Technologies of social assistance to the elderly and disabled. Providing medical and social assistance to the population

1. Legal framework governing relations in the field of SMEs for elderly and disabled people

The current legislation of the Republic of Belarus is aimed at ensuring independence, self-realization and respect for the dignity of older people and people with disabilities, expanding their participation in public life, and improving services. The legislation covers a wide range of tasks and methods for researching and solving the problems of lonely elderly people and people with disabilities, many of which are in line with international practice.

In recent years, Belarus has been in the process of forming a legal framework that makes it possible to develop sectoral regulatory legal documents to provide older people and people with disabilities with medical and social assistance and the services of specialists representing organizations from various ministries and departments.

Among the current regulatory documents, three main groups of legal norms can be distinguished on which the social policy of the Republic of Belarus in relation to elderly citizens and disabled people is based:

norms establishing the rights of all citizens regardless of age, including for older people;

norms directly related to the rights of older people and people with disabilities;

norms regulating the situation of special categories of older people (single elderly people, elderly people living alone, single disabled people, disabled people living alone, veterans, etc.).

In accordance with current legislation, single citizens include disabled citizens who do not have able-bodied family members required by law to support them. Living alone are considered disabled citizens living separately from able-bodied family members who are required by law to support them. Among the adult population, disabled citizens are persons who have reached the age entitling them to an old-age pension on a general basis, and disabled people.

The regulatory legal framework of the Republic of Belarus regulating the implementation of SMEs for elderly people and people with disabilities living alone and living alone includes a number of fundamental documents:

1.1 International standards

UN Principles for Older Persons “Making life fuller for older people” (1991)

Convention on the Rights of Persons with Disabilities. (2006)

Convention on the Protection and Promotion of the Rights and Dignity of Persons with Disabilities. (2003).

1.2 Legislative acts of the Republic of Belarus

Constitution of the Republic of Belarus (1996).

Code on Marriage and Family of the Republic of Belarus (1999).

Labor Code of the Republic of Belarus (2008).

Civil Code of the Republic of Belarus (2008).

Housing Code of the Republic of Belarus (1999).

On Health Care (1993, 2007).

On the prevention of disability and rehabilitation of disabled people (1994, 2006).

About Veterans (2001).

On social protection of citizens affected by the disaster at the Chernobyl nuclear power plant (1994).

On social protection of disabled people (2000).

On Social Services (2000).

.About the Belarusian Red Cross Society (2000).

.3 Resolutions of the Government of the Republic of Belarus

Program for providing targeted social assistance to certain categories of families and low-income citizens (2001).

State program for the promotion of a healthy lifestyle for 2002-2006 (2002).

About the republican comprehensive program on the problems of older people for 2001-2005 (2006).

On approval of a comprehensive program for the development of the service sector in the Republic of Belarus for 2002-2010 (2006).

On the republican comprehensive program of social support for the elderly and people affected by the consequences of wars (2007)

On approval of a comprehensive program to improve the system of social work with single elderly citizens in the Republic of Belarus until 2010 (2004).

On approval of the List of free and publicly available social services provided by state social service institutions of the Ministry of Labor and Social Protection system in accordance with their profile and the Regulations on the procedure and conditions for the provision of social services by state social service institutions of the Ministry of Labor and Social Protection system (2001, 2002 2005).

On the procedure and conditions for the provision of social services by state social service institutions of the Ministry of Labor and Social Protection (2005).

On approval of the main directions of socio-economic development of the Republic of Belarus for 2002-2015 (2006).

On the republican comprehensive program of social support for older people, veterans and people affected by the consequences of wars for 2006-2010. (2005)

.State program for the prevention of disability and rehabilitation of disabled people for 2002-2010. (2006).

.State program for the revival and development of rural areas for 2005-2010. (2005).

.National program of demographic security of the Republic of Belarus for 2002-2010 (2007).

.Concept of trade and consumer services for certain categories of citizens in the Republic of Belarus (2004)

.4 Regulatory legal acts of republican government bodies

.On the state and measures to further improve the medical, medicinal and sanatorium-resort provision of disabled people, participants in the Great Patriotic War and persons equivalent to them (2006).

On approval of the List of specialties according to which vocational and technical education for people with disabilities can be carried out at home (2007).

On approval of the approximate Regulations on the territorial center for social services for the population and the approximate staff of the territorial center for social services for the population (2005).

Comprehensive programs for the provision of medical and social assistance have been developed in accordance with the UN Principles for Older People “Making fulfilling lives for older people” adopted by the UN General Assembly determines the direction of all regulatory documents to ensure adequate services for single and elderly citizens living alone and people with disabilities.

2. Geriatric care in the Republic of Belarus

In the Republic of Belarus in recent decades, as well as throughout the world, there has been an active process of population aging - currently more than 2 million 176 thousand people aged 60 years and older live in the country. A characteristic feature of this process is a significant increase in the number of elderly people among the entire elderly population; Today, every fourth elderly person has already crossed the 75-year-old mark. The share of the population over 60 years of age in rural areas is 29.9%, and in cities - 12.7%. Current trends in population aging are sustainable. This suggests a more significant increase in the share of older people in the population structure of Belarus in the 21st century. In total, 1011 residents live in the Republic of Belarus who are 100 years of age or older, including 141 in the Brest region; Vitebsk - 172; Gomel - 123; Grodno -190; Minsk - 225; Mogilev region - 130 and in Minsk - 30 people. The number of lonely people, as well as patients suffering from chronic diseases that reduce physical activity and the ability to self-care, is increasing. All this determines the significantly greater need of older people for medical and social care compared to other demographic groups. In these conditions, measures are being taken to make optimal use of the resources available to the Ministry of Health, the Ministry of Social Protection and public organizations. Currently, the work of the geriatric service of the Republic of Belarus is coordinated by the chief geriatrician of the Ministry of Health, prof. V.P. Sytym and the head of the Republican Gerontological Center based on BNIIETIN, prof. I.S. Gulko. The center includes a laboratory for medical and social problems of older people, a hospital and a consultation room. Teachers from the Department of Geriatrics and Gerontology of BelGUIU also participate in the organization of geriatric care. In the health departments of the regional executive committees and the health committee of the Minsk City Executive Committee, the leading place is given to the chief geriatricians, who perform their duties on a functional basis. In the TMO, the functions of freelance geriatricians are assigned to deputy chief physicians or heads of departments of hospitals and clinics who oversee the organization of medical care for disabled veterans. Outpatient care for elderly and elderly patients is provided by local therapists, geriatric doctors and district geriatricians (therapists serving war invalids). Aging people, as a rule, suffer from chronic forms of diseases and need medical, physical, psychological and social rehabilitation not only during the recovery period after an exacerbation of the disease, but also for the purpose of secondary prevention of the disease. The overwhelming number of patients require maintenance drug therapy with antihypertensive, cardiotropic, psychotropic, metabolic and other drugs, which is currently difficult to implement due to the insufficient supply of these drugs and their rise in price. Geriatric services should focus primarily on geriatric medical rehabilitation. According to sample data, among patients visiting hospitals, the proportion of people aged 60 years and older is 25 - 40%, and among those receiving care at home - 40%. The need for health care among older people is 50% greater than in middle age. Outpatient medical care is provided to older people in outpatient clinics and by a doctor when servicing calls at home, and by visiting nurses when operating hospitals at home and in day hospitals. Mercy service nurses of the Republican Committee of the Belarusian Red Cross Society provide primary medical care to the elderly and disabled. The Red Cross charity centers employ 75% of nurses from the total number of nurses in the charity service. The Red Cross has made about 150,000 visits to homes for the elderly and single citizens, and performed 25,000 different procedures. The Social Assistance Service of the Ministry of Social Protection provides support to lonely and lonely elderly people and disabled people. The organization of medical, medicinal and sanatorium-resort provision for war invalids and similar contingents on a republican scale is entrusted to the organizational and methodological department of the Republican Clinical Hospital for Disabled Persons of the Great Patriotic War named after. P.M. Masherov, in the health departments of the Mogilev, Vitebsk and Gomel regional executive committees - to the corresponding hospitals, whose staff includes deputy chief doctors for organizational and methodological work. In the Minsk region and the city of Minsk, the organization of this work is entrusted to methodologists. In the UZO of the Grodno and Brest regional executive committees, the organization of medical care for war veterans is entrusted to the deputy chief doctors for outpatient work of regional hospitals. In RTMO, the organization of medical, medicinal and sanatorium-resort provision for war veterans is entrusted to the deputy chief doctors of the districts for medical or outpatient work. Every year, the results of work on medical provision for this contingent are discussed at regional meetings and at a republican seminar. According to sample estimates, the need for hospitalization for people aged 60 years and older is almost three times higher than for the rest of the population.

