One of the important effective mechanisms for solving and mitigating social problems of elderly citizens and people with disabilities in the context of modernization of Russian society is the organization of their social services. It should be noted that stable trends in increasing the proportion of older people in the population are becoming one of the factors of economic, political, social, spiritual and moral changes in Russian society. The constitutional proclamation of the Russian state as social, large-scale humanistic ideas of building a “society for people of all ages” turn the implementation of tasks to create conditions for improving the quality of life of older citizens into one of the key directions of state social policy. Social services are the activities of social services for social support, provision of social, social, medical, psychological, pedagogical, socio-legal services and material assistance, carrying out social adaptation and rehabilitation of citizens in difficult life situations. The totality of these services can be provided to elderly citizens and disabled people at home or in social service institutions, regardless of the form of ownership.

Elderly people and disabled people who have reached the established retirement age have the right to social services if they need permanent or temporary assistance due to partial or complete loss of the ability to independently satisfy their basic life needs due to existing limitations in the ability to self-care and movement.

Since the late 80s - early 90s of the last century, when in the country, against the background of radical transformations in all spheres of social life, the socio-economic situation of a significant part of citizens, including the elderly and disabled, sharply worsened, there was an urgent need for a transition from the old system of state social security to the new system of social protection. The demographic processes of progressive aging of the population also necessitated changes in policies regarding older people.

Evidence of the concern of a number of countries about the growing number of older people was the adoption by the UN World Assembly in Vienna in 1982 of the International Plan of Action on Aging, which prompted many countries to develop their own national policies and programs regarding the elderly. The Assembly resolution declared that “the aging should, as far as possible, be allowed to live productive, healthy, secure and satisfying lives in their own families and communities and be considered an integral part of society.” In the social security system of the USSR population, new accents also began to appear on the need to find forms of strengthening care, primarily for single elderly citizens and the disabled, and organizing assistance to them at their place of residence.

Non-stationary types of social services for elderly citizens abroad began to actively develop in the second half of the 20th century.

The Swedish decentralization regime ensured that everyone had equal access to all social services. A 1982 law placed responsibility for social care for the elderly in the hands of the communes. Communities should provide a variety of services that promote the greatest possible autonomy for older people. Assistance in housekeeping includes cooking, cleaning, laundry, meeting individual needs, etc. At the same time, for people living far from the center, everything necessary for cleaning, technical assistance, as well as personal hygiene items and books are delivered by special transport. Additional transport services upon personal request help an elderly person maintain contact with friends and acquaintances. In the system of measures to provide medical services to elderly people who have lost their independence, preference is also given to keeping them at home.

The UK government policy towards elderly citizens and disabled people is also focused mainly on creating adequate conditions for their living at home, primarily through the widespread provision of non-stationary forms and types of social services. Social and medical care at home is considered here as an important mechanism for the implementation of all social policy in the country, allowing to resolve many problems of this category of people associated with loneliness and loss of interest in life, helping to maintain contacts with others and improve living conditions. At the same time, the organization of social services is entrusted to local governments, which provide both mandatory and additional services. Not only full-time employees, but also numerous volunteers from various public, religious, charitable, youth and other organizations participate in the implementation of social programs.

Very popular among the elderly and disabled in the UK are such forms of assistance as “social club”, “social cafe”, which are usually created by religious and public charitable organizations. The main areas of their work include organizing communication between clients, their leisure time, providing inexpensive meals, medical, legal, psychological consultations, and organizing hobby groups.

In France, two types of assistance to older people are most widespread - the provision of services by “home assistants” and nursing care at home. The domestic helper service is intended to provide services primarily of a domestic nature to persons experiencing difficulties in purchasing food, preparing food, and maintaining living quarters. For elderly people with a significant degree of loss of ability to self-care, a nursing care service is provided, the functions of which, in addition to regular home care, include the provision of pre-hospital medical care and hygienic services. For persons discharged from inpatient medical institutions and who do not require intensive treatment, a “hospital at home” can be organized. Services for such persons are provided by doctors and nurses together with a social worker who provides household services.

The fundamental principles of social services for the elderly in France include the following:

• 1. Personal dignity. An elderly person, whatever his age, state of health, degree of loss of independence and level of income, has the right to service, qualified treatment and treatment.
• 2. Freedom of choice. Every elderly person whose health condition requires special intervention should have the opportunity to choose the form of care and its duration.
• 3. Coordination of assistance. Providing assistance and service requires coordinated and effective efforts that are as close as possible to the needs of the individual.
• 4. Help is provided first of all to those in need.

The experience of foreign countries attracted attention and demonstrated the legitimacy of using, in order to ensure the full functioning of elderly citizens and people with disabilities, a system of non-stationary social services that are close to their place of permanent residence and contribute to the preservation of activity and healthy longevity of these persons.

Not all single elderly and disabled people in need could receive help in boarding homes and inpatient institutions, since there were not enough places and many waited in queues. The population's needs for social services increased, and state and municipal institutions were not able to provide them in a timely and high-quality manner, even to those individuals who, for various reasons, were left without relatives and friends. These people were most often under the tutelage of friendly and sensitive neighbors, acquaintances, and bosses who were ready to help them. But the elderly needed constant and systematic care, services of a wide variety of properties. There was a growing understanding that the implementation of such tasks could only be accomplished by workers and social services specially assigned to serve them.

The first document that expressed the new direction of state policy in this area and laid the normative basis for organizing work was the resolution of the Central Committee of the CPSU, the Council of Ministers of the USSR and the All-Russian Central Council of Trade Unions dated May 14, 1985 “On priority measures to improve the material well-being of low-income pensioners and families, strengthening care about lonely elderly citizens.”

The following priorities were identified:

• - establishment of additional payments to pensions at the expense of local budgets for single pensioners in dire need from among workers, employees and members of their families;
• - establishing a 50 percent discount on the cost of medicines purchased according to doctors’ prescriptions for pensioners receiving minimum pensions;
• - increasing care for labor veterans by associations, enterprises, organizations, expanding the practice of constructing boarding schools, including inter-collective farm and collective farm, using funds from social and cultural events and housing construction funds;
• - development of the construction of residential buildings for single elderly citizens with a complex of social services and premises for the work of pensioners;
• - ensuring registration of single disabled and elderly citizens who are especially in need of help, and organizing their social services with the wide involvement for these purposes of consumer services, trade enterprises, public catering, foster services, organizations of the Red Cross society, health care institutions, individual citizens employed in the household, students with appropriate remuneration for their work.

Thus, the country began to create a system of social assistance for single elderly people, disabled people and low-income pensioners, focused on the diversity of its forms and types. In many territories, complex targeted programs “Care” and “Duty” began to be developed and implemented, and the defining institutions were the nascent multifunctional social service centers, departments of social assistance to single people at home, special residential buildings with a range of social services.

The result of the implementation of this resolution was the opening of the first experimental social assistance departments at home under the social welfare departments of the district executive committees.

The activities of such departments to identify, organize accounting and social services for single elderly citizens and disabled people in need of outside help and care gradually developed. Local social welfare authorities took responsibility and began to implement measures to provide such persons with necessary services at home, including the delivery of food, lunches, medicines and hygiene items, fuel, laundry and cleaning of residential premises. Lists of identified persons were also sent to enterprises and services of trade, public catering, housing and communal services, consumer services, and health care institutions to organize the necessary assistance at home. In some settlements, organizations of the Red Cross society and Komsomol youth groups took care of lonely elderly people and disabled people. Therapeutic and recreational activities were carried out according to individual plans. Day hospital departments and hospitals at home for the elderly developed everywhere; public health rooms appeared in residential neighborhoods in cities, which made it possible to carry out constant medical monitoring of the health status of the elderly. A network of geriatric offices in the health care system was developed.

A further step in the development of social services was the Decree of the Central Committee of the CPSU, the Council of Ministers and the All-Union Central Council of Trade Unions dated January 22, 1987 No. 95 “On measures to further improve services for the elderly and disabled.” The resolution consolidated the legal status of social assistance departments at home, and also provided for the creation of territorial social service centers that would make it possible to combine home-based and stationary forms of state support and assistance to single and disabled citizens into a single complex.

By order of the Ministry of Social Security of the RSFSR dated June 24, 1987, the Regulations on the territorial center for social services for pensioners, on the department of social assistance at home for single elderly and disabled citizens, as well as the staffing standards of these institutions were approved.

Significant successes in serving single citizens at this stage were achieved in the Ulyanovsk region. A lot of organizational work was carried out here, the “Care” program was developed, measures were taken to provide single elderly citizens living in rural areas with various types of services - from the construction and repair of a residential building to the delivery of fuel and feed for livestock in their personal farmstead. Work on medical examinations and comprehensive medical examinations of single rural residents has intensified, enterprise bosses have been assigned to them, and many have been provided with new housing. For medical and social assistance to single disabled citizens, “nursing bureaus”, “patronage bureaus” were organized, and “mercy posts” were established.

In Ivanovo, Kuibyshev and other regions, a different model of service developed through boarding houses operating in the system of social security authorities. House employees once every 7-10 days, as part of an integrated team, went to single elderly citizens and brought them a set of food, clean linen, medicines, cleaned the premises, and provided medical care. Initially, social service centers were created on the basis of existing boarding houses, but gradually the structure of these institutions changed, and they began to function autonomously, in no way connected with boarding schools.

In 1992, ten years after the adoption of the Vienna Plan of Action on Ageing, a new program of international cooperation was prepared, UN principles on older people were developed and recommended for their inclusion in national programs. Much attention in these documents was paid to the organization of care and protection of disabled elderly citizens, ensuring access to medical care, social, legal and other services that allow maintaining an optimal level of well-being, dignity and independence. It was especially emphasized that older people should live at home as long as possible. Attention was drawn to the importance of forming an active subjective life position of the oldest person. Such approaches to the status of disabled elderly people have found recognition in many countries, including Russia.

Began in the early 90s. last century, economic reforms and large-scale liberalization of prices led to a sharp drop in the living standards of the population, a deterioration in the consumption structure, and an increase in socio-psychological tension in society. As the crisis grew, a set of measures was urgently needed to reduce the level of social instability. A general focus was taken on supporting the population through a system of socially compensating measures. Using funds from budgets at all levels, reserve funds for social protection of the population began to be urgently formed, and a targeted system of social assistance was developed for the most vulnerable groups of the population, including elderly disabled citizens.

The Decree of the President of the Russian Federation “On additional measures for social support of the population in 1992” provided for the streamlining and development of the local system of providing in-kind assistance (charity canteens, social shops, etc.), as well as the creation of social assistance departments at home and territorial centers of social services for the population of emergency social assistance services. Strengthening the targeting of social support to vulnerable groups of the population in order to limit poverty and provide basic guarantees in the field of medical and social services, education and cultural development was declared a priority task of state social policy.

In the Main Directions of Social Policy of the Government of the Russian Federation for 1997, it was noted that although the general situation in the country continues to remain tense, some positive symptoms have also appeared that characterize the processes of gradual adaptation of the population to market conditions.

At the end of 1994, about 10 thousand social assistance departments at home were already functioning in the country, over

1.5 million elderly and disabled people need home care; out of every 10 thousand pensioners, 250 people received such help. In 1995, 10,710 home service departments provided social assistance to 981.5 thousand single elderly and disabled people, 42.6% of whom lived in rural areas. Moreover, of the total number of departments, 57% were located in the structure of territorial centers and boarding houses.

The high demand of older citizens for medical services has necessitated the opening of specialized departments of social and medical services at home. The number of such branches in 1998-2001. increased from 632 to 1370, i.e. more than 2 times, and the persons served by them, respectively, from 41.6 thousand to 151.0 thousand people, or 3.6 times.

Thus, in the 90s of the last century, home-based social services for elderly and disabled people of this age were intensively formed and developed in the country. Almost 150 thousand full-time workers were employed in this area. In 1995, the number of emergency social assistance services was 1,585, in which 5.3 million people received various types of one-time support within one year.

All these processes developed in line with global trends and in accordance with the requirements of international legal acts on aging issues.

The key to understanding the direction of development of social services for older people in these years can be considered the norm of the European Social Charter of May 3, 1996 “to give older people the opportunity to freely choose their lifestyle and lead an independent existence in a familiar environment, as long as they are willing and able to do so.” This".

In the activities of social assistance services, a differentiated approach to the population of those served was strengthened, taking into account the diversity of their needs and demands. The regulatory and legal framework of the policy in this area began to require further improvement, development and approval of special norms for organizing work in changing conditions.

Adoption in the mid-90s of the XX century. a number of legislative acts, federal laws “On the fundamentals of social services for the population in the Russian Federation”, “On social services for elderly citizens and disabled people”, “On social protection of disabled people in the Russian Federation”, “On state social assistance”, “On veterans”, “On charitable activities and charitable organizations”, etc. was due to these reasons and characterizes the beginning of a new stage in the development of social services for the population.

Favorable opportunities for actually providing elderly citizens with high-quality social services were created by the approval in 1997 by the Government of the Russian Federation of the target program “Older Generation”, one of the most effective social programs, characterized by an innovative approach, comprehensiveness, and sustainable financing. The program was extended for 2002-2004. and new tasks were set for this period.

The main goal of the program was to create conditions for improving the quality of life of older citizens through the development of a network of social service institutions and improvement of their activities, ensuring the availability of medical care, educational, cultural, leisure and other services, promoting the active participation of older people in society.

The “Older Generation” target program has become an effective model of intersectoral cooperation, combining the efforts of a number of ministries and departments to strengthen, first of all, the material and technical base of social service institutions for elderly citizens and the disabled. Measures were taken everywhere to overhaul, reconstruct, disaggregate, technically re-equip facilities for the elderly, and equip them with means to facilitate care for the elderly.

During the implementation of the program, emphasis was placed on the need for a systematic solution to the problems of developing social services for older people, the application of uniform principles of network management and the consistent introduction of new organizational and legal forms of institutions, ensuring the accessibility of social services through mobile social services, the availability of specialists with a high status in all main indicators.

Taking into account the norms and requirements of the main international documents, ideas were actively developed about the need to perceive the older generation not only as recipients of assistance, but also as subjects capable of being active and participating in the social life of society.

A major role in the implementation of these ideas in social work with the elderly and disabled was played by social service centers, institutions of a new type, which first appeared, as already noted, in the late 80s of the last century.

Such institutions carry out all organizational and practical activities on the territory of a city or district to provide various types of social assistance to elderly citizens, disabled people, families with children, people without a fixed place of residence and other groups of the population in need of social support.

The center has in its structure various social service units, including day care departments for the elderly and disabled, social assistance at home, emergency social assistance service, etc. Many centers have social canteens, shops, hairdressers, shoe and household appliance repair shops and other social services. The network of non-stationary social service institutions for elderly citizens and people with disabilities is developing dynamically, the total number of such centers in the country has now reached almost 2.3 thousand against 86 in 1992. The structure of the centers includes about 12 thousand social service departments at home, including employing 178.5 thousand social workers. They provide various social services to almost 1.5 million people a year, or 92.2% of elderly and disabled citizens registered for home-based services.

