Institutions for elderly and elderly people. Social services for older people. Social service institutions for older people

From this article you will learn:

What are the principles of social services for older people

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

What forms of social services are provided for older people?

What social service institutions exist for older people?

Social services for the elderly are a whole group of services intended for the elderly population in specialized institutions or at home. The list includes rehabilitation in society, assistance in economic matters and in the psychological sphere.

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;

paying special attention to 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 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 the life of one or more of the above circumstances only confirms the difficult situation in the life of a given person, but does not guarantee the 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 requiring social services for various reasons and 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:

1. 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 in the terminal stages, mental illnesses (not exacerbating), and inactive tuberculosis. Social assistance is not provided to patients with chronic alcoholism and infectious diseases. This type of service is provided under certain conditions and in the manner established by the regional executive authority.

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 where an elderly person has written a refusal of special social services after 6 months of being in the appropriate 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 for the better - 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 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, institutions of social services for older people and interdepartmental work on organizing social support for this group of the population are becoming important. 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 social assistance system for older people, social workers focused on solving such urgent problems as organizing food, medical services, housing, and material support in order to create normal living conditions for them.

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.

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 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:

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 (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.

Social services for citizens of retirement age and disabled people are the main form of protection of the population. The purpose of this program is to allow citizens who need social adaptation to stay in their familiar environment for as long as possible, protecting their interests and rights.

Who can receive this type of support?

Social services are provided to elderly citizens and people with officially recognized disabilities. Based on the legislation, the first category includes a person who has reached a certain age after retirement. A passport is considered confirmation of this fact. The fact of recognition of disability is confirmed by documentation through a medical and social examination (MSEC), based on the following principles:

• In the presence of persistent health impairment, which is caused by injuries, defects.
• There is a partial or complete loss of self-care, movement, self-control, communication, learning, and employment.
• There is a need for social protection and rehabilitation measures.

Social services for the disabled and elderly have several forms. They are provided for by Federal Law.

Home-based service

Service by a social worker at home is a traditional form, which is aimed at prolonging residence in familiar conditions while maintaining the status of people, protecting their interests and legal rights.

Home service includes:

• organizing the catering process, simultaneously with the delivery of food to home;
• assistance in purchasing medicines, industrial goods, food;
• assistance in cooking;
• taking your laundry to the dry cleaner;
• accompaniment to a medical facility, assistance in obtaining medical care;
• maintaining the home at the required hygienic level;
• assistance in obtaining legal services;
• assistance in organizing funerals.

If a person lives in a building that does not have a central water supply or heating, then the Federal Law provides for the inclusion of assistance in providing water and fuel in the list of home-based services provided by the social protection department. In addition, the elderly and disabled people have the right to receive additional services, which can be fully or partially paid for.

These include:

• stay in an institution aimed at social services. It involves day and night stay;
• urgent support;
• finding citizens in a boarding house, boarding house;
• 24-hour health monitoring;
• provision of first aid;
• feeding a weakened patient;
• performing a medical procedure;
• advisory support.

Please note that home care is provided by an employee of the social assistance department.

Social services for elderly and disabled people can be provided on a temporary or permanent basis. Citizens who have mental illnesses, are in the acute stage, suffer from chronic alcoholism, sexually transmitted diseases, active tuberculosis, and are bacteria carriers, are not provided with this service. Because they require treatment in a special institution.

Social and medical support

Social and medical support at home is aimed at solving current problems of elderly people suffering from mental illnesses that are in long-term remission, and from late-stage cancer. Legal regulation of these issues is carried out by regional executive authorities. For your information, people with disabilities can receive temporary housing in housing stock buildings for social needs.

Semi-stationary type of assistance

This service system allows you to solve the following issues:

• social and domestic nature;
• cultural service;
• medical supervision;
• organization of the nutritional process;
• ensuring human activity.

Semi-stationary services are provided to elderly people, people with disabilities who have retained the ability to move, to perform independent services, and who have no medical contraindications for enrollment in this institution. The decision to obtain the right to a semi-stationary type of service is made by the head of the institution after a written application and a certificate of the applicant’s health status.

A person can be provided with the following services: receiving one meal, overnight accommodation, pre-medical care, referral for treatment, registration in a home for the elderly or disabled, sanitary treatment, assistance in registering or recalculating a pension, assistance in finding a job, assistance in preparing documents, an insurance policy.

Semi-stationary services may be denied to carriers of bacteria, viruses, citizens who are chronic alcoholics, with an active form of tuberculosis, in the presence of severe mental disorders, sexually transmitted diseases requiring treatment in a specialized institution.