There are 4 hospitals for disabled WWII veterans with 1,860 beds in the republic, and 1,599 high-comfort wards with 4,539 beds are allocated to the general network of health care facilities, where more than 70,000 WWII veterans receive inpatient treatment annually.

To organize and coordinate work on medical and social services for the elderly, 7 geriatric centers have been created, including 2 on a full-time basis and 5 on a functional basis. (1, p. 25)

When assessing the organization of inpatient care for elderly patients, it should be noted that geriatric units are specialized departments. Main indicators of inpatient care for elderly patients: 10,304 treated, average bed day - 28.3, mortality - 0.6%. For social beds, these indicators differ significantly from the previous ones: 6650 people were treated, the average bed day was 42.3, mortality rate was 1.1%. Such differences in the main performance indicators of geriatric and social beds are associated with different tasks facing geriatric and medical and social services for the elderly population.

Of the total number of patients hospitalized in therapeutic departments of medical institutions of the Ministry of Health of the Republic of Belarus, elderly patients make up about 40%, and in some cases (cardiology, endocrinology and other departments) and more.

As can be seen from the data presented, there is a discrepancy between the high percentage of clinical beds occupied by patients aged 60 years and older and the proportion of people in this age group in the entire population (about 40% for most health care facilities relative to 20% of the total population). A lower percentage of hospitalized elderly patients in health care facilities in the Grodno and Brest regions (about 28%). This may be partly due to the fact that most older people live in families and have the opportunity to receive treatment on an outpatient basis. From sample data it is known that the need for hospitalization increases with age: 4% in 60-69 years and 31% in 85 years and older.

Currently in Belarus, citizens 60 years of age and older and people with disabilities can receive medical care in all outpatient and inpatient treatment and prevention organizations. Due to the fact that the number of elderly and senile people visiting outpatient clinics is 1.5 times higher than that of young people, and among hospitalized patients, people aged 60 years and older predominate, whose proportion ranges from 40 to 60% , and among those hospitalized in a rural district hospital - up to 80%. There are also specialized structural units to provide geriatric care to this population.

To improve outpatient care and resolve issues of clinical examination, the population aged 60 years and older is annually examined by a local physician, and, if necessary, by doctors of narrow specialties in order to identify the disease in the early stages. Preventive examinations of single and elderly people living alone in accordance with the methodological recommendations of the Ministry of Health of the Republic of Belarus are carried out quarterly.

In order to provide assistance to single and disabled citizens living alone, the Ministry of Labor and Social Protection has created a system of stationary (boarding houses of various types) and non-stationary (territorial centers for social services for the population) social services. Territorial social service centers have received the greatest development, as the most economical institutions that are closest to the real needs of people. (1, p. 25).

3. Forms and methods of social services for the elderly and disabled

In order to further improve the system of social support for elderly citizens and disabled people, on August 24, 1999, the Ministry of Social Protection issued an Order approving the Model Regulations on the Center for Social Services for Elderly Citizens and Disabled People on the territory of the Republic of Belarus.

Social services for elderly citizens and disabled people is a separate complex of organizing and implementing, on the basis of legal norms, the procedure for providing services, benefits and natural material benefits for the maintenance and social services of elderly citizens and disabled people in social protection institutions. These services, benefits and in-kind material benefits are provided to senior citizens and people with disabilities to meet their specific needs due to old age and disability.

This service may take the form of:

inpatient services in social service institutions;

Semi-stationary social services;

Social services at home;

urgent social services;

Inpatient social services are provided in boarding homes for the elderly and general disabled, boarding schools for war and labor veterans, psychoneurological boarding schools, and special boarding homes for the elderly and disabled. Social service centers for elderly citizens and disabled people provide social assistance at home, urgent social services, and semi-stationary social services.

Such institutions are being created to provide material and everyday services to elderly citizens and the disabled, to provide them with normal living conditions, to organize care, to provide them with medical care, to carry out systematic and targeted educational work, as well as to implement measures aimed at the social and labor rehabilitation of citizens.

Household services for veterans, elderly and disabled people in inpatient institutions include, in addition to providing them, in accordance with approved standards, with comfortable housing with furniture and equipment, bedding, clothing and shoes, the organization of rational and dietary nutrition, taking into account the age and health status of elderly and disabled people, the creation a favorable microclimate and indicated maintenance (maintenance) regimes close to home conditions, carrying out cultural work taking into account health status and age. Inpatient institutions carry out medical examinations for the elderly and disabled, carry out sanitary and hygienic and anti-epidemic measures, treatment, organize consultative medical care from specialists, hospitalize patients with the participation of medical institutions, as well as rehabilitation measures of a medical, social and therapeutic-labor nature.

A boarding home for the elderly and disabled of a general type is a medical and social institution intended for permanent and temporary residence on full state support or for a fee for single elderly and disabled people in need of care, household and medical services. Depending on the population of residents, general boarding houses can be divided into:

Boarding homes for the elderly and disabled;

boarding houses for disabled people aged 18 to 40 years.

Inpatient social services for war and labor veterans who need care, consumer services and medical assistance for health reasons are provided by the Republican Boarding School for War and Labor Veterans.

A psychoneurological boarding school is a medical and social institution intended for permanent, temporary (for a period of 2 to 6 months) and five-day a week accommodation of elderly citizens and disabled people suffering from chronic mental illnesses, recognized in the prescribed manner as incompetent and in need of care, household and medical services .

The psychoneurological boarding house accepts persons (women over 55 years old, men over 60 years old and disabled people of groups I and II over 16 years old) suffering from chronic mental illnesses who, for health reasons, require care, household services and medical assistance in accordance with the Instructions on Medical indications and contraindications for admission to a boarding home.

Special boarding home for the elderly and disabled is a medical and social institution intended for the permanent residence of disabled people of groups I and II who have lost social ties, elderly citizens from among those released from places of imprisonment (especially dangerous repeat offenders and other persons for whom administrative supervision is established in accordance with the current legislation), as well as persons sent from reception centers from among the indicated disabled and elderly people, previously convicted or repeatedly brought to administrative responsibility for violating public order, in need of care, household and medical care, systematic and targeted educational influence. (2, pp. 247-249).

The procedure for providing semi-stationary and urgent social services to elderly and disabled citizens, as well as social assistance at home, is regulated by the Model Regulations on the Center for Social Services for Elderly and Disabled Citizens, approved by Order of the Ministry of Social Protection dated August 24, 1999 No. 73.

The right of priority acceptance for service by the Center is enjoyed by Heroes of the Republic of Belarus, Heroes of the Soviet Union, Heroes of Socialist Labor, full holders of the Order of Glory,

Labor Glory, disabled people and participants of the Great Patriotic War, as well as disabled people fighting on the territory of other states. The right of priority acceptance for services by the Center is enjoyed by the spouses of deceased (deceased) disabled people and participants in the Great Patriotic War who have not remarried; single disabled citizens and disabled people. Social services for citizens in the center can be provided on a one-time, temporary basis (for up to 6 months or on a permanent basis. Social services are provided to citizens by the Center free of charge or on the basis of partial or full payment.