The main tasks of the center are as follows:

• - identification of the elderly, disabled, families with children and other persons in need of social support;
• - determination of specific types and forms of assistance;
• - differentiated accounting of all persons in need of social support, depending on the types and forms of assistance required, the frequency of its provision;
• - provision of various social services of a one-time or permanent nature;
• - analysis of the level of social services for the population of the city, district, development of long-term plans for the development of this area, introduction into practice of innovative technologies of assistance, depending on the nature of the needs of citizens and local conditions;
• - involvement of various government and non-governmental organizations, public structures in resolving issues of providing social, medical, social, psychological, legal assistance to elderly people and other people in need, coordinating their activities in this direction.

The provision of social services in such institutions can be provided on a full or partial payment basis or free of charge, depending on the client’s income level compared to the cost of living in the region. Funds from collecting fees for services are used to further develop social services and stimulate the work of social workers. Social service institutions are required to enter into agreements with citizens accepted for paid services, which determine the volume and types of services provided, terms, procedure and amount of payment.

Social services are provided free of charge to the following categories of clients:

• 1) single elderly citizens (single married couples) and disabled people receiving a pension in an amount below the subsistence level established for a given region;
• 2) elderly citizens and disabled people who have relatives who, due to remoteness of residence, low income, illness and other objective reasons, cannot provide them with assistance and care, provided that the amount of pension received by these citizens is lower than the subsistence level established for the given region ;
• 3) elderly citizens and disabled people living in families whose average per capita income is below the subsistence level established for a given region.

Social services are provided on a partial payment basis:

• 1) single elderly citizens (single married couples) and disabled people receiving a pension in the amount of 100 to 150% of the minimum subsistence level established for a given region;
• 2) elderly citizens and disabled people who have relatives who, for objective reasons, cannot provide them with help and care, provided that the amount of pension received by these citizens is from 100 to 150% of the minimum subsistence level established for a given region;
• 3) elderly citizens and disabled people living in families whose average per capita income is from 100 to 150% of the subsistence level established for a given region.

Social services on a full payment basis are provided to elderly citizens and disabled people living in families whose average per capita income exceeds the minimum subsistence level established for a given region by 150%.

In accordance with Art. 15 of the Federal Law “On the Fundamentals of Social Services for the Population in the Russian Federation,” paid social services in the state system of social services are provided in the manner established by the state authorities of the constituent entities of the Russian Federation. When contacting social services, older people and people with disabilities have the right to:

• 1) to choose an institution and form of service;
• 2) respectful and humane attitude on the part of the institution’s employees;
• 3) information about your rights, obligations and conditions for the provision of social services;
• 4) confidentiality of personal information that became known to an employee of the institution during the provision of social services;
• 5) protection of their rights and legitimate interests, including in court;
• 6) refusal of social services.

Restrictions on the rights of elderly and senile citizens in the provision of social services to them are allowed in the manner prescribed by Federal Law No. 122-FZ of August 2, 1995 “On Social Services for Elderly and Disabled Citizens”, and may be expressed in the premises of these citizens without their consent to social service institutions in cases where they are deprived of care from relatives and other legal representatives and at the same time are unable to independently satisfy their vital needs (loss of the ability for self-care and (or) active movement) or are recognized as legally incompetent.

The issue of placing such people in inpatient social service institutions without their consent or without the consent of their legal representatives is decided by the court on the proposal of the social protection authorities.

Refusal from the services of social service institutions for elderly and senile citizens is carried out upon a written application from their legal representatives if they undertake to provide these persons with care and the necessary living conditions.

Elderly citizens and disabled people who are bacteria or virus carriers, or if they have chronic alcoholism, quarantine infectious diseases, active forms of tuberculosis, severe mental disorders, venereal and other diseases requiring treatment in specialized healthcare institutions, may be denied social benefits. home services.

Refusal to provide elderly citizens and disabled people with social services is confirmed by a joint conclusion of the social protection body and the medical advisory commission of the health care institution.

Social services for elderly and senile citizens provided in non-stationary conditions may be terminated if they violate the norms and rules established by social service management bodies when providing this type of service.

The widespread development of social service centers and the creation of social service departments at home within their structure expresses the priority direction of policy in this area - to enable older people to remain full members of society for as long as possible and live in familiar home conditions.

At a meeting with the Minister of Health and Social Development of the Russian Federation, President of the Russian Federation D. A. Medvedev in September 2010 noted: “Now the time has come to more actively engage in the implementation of the rights of older people, to think about how to stimulate labor activity, how to help them more successfully, take this topic as one of the state priorities... This should become a big and serious work.”

The structure of demand for social services is gradually changing and depends on a number of factors. Expensive services for constant outside care, social and medical services, and nursing services are becoming increasingly in demand. First of all, this is explained by the socio-demographic processes of changing the structure of the population over working age, the disability of society, the emergence of groups of people with special needs, such as:

• 1) elderly disabled people - there are about 5.3 million of them in the country;
• 2) persons over 70 years of age - approximately 12.5 million people;
• 3) centenarians - about 20 thousand people aged 100 years and older;
• 4) lonely, long-term ill elderly people;
• 5) elderly residents of remote rural settlements - about 4 million people.

Article 16 of the Federal Law “On Social Services for Elderly and Disabled Citizens” provides for the following forms of social services for such citizens:

• 1) social services at home, which is aimed at maximizing the possible extension of the stay of elderly and disabled people in their usual social environment in order to maintain their social status, as well as to protect their rights and legitimate interests;
• 2) semi-inpatient social services in day (night) departments of social service institutions, including social, medical and cultural services for the elderly and disabled, organizing their meals, recreation, ensuring their participation in feasible work activities and maintaining an active lifestyle;
• 3) inpatient social services in stationary social service institutions (boarding homes, boarding houses, houses of mercy, homes for veterans, etc.), involving the provision of comprehensive social and domestic assistance to elderly and disabled people who have partially or completely lost the ability to self-care and who, for health reasons, need constant outside care and supervision;
• 4) urgent social services, carried out for the purpose of providing emergency one-time assistance to elderly and disabled people in dire need of social support;
• 5) social advisory assistance for elderly and disabled people, aimed at their adaptation in society, easing social tension, creating favorable relationships in the family, as well as ensuring interaction between the individual, family, society and the state.

The diversity and complexity of social problems caused by the aging population require adequate measures to provide the elderly with a guaranteed minimum of social services, and the development of such forms of service that could contribute to the realization of personal potential in old age.

Social services for older citizens in modern conditions are based on the following principles:

• - the principle of state responsibility - implies constant activity to improve the social situation of older citizens in accordance with changes occurring in society, fulfillment of obligations to prevent poverty and deprivation associated with market economic transformations, forced migration, and emergency situations of various types;
• - the principle of equality of all citizens of the older generation - implies an equal right to protection and assistance in difficult life situations, to recognition of decisions regarding one’s life activities, regardless of social status, nationality, place of residence, political and religious beliefs;
• - the principle of continuity of state social policy and stability of measures in relation to older citizens to preserve social guarantees of support and take into account their interests as a special category of the population;
• - the principle of social partnership - involves the interaction of the state, society and individual citizens in the implementation of measures to ensure the social well-being of older people, constant cooperation with family, public associations, religious, charitable organizations and other social partners providing assistance and services to older people;
• - the principle of unity of policy, commonality of views, consolidation of funds allocated to solve the priority problems of older citizens at all levels of government;
• - the principle of ensuring equal opportunities in receiving social services and their accessibility for all older citizens.

Based on these principles, the main directions for further development of the system of social services for elderly and disabled people of this age can be identified as follows:

• - sustainable increase in the level of social services at home and in inpatient settings as a factor in improving the quality of life in old age;
• - development of a network of institutions and services for social purposes of new types, allowing to take into account regional characteristics of climatic, national-ethnic, demographic, religious nature, including mobile interdepartmental social services;
• - provision of social services on an individual basis, the use of effective innovative service models close to the needs of older people;
• - consistent differentiation of the approach to determining the amount of fees for services provided, taking into account the individual needs of clients and their social status;
• - concentrating the efforts of institutions on providing older people with high-quality social and medical services, including hospices at home;
• - strengthening targeted rehabilitation and physical education and health work aimed at improving health, preventing diseases and premature aging;
• - improving interaction with social partners, public associations, charitable, religious organizations, families and volunteers in the implementation of activities to provide social services to older citizens;
• - development and implementation of innovative technologies for family care for older people in their usual environment;
• - ensuring a high level of professional training, retraining and advanced training of specialists employed in the areas of social services for the population;
• - development and implementation of research programs to study the specific lifestyle and situation of older people, dissemination of best practices in organizing their social services.

Further improvement of state social policy in relation to older citizens involves the implementation of the following priorities:

• - strengthening the legal protection of these citizens through the adoption of special legislative norms that facilitate the implementation of constitutional guarantees of their social rights, expanding the network of the legal profession and creating social courts;
• - implementation of measures to maintain a guaranteed level of income, regardless of region of residence, belonging to a socio-economic category and other conditions;
• - improving health status, ensuring accessibility for all older citizens of medical and special geriatric care, continuity and interconnection of diagnosis, treatment, rehabilitation, medical and psychological support, payment of social benefits for care, rationalization of nutrition;
• - increasing the role of the family in caring for the elderly, economic, social and psychological support for families providing care for elderly relatives, especially families with low incomes and elderly couples;
• - providing older people with decent housing conditions in accordance with minimum state standards that meet physical capabilities and lifestyle specifics, through modernization, reconstruction and repair of houses and apartments, design and construction of new types of housing, creating conditions for active recreation;
• - creating favorable conditions for feasible employment of older people, preventing discrimination on the basis of age and ensuring equal access to vocational training and retraining programs;
• - stimulating social participation and initiatives of older citizens, promoting the activities of public associations and organized communities to implement interpersonal contacts, satisfy cultural and aesthetic needs and the desire for creative self-realization;
• - providing information on measures to improve their legal, economic and social status, the activities of government bodies to protect the rights of people of the older generation

One of the important facts for ensuring the effectiveness of social services for the elderly and disabled is the correct selection, training and placement of personnel. Until recently, the level of professional training of social workers providing home-based services to older people was regulated by the relevant tariff and qualification characteristics approved by resolutions of the Ministry of Labor of Russia dated October 12, 1994 No. 66, dated February 22, 1996 No. 12. They determined the job responsibilities of the employee and the amount of knowledge and skills required to provide social services guaranteed by the federal list to an elderly person at home.

In connection with the adoption of Decree of the Government of the Russian Federation of August 5, 2008 No. 583 “On the introduction of new systems of remuneration for employees of federal budgetary institutions and federal state bodies, as well as civilian personnel of military units, institutions and divisions of federal executive authorities, in which the law provides military and equivalent service, the remuneration of which is currently carried out on the basis of a unified tariff schedule for remuneration of employees of federal government institutions”, the norms of these acts have become invalid. Currently, remuneration systems for workers in this area are regulated by collective agreements, agreements, and local acts in accordance with the current legislation of the Russian Federation and its constituent entities. The abolition of the Unified Tariff Schedule made it possible to change the basic principles of setting wages depending on the quantity and quality of work performed, and to introduce incentive payments to the employee’s basic salary.

In conjunction with the processes of formation of the social service system, multi-level training of specialists for this field has been successfully developing in the country in recent decades. Social workers receive initial vocational education in vocational schools for various purposes. Secondary vocational educational institutions train mid-level specialists. And finally, the implementation of higher professional and additional postgraduate education programs in the specialty “social work” is carried out by higher educational institutions. The Russian State Social University has become the leader of domestic social education, heading the educational and methodological association, which currently has 236 state universities engaged in training specialists for this field.

The profession of a social worker has a pronounced humanistic orientation, and the professional competence of social service specialists is the most important factor in increasing the effectiveness of public policy towards older citizens. The concept of “competence” includes complex content that integrates basic professional, socio-legal, socio-psychological, socio-pedagogical, socio-gerontological and other characteristics. The competence of a specialist should be considered primarily as a set of knowledge, skills, abilities, qualities and personality traits necessary for professional activity in this field.

In a number of foreign countries, where the training of social work specialists has been carried out for many decades, certain criteria for their professional competence have been developed. The same problem is becoming relevant in Russia. At the same time, it should be noted that professionalism, as one of the leading components of social work, is also based on personal qualities, value orientations and interests of the social worker himself as a subject of assistance. The development of personal interest in the chosen profession, ideas about the basics of social work technology, its place in the system of social relations and the formation of motivational attitudes towards one’s activities contribute to the successful solution of social problems.

In the USA, for example, it is believed that the professional competence of a social worker combines the following components:

• 1) conceptual competence or understanding of the theoretical foundations of the profession;
• 2) instrumental competence is the possession of basic professional skills and abilities;
• 3) integrative competence is the ability to combine theoretical knowledge and practical skills in one’s professional activities;
• 4) analytical competence - the ability to analyze social processes, identify trends and patterns;
• 5) correctional competence - the ability to modify, adapt, adapt one’s actions to a changing situation;
• 6) evaluative competence or the ability to evaluate one’s professional actions, determine their effectiveness and efficiency.

Similar approaches in the process of training specialists in social work are being carried out in Russia, developing in close unity with the growing network of social institutions and relying on the norms of legislation in force in this area, state standards of social services for the population.

Social work specialists in modern conditions are in demand in government and non-governmental social services, organizations, labor collectives of production enterprises, associations, healthcare institutions, military units, and the penitentiary system. The needs of individual population groups, specific social situations, and the characteristics of people’s lives dictate the need to develop various modifications of social technology for providing assistance. The functional activity of a specialist in various areas of social practice can have a multivariate coloration.

In the qualification characteristics of specialists working in the field of social services for older people, the following qualities are especially significant: professional preparedness, erudition in the processes of socio-economic development of society, communication skills, emotional stability and readiness for psychological stress, tolerance, ability to make decisions and responsibility for them consequences, the ability to attract the attention of others to the results of one’s professional activities, and to interact with various social institutions of society. The basic characteristics remain a motivational and value-based attitude towards one’s profession, professional consciousness and self-awareness.

It should be noted that at present, a draft amendment to the Federal Law “On the Fundamentals of Social Services for the Population in the Russian Federation” has been submitted to the State Duma, which will meet the realities of modern life in Russian society and the changing socio-economic conditions. These changes are due primarily to the fact that the provisions of the current laws do not fully satisfy the needs of the population for high-quality social services.

There are regional differences in the scope of citizens' rights to social services, the levels of their implementation and accessibility. There have been queues for a long time to receive social services at home and in inpatient settings. In the constituent entities of the Russian Federation, the grounds for recognizing citizens as needing social services are defined differently. All these points require thorough legislative adjustments and unification of approaches to organizing the provision of services.

It is also envisaged to introduce a number of new basic concepts and terms, such as “state assignment for the provision of social services”, “individual need”, “social service provider” and some others. All this is aimed at strengthening the status of participants in social services for the population, including this area in the system of relations arising from the legal status of budgetary, autonomous and government institutions, placing state (municipal) orders, state support for socially oriented non-profit organizations, charitable and volunteer activities.