This assistance is provided to the following segments of the population:

• citizens of Russia, foreigners with a residence permit;
• people registered at the place of residence or registered at the place of stay;
• disabled people;
• elderly people.

Inpatient service

Inpatient services are aimed at providing citizens with various types of assistance. This social support has some principles:

• assistance is provided to persons who have partially or completely lost the ability to serve, people who require constant care and supervision;
• inpatient institutions are able to provide the necessary sanitary and hygienic requirements;
• medical and sanitary care is provided;
• allows you to carry out MSEC to establish a disability group or extend it;
• allows for social adaptation and medical rehabilitation;
• allows you to ensure visits from a clergyman, a lawyer, relatives, a notary;
• provides premises for religious ceremonies.

Inpatient institutions create the most adequate conditions based on age, health status, provide not only medical care, but also rehabilitation and rest. These establishments have the following features. Inpatient care is provided in homes for the elderly and disabled. They accept citizens who have reached retirement age, disabled people of the first and second groups, who have no relatives obligated to support them.

Boarding homes accept people only with 1st disability group, 18-40 years old, who do not have able-bodied children or parents. The orphanage boarding house houses children aged 4-18 years with physical and mental pathologies. An important condition is the separation of children with mental illnesses from physical ones.

The psychoneurological boarding school accepts people who suffer from mental illnesses and need help from third parties and medical care, regardless of the presence of able-bodied relatives. The social boarding house accepts persons who systematically violate internal regulations, engage in begging and vagrancy.

Inpatient institutions provide medical care, rehabilitation services, help with everyday life, and organize work activities. A permit to a boarding home is given by the social assistance department on the basis of an application signed by the patient’s representative and a medical card. After a person is declared incompetent, he is placed in a hospital.

Please note that if the state of health allows, then with the permission of the director, a sick or elderly person has the opportunity to temporarily leave the boarding school.

Urgent service

This type is aimed at obtaining the necessary emergency care for elderly people and young people who are disabled. The support is one-time in nature and is aimed at solving material and everyday issues with the following types of services:

• receiving hot meals and food packages;
• obtaining shoes, clothing, necessary items;
• receiving one-time financial assistance;
• provision of temporary housing;
• obtaining legal advice;
• receiving urgent assistance from doctors, social workers, and clergy.

Urgent assistance is provided for people who are in an acute social situation. Assistance can be provided to the following segments of the population: unemployed low-income people, single pensioners, disabled people, families consisting of pensioners where there are no working family members, with an average per capita income below the subsistence level, citizens who have lost a close relative and do not have funds for his burial .

When applying for help at your local social security office, you must present:

• passport;
• work book;
• pensioner's ID;
• certificate of disability;
• certificate of family composition;
• certificate of income for 3 months.

Please note that urgent social assistance is provided by the municipal social protection center.

Social advisory type of assistance

Social advisory support is aimed at the adaptation of people with disabilities in society, helps relieve tension in relationships, creates a favorable environment in the family, and ensures communication in society and the state. Disabled people are provided with social support in solving problems by identifying citizens who need advice, preventing social deviations, and working with families in which disabled people live.

Leisure activities for the elderly and disabled are organized, consultations are provided in the field of career guidance, training, further employment, government agencies provide the necessary sample, public organizations help combat common problems, and legal advice is provided. Social advisory assistance is provided by the municipal social service center and the local department of social protection of the population.

other services

Based on the legislation of the Russian Federation, people with disabilities have the right to receive the following social services: receiving free medical care, providing necessary medications prescribed by a doctor in accordance with a certain list, receiving sanatorium treatment, preferential travel on public, river, rail, air transport.

Disabled people receive free vouchers, and if canceled, compensation is paid.

A disabled person has the right to refuse to use the listed services and receive a monthly allowance. This amount in 2019 is:

• disabled people of group 3 – 2073.51 rubles;
• disabled people of group 2 – 2590.24 rubles;
• disabled people of group 1 – 3626.98 rubles;
• for disabled children – 2590.24 rubles.

Social services are aimed at adaptation, medical care, rehabilitation, consultation for people with disabilities and the elderly. These points are regulated by the legislation of the Russian Federation.

Network of inpatient facilities social services in Russia are represented by 1,400 institutions, the vast majority of which (1,222, or 87.3% of their total number) serve elderly citizens, including 685 (56.0% of the total number of institutions) boarding homes for the elderly and disabled (total type), including 40 special institutions for the elderly and disabled people who have returned from places of serving their sentences; 442 (36.2%) psychoneurological boarding schools; 71 (5.8%) boarding houses of mercy for the elderly and disabled; 24 (2.0%) gerontological (gerontopsychiatric) centers.