The structural divisions of the Center are departments of social assistance at home, day care, and urgent social services.

On the territory of a district, city, administrative district in a city, urban village, one department of social assistance at home (hereinafter referred to as the social department) is created for permanent or temporary (up to 6 months) social services and provision of pre-medical medical care in home conditions to citizens in need of outside help due to partial loss of the ability to self-care and those who have lost the ability to self-care.

The activities of the social department are aimed at maximizing the possible extension of citizens’ stay in their usual habitat and maintaining their social, psychological and physical status.

The social department performs the following tasks:

Providing citizens with social, domestic and pre-medical medical care, qualified care in home conditions;

organization of social services for citizens by trade, public catering, domestic and communal services, health care institutions, notary institutions, sponsoring enterprises, other institutions and public organizations;

establishing and maintaining communication with labor collectives where previously served citizens worked, as well as with other state and non-state structures to provide social support to citizens;

providing moral and psychological support to serviced citizens and members of their families;

training of relatives of the citizens served in practical skills of general care for the sick;

identifying and accepting visually impaired people as members of the Belarusian Association of the Visually Impaired (BelTIZ), involving them in active social and labor activities.

The social department provides citizens with the following types of services:

delivery of food, meals, essential industrial goods, medicines, charitable and other types of in-kind assistance;

assistance in obtaining medical care, including escort to medical institutions;

maintenance of living conditions in accordance with hygienic requirements, payment for living space, utilities and other services;

assistance in organizing legal assistance and other legal services, including the preparation of documents for the establishment of guardianship and guardianship, for the exchange and privatization of housing, for obtaining registered privatization checks "Property", for placement in stationary institutions of the social protection system;

harvesting vegetables for the winter;

placing orders for fuel delivery, lighting stoves, water delivery, assistance in stocking feed and processing household plots;

feeding the patient and, if necessary, organizing hot meals at home;

cleaning of residential premises;

measuring body temperature, blood pressure, applying compresses, applying dressings, treating bedsores, wound surfaces, performing cleansing enemas;

performing intramuscular and subcutaneous administration of medications in accordance with the prescription of the attending physician;

carrying out hygienic treatment of persons served (wiping, washing, hygienic baths, cutting nails, combing, changing linen);

collection of materials for laboratory research;

carrying out sanitary educational work among the persons served;

provision of emergency first aid;

assistance in organizing funeral services.

The board of the district, city and inter-district organization BelTIZ performs the following functions:

promotes improvement of living conditions, financial situation, medical and commercial services for visually impaired people;

establishes and maintains constant contact with members of the partnership, defends their rights and interests in state, judicial, economic and other bodies;

carries out activities for basic rehabilitation of disabled people; organizes patronage for single disabled people and elderly families;

is engaged in production and economic activities;

promotes the identification of blind and visually impaired children and facilitates their placement in special boarding schools;

accepts entrance and membership fees;

Social and domestic services at home are provided free of charge to single elderly citizens who have reached the age of (women - 55 years old, men - 60 years old), disabled people of the 1st and 2nd groups, as well as elderly citizens and disabled people who do not have able-bodied relatives who are obliged to support them according to the law, in the locality of residence.

Home-based services are partially paid for by: elderly citizens and disabled people who have relatives who are required by law to support them and who live with them in the same locality.

Payment for services is charged from the above-mentioned category of citizens in the amount of 25 percent of the minimum pension. Payment for home-based services in full is charged: from elderly citizens and disabled people living in families whose able-bodied members are required to support them by law; from all categories of citizens when providing them with social and domestic services not included in the list provided for by the Model Regulations.

The social department provides specialized assistance to citizens who have lost the ability to self-care. Work to serve this category of citizens is carried out in close cooperation with territorial health care institutions and the Mercy Service of the Red Cross Society.

Specialized service for citizens who have lost the ability to self-service is carried out by a team of employees of the department: social and household - social workers, provision of pre-medical care - by nurses. Social workers providing specialized assistance carry out their activities in cooperation with the department nurse. The frequency of visits by social workers to those served at home, the territory of service and the work schedule of social workers and nurses are established by the head of the department, taking into account the severity of the condition of the citizens served, the nature of the services provided, the compactness of accommodation, transport links, the presence of trade enterprises, public catering, consumer services, as well as health care institutions.

For citizens in need of outside assistance due to a partial loss of the ability to self-service, the frequency of visits by social workers is set at least 2 times a week.

For citizens who have lost the ability to self-service, the frequency of visits by social workers is set at least 3-4 times a week.

The frequency of visits to serviced persons by nurses is established by the head of the department in agreement with the attending (district) doctor, but at least 3 times a week.

Nurses of the social department organize their work in cooperation with the territorial health care institutions to which they are attached.

To provide first aid, the social department must have a minimum set of medicines (with the exception of narcotic and potent ones) and dressings.

The fulfillment by nurses of planned medical appointments for the persons served is made only on the appointment of the attending (district) doctor.

Nurses can provide paid services to citizens who have lost the ability to self-service and live in a family. Services include assistance with daily living needs, basic hygiene, doctor-prescribed care, and, where possible, contact with others.

Emergency Social Services Department (hereinafter - emergency department) is intended to provide citizens in dire need of social support, emergency assistance of various types character aimed at maintaining their vital functions.

Urgent social services include the provision of the following social services:

one-time provision of citizens in dire need with free hot meals, including by providing them with free food coupons, or food packages;

provision of clothing, shoes and other basic necessities;

one-time provision of financial assistance;

provision of emergency pre-hospital medical care;

assistance in organizing overnight accommodation or obtaining temporary living quarters;

providing citizens with legal assistance in order to protect their rights and legitimate interests;

provision of emergency medical and psychological assistance, including through the “helpline”;

provision of necessary information and consultations on social assistance issues;

provision of other forms of urgent social assistance, determined by regional characteristics.

The emergency department has premises (“Mercy Salon”) for collecting and storing clothing, shoes and other essential items, and must have a minimum set of medications and dressings to provide emergency first aid.

The activities of the emergency department are based on cooperation with various government agencies, public, charitable, religious organizations and associations, foundations, as well as individual citizens.

The day care department (hereinafter referred to as the day department) is a semi-stationary structural unit of the Center and is intended for social, cultural, and medical services for citizens who have retained the ability for self-care and active movement, organizing their meals and recreation, attracting them to feasible work activities and maintaining an active image life.

The day department is created to serve from 25 to 35 citizens.

In the day department, premises are allocated for rooms for pre-hospital (medical) medical care, club work, a library, occupational therapy workshops, etc.

To organize the recreation of citizens in the day department, if the necessary space is available, a sleeping area is equipped with the provision of individual bedding to those served.

The citizens served may, with their voluntary consent and in accordance with medical recommendations, participate in feasible labor activities in specially equipped medical labor workshops or subsidiary farms.

4. Providing medical and social assistance in the Chashniksky district of the Vitebsk region

Projects to help older people are being successfully implemented in the region. The most active participants in mini-projects implemented by regional organizations of the BCCC, among the elderly, help nurses care for those in greater need of help - disabled people who are bedridden, who have completely or partially lost the ability to motor activity and self-care. Thus, in Dubrovno, the mini-project “House Without Loneliness” brought together active participants in the elderly people’s club. They organize concerts for elderly people from remote areas, and after the concert they provide household help and other services to those in need. In fact, senior citizens become Red Cross volunteers and active helpers.

More than 5.3 thousand veterans of the Vitebsk region receive patronage assistance from BRSM activists. The guys constantly provide assistance to older people in preparing fuel, helping to do chores around the house and in the garden, harvesting crops, and also respond to any other requests that they are able to fulfill. In addition, the regional committee has created a hotline, by calling which war veterans and lonely elderly people can always seek help. This year alone, 202 veterans called her.