The expansion and specification of the list of powers of federal government bodies and government bodies of constituent entities of the Russian Federation in the field of social services for the population, defined by the bill, also reflect modern approaches, technologies and management solutions tested in practice in this area.

The adoption of these changes will certainly be a new step towards further improvement of the system of social assistance to the population.

Questions for self-control:

• 1. What is social services for the population?
• 2. How do you understand the activities of the social service system, what elements does this system include?
• 3. What forms of social services are available for older citizens?
• 4. What types of non-stationary services for older people are most popular in modern conditions?
• 5. What principles are social services for older citizens and disabled people based on?
• 6. What qualities should a specialist working with older people have?

2.1 Organization and methods of work of the Social Service Center

Social work is an activity carried out by a professionally trained specialist to provide assistance to people in need who are unable to solve their life problems without outside help.

Social work with elderly disabled people consists of providing practical assistance to those who have a low financial level, suffer from various diseases, have disabilities, as well as creating conditions conducive to their physical survival and maintaining their social activity. Social work with such a contingent can be considered at two levels:

Macro level. Work at this level involves measures taken at the state level, its attitude towards elderly people with disabilities as part of society. These include: the formation of social policy taking into account the interests of older people with disabilities; development of federal programs; creation of a comprehensive system of social services for the elderly and disabled, including medical, psychological, advisory and other types of social assistance; training of specialists to work with older people and people with disabilities.

Micro level. This work is considered at the level of each elderly person, namely: whether he lives in a family or alone, health status, ability to self-care, age, environment, support, whether he uses social services and even the identity of the social worker who works directly with him .

To ensure a decent life for elderly people with disabilities, Social Service Centers have proven themselves very positively in the social protection system, helping single elderly citizens and people with disabilities adapt to difficult life situations.

Social and medical services at home are provided to disabled people who need permanent or temporary (up to 6 months) outside assistance due to partial or complete loss of the ability to self-care. The staff of this department includes nurses who provide patronage to disabled people at home and provide the following services: health monitoring, feeding weakened patients, sanitary and hygienic procedures (measuring body temperature, blood pressure, monitoring medication intake). Nurses carry out medical procedures in accordance with the prescription of the attending physician: subcutaneous and intramuscular administration of medications; application of compresses; dressings; treatment of bedsores and wound surfaces; collection of materials for laboratory research; provide assistance in the use of catheters and other medical devices. Medical workers teach relatives of disabled people practical skills in general patient care.

The main directions of social and medical services are maintaining and improving the quality of life of clients, reflecting not only the functional, physical and psychological state of a person’s health, but also his social activity, ability to self-care, material support and living conditions, as well as satisfaction with the feeling of his own physical and psychological well-being.

Medically oriented functions of OSMO:

Organization of medical care and patient care;

Providing medical and social assistance to the family;

Medical and social patronage of various population groups;

Providing medical and social assistance to chronically ill patients;

Organization of palliative care;

Prevention of recurrence of the underlying disease, disability, mortality (secondary and tertiary prevention);

Health and hygiene education;

Informing the client about his rights to medical and social assistance and the procedure for its provision, taking into account the specifics of the problems, etc.

The activities of a social worker in OSMO, aimed at eliminating problems associated with loneliness of older people and disabled people, depend on the specifics of the legislation and the institution that cooperates with needy categories of the population. Social services for elderly and elderly citizens at the regional level have been carried out since 01/01/2015 in accordance with Federal Law No. 442 “On Social Services for Citizens in the Russian Federation”, but the activities of local authorities and local legislation in this area are of primary and overwhelming importance. In order to implement Federal Law No. 442, the Moscow Government decided: to approve the Procedure for the provision of social services in Moscow from 01/01/2015. Local legislation duplicates federal legislation in its basic principles, but adjusts it in accordance with the specifics and needs of Moscow.

The priority functions of the organization of social assistance at home related to the loneliness of elderly disabled people are the provision of services such as: socio-pedagogical, socio-psychological, services in order to increase the communicative potential of recipients of social services.

Social and pedagogical services play a leading role in overcoming loneliness. Their tasks:

Gaining new knowledge to help you respond flexibly to changes in life;

Creating opportunities for creative development and self-realization of experience and knowledge of elderly people with disabilities;

Realization of the need for communication.

The problem of older disabled people’s lack of opportunity to communicate with each other, have hobbies, hobbies, and organize their leisure time is also becoming more and more urgent. The lack of such opportunities contributes to the development of a subjective state of loneliness.

Loneliness therapy is a set of actions, technological approaches and theories aimed at both preventing loneliness and eliminating its consequences. A social worker must be well versed in loneliness therapy methods in order to be able to choose the optimal model in each specific case that will contribute to practical results. Here we need to take into account the variety of factors leading to loneliness. Helping lonely people should be about changing the situation, not about the person's personality. The social worker is called upon to use methods that do not negatively affect a person’s loneliness.

In general, in the regions in the field of organizing social services for elderly people with disabilities, home and inpatient services are used; provision of social services to older people on the basis of the implementation of the principle of an individual approach; development of a network of new types of social service organizations, primarily gerontological centers, small-capacity homes, temporary residence homes, gerontopsychiatric centers, mobile social services; development of a range of additional paid services in the state and non-state social service sector; provision of social and medical services to older people, including on the basis of hospice-type institutions, including hospices at home; interaction with public associations, charitable organizations, families and volunteers in providing social services to older people and disabled people.

Legislation at the regional level takes into account that different people require different services. Different pensioners need a different set of social services, not all of which are provided free of charge for everyone. The most popular existing forms remain semi-stationary. There are about 4.5 thousand of them across the country - they are in almost every city, serving about 20 million people. Social services at home are no less in demand.

The experience of the regions in social technologies for elderly disabled people, aimed, among other things, at overcoming the problem of loneliness is interesting - the example of the Kurgan region: “Dispensary at home.” This technology involves carrying out a complex of restorative therapy, rehabilitation measures, organizing meals, providing healthy leisure time, and creating psychological comfort for elderly disabled people at home. At the “preventoriums at home”, activities are carried out to carry out doctor’s prescriptions for vitamin therapy, herbal medicine, general developmental physical exercises, aerotherapy, massage courses, monitoring the health status of citizens, etc.

Enrollment in the “preventorium at home” is carried out by order of the director of the Social Service Center on the basis of a personal application from a citizen. Services in the “preventorium at home” are provided for 2-3 weeks, the work of which involves nurses, social workers, a psychologist, a massage therapist, an exercise therapy instructor, a rehabilitation specialist for the disabled, etc.

In Moscow, at the State Budgetary Institution TCSO “Alekseevsky” in the “Maryina Roshcha” branch, the technology of social patronage is widespread. It is carried out in stages: informing citizens about the activities of the social service center; conducting a survey of socio-economic living conditions; registration of needy citizens with the center; providing assistance in solving their problems. Social patronage uses interdepartmental interaction.

Social services in the form of social services at home, in volumes determined by established standards, are provided:

free of charge - to recipients of social services on the terms provided for by Federal Law No. 442 of December 28, 2013 “On the basics of social services for citizens in the Russian Federation” and categories of citizens included in the additional list for Moscow, PP No. 827 of December 26, 2014 .

For a partial payment (50% of the tariff for a full payment) - in cases where recipients have an average per capita income in the amount of 150 to 250% inclusive of the subsistence minimum established in the city of Moscow for the main socio-demographic groups of the population;

for full payment - in cases where recipients have an average per capita income of over 250% of the subsistence level established in Moscow for the main socio-demographic groups of the population.

The priority functions of organizing home care are:

Providing social and domestic assistance and pre-medical medical care in home conditions to disabled people and elderly citizens, and other needy categories of the population;

Social, cultural, medical pre-medical care for citizens, organizing their nutrition and recreation, maintaining an active lifestyle;

Providing urgent one-time assistance to citizens in dire need of social support (clothing, food, psychological, legal, etc.);

Implementation of measures for social rehabilitation of disabled people;

Providing citizens in dire need, including people without a fixed place of residence, with hot meals in a charity canteen.

The main objectives of organizing home care: creating conditions for the maximum possible extension of citizens’ stay in their usual habitat and maintaining their social, psychological and physical status, providing sociocultural, socio-psychological, socio-medical services; carrying out preventive measures in order to improve the quality of life, maintain health, and adapt to the changed conditions of society.

Home assistance for elderly disabled people is aimed at eliminating a complex of existing problems in relation to pensioners who are not inclined to seek help on their own or avoid it, not wanting to personally collect documents, etc.

The priority of the specialists’ work in this case is:

Psychological support;

Coordinating socialization;

Adaptive - development of adaptive abilities;

Wellness;

Prevention of deviant behavior;

Monitoring the condition of the pensioner, the conditions of their stay and safety in the family.

Thus, at the Center for Social Services, technologies for working with elderly disabled people at home are based on scientifically based data on the differentiation of social activity of certain categories of citizens.

Social activity is represented by the ability of recipients of social services to self-service, participate in work activities, engage in leisure activities, and the ability and desire to communicate. These priorities help overcome social and psychological isolation. The assistance of a social worker is especially necessary for elderly disabled people in the social and medical care department.

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1 FEDERAL STATE AUTONOMOUS EDUCATIONAL INSTITUTION OF HIGHER EDUCATION “BELGOROD STATE NATIONAL RESEARCH UNIVERSITY” (NIU “BelSU”) FACULTY OF SOCIAL AND THEOLOGICAL DEPARTMENT OF SOCIAL WORK OR GANIZATION OF SOCIAL SERVICES FOR ELDERLY CITIZENS AND DISABLED CITIZENS IN THE CONDITIONS OF AN COMPREHENSIVE CENTER FOR SOCIAL SERVICES TO THE POPULATION: PROBLEMS AND PROSPECTS Thesis work of a correspondence student, direction 03/39/02. Social work 5th year group 87001152 Kosenko Svetlana Aleksandrovna Scientific supervisor Ph.D. Sciences, Associate Professor of the Department of Social Work Kulabukhov D.A. Reviewer: Director of MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District” L.T. Gamayunova BELGOROD 2016

2 CONTENTS INTRODUCTION 3 1. THEORETICAL FOUNDATIONS FOR STUDYING SOCIAL SERVICES FOR ELDERLY CITIZENS AND DISABLED CITIZENS IN THE CONDITIONS OF AN COMPREHENSIVE CENTER FOR SOCIAL SERVICES TO THE POPULATION 10 1.1. Social services for elderly citizens and disabled people: essence and specifics 10 1.2. Forms of social services for elderly citizens and disabled people in the conditions of a comprehensive center for social services for the population 28 2. ORGANIZATION OF SOCIAL SERVICES FOR ELDERLY CITIZENS AND DISABLED CITIZENS IN THE CONDITIONS OF MBSUSSZN "COMPRETE CENTER FOR SOCIAL SERVICES FOR THE POPULATION OF VOLOKONOVSKY DISTRICT" 36 2.1. Problems of organizing social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population 36 2.2. Recommendations for improving social services for elderly and disabled citizens in the conditions of a comprehensive center for social services for the population 62 CONCLUSION 68 REFERENCES 74 APPENDIX 80

3 INTRODUCTION Relevance of the study. Currently, measures to improve social services for elderly citizens and people with disabilities are among the priority areas of state social policy. In the Belgorod region, a network of social service institutions for elderly citizens and the disabled has been developed. An important role in the development of new technologies for serving elderly citizens and people with disabilities belongs to integrated social service centers. At the same time, the need to coordinate the efforts of state and public structures in solving socio-economic, family, everyday, psychological and other problems of elderly citizens and people with disabilities is becoming more and more obvious. Social services are the activities of social services for social support, provision of social, social, medical, psychological, pedagogical, social and legal services and material assistance, carrying out social adaptation and rehabilitation of citizens in difficult life situations. The concept of “social assistance” is often used as a synonym for the concept of “social service”. Along with social security, social insurance, employment promotion, as well as healthcare, education, culture, housing and communal services, social services are among the branches of the social sphere. The peculiarities of economic services necessitate the participation of the social state and philanthropists in the organization and financing of these services. State participation in the provision of social services is intended to ensure the implementation of the principles of social justice and resolve the problems of insufficient information and irrationality of consumer choice.

4 Everywhere the state has created institutions to provide certain types of social services to elderly citizens and people with disabilities. As a rule, in government institutions social services are provided free of charge or for a fee that only partially covers costs. Social service systems vary significantly across countries. In Russia, social reforms are being carried out at the federal, regional and local levels, which sometimes take place without sufficient consideration of social consequences. They also seriously affect the sphere of social services for the elderly and disabled. The organization of social services for elderly citizens and disabled people is given increasing importance in our country every year; it is considered as an extremely necessary addition to cash payments, significantly increasing the efficiency of the entire state social security system. Social policy in relation to elderly citizens and people with disabilities, its scope, direction and content throughout the history of the country were influenced and determined by socio-economic and specific socio-political tasks facing society at one or another stage of its development. The allocation in the general structure of social policy of a special direction - social services relating to the well-being and health of elderly citizens and people with disabilities, is due to rather specific conditions and lifestyles, the characteristics of their needs, as well as the level of development of society as a whole. The social service system covers a wide range of services, in particular, medical care, maintenance and service in boarding schools, home care for those in need of care, housing and communal services, leisure activities, etc. . In the field of social services, the possibility of exercising the right to receive it often depends on the decision of the competent authority, since the whole

5, a number of social services provided in this area are still among the scarce ones, not guaranteed to absolutely every elderly and disabled person. Social services for elderly citizens and people with disabilities should be focused on ensuring the availability of basic social services and guarantees for elderly citizens and people with disabilities, regardless of their place of residence. The social vulnerability of elderly citizens and people with disabilities is associated primarily with their physical condition, the presence of diseases, decreased physical activity, and the presence of a psychological factor that forms contact with other segments of the population. Therefore, elderly citizens and people with disabilities are the least protected and most socially vulnerable part of society. The degree of scientific development of the problem. Social work with older citizens was studied by M.D. Alexandrova E.I. Kholostova and V.D. Alperovich, other domestic G.S. Alekseevich, scientists. B.G. Ananyeva, In the works of A.V. Dmitrieva, S.G. Markovina, N.V. Panin, touches on complex and multifaceted problems of social services for elderly citizens and the disabled. E.V. Karyukhin, O.V. Krasnova, E.I. Kholostova and other authors reveal the gerontological aspects of the problem, focus on social work with elderly citizens, consider problems associated with health disorders in elderly citizens, human adaptation to old age, describe the methods and principles of social work and medical and social services for elderly citizens. Historical aspects of the problem are analyzed in the works of such authors as O.V. Ergaeva, N.G. Kovaleva, E.A. Kurulenko I.A. Litvinov, M. Mead and some others. The authors analyzed the situation and

6 social status of older citizens in different societies and at different historical moments. The above works highlight various aspects of the situation of elderly citizens and people with disabilities, the theory and practice of their social services, explore the problems of developing positive attitudes in society towards elderly citizens and people with disabilities, and reveal opportunities for improving their standard of living. A fairly large group of publications on the problem under study consists of articles in scientific and popular science magazines (“Socium”, “Social Work”, “Social Worker”, etc.), which highlight the problems of older people and people with disabilities and ways to solve them ( T.V. Karsaevskaya, A. Komforsh, E.A. Sigida V.D. Shatalov, etc. The object of the study is social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population. The subject of the study is the specifics of organizing social services for elderly citizens and disabled people at the municipal level. Purpose of the study: to reveal the specifics of the organization of social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population and to develop recommendations for its improvement. The achievement of this goal is facilitated by solving the following tasks: 1) to identify the specifics of social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population; 2) study the features of the organization of social services for elderly citizens and disabled people in the MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District”;

7 3) diagnose the problems of organizing social services for elderly and disabled citizens in the conditions of a comprehensive center for social services for the population and develop recommendations for its improvement. The theoretical and methodological basis of the study is the basic conceptual provisions of theories about the individual as a subject of activity and the highest social value, the concept of a person-oriented approach, the idea of ​​humanization and democratization of the social protection system for older people in modern Russia. As well as social approaches in the history and theory of social work with elderly citizens and people with disabilities, presented in the studies of I.G. Zainyshev and E.I. Single. The activity approach in the history and definition of the essence of social work with older citizens is presented in the concept of L.G. Guslyakova, in her opinion, “social work is defined as a type of social activity, as a system of social protection, as the activities of government organizations and individuals to provide assistance, as activities to restore and preserve the psycho-mental and social connections of the individual with the environment.” Research methods: theoretical – analysis of literature and official statistics on the research topic; analysis of reports from the work of the MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District”; empirical – survey method (questionnaire), expert survey. The empirical basis of the study was: - the results of a sociological study by the author “Problems of organizing social services for elderly citizens and the disabled in the conditions of a comprehensive center for social services for the population (using the example of MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District” (November 2015)).