Over 200 thousand people currently live in inpatient social service institutions. This number includes disabled children and people of working age who need constant care and medical care. There were 150-160 thousand people living in the elderly, which is just over 0.5% of the total number of older citizens.

Over the past five years, the number of places in all inpatient social service institutions has increased by only 3.5%, in general boarding homes - by 8.4%. In psychoneurological boarding schools, there was a decrease in the total bed capacity of 3.6%. The number of people living in these institutions changed in approximately the same proportions: 1.1 and 11.8 > more and 0.4% less, respectively.

The dynamics of development of both the network of stationary social service institutions and their main types did not make it possible to fully satisfy the needs of older citizens for stationary social services, to eliminate the waiting list for placement in boarding schools, which in general increased by 2.5 times over 10 years, general type boarding houses - 6.1 times, in psychoneurological boarding schools - 2.1 times.

Thus, despite the increase in the number of inpatient social service institutions and the number of residents living in them, the scale of the need for relevant services increased at a faster pace and the volume of unsatisfied demand increased.

As positive aspects of the dynamics of development of stationary social service institutions, one should indicate the improvement of living conditions in them by reducing the average number of inhabitants and increasing the area of ​​bedrooms per bed almost to sanitary standards. The average capacity of a general boarding house over 13 years decreased from 293 to 138 places (more than twice), a psychoneurological boarding school - from 310 to 297 places. The average area of ​​living rooms increased to 6.91 and 5.91 m2, respectively. The given indicators reflect the trend of disaggregation of existing inpatient social service institutions and increasing the comfort of living in them. The noted dynamics are largely due to the expansion of the network of low-capacity boarding houses.

Over the past decade, specialized social service institutions have developed - gerontological centers and boarding houses of mercy for the elderly and disabled. They develop and test technologies and methods that correspond to the modern level of providing social services to the elderly and disabled. However, the pace of development of such institutions does not fully meet objective social needs.

In most regions of the country there are no gerontological centers yet, which is mainly due to existing contradictions in the legal and methodological support for the activities of these institutions. Until 2003, the Russian Ministry of Labor recognized only institutions with permanent residence facilities as gerontological centers. At the same time, Federal Law No. 195-FZ of December 10, 1995 “On the Fundamentals of Social Services for the Population in the Russian Federation” (Article 17) does not include gerontological centers in the range of inpatient social service institutions (subclause 12, clause 1) and highlighted as an independent type of social service (subclause 13, clause 1). In reality, various gerontological centers with differentiated types and forms of social services exist and operate successfully.

For example, Krasnoyarsk regional gerontological center "Uyut", created on the basis of a sanatorium-preventorium, it provides rehabilitation and health-improving services to veterans using a form of semi-stationary service.

A similar approach is practiced along with scientific, organizational and methodological activities and was created in 1994 among the first Novosibirsk Regional Gerontological Center.

The functions of charity houses have largely taken over Gerontological Center "Ekaterinodar" (Krasnodar) and gerontological center in Surgut Khanty-Mansiysk Autonomous Okrug.

In general, statistical reporting data indicate that gerontological centers to a greater extent perform the tasks of care, provision of medical services and palliative care, more likely to be characteristic of compassionate homes. In the current situation, people on bed rest and in need of constant care make up 46.6% of all residents in gerontological centers, and 35.0% in boarding homes specially designed to serve such a contingent.

Some gerontological centers, for example Gerontological Center "Peredelkino" (Moscow), Gerontological Center "Cherry" (Smolensk region), Gerontological Center "Sputnik" (Kurgan region), perform a number of functions that are not fully implemented by medical institutions, thereby satisfying the existing needs of older people for medical care. However, at the same time, the own functions and tasks of gerontological centers for which they are created may fade into the background.

Analysis of the activities of gerontological centers allows us to conclude that scientific, applied and methodological orientation should prevail in it. Such institutions are designed to contribute to the formation and implementation of scientifically based regional social policies regarding older people and people with disabilities. There is no need to open many gerontological centers. It is enough to have one such institution, under the jurisdiction of the regional social protection body, in each subject of the Russian Federation. The provision of routine social services, including care, should be provided by specially designated general boarding houses, psychoneurological boarding schools and houses of mercy.

So far, without serious methodological support from the federal center, the heads of territorial bodies of social protection of the population are in no hurry to create specialized institutions, preferring, if necessary, to open gerontological (usually gerontopsychiatric) departments and mercy departments in already existing inpatient social service institutions.