To organize more effective work in educational institutions of the region, “Mercy” detachments have been created, for which the “Veteran Lives Nearby”, “Care”, “Sensitive Heart”, “Bureau of Good Services” campaigns have already become traditional. There are volunteer teams. And in the Orsha region, the primary organizations of the Belarusian Republican Youth Union are assigned to the military hospital "Yurtsevo".

More than 7 thousand veterans of the Great Patriotic War live in the Vitebsk region. All veterans of the Great Patriotic War, single people living alone, and elderly citizens are registered, and their living conditions are regularly examined. There are no problems with dental prosthetics, provision of wheelchairs and medications for disabled people. All problems that arise regarding the repair of housing, stoves, electrical wiring, installation of fences, cultivation of personal plots, and the purchase of fuel are resolved on time. .

In Grodno, the implementation of comprehensive programs to improve social work with single elderly citizens, as well as to support older people, veterans and people affected by the consequences of wars, continues. In the regional center, as of January 1, 2010, 3,097 single and 3,573 elderly citizens living alone were identified. Financial assistance from the city budget and the social protection fund was provided to 3,233 pensioners, disabled people and other citizens who found themselves in difficult life situations. The total amount of assistance amounted to Br333 million. In 2009, social assistance at home through the Social Service Centers was provided to 989 single and elderly citizens living alone. At the same time, 209 people were served free of charge, including 52 disabled people, 120 participants in the Great Patriotic War, 7 families of victims.

The regional center is home to (as of January 1, 2010) 1,187 veterans of the Great Patriotic War, including 598 participants and 225 disabled veterans of the Great Patriotic War, 320 home front workers, 33 residents of besieged Leningrad, 8 air defense workers, three participants in mine clearance. Over the past year, war veterans received financial assistance worth Br196 million from various sources. Nine veterans were provided with housing, and more than 100 housing repairs were completed. Veterans were also provided with assistance in repairing stoves and electrical wiring, installing autonomous fire detectors, telephones, and providing potatoes and vegetables.

Opened in 2008, the Grodno City Boarding Home for the Elderly and Disabled and the Grodno City Night Stay Home for Homeless Persons perform their functions. Thus, all 77 beds in the nursing home are filled. During the year, 162 people applied to the second institution; currently about 30 people without a fixed place of residence live there. .

Currently, in every district of the Grodno region there are Social Service Centers for the Population (hereinafter referred to as the Centers), in which 105 branches and 123 social points are open and operating, of which 93 are on a visiting basis.

In the 1st quarter of 2010, 74,652 people applied to the Centers for various types of assistance.

Social workers of the social assistance departments at home of the Centers serve 12,296 elderly citizens and disabled people in need of outside care, of which 179 were disabled people of the Great Patriotic War, 434 participants of the Great Patriotic War, 58 family members of the deceased, 3,591 disabled people of groups I and II. , citizens who have lost the ability to self-care - 141.

1,998 people received services free of charge, 9,757 with partial payment, and 541 with full payment.

The work of 16 social service teams for citizens on a mobile basis and 9 economic teams has been organized to provide assistance to residents of rural and remote settlements. Assistance was provided to 619 citizens.

The centers of the region provide social services of a one-time nature to the population (10,587 services were provided to 2,865 citizens), rental of technical means of social rehabilitation - to 239 citizens. In order to provide elderly disabled citizens and disabled people with a temporary round-the-clock stay with a complex of material and welfare support, organization of care and provision of social, household assistance, 7 departments of round-the-clock stay for elderly citizens and disabled people operate in 6 Centers.

To assist disabled people in social adaptation and rehabilitation, as well as training disabled people in labor skills that ensure the realization of their rights and potential employment opportunities, day care departments for disabled people have been organized in all Centers.

For the first quarter of 2010, state support was assigned to 7,348 citizens in the amount of 2,043.8 million rubles, including in the form of a monthly social benefit - 6,313 citizens in the amount of 1,663.5 million rubles, in the form of a one-time social benefit - 400 citizens in the amount of 75 .6 million rubles, social benefits for payment of technical means of social rehabilitation - 635 citizens in the amount of 304.7 million rubles.

For elderly citizens and disabled people who have lost full or partial ability to self-service, in need of care and assistance, household and medical care, there are 12 stationary social institutions in the region: 5 - neuropsychiatric profile, 7 - general, where more than 1900 elderly citizens live and disabled people.

The necessary conditions for the residence of citizens are provided and maintained in boarding houses, repair and construction work is carried out, and the improvement of the adjacent territory is carried out.

As of April 1, 2010, 3229 veterans live in the region (as of January 1, 2009 - 3958).

Measures are being taken in the region to implement the Republican comprehensive program of social support for the elderly, veterans and people affected by the consequences of wars for 2006-2010, approved by the Decree of the Council of Ministers of the Republic of Belarus dated December 19, 2005 No. 1488. Twice a year surveys of the material and living conditions of war veterans are conducted. As of April of this year, 475 applications received from veterans have been completed.

During the first quarter of 2010, veterans received assistance from the local budget in the amount of 52.7 million rubles, of which they spent: on the repair of apartments, houses and outbuildings (102 people) in the amount of 44.3 million rubles, repair of stoves ( 8 people) in the amount of 3.0 million rubles, repair of electrical wiring (9 people) in the amount of 4.9 million rubles, installation of fire detectors (34 people) in the amount of 0.5 million rubles.

At present, the payment of material assistance is being completed in accordance with the Decree of the President of the Republic of Belarus dated February 18, 2010 No. 69 “On the provision of one-time material assistance to veterans of the Great Patriotic War and certain categories of citizens affected by the consequences of the war, in connection with the celebration of the 65th anniversary of the Victory in the Great Patriotic War".

Disabled people and participants of the Great Patriotic War are constantly provided with material and in-kind assistance from the funds of local budgets, organizations, the Fund for Social Protection of the Population. This assistance was provided for a total amount of 100.5 million rubles, of which 88.3 million rubles is monetary assistance, and 12.2 million rubles in kind.

In pursuance of the Decree of the President of the Republic of Belarus “On sanatorium-and-spa treatment and rehabilitation of the population”, 2038 invalids and war veterans were paid financial assistance in the amount of 724.5 million rubles this year instead of unused vouchers to sanatorium-resort institutions or health-improving organizations.

According to the Law of the Republic of Belarus “On state social benefits, rights and guarantees for certain categories of citizens” and the resolution of the Council of Ministers of the Republic of Belarus “On the state register (list) of technical means of social rehabilitation and the procedure for providing them to certain categories of citizens” for January-March 2010 133 disabled people were given wheelchairs (including 4 war veterans), 41 citizens received wheelchairs for humanitarian aid, 75 received technical means of social rehabilitation used as rehabilitation devices (including 3 war veterans), 124 veterans received prosthetic devices - orthopedic products.

As of April 1, 2010, social assistance departments at home of social service centers provide services to 179 disabled people and 434 veterans of the Great Patriotic War. These services are provided free of charge.

In the work on social support for war veterans, the main thing for the executive branch is to increase responsibility for solving problems of a material and everyday nature, to stimulate the desire to actively help people in need, to look for optimal ways and means to solve these problems, taking into account specific opportunities, economic conditions and a targeted approach to providing help.

help for elderly disabled person social

List of sources

1. Glushanko, V.S. Modern problems of improving medical and social care: Monograph / V.S. Glushanko, V.V. Kolbanov, I.V. Levitskaya, I.N. Moroz, S.A. Morozova, T.G. Svetlovich - under. ed. Secretary of the BOKK V.V. Kolbanova - Vitebsk: VSMU, 2008. - 185 p.

Gushchin, I.V. Social Security Law: Textbook for University Students / Ed. ed. I.V. Gushchina. - Minsk: Amalfeya, 2002. - 512 p.

3. Ukrainian, P.P. Social work: theory and organization: a manual for university students / P.P. Ukrainian, S.V. Lapina, S.N. Burova and others - 2nd ed. - Minsk: TetraSystem, 2007. - 288 p.