8 - results of secondary analysis of sociological studies conducted in various years by academic institutes and research centers of the Russian Academy of Sciences, materials of the Russian monitoring of the economic situation and health of the population, etc. The information base for research into social services for elderly citizens and people with disabilities is reflected in various kinds of instructions and provisions aimed at improving the process of social services. The implementation of this process was facilitated by the adoption of federal laws “On the fundamentals of social services for the population in the Russian Federation”, “On social services for elderly citizens and disabled people”, “On social protection of disabled people in the Russian Federation”, directly addressed to elderly citizens and disabled people. To develop federal laws, Resolutions of the Government of the Russian Federation and departmental regulations were adopted regulating the procedure for providing social services to elderly citizens and people with disabilities. In the Belgorod region, various legal acts were adopted (decrees of the head of the regional administration “On the program to improve the quality of life of the population”, “On the program of the regional administration for social support of the low-income population”, “On the procedure and terms of payment for social services provided by state and municipal social institutions services”, the Law of the Belgorod Region “On the Living Wage”, “On the Consumer Basket”, etc.), which made it possible to specify the provisions of federal legislation at the regional level and bring them closer to local conditions. Theoretical and practical significance of the study. The main results and conclusions of the study allow us to expand our understanding of social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population.

9 Research materials can be used when teaching courses on social work, social policy, etc. and in the system of training, retraining and advanced training of social work specialists. Approbation of research results. The thesis was commissioned by MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District.” The testing of the research results was carried out during pre-graduation practice on the basis of the MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District” and recommended for practical use. The structure of the thesis includes: introduction, two chapters, conclusion, bibliography and appendix.

10 1. THEORETICAL FOUNDATIONS FOR STUDYING SOCIAL SERVICES FOR ELDERLY CITIZENS AND DISABLED CITIZENS IN THE CONDITIONS OF AN COMPREHENSIVE CENTER FOR SOCIAL SERVICES TO THE POPULATION 1.1. Social services for elderly citizens and people with disabilities: essence and specifics In domestic literature, elderly citizens are usually considered as a large public, social or socio-demographic group, and sometimes these definitions are combined. Some authors consider them a social group of a non-productive nature: although they do not directly participate in social production, they occupy an important place in the system of diverse social activities. Others argue that older citizens are primarily a socio-demographic group. The social living conditions of older citizens are primarily determined by their health status. Self-esteem is widely used as an indicator of health status. Due to the fact that the aging process does not occur in the same way for certain groups and individuals, self-esteem varies greatly. Another indicator of health status is active life activity, which decreases among older citizens due to chronic diseases, deterioration of hearing, vision, and the presence of orthopedic problems. The incidence rate of elderly citizens is several times higher than that of young people. Elderly citizens are alarmed about their financial situation, the level of inflation, and the high cost of medical care. Financial situation is the only problem that can compete in its importance with health.

11 Modern theories of aging play an important role in organizing social services for older citizens, because they interpret and generalize experience, information and observational results, and help predict the future. The social worker needs them primarily in order to organize and streamline his observations, draw up a plan of action and outline their sequence. The choice of one theory or another determines the nature and amount of information that the specialist will collect, as well as the methods for organizing interviews with the client. Finally, the theory allows the specialist to “keep his distance,” i.e. objectively assess the situation, the causes of the client’s psychological discomfort, as well as real ways to solve the problem. Consistently applying one or another theory or synthesizing several theoretical principles, a social service employee purposefully fulfills the mission assigned to him - corrects and stabilizes the social functioning of an individual, family, group of organizations. By the way, it is precisely this social orientation that distinguishes social work from friendly participation or related intervention. Social work with older citizens involves the use of theories of liberation, activism, minorities, subculture, age stratification, etc. According to the theory of liberation, in the process of aging people become alienated from those who are younger; In addition, there is a process of liberation of older citizens from social roles - meaning roles related to work, as well as leadership and responsibility. This process of alienation and liberation is determined by the social situation in which older citizens find themselves. It can also be considered one of the ways for older citizens to adapt to the limitations of their capabilities and come to terms with the idea of ​​inevitably approaching death. According to the liberation theory, in the social aspect, the process of alienation of older citizens is inevitable, since the positions they occupy

12 at some point must pass to younger people who are able to work more productively. The priority direction of social work with older citizens is organizing their living environment in such a way that they always have a choice of ways to interact with this environment. Freedom of choice gives rise to a feeling of security, confidence in the future, and responsibility for one’s own and other people’s lives. Old age in real life is often a period when help and support are needed to survive. Self-esteem, independence and help, which interferes with the implementation of these feelings, come to a tragic contradiction. Elderly citizens sometimes have to give up their independence and independence for the sake of a fulfilling life, realized in interaction and communication. Elderly citizens also have a problem such as loneliness, the victims of which are more often men than women. This is loneliness that occurs as a result of a decline in intellectual activity, along with a decrease in physical activity. Not only do women live longer than men, but they are also less susceptible to the effects of aging in general. Most older women are able to dedicate themselves to housekeeping more often than most older men. With retirement, the number of cases for men decreases, but the number of cases for his wife increases noticeably. While a retired man loses his role as a “breadwinner” of his livelihood, a woman never gives up her role as a housewife. The socio-medical problems of centenarians (elderly, aged, elderly) are primarily divided into purely social and purely medical. But this division is not in essence, but in form. Both problems arose at the dawn of civilization and culture. The very position of an elderly citizen not only in society, but in life is such that it distinguishes him

13 essentially from all other age groups, and depending on how a particular society views old age, relevant socio-medical problems are identified and addressed. The character of an elderly citizen is deformed due to aging. This deformation is a rather complex process (how a person lived, so he ages). For the time being, all workers (no matter in what area of ​​social employment) retain character traits that are of hereditary origin. With age, professional deformation of character appears, the so-called accentuation of certain character traits - suspiciousness, hot temper, vulnerability, anxiety, pedantry, touchiness, emotional lability, hysteria, isolation, exhaustion, pickiness, unfair assessments of one’s actions and the actions of others, reactive regression of mental abilities, stereotypically repeated in “vulnerable situations”, etc. . This state of affairs cannot be explained by socio-economic (material) or socio-psychological factors. The reasons lie much deeper. Only medical genetics could objectively interpret the dramatic changes in the psyche of a centenarian, which are confirmed by socio-gerontological studies. An elderly citizen and his family are one of the most pressing problems of our society in general, and social medicine in particular. This problem seems unsolvable either by public or government measures aimed at strengthening the social protection of the population; to an even lesser extent – ​​through medical means. The quality of life of elderly citizens and people with disabilities depends not only on the mental characteristics of various groups of citizens, but also on the socio-economic (domestic, material) and socio-cultural conditions in which their lives have passed and are passing.

14 Older people and those who will soon cross the appropriate age limit separating them from the younger and middle generations associate their social expectations and hopes with significant changes in the field of social services. Our society's perceived lack of sensitivity and attention to old people, veterans, insufficient consideration of their objective requests and needs obliges us to move from calls for improving their medical care and improving social assistance to radical measures - the creation in the country of a wide system of social services for elderly citizens as an integral part of a single state social security system. Social services include everything that elderly and disabled citizens receive from public consumption funds in addition to pensions and benefits. In this case, the society assumes all or part of the costs associated with paying the cost of services provided to elderly and disabled people in need of certain types of social assistance. At the same time, in the order of social services, specific needs characteristic of this category of citizens are satisfied. The development of social services for the elderly and disabled in our country is becoming increasingly important every year; it is considered as an extremely necessary addition to cash payments, significantly increasing the efficiency of the entire state social security system. The concept of disability was characteristic of social policy regarding people with limited physical capabilities (disabled people) until the 60s of the twentieth century. Disability was perceived as a person’s personal pathology, and all its problems were understood as a consequence of this pathology. That is, the individual's limitations were considered in the context of the relationship between a person and his illness. All problems of a disabled person are a consequence of health pathology and he must adapt to the world of “normal” people.

15 The concept of disability is described on the basis of the “sick role” model, in which illness is viewed as a form of social deviation, where the individual plays a specific role: he is freed from usual social responsibilities, is not considered to blame for his illness, strives to recover and seeks professional help, fulfills assignments a competent doctor. Disability (limited capabilities) is understood as a consequence of the fact that the social and physical conditions (culture of society, psychological climate, social and political organization, etc.) in which a person with poor health lives and works narrows the possibilities for her self-realization, that is disabled people are seen more as an oppressed group. The essence of the problem is inequality of opportunity in the presence of equality of rights. The content of social rehabilitation is the social integration of people with disabilities and assistance in their awareness and implementation of their inalienable human rights. That is, in contrast to the previous understanding, we are talking about the influence of the sociocultural environment on the life activity of a person with disabilities. In the course of historical development, the exclusively medical approach was gradually replaced by a social understanding of rehabilitation, which emphasized the need to restore all social capabilities of a person. Currently, the biopsychosocial model of disability prevails, as embodied in the International Classification of Disability and Health Functioning, which expands the understanding of disability and allows us to study the influence of medical, individual, social, and environmental factors on functioning and disability. In R. Barker's Dictionary of Social Work, social service is interpreted as the provision of specific social services to meet the needs necessary for normal development to people who are dependent on others and who cannot take care of themselves.

16 Social services are social activities aimed at meeting the social needs of various categories of the population. This is the process of providing social services to the population. The Federal Law “On the Fundamentals of Social Services for the Population in the Russian Federation” in Article 1 emphasizes that “social services represent the activities of social services for social support, provision of social, social, medical, psychological, pedagogical, socio-legal services and material assistance, social adaptation and rehabilitation of citizens in difficult life situations.” The Law reveals the main content of the types of social services: financial assistance, social services at home, in inpatient settings, social patronage of citizens, etc. The Federal Law “On Social Services for Elderly Citizens and Disabled Persons” states that “social services are activities for meeting the needs of these citizens for social services.” The Federal Law “On the Fundamentals of Social Services for the Population in the Russian Federation” states that “social services are enterprises and institutions, regardless of their form of ownership, that provide social services, as well as citizens engaged in entrepreneurial activities in providing social services to the population without forming a legal entity.” There are two groups of functions of the social service system: 1. Essentially active functions (preventive, social rehabilitation, adaptation, security and protective, social functions (personal patronage). 2. Moral and humanistic, humanistic, social and humanistic).

17 So, social services to the population includes types, types, methods, organizational forms, procedures, technologies, subjects and objects of social services, the result of the provision of social services. In the Russian Federation, a system of social services for elderly citizens and people with disabilities is developing; social services are provided by more than 12 thousand institutions - stationary, semi-stationary and non-stationary. Now there are more than a thousand inpatient institutions of various types: 406 boarding houses (boarding houses) for war and labor veterans, 442 psychoneurological boarding schools, etc. Various services are being created and developed: psychological and pedagogical assistance, socio-psychological, psychological-medico-social, social and leisure , career guidance, rehabilitation, etc. The Federal Law “On Social Services for Elderly Citizens and Disabled People” significantly complements and specifies ideas about social services for certain social groups of society, regulates relations in the field of social protection of elderly citizens and disabled people. The Law defines the subject of activity as follows: “social services are activities to meet the needs of specified citizens for social services.” Social services include a set of social services that are provided to elderly citizens and the disabled at home and in social service institutions, regardless of their form of ownership. There is an opportunity to receive social services sufficient to meet the basic needs of life, which are included in the federal and territorial social services guaranteed by the state: - care; lists

18 - catering; - assistance in obtaining medical, legal, socio-psychological and natural types of assistance; - assistance in professional training, employment, organization of leisure; - assistance in organizing funeral services and others that are provided to elderly citizens and disabled people at home or in social service institutions. The federal law uses such basic concepts as: Social service - an enterprise or institution, regardless of its form of ownership, providing social services. A social service client is a citizen who is in a difficult life situation and who is provided with social services in connection with this. A social service is a service that is provided free of charge or for an incomplete market price, that is, fully or partially at the expense of society. A service that is sold as a product (material consumer goods or consumer services) is not a social service, even if it is used by citizens in difficult life situations. A difficult life situation is a situation that objectively disrupts the life of a citizen (disability, inability to self-care due to old age, illness and a number of other circumstances: orphanhood, lack of work, a specific place of residence, loneliness, etc.), which he cannot overcome on your own. The basis for free social services for citizens who are incapable of self-care due to old age, illness, disability and who do not have relatives who can provide them with

19 help and care, serves a low per capita income, below the subsistence level established for the region in which they live. Social services for elderly citizens and people with disabilities are carried out in accordance with the ethical principles of the International Labor Organization (ILO): - personal dignity - 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 active, coordinated and consistent; - individual nature of assistance - assistance is provided to the elderly or disabled citizen himself, taking into account his environment; Functions of the social service system: - essentially-active rehabilitation (preventive, adaptive, social-active-security-protective, social patronage); - moral-humanistic, social-humanistic), (personal-humanistic, the implementation of these functions is associated with the optimal level of functioning of all subsystems and elements of social services. The main principles of activity in the field of social services for elderly citizens and disabled people are: - provision of state guarantees; - compliance human and civil rights; - continuity of all types of social services; - orientation of social services to individual needs;

20 - priority of measures for social adaptation; - responsibility of state authorities, local governments and institutions, as well as officials in ensuring the rights of elderly citizens and people with disabilities. Social services have the following characteristics: - targeting - provision of social services based on the need of a particular elderly person; - accessibility - services should be as close as possible geographically to the person who needs them; - voluntariness - services cannot be provided against the will of the citizen, except in cases when it comes to a threat to the life and safety of the elderly and disabled; - humanity - a person in a difficult situation needs a caring and attentive attitude towards himself; - confidentiality – non-disclosure of the client’s secrets, respect for his feelings; - preventive orientation - assistance should be provided not only when a person is already in a difficult situation, but should also warn him. - respect for human and civil rights, continuity of all types of social services; - conditions for the formation and implementation of human life; - the relationship between freedom and the social conditioning of the individual, the socially justified (or unjustified) measure of this freedom and the possibility of its implementation in society. All social service institutions are open institutions. Placement of citizens who find themselves in difficult life situations in these institutions is carried out with their voluntary consent, on a permanent or temporary basis.

