly citizens living in it, and it also has a 24-hour control center, provided with internal communications with all residential premises and external telephone communications.

Medical care for citizens living in a special house is provided by relevant specialists from territorial treatment and preventive institutions.

Based on current legislation, citizens living in such houses are paid a full pension. They have the right to priority referral to inpatient institutions of social protection authorities.

The organization of special homes for single elderly people and elderly couples is one of the promising ways to solve a whole range of social problems of pensioners and senior citizens.

2.5. History of the development of social gerontology

2.6. Social theories of aging

Chapter 3. Medical problems of the elderly and senile age

3.1. Concept of health in old age

3.2. Senile ailments and senile infirmity. Ways to alleviate them

3.3. Lifestyle and its importance for the aging process

3.4. Last departure

Chapter 4. The phenomenon of loneliness

4.1. Economic aspects of loneliness in old age

4.2. Social aspects of loneliness

4.3. Family relationships of elderly and old people

4.4. Mutual assistance between generations

4.5. The role of home care for helpless old people

4.6. Stereotype of old age in society. The problem of fathers and children"

Chapter 5. Mental aging

5.1. The concept of mental aging. Mental decline. Happy old age

5.2. The concept of personality. The relationship between the biological and the social in man. Temperament and character

5.3. A person's attitude towards old age. The role of personality in the formation of a person’s psychosocial status in old age. Individual types of aging

5.4. Attitude towards death. The concept of euthanasia

5.5. The concept of abnormal reactions. Crisis conditions in gerontopsychiatry

Chapter 6. Higher mental functions and their disorders in old age

6.1. Sensation and perception. Their disorders

6.2. Thinking. Thought disorders

6.3. Speech, expressive and impressive. Aphasia, its types

6.4. Memory and its disorders

6.5. Intelligence and its disorders

6.6. Will and drives and their disorders

6.7. Emotions. Depressive disorders in old age

6.8. Consciousness and its disorders

6.9. Mental illnesses in old and senile age

Chapter 7. Adaptation to old age

7.1. Professional aging

7.2. Principles of rehabilitation at pre-retirement age

7.3. Motivations for continuing to work after reaching retirement age

7.4. Using the residual working capacity of old-age pensioners

7.5. Adaptation to the retirement period of life

Chapter 8. Social protection of elderly and old people

8.1. Principles and mechanisms of social protection of the elderly and senile population

8.2. Social services for elderly and elderly people

8.3. Old age pension

8.4. Old-age pensions in the Russian Federation

8.5. Socio-economic problems of pensioners in the Russian Federation during the transition period

8.6. The origins of the pension system crisis in the Russian Federation

8.7. Concept of reform of the pension system in the Russian Federation

Chapter 9. Social work with elderly and elderly people

9.1. Relevance and significance of social work

9.2. Differential characteristics of elderly and old people

9.3. Requirements for the professionalism of social workers serving older people

9.4. Deontology in social work with elderly and elderly people

9.5. Medical and social relationships in serving the elderly and old people

Bibliography

Content

Chapter 9. Social work with elderly and elderly people 260

107150, Moscow, st. Losinoostrovskaya, 24

8.2. Social services for elderly and elderly 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 the disabled.” According to this Law, the social service system is based on the use and development of all forms of ownership 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 older 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 meet 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.

Social services for old people can be permanent or temporary depending on their wishes. It can be completely free, partially paid or paid.

Inpatient social services 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, need 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.

Boarding houses for labor veterans (nursing homes) 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, to build almshouses for them, for men and women, to keep them there , providing food and clothing at the expense of the treasury.

During the reign of Alexei Mikhailovich, by his order, the Kondinsky Monastery was built 760 versts from Tobolsk specifically for the charity of the old, crippled, rootless 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 people. 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 hard work” 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, they could develop their own estates, have subsidiary farming in rural areas, and 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 assistance, 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 visits by their lawyer, notary, clergyman, relatives, representatives of 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- this is absolutely new form stationary social services. 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, who are involved in vagrancy and begging, and who are 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 (every year decreasing) 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 financing 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 primarily. In this case, a referral to a medical and social bed is given by social service centers in agreement with the local doctor. IN last years The experience of organizing wards for routine treatment of old people, where all types of medical procedures are carried out, is becoming 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 team members visit local residents, including the elderly, at home, provide them with all types of medical care, as well as financial assistance, give them medicines, food packages, sets of industrial 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 who suffer 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 various kinds 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.