4. Kholostova E.I. Technologies of social work: textbook - M.: INFRA-M, 2002. - 400 p.

5. http: www/minzdrav.by/med/article/see/php? art - nid-1308art-from=25 V.P. Well-fed.

The state and ways to improve the geriatric service in Belarus. Ministry of Health of the Republic of Belarus. Belarusian State Institute for Advanced Training of Doctors.

. #"justify">. #"justify">8. #"justify">Organization of medical and social assistance in Grodno. Grodno regional executive committee of the Council of Deputies. 9. #"justify">Providing social assistance in the Grodno region. Grodno Executive Committee of the Council of Deputies.

. #"justify">..#"justify">. #"justify">13. www.cis.minsk.by/main.aspx? uid=6406 Implementation of social programs to protect the elderly in the Republic

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Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” The basic principles of health protection are: 1) respect for the rights of citizens in the field of health protection and ensuring state guarantees associated with these rights; 2) priority of the patient’s interests in the provision of medical care; 3) priority of protecting children's health; 4) social protection of citizens in case of loss of health; 5) responsibility of state authorities and local governments, officials of organizations for ensuring the rights of citizens in the field of health protection; 6) accessibility and quality of medical care; 7) inadmissibility of refusal to provide medical care; 8) priority of prevention in the field of health care; 9) maintaining medical confidentiality.

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Federal Law of November 24, 1995 N 181-FZ "On the social protection of disabled people in the Russian Federation" Article 1 A disabled person is a person who has a health impairment with a persistent disorder of body functions, caused by diseases, consequences of injuries or defects, leading to limitation of life activities and necessitating his social protection. Limitation of life activity - complete or partial loss of a person’s ability or ability to perform self-care, move independently, navigate, communicate, control one’s behavior, study and engage in work. Depending on the degree of disorder of body functions and limitations in life activity, persons recognized as disabled are assigned a disability group, and persons under the age of 18 are assigned the category “disabled child.” (as amended by Federal Law No. 172-FZ of July 17, 1999) Recognition of a person as disabled is carried out by the federal institution of medical and social examination. The procedure and conditions for recognizing a person as disabled are established by the Government of the Russian Federation. (as amended by Federal Law dated August 22, 2004 N 122-FZ)

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Federal Law No. 122-FZ of August 2, 1995 "On Social Services for Elderly Citizens and the Disabled" Social services for the elderly and disabled. Social services for elderly and disabled citizens is an activity to meet the needs of these citizens in social services. Social services include a set of social services that are provided to elderly citizens and the disabled at home or in social service institutions, regardless of ownership.

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Federal Law of December 10, 1995 N 195-FZ "On the Fundamentals of Social Services for the Population in the Russian Federation" Article 1. Social services Social services are the activities of social services for social support, provision of social, social, medical, psychological and pedagogical , social and legal services and financial assistance, social adaptation and rehabilitation of citizens in difficult life situations. Article 2. Legislation of the Russian Federation on social services The legislation of the Russian Federation on social services consists of this Federal Law, other federal laws and other regulatory legal acts of the Russian Federation, as well as laws and other regulatory legal acts of the constituent entities of the Russian Federation.

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National standard of the Russian Federation GOST R 53058-2008 "Social services for the population. Social services for elderly citizens. Services for inpatient social services: - provision of living space, premises for organizing rehabilitation activities, occupational therapy and cultural and leisure activities; - social and domestic services individually servicing and hygienic nature for elderly citizens who are unable for health reasons to carry out ordinary everyday procedures - preparing and serving food, including dietary nutrition; Services for semi-stationary social services: - provision of premises for organizing rehabilitation activities, occupational therapy and cultural and leisure activities; - provision hot meals; - provision of bedding and a sleeping place in a special room.

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National standard of the Russian Federation GOST R 52884-2007 "Social services to the population. Procedure and conditions for the provision of social services to elderly citizens and the disabled" (approved by order of the Federal Agency for Technical Regulation and Metrology dated December 27, 2007 N 562-st) Social services elderly citizens (women over 55 years old, men over 60 years old) and disabled people (including disabled children) should be provided in compliance with the following principles of social justice: a) respect for civil and human rights; b) orientation of social services to the individual needs of elderly citizens and disabled people; c) priority of measures for social protection of elderly citizens and disabled people; d) ensuring equal opportunities in receiving social services and their accessibility for all elderly citizens and disabled people; e) provision of state guarantees in the field of social services to the population.

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Decree of the Government of the Russian Federation of November 25, 1995 N 1151 "On the federal list of state-guaranteed social services provided to elderly citizens and disabled people by state and municipal social service institutions" Services provided to elderly citizens and disabled people living in inpatient social service institutions: Financially -household services Catering, household and leisure services Social-medical and sanitary-hygienic services Services related to social and labor rehabilitation: Legal services: Assistance in the organization of ritual services. Catering, household and leisure services: Socio-medical and sanitary-hygienic services: Employment assistance

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Decree of the Government of the Russian Federation of April 15, 1996 N 473 “On the procedure and terms of payment for social services provided to elderly citizens and disabled people by state and municipal social service institutions” Social services included in the federal list of state-guaranteed social services (hereinafter referred to as social services ), approved by Decree of the Government of the Russian Federation of November 25, 1995 N 1151 “On the federal list of state-guaranteed social services provided to elderly citizens and disabled people by state and municipal social service institutions” (Collected Legislation of the Russian Federation, 1995, N 49, Art. 4798), are provided to elderly citizens and disabled people at home, in semi-stationary and stationary conditions by state and municipal social service institutions (hereinafter referred to as social service institutions) free of charge, as well as on the basis of partial or full payment. 2. Social services are provided at home, in semi-stationary and stationary conditions by social service institutions free of charge: to single elderly citizens (single married couples) and disabled people receiving a pension in an amount below the subsistence level established for a given region; 3. Social services are provided at home, in semi-stationary and stationary conditions by social service institutions on the basis of partial payment:

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Decree of the Government of the Russian Federation of June 24, 1996 N 739 “On the provision of free social services and paid social services by state social services” Regulations on the provision of free social services and paid social services by state social services. 1. The main types of social services (social services at home, in stationary social service institutions, provision of temporary shelter in specialized social service institutions, day stay in social service institutions, advisory assistance and rehabilitation services) are provided to the population by state social services free of charge and for a fee. 2. For a fee (partial or full), the main types of social services are provided to citizens by state social services on the terms established by Decree of the Government of the Russian Federation of April 15, 1996 N 473 “On the procedure and terms of payment for social services provided to elderly citizens and disabled people by state and municipal social service institutions", except for the cases specified in paragraph 2 of these Regulations.

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Changes in the social status of a person in old age and the position of a disabled person in society associated with the cessation or limitation of labor and social activities give rise to serious social problems. The most pressing of them is the limitation of life activity of elderly people and people with disabilities and the associated transformation of value orientations. In solving this problem, improving the system of social rehabilitation and social assistance for the elderly and disabled is of paramount importance. The concept " social rehabilitation“includes a set of socio-psychological, economic, political, legal, medical, professional and other measures aimed at providing the necessary conditions for the return of these population groups to normal life and consolidating their social status at all levels of government policy.

Social help– this is provision in cash and in kind, in the form of benefits and services, provided taking into account legislative norms and social guarantees established by the state for the elderly and disabled.

Traditional forms of social security include cash payments (pensions, benefits, etc.); in-kind provision (food, medicine, clothing, etc.); services and benefits; stationary and non-stationary types of services. At the present stage of development of economic relations, an important condition for the social rehabilitation of this category of society is maintaining the standard of living by increasing pensions. Taking into account the proposals and capabilities of the Pension Fund of the Russian Federation, a new minimum pension amount was established and a mechanism for indexing pensions depending on rising prices was introduced. In the Moscow region, on the basis of the Pension Fund of Russia, an experiment is being conducted to develop a model of the future Federal Pension Service as an independent financial and banking system.