21 The most important forms of social services are such as social services at home; semi-stationary services in day (night) departments of social service institutions; stationary social services in boarding homes, boarding houses, etc.; urgent social services; social advisory assistance; provision of living space in special homes for the elderly, etc. Non-stationary social institutions are a relatively new form of providing social assistance to the elderly population and disabled people in the Russian Federation. The legislation provides for five forms of social services for elderly citizens and people with disabilities: social services at home (including social and medical services); semi-stationary social services in day (night) departments of social service institutions; stationary social services in stationary social service institutions (boarding homes, boarding houses and other social service institutions, regardless of their name); urgent social services; social advisory assistance. Social services, at the request of elderly citizens and disabled people, can be provided on a permanent or temporary basis. Social services at home are one of the main forms of social services, aimed at maximizing the possible extension of the stay of elderly citizens and disabled people in their usual social environment in order to maintain their social status, as well as to protect their rights and legitimate interests. Home-based social services guaranteed by the state include: catering, including home delivery of food; assistance in purchasing medicines, food and industrial goods of prime necessity; assistance in obtaining

22 medical assistance, including escort to medical institutions; maintaining living conditions in accordance with hygienic requirements; assistance in organizing legal assistance and other legal services; assistance in organizing funeral services; other home-based social services. When serving elderly citizens and disabled people living in residential premises without central heating and (or) water supply, home-based social services included in the list of state-guaranteed social services include assistance in providing fuel and (or) water. In addition to the home-based social services listed above, elderly citizens and people with disabilities may be provided with additional services on a full or partial payment basis. Social and medical care at home is provided to elderly citizens and disabled people who need home-based social services, suffering from mental disorders (in remission), tuberculosis (except for the active form), serious diseases (including cancer) in late stages, with the exception of quarantine infectious diseases, chronic alcoholism, severe mental disorders, venereal and other diseases requiring treatment in specialized healthcare institutions. The procedure and conditions for social and medical care at home are determined by the executive authorities of the constituent entities of the Russian Federation. As a rule, social services are provided in semi-stationary institutions: - overnight stay homes; - social shelters; - social hotels; - centers of social adaptation. and in

23 Semi-stationary social services include social, medical and cultural services for elderly citizens and people with disabilities, organizing their meals, recreation, ensuring their participation in feasible work activities and maintaining an active lifestyle. Semi-stationary social services are accepted for elderly and disabled citizens in need who have retained the ability for self-care and active movement and who have no medical contraindications for enrollment in social services. The decision on enrollment is made by the semi-stationary head of a social service institution on the basis of a personal written application from an elderly or disabled citizen and a certificate from a health care institution about his state of health. The procedure and conditions for semi-stationary social services are determined by the executive authorities of the constituent entities of the Russian Federation. Social advisory assistance to elderly citizens and people with disabilities is aimed at their adaptation in society, easing social tension, creating favorable relationships in the family, and ensuring interaction between the individual, family, society and the state. Social services for elderly citizens and people with disabilities are provided by decision of social protection authorities in institutions under their jurisdiction or under agreements concluded by social protection authorities with social service institutions of other forms of ownership. The rights of elderly citizens and people with disabilities when providing them with social services may be limited in cases provided for by law. Restrictions on rights may be expressed in the placement of these citizens without their consent in social service institutions if they are deprived

24 care and support of relatives or other legal representatives and are not able to independently satisfy their vital needs (loss of the ability to move) or to self-care are recognized as incompetent in the manner established (or) active by law. The issue of placing elderly citizens and people with disabilities in inpatient social service institutions without their consent or without the consent of their legal representatives is decided by the court on the proposal of the social protection authorities. Elderly citizens and disabled people who are bacteria or virus carriers or have chronic alcoholism, quarantine infectious diseases, active forms of tuberculosis, severe mental disorders, venereal and other diseases requiring treatment in specialized healthcare institutions may be denied social services at home . The refusal to provide elderly citizens and disabled people with social services in this case is confirmed by a joint conclusion of the social protection body and the medical advisory commission of the health care institution. Social services for elderly citizens and people with disabilities provided in non-stationary conditions may be terminated if they violate the norms and rules established by social service management bodies when providing this type of service. Let us consider in detail the main forms of social services for elderly citizens and disabled people: 1. Social services for elderly citizens and disabled people includes: 1) social services, medical services); at home (including social

25 2) semi-stationary social services in day (night) departments of social service institutions; 3) stationary social services in stationary social service institutions (boarding homes, boarding houses and other social service institutions, regardless of their name); 4) urgent social services; 5) social advisory assistance. 2. Elderly citizens and disabled people may be provided with living quarters in social housing stock buildings. 3. Social services, at the request of elderly citizens and disabled people, can be provided on a permanent or temporary basis. Social services at home: 1. Social services at home is one of the main forms of social services, aimed at maximizing the possible extension of the stay of elderly citizens and disabled people in their usual social environment in order to maintain their social status, as well as to protect their rights and legitimate interests . 2. Home-based social services included in the list of state-guaranteed social services include: 1) catering, including food delivery to your home; 2) assistance in purchasing medicines, food and industrial goods of prime necessity; 3) assistance in obtaining medical care, including accompaniment to medical institutions; 4) maintaining living conditions in accordance with hygienic requirements; 5) assistance in organizing legal assistance and other legal services;

26 6) assistance in organizing funeral services; 7) other home-based social services. 3. When serving elderly citizens and disabled people living in residential premises without central heating and (or) water supply, home-based social services included in the list of state-guaranteed social services include assistance in providing fuel and (or) water. 4. In addition to home-based social services provided for in the lists of state-guaranteed social services, elderly citizens and disabled people may be provided with additional services on full or partial payment terms. 5. Social services at home are provided in the manner determined by the executive authority of the constituent entity of the Russian Federation. Social and medical services at home are provided for elderly and disabled citizens in need of home-based social services, suffering from mental disorders (in remission), tuberculosis (except for the active form), serious diseases (including cancer) in the late stages, beyond with the exception of diseases specified in part four of Article 15 of the Federal Law. The procedure and conditions for social and medical care at home are determined by the executive authorities of the constituent entities of the Russian Federation. Urgent social services for elderly citizens and disabled people: 1. Urgent social services are provided to provide one-time emergency assistance to elderly citizens and disabled people who are in dire need of social support.

27 2. Urgent social services may include the following social services: 1) one-time provision of free hot meals or food packages to those in dire need; 2) provision of clothing, shoes and other essential items; 3) one-time provision of financial assistance; 4) assistance in obtaining temporary housing; 5) organization of legal assistance in order to protect the rights of persons served; 6) organizing emergency medical and psychological assistance with the involvement of psychologists and clergy for this work and the allocation of additional telephone numbers for these purposes; 7) other urgent social services. Social advisory assistance. 1. Social advisory assistance to elderly citizens and people with disabilities is aimed at their adaptation in society, easing social tension, creating favorable relationships in the family, as well as ensuring interaction between the individual, family, society and the state. 2. Social advisory assistance to elderly citizens and people with disabilities is focused on their psychological support, increased efforts in solving their own problems and includes: 1) identifying people in need of social advisory assistance; 2) prevention of various kinds of socio-psychological deviations; 3) work with families in which elderly and disabled citizens live, organizing their leisure time;

28 4) advisory assistance in training, vocational guidance and employment of disabled people; 5) ensuring coordination of the activities of government agencies and public associations to solve the problems of elderly citizens and people with disabilities; 6) legal assistance within the competence of social service authorities; 7) other measures to form healthy relationships and create a favorable social environment for elderly citizens and people with disabilities. The procedure and conditions for the provision of free home-based, semi-stationary and stationary social services, as well as on the terms of full or partial payment, are established by the executive authorities of the constituent entities of the Russian Federation. Thus, social services for elderly citizens and people with disabilities is an important factor in improving the system of social protection of the population and the social policy of the Russian state as a whole. Non-stationary and semi-stationary social service institutions help to establish various forms of social work, to better take into account the interests and needs of elderly citizens and people with disabilities in direct contact with them. 1.2. Forms of social services for elderly and disabled citizens in the conditions of a comprehensive center for social services for the population Elderly citizens (women over 55 years old, men over 60 years old) and disabled people (including disabled children) in need of permanent or temporary assistance in connection with partial or complete loss of the ability to independently satisfy their basic

29 vital needs due to limited ability for self-care and (or) movement, have the right to social services provided in the state and non-state sectors of the social service system. Integrated social service centers are the leading government institutions in the field of non-stationary social services for elderly citizens and the disabled. The centers help to establish various forms of social work, to better take into account the interests and needs of various categories of elderly people and disabled people in direct contact with them. Centers may have in their structure various divisions of social services: departments of day care for the elderly and disabled, social assistance at home, emergency social assistance services, etc. Currently, social service centers have the following departments: - department of home-based social services; - day care department; - temporary residence department (mainly in rural areas); - department of social and medical services at home; - emergency social services department; - department of social rehabilitation. Centers are becoming effective non-stationary forms of social support for older people and people with disabilities in the Russian Federation. An extremely important area of ​​activity of the Centers is social services at home - this is one of the main types of social work. Its main goal is to maximally prolong the stay of citizens in their usual habitat, support their personal and social status, and protect their rights and legitimate interests.

30 The main home-based services guaranteed by the state include: catering and home delivery of food; assistance in purchasing medicines and essential goods; assistance in obtaining medical care and escort to medical institutions; assistance in maintaining living conditions in accordance with hygienic requirements; assistance in organizing funeral services and burying lonely dead; organization of various social services (housing repairs, provision of fuel, cultivation of personal plots, water delivery, payment of utilities, etc.); assistance in paperwork, including for the establishment of guardianship and trusteeship, exchange of housing, placement in inpatient institutions of social protection authorities. Social services at home are provided free of charge, with partial payment or for full payment. Free services are provided, for example, to single elderly citizens and disabled people who do not receive a pension supplement for care or who have able-bodied relatives who are required to support them by law but live separately, as well as those living in families whose per capita income is lower than that established for the given region minimum level. Thus, the main directions of activity of the comprehensive center for social services for the population are: identification of elderly citizens and disabled people in need of service; provision of social, domestic and other necessary assistance at home; assistance in providing persons served with benefits and benefits established by current legislation; ensuring to the citizens served their rights and benefits established by current legislation. Day care departments, also created on the basis of social service centers for the population, are also becoming increasingly developed. They are intended for everyday, medical, cultural services for pensioners and disabled people, organizing their recreation, attracting

31 to feasible work, maintaining an active lifestyle. These departments are created in accordance with the Regulations to serve at least 30 people. They enroll elderly and disabled people, regardless of their marital status, but who have retained the ability for self-care and active movement, based on personal desire and medical conclusion. Pensioners and disabled people, as a rule, are served by the social assistance department free of charge. For example, the Emergency Social Services Department (OSSO) provides emergency social assistance of a one-time nature to elderly citizens and disabled people who are in dire need of social support. Urgent social assistance is the most common type of social support for the elderly population in non-stationary conditions; includes the following state-guaranteed social services: - one-time provision of free hot meals or food packages to those in dire need; - provision of clothing, footwear and basic necessities; - assistance in obtaining temporary housing; - provision of emergency psychological assistance; - provision of humanitarian assistance; - provision of legal and other advisory services. An important circumstance is the need for a new style of work of these institutions, the use of not only supervisory and prohibitive measures, but also carrying out explanatory work, promoting a healthy lifestyle among residents. In the Russian Federation, a developed system of non-stationary and semi-stationary forms of social services includes such social service institutions (departments) as social service centers for the population (1955 units), including comprehensive social service centers for the population (822). IN

The 32 structure of the centers includes departments for temporary residence (684 for 14.4 thousand places) and day care (1183 for 32.4 thousand places). 21.7 thousand people live in special homes for single elderly citizens, where there is a range of social services (725). The active development of semi-stationary forms of service, including temporary accommodation departments, contributed to the reorganization of some of them into low-capacity houses - the establishment of an optimal model of relationships between residents and staff. The network of non-state inpatient institutions is expanding. Social assistance and services in each region of Russia are carried out taking into account its specifics. The main areas of work are the following: drawing up and implementing social programs and plans, holding joint events and boards, meetings and seminars with management and practitioners, organizing a team form of medical and social services for the elderly and disabled, creating rooms for medical and social assistance, training and etc. It should be noted that joint activities are already producing positive results. Practice confirms the feasibility and effectiveness of joint actions. The team form of care for seriously ill patients is becoming increasingly widespread and recognized. Such comprehensive services allow us to increase the number of patients served and expand the types and volumes of services provided to them. For example, in the Kirov region, a departmental center for gerontological rehabilitation operates at JSC “Plywood Mill “Red Anchor” in the city of Slobodsky. The Hospice House of St. was opened in Volgograd. Seraphim of Sarovsky (social shelter), whose hospital is designed for 35 people. It is mainly inhabited by pensioners and people without a fixed place of residence. The church provides all possible financial assistance to the house.

33 Taking into account the need to provide citizens living in rural settlements remote from industrial centers and transport routes with targeted, prompt assistance, social protection authorities are actively developing various models of mobile social services. Such service is vital for those elderly citizens and people with disabilities who find it difficult to contact medical, law enforcement and other socially significant institutions, including those providing household and commercial services to the population. In addition, it costs people at least half as much as the prevailing local tariffs for transport and other services. In order to test the mechanism of this social technology, within the framework of the federal target program “Older Generation”, a pilot project “Development of an emergency social assistance service on a mobile basis” is being carried out in the region. In the Kirov region, such a social service as the “Mercy Bus” has existed for 10 years. The search for new social technologies that increase the availability of social services for the population has led to the emergence of such a model of social services for rural residents as interdepartmental centers for resolving social issues created under municipal self-government bodies, or rural mini-centers. There are currently 384 mini-centers in the Penza region. Their main tasks include identifying and differentiated accounting of citizens and families in need of social assistance. Determining the necessary forms of assistance and the frequency of its provision, providing assistance and services to citizens, informing the population on various issues, conducting social, recreational, preventive and other activities for the population at their place of residence. All mini-centers in the region operate on a voluntary basis. They employ about 2 thousand people. As a rule, mini-centers are managed by the heads of rural administrations, the staff includes from 5 to 7 representatives

34 education, healthcare, social protection of the population, other departments and services, public organizations. In connection with the need to carry out social rehabilitation work and recreational activities with elderly citizens who are unable to go to sanatoriums, over the last five years a set of measures has been taken to open social health centers and social rehabilitation departments. In the city of Kemerovo, a center has been equipped that fully meets the requirements of independent living for elderly and disabled people, and staff have been trained to identify the needs of elderly and disabled citizens and train additional employees in modern methods of working with them. In Novokuznetsk, a special “Memory Center” was created and more than 200 apartments were partially refurbished. The Department of the Samara Social Region, in order to protect the population of the permanent administration and improve the provision of social services to the population, takes an active part in the implementation of a number of international projects. According to the terms of reference, the main goal of one of the projects was to develop a viable, affordable and practical social protection system that takes into account the real needs of socially vulnerable categories of the population. An experimental rehabilitation center for elderly and disabled citizens has been created in the Samara region, on the basis of which innovative domestic and foreign technologies and methods of rehabilitation and integration of elderly and disabled citizens into society are being developed; analysis and forecasting of the socio-demographic situation in the region; identifying the causes of social maladjustment; studying the need for social services; constant monitoring of problems arising in the lives of older citizens

35 and disabled. The experimental center for gerontological rehabilitation functions not only as a social service institution, but also as a center for training social workers in practical skills in using auxiliary and technical means of rehabilitation, as well as means that make life easier for disabled people and caring for seriously ill people. All conditions have been created here for training social workers, rehabilitation specialists, cultural organizers, psychologists, programmers, students of educational institutions, representatives of public organizations of the disabled, volunteers from all cities and districts of the region. The acquired knowledge is widely used by them in practice in healthcare institutions, social protection of the population and at the place of residence of elderly citizens and disabled people. The center provides training for elderly citizens, people with disabilities and members of their families on how to care for people with disabilities, how to use rehabilitation means, and how to provide psychological assistance. Thus, comprehensive social service centers are the leading government institutions in the field of non-stationary social services for elderly citizens and the disabled. The centers help to establish various forms of social work, to better take into account the interests and needs of various categories of elderly citizens and people with disabilities in direct contact with them. Centers may have in their structure various social service units: day care departments for the elderly and disabled, social assistance at home, emergency social assistance services, etc. Centers are becoming effective non-stationary forms of social services for elderly citizens and people with disabilities in the Russian Federation.

36 2. ORGANIZATION OF SOCIAL SERVICES FOR ELDERLY CITIZENS AND DISABLED CITIZENS IN THE CONDITIONS OF MBSUSSZN “COMPRETE SOCIAL SERVICE CENTER FOR THE POPULATION OF VOLOKONOVSKY DISTRICT” 2.1. Problems of organizing social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population More than 31,382 people live in the Volokonovsky district, including more than 6,000 people with disabilities. The budgetary institution of social services of the social protection system of the population “Comprehensive Center for Social Services of the Population” of the Volokonovsky District (hereinafter referred to as the Center) operates on the territory of the district. It is intended for comprehensive social services for citizens in need of social support, by providing timely and qualified social assistance of various types, providing individual citizens who find themselves in difficult life situations with assistance in realizing their legal rights and interests, and assisting in improving their social and financial situation. The structure of the Center includes: four departments of social services at home for elderly citizens and the disabled, created to serve citizens living in urban areas and citizens living in rural areas or the urban sector that do not have public amenities; department of temporary residence of elderly citizens and disabled people; emergency social services department; advisory department. In accordance with the goals of its activities, the institution provides the following types of social services:

37 1. social and everyday 2. socio-medical 3. socio-psychological 4. socio-pedagogical 5. socio-legal. Department of Social Services for Elderly and Disabled Citizens. The main task of the department is to provide social assistance at home to elderly citizens and disabled people who need permanent or temporary assistance due to partial loss of independent ability due to limited ability to meet the basic needs of life, self-care and (or) movement. Functions of the department: - informing and consulting citizens on social service issues; - collection and preparation of documents for social services; - receiving documents from citizens; - execution of the decision on enrollment (queueing) or refusal of social services with mandatory notification of the applicant; - admission to social services (conclusion of an agreement on social services) with the subsequent provision of state-guaranteed social services, as well as additional social services; - carrying out calculations (recalculation) for social services; - maintaining documentation of services provided, in accordance with the implementation of the schedule of control checks, quality reporting. State social services, social incoming services (hereinafter referred to as the list of guaranteed social services),

38 are provided to elderly citizens and disabled people at home free of charge, as well as on the basis of partial or full payment. Social services are provided at home free of charge: - to single elderly citizens (single married couples) and disabled people who have an income (average per capita income) below the subsistence level established for the corresponding socio-demographic groups of the population in the Belgorod region; - elderly citizens living alone and disabled people who have relatives who, due to old age, disability, illness, imprisonment, permanent residence outside the Belgorod region and other objective reasons supported by documents, cannot provide them with help and care , provided that the amount of income received by these citizens is below the subsistence minimum established for the corresponding socio-demographic groups of the population in the Belgorod region; - families consisting of elderly citizens and (or) disabled people whose average per capita income is below the subsistence level established for the corresponding socio-demographic groups of the population in the Belgorod region. Social services at home are provided on a partial payment basis to: - single elderly citizens (single married couples) and disabled people receiving income (average per capita income) in the amount of 100 to 150 percent of the subsistence level established for the relevant socio-demographic groups of the population in Belgorod regions; - elderly citizens living alone and disabled people who have relatives who cannot due to old age, disability, illness, or being in prison,

39 permanent residence outside the Belgorod region and other objective reasons, confirmed by documents, provide them with assistance and care, provided that the amount of income received by these citizens is from 100 to 150 percent of the subsistence level established for the corresponding socio-demographic groups of the population in the Belgorod region regions; - families consisting of elderly citizens and (or) disabled people, provided that the average per capita family income is from 100 to 150 percent of the corresponding cost of living, socio-demographic groups established for the population in the Belgorod region. - the monthly amount of partial payment for social services provided at home is 50 percent of the cost of full payment for services. Social services at home are provided on a full payment basis to: - single elderly citizens (single married couples) and disabled people, if their income (average per capita income) exceeds 150 percent of the subsistence level established for the corresponding socio-demographic groups of the population of the Belgorod region; - elderly citizens living alone and disabled people who have relatives who, due to old age, disability, illness, imprisonment, permanent residence outside the Belgorod region and other objective reasons supported by documents, cannot provide them with help and care , provided that the amount of income received by these citizens exceeds 150 percent of the subsistence minimum established for the corresponding socio-demographic groups of the population of the Belgorod region;

40 - families consisting of elderly citizens and (or) disabled people, provided that the average per capita family income exceeds 150 percent of the subsistence level established for the corresponding socio-demographic groups of the population of the Belgorod region; - elderly citizens and disabled people who have close relatives of working age living in the Belgorod region. For elderly citizens and disabled people, the department of social services for elderly citizens and disabled people provides the following services at home: 1. Catering services (provided taking into account health status): - assistance in preparing food, including dietary meals; - purchase and home delivery of food products, hot lunches from the canteen (in the client’s area of ​​residence). 2. Household organization services: - water delivery; - heating stoves (delivery of firewood and coal), kindling and removal of ash, depending on weather conditions; - assistance in providing fuel to those living in residential premises without central heating (paperwork, payment of bills, ensuring control over fuel delivery); - purchase and home delivery of essential industrial goods (in the client’s area of ​​residence); - handing over items for washing, dry cleaning, repairs and their return delivery (if there are no enterprises in the client’s area of ​​residence that provide these services, washing and repairs at home); - assistance in organizing home repairs (determining the scope of work, organizing repair work, assistance in purchasing and delivering materials for repairs);

41 - assistance in paying for housing and utilities (filling out receipts, reconciling payment documents, paying bills); - assistance in organizing the provision of services by trade, public utility, communications and other enterprises providing services to the population. 3. Services for organizing leisure time: - assistance in writing letters; - assistance in providing books, magazines, newspapers (subscription, delivery and dispatch of printed publications, parcels, registration in the library, delivery of books from the library located in the client’s area of ​​residence); - assistance in visiting theaters, exhibitions and other cultural events; - accompaniment outside the home. 4. Social, medical and sanitary-hygienic services (care is provided taking into account the state of health): - cleaning of living quarters (taking out garbage, cleaning dust from floors, walls, furniture, etc.); - assistance in the provision of medical care in the scope of the basic program of compulsory health insurance for citizens of the Russian Federation, targeted programs and territorial programs of compulsory health insurance provided by state and municipal medical institutions; - assistance (support in conducting medical and social institutions and expert examinations of the social and medical commission within the locality, assistance in preparing documents for disability); - assistance in providing, according to the conclusion of doctors, medicines and medical products (within the locality);

42 - provision of psychological assistance (conversations, if necessary, consultation with a psychologist); - assistance in hospitalization, accompaniment to medical institutions (within the locality); - visiting inpatient healthcare institutions in order to provide moral and psychological support to those served; - assistance in obtaining vouchers for sanatorium-resort treatment (assistance in paperwork); - assistance in obtaining dental and prosthetic and orthopedic care, as well as in providing technical means of care and rehabilitation (visiting a dental clinic without a patient, making an appointment, accompanying a patient to an appointment with a dentist or orthopedist). 5. Legal services: - assistance in preparing documents; - assistance in obtaining legal benefits and established benefits for the current ones (organizing specialist consultations); - providing assistance on pension issues and other social benefits (assistance in paperwork, consulting); - assistance in obtaining legal assistance and other legal services (organizing specialist consultations). 6. Funeral services. The temporary residence department for elderly and disabled citizens is one of the places where veterans, disabled and elderly citizens restore physical and spiritual health. At the service of vacationers in the department: - therapeutic procedures: inhalation, magnetic therapy, electrotherapy, lymphatic drainage, turmanev mat; manual and hardware massage; turpentine, pearl, salt baths; circular shower, mud therapy;

43 - a psychological relief room with medical devices, where classes, psychological trainings, and the provision of psychological assistance are organized; - varied, high-quality meals 4 times a day; - a rich leisure program: competitions, quizzes, karaoke and singing to a musical instrument, performances by creative groups, library work, field trips to places of interest. The leisure department was opened in 2007 and employs 70 people. There are 2 clubs in the department: the Elderly Club “Ray of Hope”, the Club for Wheelchair Users “Zhiznelub”. The activities of the department are aimed at the direct participation of older citizens in cultural, social and rehabilitation activities, as well as promoting health, increasing physical activity and improving social well-being. The “Ray of Hope” senior citizens’ club has 4 interest sections: amateur arts; skillful hands; intellectual outlook, healthy lifestyle. Meetings at the club take place 1-2 times a week. Meetings at the wheelchair club are held once a quarter and are thematic in nature. Excursions around the area are conducted according to developed routes. Emergency Social Services Department. The main task of the department is to provide urgent social assistance to citizens in dire need of social support and emergency assistance for one-time life activities. character aimed at maintaining them

44 Functions of the department: - taking immediate measures aimed at temporarily supporting the life of citizens in dire need of social support by providing various types of assistance; - identification and registration of citizens in dire need of social assistance not in the territory of the Volokonovsky district municipal district; - providing the necessary information and conducting consultations on the provision of social support measures for the low-income population and preferential categories of citizens; - collection of necessary documents to provide financial assistance; - assistance in preparing documents for sending citizens to boarding homes and gerontological centers; - assistance in providing citizens who find themselves in difficult life situations with clothes, shoes, and other essential items; - provision of free food packages; - provision of the “Social Taxi” service on specialized vehicles for the transportation of citizens with limited mobility in order to visit socially significant infrastructure facilities in the Volokonovsky district; - provision of additional services, according to the “Tariffs for additional social services provided to elderly citizens and disabled people by state institutions (departments) of social services for the population of the Belgorod region”, approved by the Commission for State Regulation of Prices and Tariffs of the Belgorod Region. The Emergency Social Services Department provides assistance to the following categories of citizens: disabled people; senior citizens; victims of fires, natural disasters, radiation and man-made disasters; refugees and internally displaced persons; large families; low-income and single-parent families; families raising children -

45 disabled people; citizens living alone, of working age, who have partially lost the ability to self-care due to a long-term (more than one month) illness, relatives who, for objective reasons, are not able to care for them; low-income citizens living alone who, for reasons beyond their control, have an income below the subsistence level established for the corresponding socio-demographic groups of the population of the Belgorod region. The procedure for providing services: 1. Social services for citizens in the Emergency Social Services Department are carried out on a one-time or temporary (up to one month) basis. 2. Social services are provided to citizens on the basis of an identification document and a written application addressed to the head of the Social Security Service. 3. The service area for employees of the Emergency Social Services Department is determined on the territory of the Volokonovsky District municipal district, taking into account the degree and nature of the need of pensioners and disabled people for help. Procedure for payment for services: 1. Emergency social services are provided free of charge: - providing the necessary information and conducting consultations on the provision of social support measures for the low-income population and privileged categories of citizens; - collection of necessary documents to provide financial assistance; - assistance in preparing documents for sending citizens to boarding homes and gerontological centers; - assistance in providing citizens who find themselves in difficult life situations with clothes, shoes, and other essential items; - provision of free food packages.

46 2. The “Social Taxi” service is provided in accordance with the Regulations on the procedure for providing the “Social Taxi” service in the Volokonovsky district, approved by the resolution of the head of the administration of the Volokonovsky district dated March 24, 2008 No. 265 “On the procedure for providing the “Social Taxi” service in Volokonovsky area." 3. Additional social services are provided on the basis of full payment based on the established tariffs for additional social services, approved by the Commission for State Regulation of Prices and Tariffs in the Belgorod Region. In order to provide social services at home to elderly citizens and disabled people of the Volokonovsky district, the emergency social service department of the municipal institution "KTSSON of the Volokonovsky district" operates a mobile integrated team "Mercy", which includes: - heads of social service departments at home; - social workers; - social work specialists; - carpenters; - medical worker; - specialist in repair of household appliances. The advisory department carries out its activities in cooperation with the structural divisions of the institution. The main tasks of the advisory department: - organizing public awareness using information technology, providing access to information about the activities of the institution through electronic communication channels. - ensuring automation of the provision of social support measures to the population. - providing information support for the activities of the institution. - providing technical support for the activities of the Institution.