Currently, a network of non-state pension funds is developing as an additional source of social protection for older people. One of the effective measures for social rehabilitation of the elderly and disabled is their employment .

Benefits have been established for enterprises that employ disabled people. Institutions and organizations that employ 30% of disabled people from the total number of employees enjoy the right to preferential taxation; over 50% are completely exempt from taxes and payments. In connection with the structural restructuring of the economy, preference is given to the creation of new industries, environmentally friendly industries (farms, small and medium-sized businesses, etc.).

A special role in the rehabilitation system for the elderly and disabled belongs to medical and social rehabilitation . A network of federal and regional centers for rehabilitation treatment, multidisciplinary medical rehabilitation, specialized sanatorium and resort institutions, etc. is being created. New tasks have also been set for the Main Directorate of Medical and Social Expertise and Rehabilitation of Disabled Persons (MSE, former VTEC). Their functions include the development of individual rehabilitation programs with the determination of the specific volume, types and timing of their implementation. The mechanism for social protection of older people and disabled people is implemented at the state (federal) and regional (local) levels. At the state level, guaranteed provision of established amounts of pensions, benefits and other types of in-kind support, services and benefits is ensured. At the regional level, issues of additionally increasing the standards of state provision for needy disabled citizens are being resolved.

In modern conditions, the center of gravity of social protection for the elderly and disabled is shifting directly to local authorities. Many regions have established discounts on transport fares for elderly and disabled people. A network of special residential boarding houses for single elderly people and married couples with a range of social and welfare services is being developed. Accommodation and all types of social assistance in boarding homes are provided free of charge. Almost every such institution has created labor therapy workshops with various types of employment: sewing, haberdashery, shoemaking, carpentry, etc. In rural boarding houses there are subsidiary farms with developed forms of vegetable gardening, horticulture, beekeeping, etc. A system of cultural events is being developed (concerts, excursions, sports and health shows, theme evenings, interest clubs, etc.), brigade forms of labor organization, collective and rental contracting are being introduced. The organization of free meals at the expense of local budgets, territorial funds for social support of the population (Irkutsk, Magadan, Oryol, Penza, Rostov, Tambov and other regions) is currently gaining importance.

The Ministry of Social Protection of the Population of the Russian Federation has developed and is implementing federal target programs (“Social protection of the disabled,” “Social protection of the elderly,” etc.) designed for the development of low-mobility groups of the population. Emergency social assistance services are being created on the basis of territorial centers to provide immediate measures aimed at temporarily supporting the life of the elderly and disabled. This form of social service, such as home assistance, is becoming systematic (since 1987).

In Russia, a reform of the entire social insurance system has begun, private pension and insurance funds are appearing, medical insurance is being improved with the establishment of additional guarantees for the elderly and disabled. It is necessary to improve the legal basis of the social protection system for this category of the population.

One of the pressing problems is the training of social workers with higher specialized education to work in boarding homes and rehabilitation centers for the social, everyday and socio-psychological adaptation of disabled and elderly people. In 1991, faculties and training courses for social work specialists were opened in a number of universities in the country, and the Russian State Social Institute was created, but the need for qualified social workers is still quite great. There is a particular demand for high-class specialists in the field of organizing socio-cultural activities in solving the life problems of elderly people and people with disabilities. A social worker in his professional activities can perform different social roles: a defender of the interests of a vulnerable category of people, a sociologist, an expert on social and legal policy, a psychological consultant, etc. Improving the system of social protection and social support for the elderly and disabled in modern conditions - a necessary guarantee of their social rehabilitation and ensuring normal life activities during the crisis transition period of economic relations.

Social assistance to the elderly and disabled is provided in accordance with the country's laws on pensions. Decree of the Government of the Russian Federation dated May 20, 1998 No. 463 approved the “Pension Reform Program in the Russian Federation”, which assesses the current state of pension provision, outlines the main directions for the development of the reform concept, identifies the sources of formation of financial resources of the pension system, the role of personalized accounting, and provides the necessary recommendations and clarifications (see Bulletin of the Ministry of Labor and Social Development of the Russian Federation, 1998, No. 6).

The pension system is a complex technological chain consisting of a number of links - from the appointment to the payment of pensions. The current legislation establishes two types of pensions: labor And social. The procedure for their calculation, payment, recalculation, indexation is regulated by various regulations. The following have the right to an old-age pension on a general basis: men - upon reaching 60 years of age with a total work experience of at least 25 years; women - upon reaching 55 years of age and with total work experience
20 years. On preferential grounds, a reduced work experience is counted in the regions of the Far North, in places with special working conditions. The regulations establish that citizens can apply for a pension at any time after the right to it arises, without restrictions for any period and regardless of the nature of the occupation at the time of application. Pensions are paid at the expense of the Pension Fund of the Russian Federation. Labor pensions appointed in connection with labor or other socially useful activity, are divided as follows: by old age, by disability, by the loss of a breadwinner, for length of service. (Resolution of the Ministry of Labor of the Russian Federation dated May 22, 1996 No. 29, art. 12, 78, 78-2). According to the current legislation, the principle of accounting for the length of service is laid down in the mechanism for calculating pensions. The old-age pension is determined at a rate of 55% of earnings and 1% for each year of total work experience in excess of the required. However, the pension amount should not exceed 75% of wages.

The procedure for calculating disability pensions, on the occasion of the loss of a breadwinner, for long service has its own characteristics. The size of the pension for complete disability (I-II groups) is 75% of earnings, for partial - 30%. The law encourages the work of old-age pensioners and after the appointment of a pension by setting an allowance for each year worked. The old-age pension is paid in full, regardless of whether the pensioner is working or not. There is a provision for recalculation of pensions due to an increase in length of service. The amount of the pension for years of service is determined depending on the length of service, but not on the total length of service. The average monthly earnings when assigning a pension is determined (at the request of the applicant for a pension): for the last 24 months of work (service, except for military service) before applying for a pension or for any 60 months of work (service) in a row during the entire working life before applying for a pension (Article 102, Chapter VII of the Law of the Russian Federation “On State Pensions in the Russian Federation of May 20, 1998). From the number of months for which the average monthly earnings are calculated, incomplete months of work are excluded (at the request of the person applying for a pension). In this case, the excluded months are replaced by others immediately preceding or immediately following the selected period.

Pensioners who have worked for at least 24 months after receiving a pension with higher earnings can have their pension recalculated (upon their application). The pension increase is provided for:

· Heroes of the Soviet Union, Heroes of the Russian Federation, Heroes of Socialist Labor and citizens awarded the Order of Glory of three degrees - by 50%, but not less than 100% of the minimum old-age pension (Part 1 of Article 17 of the Law);

· champions of the Olympic Games – by 50% (Part 1 of Article 17 of the Law);

· participants of the Great Patriotic War – 100%
(Part 1 of Article 17 of the Law);

· citizens - former minor prisoners of concentration camps, GHETTOs and other places of forced detention - 100% of the minimum old-age pension (Part 1 of Article 17 of the Law);

· citizens who were unreasonably repressed for political reasons and subsequently rehabilitated - 50% of the minimum old-age pension (Part 1 of Article 17 of the Law);

· disabled people since childhood due to injury, concussion or injury associated with military operations during the Great Patriotic War or their consequences - 100% of the minimum old-age pension (Part 1 of Article 17 of the Law), etc.

Social pensions are established for citizens who for some reason do not have the right to a labor pension. Pension legislation provides the right to choose the type of pension. The right to simultaneously receive two pensions (old age, long service and disability) is granted to Russian citizens who have become disabled as a result of a military injury. Social pensions are provided to disabled people of groups I and II, including those disabled since childhood; disabled children under 16 years of age; children under 18 years of age who have lost one or both parents. A social pension is a state-guaranteed right to provide pensions to those citizens who, for objective reasons, have not acquired the required work experience.