47 - organization of development and improvement of automated systems, introduction of new technologies. - ensuring maximum efficiency from the automated systems used. - providing the media with the necessary information and explanations regarding the activities of the Institution. - monitoring media coverage of the Institution’s activities, organizing a prompt response to critical publications, speeches, messages, etc. Functions of the advisory department: - carries out work to introduce modern information technologies into the institution. - carries out the technological process of collecting, processing and analyzing information in all areas of activity of the MU “Comprehensive Center for Social Services for the Population of the Volokonovsky District”. - ensures the security of personal information processed and stored using computer technology in accordance with the legislation of the Russian Federation. - provides all structural divisions of the Institution with computer, copying and computing equipment and consumables for it. - administers the information database of citizens entitled to social support (automated receipt of operational statistical data, maintaining directories, testing, indexing, eliminating system errors during the operation of the software, restoring information in case of errors). - administers a local area network with dedicated servers (configuring, testing, troubleshooting

48 networks, restoration and correction of information in case of errors during operation). - instructs the institution’s specialists on the operation of hardware and software. - administers the help terminal and the official website of the Department. - provides technical support for activities carried out by the Department. - collects and transmits payment and reporting information to third parties in electronic form and on paper. - interacts with the media and prepares information material for publication. The center is part of the Department of Social Protection of the Population of the Volokonovsky District Administration. In general, the work of the Administration of the Volokonovsky Social District with the protection of citizens, the population with disabilities (disabled) and elderly citizens is aimed at the development and implementation of innovative programs, technologies for organizing social, social and legal guidance, labor and counseling, professional rehabilitation people with disabilities. Thus, in 2015, 236 people with disabilities, including 102 families with children with disabilities, were provided with methodological and advisory assistance. In addition, the Department of Social Protection of the Population of the Volokonovsky District Administration carries out systematic work with people with disabilities. The cooperation program with the Department of Culture of the Volokonovsky District Administration “Step into the World” provides assistance in social rehabilitation and their integration into society for 98 disabled children. As part of the program, there is a communication club “Nika”, where classes are held monthly to promote the discovery and development of creative

49 abilities of children with disabilities. As part of the club, there is a school for parents, “The Art of Education,” where seminars, lectures, trainings, debates, and consultations are held (with the participation of doctors, psychologists, teachers, and lawyers). In 2015, 9 club meetings were held. On the website of the Volokonovsky District Administration, there is a page “We are together” for the publication of materials and communication between disabled children and their parents. Information and educational methodological materials for parents of disabled children were produced and designed. Activities have been organized for the rehabilitation of disabled children, providing them with various types of charitable assistance with books, sweet sets, and stationery. In 2015, 24 disabled children under the age of 18, together with accompanying persons, underwent rehabilitation at the State Budgetary Institution “Rehabilitation Center for Children and Adolescents with Disabilities.” The Volokonovsky boarding house for elderly citizens and disabled people, located in the village of Pogromets, currently houses 15 people, for whom all the necessary conditions have been created for living and receiving qualified medical care. In the Volokonovsky district, in addition to health procedures, a rich cultural program is carried out for elderly citizens and the disabled. Such integrated programs are carried out as “Promenade of Youth”, “Let's Talk about Love”, “Relaxing in Russian”, “Interesting Facts”, “Sixty Plus”, “Diet Secrets”, “Leisya Song”, “Anniversaries”, “Russian Lotto”, etc. The main goal is to reveal and maintain the individual creative abilities of elderly citizens and disabled people in the Department. Song gatherings such as “To the Sound of the Accordion” and “Song Crossroads” have become traditional.

50 For elderly citizens and people with disabilities, field trips to rural areas and walking tours in the center of the village of Volokonovka with a visit to the local history museum are conducted. There are two rental points for rehabilitation equipment for the disabled: in the USZN of the administration of the Volokonovsky district and the Russian Red Cross in the Volokonovsky district. Wheelchairs are in particular demand. USZN of the Volokonovsky district administration provides services free of charge, according to the contract. BROOOO "Russian Red Cross" in the Volokonovsky district provides wider rental services, you can rent: strollers, walkers, crutches, canes, blood pressure monitors. In order to ensure accessibility for elderly citizens and disabled people of objects and services in priority areas of life, certification of 62 social infrastructure objects in the district was carried out. Based on accessibility passports, the module “Interactive Map of Object Accessibility” was filled with information on the “Learning to Live Together” website on the Internet information and telecommunications network in order for elderly citizens and people with disabilities to receive information about the possibility of visiting social infrastructure facilities. A “road map” action plan has been developed to increase the accessibility indicators for elderly citizens and disabled people of objects and services in the field of social protection, healthcare, education, culture, transport services, communications and information. The goal of the “road map” is to ensure unhindered access to facilities and services in priority areas of life for people with disabilities and other low-mobility groups (people who have difficulty moving independently, receiving services, and necessary information) in the Volokonovsky district. Time frames and expected results of the implementation of the “road map”: increasing the share of social, engineering and transport facilities accessible to people with disabilities and other groups of the population with limited mobility

51 infrastructures in which services are provided to the population, in the total number of facilities - 100 percent in 2030. In 2015, the Department of Social Protection of the Population of the Volokonovsky District Administration provided financial assistance to 98 citizens with disabilities in the amount of 421.0 thousand rubles. from regional and local budget funds. Payments of monthly monetary compensation were made to 6,000 citizens with disabilities to pay for housing and utilities in the amount of more than 27 million rubles. Monthly child benefits were paid to 31 disabled children in the amount of 947 thousand rubles. In 2015, the Volokonovsky District Employment Center employed 15 disabled people. In 2015, the Department of Social Protection of the Population of the Volokonovsky District Administration carried out certain work aimed at caring for, protecting and supporting the low-income population, pensioners, children, single elderly citizens and everyone who needs social protection. The social protection system for the population of the Volokonovsky district employs 149 workers. The average salary for the social protection department of the district administration is 17,616.00 rubles, including the average salary of a social worker - 17,014.00 rubles, and employees of a boarding school - 16,532.00 rubles. The structure of the Department of Social Protection of the Population of the Volokonovsky District Administration includes the Volokonovsky Boarding Home for Elderly Citizens and Disabled Persons. In 4 departments of social assistance at home in the district, 49 social workers work, who serve 394 single pensioners, of which 18 people are free, 376 people are paid. 1082 additional services were provided in the amount of 151.9 thousand rubles.

52 The Department of Emergency Social Assistance, intended to provide citizens in dire need of social support with one-time assistance aimed at maintaining their livelihoods, provided assistance in 2015 in the form of: - payment of a targeted one-time benefit to 979 citizens (394 families) in the amount of 1,651, 0 thousand rubles; - targeted benefits based on a social contract - 30 families in the amount of 373.2 thousand rubles; - distribution of free bread - 480 pcs.; - used items – 9 people. (20 units). 793 “Social Taxi” services were provided to disabled people in the district. The “Mercy” brigade provided social assistance at home to 34 elderly citizens of the district. There are 8,837 citizens of preferential categories registered with the Department of Social Protection of the Population of the Volokonovsky District Administration, of which 5,947 are federal beneficiaries, 2,890 are regional. The title “Veteran of Labor” was awarded to 40 citizens. Monthly cash payments were made to: - labor veterans - 917 people. in the amount of 7815.7 thousand rubles; - home front workers – 2 people. in the amount of 18.0 thousand rubles; - repressed – 8 people. in the amount of 76.7 thousand rubles; - children of war - 364 people. in the amount of 3184.5 thousand rubles; - disabled people due to military trauma, and members of their families (306-FZ) – 41 people. in the amount of 3537.4 thousand rubles; - widow of the Hero of Socialist Labor - 1 person. in the amount of 69.6 thousand rubles. Compensation payments were made in 2015: - to compensate for harm to disabled people at the Chernobyl Nuclear Power Plant - 2 people. and 1 widow of the deceased in the amount of 623.7 thousand rubles; - for food for disabled people and participants in the liquidation of the Chernobyl accident in 1986-1987. – 17 people in the amount of 112.5 thousand rubles;

53 - for health improvement for disabled people and participants in the liquidation of the Chernobyl accident - 23 people. in the amount of 17.4 thousand rubles. An additional payment to the pension was made for: - civil servants - 10 people. in the amount of 337.8 thousand rubles; - municipal employees – 48 people. in the amount of 1673.5 thousand rubles. Orthopedic products were issued to 4 citizens who do not have a disability group. Tickets for travel on the suburban railway transport "Veteran of Labor" were issued - 10 people. Issued vouchers to the “Beautiful” sanatorium – 21 people. Subsidies for housing and communal services were assigned and paid to 252 families in the amount of 2266.5 thousand rubles. Payments of monthly monetary compensation were made to preferential categories of citizens to pay for housing and utilities for 8,837 people. in the amount of 42991.0 thousand rubles, including: - federal beneficiaries in the amount of 33492.0 thousand rubles; - regional beneficiaries in the amount of 9499.0 thousand rubles. Unified social travel tickets, according to the Decree of the Governor of the Belgorod Region dated January 28, 2005 No. 11 “On the introduction of a unified social travel ticket on the territory of the Belgorod Region”, 123 pieces were sold in 2015: - to beneficiaries at the federal level - 76 tickets; - beneficiaries at the regional level – 37 tickets; - nurses of the Russian Red Cross in the Volokonovsky district - 10 tickets. Paid to 4 disabled people who have a vehicle in accordance with the medical indications established by ITU institutions for the provision of vehicles, compensation in the amount of 50 percent of the insurance premium they paid under the contract

54 compulsory civil liability insurance of vehicle owners in the amount of 6.1 thousand rubles. In 2015, specialists from the Center for Social and Psychological Assistance to Families and Family Placement for Children Without Parental Care carried out: - consultations – 915 people; - diagnostic examination – 58 people; - psychocorrectional and developmental classes – 352; - visiting 173 families. 1,317 people applied for socio-psychological and legal assistance to the Center for Socio-Psychological Assistance to Family and Family Placement for Children Left Without Parental Care - 2 people. in 2015. A significant improvement in intra-family relations was recorded in 15 families. 224 people received psychological relief in a relaxation room. In 2015, 11 meetings of the Nika communication club were prepared and held for children with disabilities, which were attended by 67 children and 48 parents. To study the problems of organizing social services for elderly citizens and disabled people, the author conducted a sociological study “Problems of organizing social services for elderly citizens and disabled people in the conditions of the MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District” in November 2015. The problem of this study was to find ways to improve social services for elderly and disabled citizens in the conditions of an integrated center for social services for the population, which will help improve the quality of life of elderly citizens and disabled people, and create conditions for optimization

55 their lifestyle and solutions to various problems related to social services and health maintenance. The purpose of the study was to determine the problems of organizing social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population. To achieve the goal, the following research tasks were set: 1. To study the features and specifics of the organization of social services for elderly citizens and people with disabilities in the MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District.” 2. Conduct a diagnosis of problems in organizing social services for elderly and disabled citizens in the conditions of a comprehensive center for social services for the population and develop recommendations for its improvement. Object of study: social services for elderly and disabled citizens in the conditions of a comprehensive center for social services for the population. Subject of research: the specifics of organizing social services for elderly citizens and disabled people at the municipal level. The most important forms of social services are such as social services at home; semi-stationary services in day (night) departments of social service institutions; stationary social services in boarding homes, boarding houses, etc.; urgent social services; social advisory assistance; provision of living space in special homes for the elderly, etc. Integrated social service centers are the leading government institutions in the field of non-stationary

56 social services for pensioners and disabled people. The centers help to establish various forms of social work, to better take into account the interests and needs of various categories of elderly people and disabled people in direct contact with them. The difficult socio-economic situation in the organization of social services for elderly citizens and disabled people is intended to be mitigated by non-stationary social service institutions that help improve the quality of life of elderly citizens and disabled people, create conditions for optimizing their lifestyle and solving various problems related to maintaining health. with social It is assumed that comprehensive services and the study of the organization of social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population will allow us to determine the problems of its organization, ways to solve them, and, as a result, prospects for the development of the organization of social services for elderly citizens and people with disabilities. To solve the assigned problems, a set of research methods was used, mutually verifying and complementing each other: the method of expert survey, questionnaire; study and analysis of the documentation of the MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District”; quantitative and qualitative analysis of the results of sociological research. Three main groups were considered: specialists from the MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District”; elderly citizens living in the Volokonovsky district; disabled people living in the Volokonovsky district. Characteristics of the methods used for collecting primary sociological information: the author used an expert survey to collect primary sociological information. methods of questioning, interviewing,

57 The volume of observation was 36 elderly and disabled citizens. Results of a survey of elderly and disabled citizens. The majority of respondents note an awareness of difficulties associated with age and disability (62%). These groups of respondents perceive limited opportunities and old age as a negative period of dependence on close and not so close people. A significant portion of respondents (38%) who have not yet felt the approaching problems associated with old age and disability lead an active lifestyle and are not limited in finances and decisions. The majority of elderly citizens and people with disabilities put material problems first - 52%, considering them as the main ones limiting them today. Difficulties related to health status are also important – 34%. However, respondents put them in second place, apparently thereby believing that some of the health difficulties can be solved with more funding. Psychological difficulties (11%) were noted by a relatively small group of respondents. Diagram 1. Indicate the problems most acutely facing you: 60% 50% 40% 30% 52% 20% 34% 10% 11% 3% 0% Material Health state Psychological All of the above Old age, as a period of people’s lives, absorbs many fundamental problems of both the biological and medical sphere, as well as issues of social and

58 personal life of society and each individual. During this period, many problems arise for older citizens, since older people belong to the category of the “low-mobility” population and are the least protected, socially vulnerable part of society. This is primarily due to defects and physical condition caused by diseases with reduced motor activity. Disability and chronic diseases reduce the ability to self-care and adapt to changes. Difficulties may arise with others, including loved ones, even with children and grandchildren. The psyche of the elderly and touchiness, old people may be distinguished by senile, sometimes depression, irritability, sometimes leading to suicide, leaving home. Elderly citizens and people with disabilities are characterized by faith in the power of the state and their dependence on it (54%). The majority of respondents believe that the state can and should solve their problems. Senior citizens and people with disabilities do not just rely on the organization of social services. In most cases, they consider it mandatory. In order to identify the effectiveness of existing forms of organizing social services, we interviewed specialists from the MBSUSOSSZN “Comprehensive Center for Social Services for the Population of the Volokonovsky District”, who directly work with elderly citizens and the disabled (12 people). As part of the study, several blocks of problems were identified: - Quality of social services for elderly citizens and people with disabilities; - The need of elderly citizens and people with disabilities for specific types of social services. As a result of the expert survey, the following data were obtained:

59 Diagram 2. Indicate the problems arising in social services for elderly citizens and disabled people: 50% 45% 40% 35% 30% 25% 47% 20% 34% 15% 10% 12% 5% 7% 0% Material In assessment Mat.-techn. base of the main problems, Personnel shortage inherent in the Legal imperfection of the social service system for elderly citizens and people with disabilities, the majority of experts noted insufficient funding - 47% and a lack of qualified personnel - 12%, 34% of experts pointed to the need to update the material and technical base of the social service system for citizens elderly and disabled people, 7% noted the imperfection of the regulatory framework for social services. It is obvious that the financing of social institutions does not allow for the dynamic development of social service activities and the expansion of the list of services provided to elderly citizens and the disabled. The lack of qualified personnel is caused by insufficient wages, lack of career prospects, etc. The respondents’ answers to the question “How do you assess the level of social services for elderly citizens and disabled people” were distributed as follows:

60 Diagram 3. 80% Level of social services for elderly citizens and disabled people 70% 60% 50% 40% 72% 30% 20% 10% 0% 18% 7% High 3% Quite high Satisfactory Low Very high - 7% Quite high – 18% Completely satisfactory – 72% Insufficient – ​​3% As noted in the previous question, the lack of normal funding and insufficient educational and professional level of specialists does not allow providing clients with social services of the required level. To increase efficiency, it is necessary to increase funding for social services for elderly citizens and the disabled by an order of magnitude; this would expand the range of services provided to them. Based on the analysis of the results obtained, it can be noted that the majority of respondents (67%) consider the financial situation of elderly citizens and people with disabilities to be disastrous. It can be concluded that respondents equally highly rated the need of elderly citizens and disabled people for all types of social services that will help improve the financial situation of elderly citizens and disabled people, as well as for services to provide social and domestic assistance.