The social pension is set in the following amounts:

Disabled children of groups I and II since childhood, disabled children, as well as children who have lost both parents and a single mother - in the amount of the minimum old-age pension
(Part 1 of Article 17 of the Law);

Disabled people of group II (except for disabled parents and citizens who have reached 65 and 60 years of age (men and women, respectively) - in the amount of 2/3 of the minimum old-age pension;

For disabled people of group III – in the amount of 1/2 pension.

An application for a pension is considered by the social protection authority no later than 10 days after its receipt with all the necessary documents (Article 118, Chapter IX of the Law). The pension is paid for the current month. Delivery and forwarding are carried out at the expense of the state. Amounts of assigned pensions not received by the pensioner on time are paid for the past time, but no more than in three years before applying for them. Pension amounts not received on time due to the fault of the authorities assigning or paying pensions are paid for the past without any limitation (Article 123, Chapter IX of the Law).

The financial pension system has mechanisms for compensation and indexation of pensions in connection with rising consumer prices and inflation. Pension provision is carried out directly by state social protection authorities of the Russian Federation and their pension services. The legislation defines the procedure for paying pensions during a pensioner’s stay in a home for the elderly and disabled; in case of deprivation of liberty by a court verdict, etc. There is a judicial procedure for resolving disputes in the field of pension provision.

An effective form of social security for the population is benefits. The state shows special concern for the protection of motherhood and childhood. Maternity benefits are set at 100% of wages, regardless of the mother’s work experience. Since 1993, “children’s” benefits have been paid: for children under 1.5 years old - in the amount of the minimum wage, up to 6 years old - 70%, from 6 to 16 years old - 60%.

Child benefits for single mothers, military families and families in which the father evades paying alimony have been increased by 1.5 times. Social benefits (for temporary disability, pregnancy and childbirth, child care, children for low-income families, etc.) are paid at the expense of the Social Insurance Fund, the Pension Fund and other extra-budgetary funds. The increase in the amount of benefits is provided for by law, taking into account marital status and local conditions.

In recent years, a number of legal acts have been adopted aimed at increasing the responsibility of enterprises for compensation for damage from work-related injuries of citizens, determining the procedure for paying unemployment benefits, etc. The Government of the Russian Federation adopted the Resolution “On approval of the procedure for registering unemployed citizens” dated April 22, 1997 No. 458, employment programs are being developed. The State Employment Fund of the Russian Federation pays benefits and compensations for unemployment, scholarships for the period of retraining and retraining, provides material assistance, etc.

In 1995, the Concept for the reform of pension provision in the Russian Federation was developed with the aim of establishing criteria and streamlining pension benefits, and an integral indicator of disability was identified.

Timely payment of pensions and benefits to citizens is one of the most important functions of the social security system.

Questions for self-control

1. What are the main problems of social protection of older people and disabled people in modern conditions?

2. The essence of the concepts of "social assistance" and "social rehabilitation".

3. Describe the types of pension provision.

4. Name the main conditions for the appointment and payment of a labor pension.

5. Formulate the features of the calculation of social pensions.

1. Alexandrova G. Years and worries. M., 1990.

2. Wisniewska-Roszkowska K. New life after sixty. Per. from Polish. M., 1989.

3. Gordin V. What are the benefits of old age? M., 1988.

4. On pension provision for citizens of the Russian Federation. M., 1992.

5. Living environment for disabled people. M., 1990.

6. Sonin M.Ya., Dyskin A.A. An elderly person in the family and society. M., 1984.

7. Starchenko N.A., Alilova Yu.M. Medical and labor examination. M., 1997.

As you age, your need for medical care increases. Due to the natural aging of the body, a number of chronic diseases appear; the number of people in need of constant medical supervision and the help of cardiologists, neurologists, gerontologists, and geriatricians is growing. Determining the degree of participation in the work activity of a retired person, helping him adapt to new conditions, and promoting the formation of an adequate lifestyle are the tasks of a medical and social specialist.

The social worker must know:

Fundamentals of personality psychology and socio-psychological aspects of helping the elderly;

Fundamentals of Russian legislation on benefits and advantages established for elderly citizens.

A social worker is obliged to clearly and steadily comply with the requirements of federal and regional legislation, to bear responsibility in accordance with the labor legislation of the Russian Federation for failure to perform or improper performance of his duties, leading to the infringement of the rights and legitimate interests of citizens; for the disclosure of confidential information that became known to him in connection with the performance of official duties.

The basic principles of social services for citizens are formulated in the Federal Law “On Social Services for Elderly and Disabled Citizens” (May 17, 1995).

This law regulates relations in the field of social services for elderly citizens, establishes economic, social and legal guarantees, based on the need to establish the principles of philanthropy and mercy in society.

The basic principles of activity in the field of social services for elderly citizens are set out in Art. 3 Laws: respect for human and civil rights; provision of state guarantees in the field of social services; ensuring equal opportunities to receive services and their accessibility; orientation of social services to individual needs, etc.

Social services include a set of social services (care, catering, assistance in obtaining medical, legal, socio-psychological and natural types of assistance, assistance in organizing leisure time) (Article 1 of the Law).

Social services should take care of the physical health of older people, encourage them (and facilitate the creation of conditions) to engage in sports. Practice shows that participation in competitions, marathon races, cross-country skiing, etc. has a beneficial effect on the health of older people.

However, a sick person, naturally, should not run marathons. According to special studies conducted by the Institute of Gerontology of the Academy of Medical Sciences, 25-30% of old people are bedridden). Aging and associated deterioration in health and illness predetermine the need for constant medical care, home care, and placement of the elderly or sick in specialized homes or hospitals.

Elderly citizens and disabled people who need permanent or temporary assistance due to partial or complete loss of the ability to independently satisfy their basic life needs have the right to social services.

Article 16 of this law contains forms of social services, they include:

1. Social services at home (including social and medical services).

2. Semi-stationary services in day (night) departments of social service institutions.

3. Inpatient services (boarding homes, boarding houses, etc.).

4. Urgent social services.

In accordance with the Decree of the Government of the Russian Federation dated April 23, 1997 No. 480 “On approval of the Regulations on the Ministry of Labor and Social Development of the Russian Federation,” the Ministry of Labor of Russia organizes, together with federal executive authorities and executive authorities of the constituent entities of the Russian Federation, the creation and development of a network of comprehensive and specialized state, municipal, private and other social services, incl. semi-stationary, stationary and other social service institutions.

Inpatient services and social services for elderly citizens and the disabled are provided under the conditions and in the manner established by the Federal Law of December 10, 1995 No. 195-FZ “On the Fundamentals of Social Services for the Population in the Russian Federation” and the Federal Law “On Social Services for Elderly Citizens and Disabled Persons” .

In general boarding homes, psychoneurological boarding schools, rehabilitation centers, homes of mercy, and gerontological centers, social services are provided to citizens in need of constant outside care, living conditions are provided, and medical, social, and psychological activities are carried out.

Semi-stationary and non-stationary services are characterized by a variety of forms and types of services (night stay homes, comprehensive centers, centers or departments for day and temporary stay, and others). Their main task is to individualize the range of services provided, taking into account the needs of social service clients.

The emergency social service center provides emergency assistance of a one-time nature, for example, emergency medical and psychological assistance.

In the Omsk region there are many institutions whose activities are aimed at such a category of clients as the elderly. It has a Gerontological Center - this is a social and medical institution that carries out activities not only of a medical and social nature, but also carries out scientific, practical and organizational and methodological work in the fields of gerontology and geriatrics. The Nadezhda MU Center for Social Services for Pensioners has a medical rehabilitation department, and doctors and psychologists provide consultations. There are comprehensive centers for social assistance and services (“Penates” of the Central Autonomous Okrug), boarding homes for the elderly and disabled, and boarding houses for war and labor veterans.

Of course, older people want to live in their own home, in a familiar environment. Expanding home care allows older people to live longer in their own homes and delays their transition to nursing homes. Home-based services guaranteed by the state (in Article 18 of Law No. 122-FZ) in our country are becoming more and more diverse.

For citizens in need of home-based social services who suffer from mental disorders (in remission), tuberculosis (except for the active form), and serious illnesses in the later stages, social and medical services are provided at home.

Social and medical services are provided by specialized departments at municipal social service centers or at social protection authorities. Branches carry out their activities in accordance with federal laws and other regulations of the municipality.

The main activities of the department:

1. Providing citizens with qualified general care and pre-hospital medical care at home.

2. Monitoring the health status of the citizens served and carrying out activities aimed at preventing exacerbations of their chronic diseases.

3. Provides services: emergency first aid, calling a doctor to your home; accompaniment of served citizens to health care institutions and visiting them in these institutions in case of hospitalization; carrying out medical procedures (measuring temperature, blood pressure, applying compresses, performing dressings, treating bedsores, wound surfaces, performing cleansing enemas); implementation of subcutaneous and intramuscular injections of drugs in accordance with the prescription of the attending physician; provision of sanitary and hygienic assistance; collection of materials for laboratory research and other services.

In his work, a social worker is guided by the current legislation of the Russian Federation, the Regulations on the Department of Social Services, and job descriptions.

Decree of the Government of the Russian Federation dated March 17, 2003 No. 158 provides for the provision by the Russian Pension Fund of targeted medical assistance to non-working pensioners receiving an old-age pension. According to this resolution, the Pension Fund of the Russian Federation took on the role of the insurer: a mandatory condition is the standard of treatment services - the Pension Fund of the Russian Federation pays 525 rubles for each elderly Russian. per year, no less than this amount must be contributed to the medical care of non-working pensioners and regional administrations. Thanks to this program, it will be possible to establish strict accounting of services provided to the elderly, calculate the “cost” of each disease and not only bring order to the medical insurance of the elderly, make pensioners profitable for the state, but also replenish the pensioner’s budget.

Sociological research in our country has shown that the main directions for ensuring the well-being of the elderly are: improving pensions, developing home care services, increasing the number of nursing homes and improving living conditions in them.

It happens that in Russia old people are left without the support of children and relatives, while in dire need of help. Due to health conditions or age restrictions, older people have difficulty cleaning the house, preparing food, washing and ironing clothes, going to the store, and so on. If it is proven that the old man needs support, the state will provide him with social assistance at home for older people. In the article we will look at what kind of social assistance at home is provided for elderly people in 2019.

What types of social assistance are there?

The concept of social support for older people includes the following types of services:

Providing social and advisory assistance to help the elderly and people with disabilities adapt to society.
Providing one-time emergency assistance.
Providing semi-inpatient care.
Service in a hospital setting (boarding home, boarding house, etc.).
Providing assistance from a social worker at home.

What is social assistance at home for older people?

Due to the fact that older people are the weakest category of citizens of the country, the state provides them with the opportunity to receive social assistance at home.

Let's figure out what types of services a social service can offer:

Call an ambulance to your home.
Accompaniment during a trip to a sanatorium, health resort, or medical institutions.
Accompaniment to a banking institution, to a branch of the Russian Post, to social security authorities for the purpose of writing applications, paying utility bills, filing petitions, etc.
Assistance in obtaining disability through medical and social examination.
Cleaning the house and carrying out cosmetic repairs to the living space.
Carrying out manipulation and other hygiene procedures.
Delivery of drinking water and solid fuel to elderly people living in premises without central heating and water supply.
Going to the pharmacy to buy medicine.
Shopping for food, household chemicals, essentials, etc.
Assistance in organizing everyday life, leisure, and nutrition.

When providing assistance to older people, their health status must be taken into account. Thus, persons who cannot take full care of themselves will be provided with proper care and hygiene. If a citizen needs any further assistance, the social worker is obliged to consider the possibility of providing it. For example, if we are talking about assistance in completing documentation, obtaining legal advice, obtaining secondary or higher education.

Conditions for providing social assistance

In order for a social worker to start visiting a pensioner’s home, it is necessary to first enter into a conclusion, which will indicate all the conditions for providing the person with an approved list of services. The contract will also specify how often the assistant will come to his home - once a week, daily or several days during the week. This depends on how independent the applicant is in caring for himself and his home.

The agreement must be signed by the elderly person himself or his authorized representative. The agreement is valid for a year, but when the new year begins, there is no need to apply for an extension - the agreement will be extended automatically.

Who is eligible to receive social assistance

Citizens of retirement age can receive a positive response from the authorities authorized to provide social assistance at home:

disabled people of any age;
retired women over 55 years of age;
men are retired from 60 years old.

The main criterion for selecting people who are in particular need of outside help is to determine the possibility of independent movement and full provision of their vital needs.

Who may be denied social assistance?

The decision to provide assistance or to refuse it is made by a special commission.

the presence of tuberculosis or another contagious disease, and therefore its carrier is required to stay in a specialized closed medical institution;
presence of a sexually transmitted or quarantine disease;
classifying a citizen as a drug addict;
alcoholism;
the presence of mental disorders, due to which the social worker may be harmed;
lack of housing for those in need of help;
lack of social workers to provide assistance to everyone.

Where to go and who provides social assistance

To request social assistance, please contact your regional office:

social protection authorities;
regional complex center.

Specialists from these institutions will determine whether the elderly person really needs outside help and whether it needs to be provided.

How is social care provided at home for older people?

Both the person in need, his relative or even a neighbor can apply for social assistance if he himself has limited mobility. A specially organized commission reviews the case, checks the availability of social workers and determines whether the applicant really needs social support and what services he will need to provide.

Based on the results of the commission’s work, an individual social support program will be drawn up. The social service worker will be informed about the need to provide certain types of services.

The study of materials and documents will take a maximum of 10 calendar days from the date of application. If a positive decision is made, the elderly person must sign an agreement with the social service to provide assistance to him.

Restrictions on the rights of citizens when receiving social assistance

If a citizen receives social assistance due to the fact that he is unable to actively move or take care of himself, observe the rules of personal hygiene, prepare his own food, and so on, by a court decision or after obtaining the consent of relatives, the elderly person can be sent to a specialized institution. There the person will be prescribed a course of treatment, or he will be assigned there for further permanent residence.

How much does it cost to provide social assistance at home?

The services of a social worker may cost the elderly person nothing, or they may be provided for a fee.

Since the beginning of 2015, social support has been provided free of charge to certain preferential categories of applicants and to those whose monthly income is less than or equal to the regional subsistence minimum. Services will also be free for disabled people and participants of the Great Patriotic War.

All other elderly people will pay for social service services, but the amount of payment will not exceed 250 rubles, regardless of the list of services and their quantity.

What documents will be needed to apply for social assistance?

To apply for social assistance at home, you will need to provide the social center with a set of documents, including:

Document	Where to get it
	Filled out on the spot according to the social model. services
Photocopy of the applicant's passport	–
Certificate of family composition	Housing department, passport office
A power of attorney certified by a notary and a passport of a proxy (for applicants drawing up documents through a proxy)	–
Certificate of a disabled person or WWII participant (if available)	USZN
Conclusion of medical and social expertise (for disabled people)	ITU Bureau
Certificate of monthly income (for low-income people, if available)	Where you receive additional income other than a pension

Legislative acts on the topic

Decree of the President of the Russian Federation dated January 29, 2000 No. 115	On measures to improve the living conditions of the elderly and disabled in state and municipal inpatient social service institutions
Federal Law of July 17, 1999 No. 178-FZ	Legal and organizational basis for the provision of state social assistance to low-income families, low-income citizens living alone and other categories of citizens
Decree of the Government of the Russian Federation of April 15, 2014 No. 296	On social support for citizens

Common mistakes

Error: A relative asks for a certificate of incapacity of an elderly person based on the fact that he uses social services at home.