61 Analysis of the results shows that, in general, elderly citizens and people with disabilities are provided with exactly the services they need, but it is alarming that these services are not provided to the full extent. Having analyzed the data from statistical reports on the work of the social service center of the administration of the Volokonovsky district and the data obtained during the study, we can conclude that the organization of social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population has some problems: - the continuous growth of the elderly population increases the workload for social services; - lack of sufficient information among elderly citizens and disabled people about the forms and institutions of social services; - some forms of social services for elderly citizens and people with disabilities are not effective enough; - insufficient accessibility of the social environment for elderly citizens and disabled people; - the impossibility of continuing the work activity of elderly citizens, while maintaining physiological well-being; - problems of interdepartmental interaction in the social sphere; - unsatisfactory financial, material and technical support for the activities of social service institutions; - unsatisfactory staffing and information support for the activities of social service institutions; - elderly citizens and people with disabilities often have problems that require specific assistance, so it is quite difficult to provide full and effective assistance to a client who has a number of problems. Questionnaires for elderly citizens, disabled people and experts are in the appendix (appendices 1-3).

62 2.2. Recommendations for improving social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population Improving social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population depends both on the financial support and material and technical base of institutions, and on personnel training, from the implementation of social partnership approaches and mutual responsibility of the state, employers, and society. Much depends on an adequate regulatory framework, increased wages and the prestige of social workers. The developed recommendations for improving social services for elderly citizens and people with disabilities in the conditions of an integrated center for social services for the population are comprehensive: 1. It is necessary to coordinate the efforts of state and public structures in solving socio-economic, family, everyday, psychological and other problems of elderly citizens and people with disabilities , as well as further steps to delineate the obligations and powers of authorities in the field of social services for citizens. In relation to the activities of government bodies, it is necessary to improve the political and legal support for the system of social services for elderly citizens and the disabled. An important direction in the development of state social policy in relation to elderly citizens and people with disabilities should be a set of political, legal, economic, medical, social, scientific, cultural, outreach and personnel measures aimed at achieving elderly citizens

63 age and disabled people material well-being and social well-being, creating conditions for active participation in society and longevity. To achieve this, the following measures are necessary: ​​- overcoming stereotypical views on old age; - overcoming negative attitudes towards people with disabilities; - sustainable improvement of the level and quality of life of elderly citizens and people with disabilities based on social solidarity and justice; - formation of a positive assessment of the role of the older generation in society as the bearer of moral, aesthetic cultural values ​​and the main link in their transmission to younger generations; - increasing funding for media that systematically cover the problems of elderly citizens and people with disabilities; - strengthening the material base of social service institutions for the elderly and disabled based on strengthening interaction with non-state structures and charitable organizations. It is also necessary to carry out targeted activities to further strengthen the system of social services working with elderly citizens and people with disabilities, develop social infrastructure that takes into account their needs, and develop appropriate care strategies. The relevance of these measures is due to the need for labor and economic costs in caring for elderly family members and people with disabilities, especially the elderly and long-livers. When developing these strategies, the interests of women of all ages who traditionally provide care for dependent family members must be taken into account. It is necessary to introduce a number of changes to the legislation on social services for elderly citizens and disabled people, clarifying the conditions for providing these persons with social, rehabilitation and other services and providing for the introduction of effective control over their

64 compliance with state standards approved in accordance with the established procedure. It is necessary to provide legal guarantees to elderly citizens and disabled people in order to ensure equal opportunities in the implementation of their civil, economic, social political and other rights and freedoms provided for by the Constitutions of the Russian Federation and the legislation of the Russian Federation. 2. Solving socio-economic problems caused by population aging and disability requires finding material and other resources, focusing them on priority goals, and coordinating programs implemented in the interests of elderly citizens and people with disabilities with general strategies for sustainable development. Recommendations for solving socio-economic problems of social services for elderly citizens and people with disabilities in the conditions of an integrated center for social services for the population largely boil down to the following: - diversification of funding sources is necessary; - it is necessary to introduce elements of budget management; - restructuring of the network of social institutions is necessary; - it is necessary to develop competitive interdepartmental relations. It should also be noted the important role of introducing social partnership into the system of social service institutions for elderly citizens and disabled people. It represents the interaction of the state, society and citizens of the older generation in the implementation of activities aimed at the welfare and social well-being of elderly citizens and people with disabilities, constant cooperation with family, public associations and other social partners that provide elderly citizens and people with disabilities with protection, assistance and services .

65 Elderly citizens and people with disabilities, as a rule, have limited physical and material opportunities for an active life and come to terms with their problems. However, this is not a reason to treat them only as pensioners and patients, since they contribute to the social development of our region and the country as a whole, show interest in changes in modern society, social, cultural, economic life, have a powerful reserve of knowledge, skills and abilities, support the solidarity of generations and are guardians of spiritual and moral values. 3. It is necessary to attract elderly citizens and disabled people - clients of the system of social service institutions - to cooperation and development of social development strategies through meetings with the heads of the regional administration, enterprises, institutions, and organizations. In addition, conduct written and oral public opinion polls (in particular, disabled people and elderly citizens), which allow them to be involved in the development and implementation of new models and forms of social services, and allow them to participate in service planning. Feedback enables older people to successfully perform social roles, adapt to changes in the environment, increases their sense of self-esteem, allows older people to develop a sense of internal control over the situation, and become competent. In addition to the above, it is necessary to implement the following measures necessary to improve social services for elderly citizens and people with disabilities: - implementation of scientific and methodological support for the activities of social services; - introduction of new social technologies and new forms of work with elderly citizens and people with disabilities; - carrying out socially-oriented educational work with elderly citizens and people with disabilities;

66 - development and improvement of the implementation of social, new social programs for socio-medical, psychological and pedagogical assistance to elderly citizens and the disabled. It is necessary to carry out the process of training and advanced training of social workers in the following areas: - retraining and advanced training of working specialists; - training of young specialists; - creation of teaching aids and complexes necessary for the effective organization of the educational process. Reasonable use of accumulated world and domestic experience, study and generalization of cultural and historical traditions should become the basis for training professional workers for the social sphere. It is also important to note the prospects for the development of social services for elderly citizens and people with disabilities. The modern social service system has been formed over the past decades. Social services for elderly citizens and people with disabilities have now become an integral part of social security, one of its rapidly developing elements. Currently, in connection with the processes of reforming economic and social life in the country, the sphere of social services for elderly citizens and people with disabilities is continuously and dynamically developing. But, despite the large number of regulatory legal acts regulating relations in social services for elderly citizens and people with disabilities, it is worth emphasizing that they do not yet fully meet the requirements set by society and do not correspond to the tasks that the state has set for itself. Therefore, it is necessary to further actively develop a system of providing elderly citizens and people with disabilities with assistance to maintain their health and material

Level 67. Well-drafted legislation can certainly help in the further development and improvement of the sphere of social services for elderly citizens and people with disabilities. It is obvious that after a certain time a new model of social services for elderly citizens and people with disabilities will be formed, which will simultaneously meet the objective needs of Russian society and the financial and economic capabilities of the state. Thus, we can say that in the last few years a breakthrough has been made towards the effective and efficient functioning of the entire social service system as a whole, as well as the social service system for elderly citizens and the disabled. The successful development of social services for elderly citizens and disabled people can be positively influenced by the implementation of recommendations developed by the author to improve social services for elderly citizens and disabled people in the conditions of a comprehensive center for social services for the population, the introduction of additional types, forms and guarantees of social services.

68 CONCLUSION The organization of social services for elderly citizens and disabled people in the Russian Federation is given more and more importance every year. Social policy in relation to elderly citizens and people with disabilities, its scope, direction and content throughout the history of the country were influenced and determined by socio-economic and specific socio-political tasks facing society at one or another stage of its development. The allocation in the general structure of social policy of a special direction - social services relating to the well-being and health of elderly citizens and people with disabilities, is due to rather specific conditions and lifestyles, the characteristics of their needs, as well as the level of development of society as a whole. Currently, measures to improve social services for elderly citizens and people with disabilities are among the priority areas of state social policy. The social service system covers a wide range of services, in particular, medical care, maintenance and service in boarding schools, home care for those in need of care, housing and communal services, leisure activities, etc. In the field of social services, the possibility of exercising the right to receive it often depends on the decision of the competent authority, since a number of social services provided in this area are still among the scarce ones that are not guaranteed to absolutely every elderly and disabled person. Social services for elderly citizens and people with disabilities should be focused on ensuring the availability of basic social services and guarantees for elderly citizens and people with disabilities, regardless of their place of residence.

69 Social vulnerability of elderly citizens and disabled people is associated primarily with their physical condition, the presence of diseases, decreased physical activity, and the presence of a psychological factor that forms contact with other segments of the population. Therefore, elderly citizens and people with disabilities are the least protected and most socially vulnerable part of society. In the Belgorod region, a network of social service institutions for elderly citizens and the disabled has been developed. An important role in the development of new technologies for serving elderly citizens and people with disabilities belongs to integrated social service centers. At the same time, the need to coordinate the efforts of state and public structures in solving socio-economic, family, everyday, psychological and other problems of elderly citizens and people with disabilities is becoming more and more obvious. Having analyzed the statistical data obtained during the study, we came to the conclusion that the organization of social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population has some problems: - the continuous growth of the elderly population increases the burden on social services; - lack of sufficient information among elderly citizens and disabled people about the forms and institutions of social services; - some forms of social services for elderly citizens and people with disabilities are not effective enough; - insufficient accessibility of the social environment for elderly citizens and disabled people; - the impossibility of continuing the work activity of elderly citizens, while maintaining physiological well-being; - problems of interdepartmental interaction in the social sphere;

70 - unsatisfactory financial, material and technical support for the activities of social service institutions; - unsatisfactory staffing and information support for the activities of social service institutions; - elderly citizens and people with disabilities often have problems that require specific assistance, so it is quite difficult to provide full and effective assistance to a client who has a number of problems. To solve existing problems, the author developed recommendations for improving social services for elderly citizens and people with disabilities in the conditions of an integrated center for social services for the population, which are comprehensive in nature: 1. It is necessary to coordinate the efforts of state and public structures in solving socio-economic, family and psychological problems and other problems of elderly citizens and people with disabilities, as well as further steps to delineate the obligations and powers of authorities in the field of social services for citizens. In relation to the activities of government bodies, it is necessary to improve the political and legal support for the system of social services for elderly citizens and the disabled. An important direction in the development of state social policy in relation to elderly citizens and people with disabilities should be a set of measures of a political, legal, economic, medical, social, scientific, cultural, information, propaganda and personnel nature, aimed at achieving material well-being and social well-being, creating conditions for active participation in society and longevity. To achieve this, the following measures are necessary: ​​- overcoming stereotypical views on old age; - overcoming negative attitudes towards people with disabilities;

71 - sustainable increase in the level and quality of life of elderly citizens and people with disabilities based on social solidarity and justice; - formation of a positive assessment of the role of the older generation in society as the bearer of moral, aesthetic cultural values ​​and the main link in their transmission to younger generations; - increasing funding for media that systematically cover the problems of elderly citizens and people with disabilities; - strengthening the material base of social service institutions for the elderly and disabled based on strengthening interaction with non-state structures and charitable organizations. It is necessary to introduce a number of changes to the legislation on social services for elderly citizens and disabled people, clarifying the conditions for providing these persons with social, rehabilitation and other services and providing for the introduction of effective control over their compliance with state standards approved in the prescribed manner. Also, it is necessary to provide legal guarantees to elderly citizens and disabled people in order to ensure equal opportunities in the implementation of their civil, economic, social political and other rights and freedoms provided for by the Constitutions of the Russian Federation and the legislation of the Russian Federation. 2. Solving socio-economic problems caused by population aging and disability requires finding material and other resources, focusing them on priority goals, and coordinating programs implemented in the interests of elderly citizens and people with disabilities with general strategies for sustainable development. Recommendations for solving socio-economic problems of social services for elderly citizens and disabled people in

72 conditions of a comprehensive center for social services for the population largely boil down to the following: - diversification of funding sources is necessary; - it is necessary to introduce elements of budget management; - restructuring of the network of social institutions is necessary; - it is necessary to develop competitive interdepartmental relations. It should also be noted the important role of introducing social partnership into the system of social service institutions for elderly citizens and disabled people. It represents the interaction of the state, society and citizens of the older generation in the implementation of activities aimed at the welfare and social well-being of elderly citizens and people with disabilities, constant cooperation with family, public associations and other social partners that provide elderly citizens and people with disabilities with protection, assistance and services . 3. It is necessary to attract elderly citizens and disabled people - clients of the system of social service institutions - to cooperation and development of social development strategies through meetings with the heads of the regional administration, enterprises, institutions, and organizations. In addition, conduct written and oral public opinion polls (in particular, disabled people and elderly citizens), which allow them to be involved in the development and implementation of new models and forms of social services, and allow them to participate in service planning. Feedback enables older people to successfully perform social roles, adapt to changes in the environment, increases their sense of self-esteem, allows older people to develop a sense of internal control over the situation, and become competent. In addition to the above, it is necessary to implement the following measures necessary to improve social services for elderly citizens and disabled people:

73 - implementation of scientific and methodological support for the activities of social services; - introduction of new social technologies and new forms of work with elderly citizens and people with disabilities; - carrying out socially-oriented educational work with elderly citizens and people with disabilities; - development and improvement of the implementation of social, new social programs for socio-medical, psychological and pedagogical assistance to elderly citizens and the disabled. It is necessary to carry out the process of training and advanced training of social workers in the following areas: - retraining and advanced training of working specialists; - training of young specialists; - creation of teaching aids and complexes necessary for the effective organization of the educational process. Reasonable use of accumulated world and domestic experience, study and generalization of cultural and historical traditions should become the basis for training professional workers for the social sphere. Social services for elderly citizens and people with disabilities have now become an integral part of social security, one of its rapidly developing elements. Currently, in connection with the processes of reforming economic and social life in the country, the sphere of social services for elderly citizens and people with disabilities is continuously and dynamically developing. It is obvious that in the near future a new model of social services for elderly and disabled citizens will be formed, which will simultaneously meet the objective needs of the Russian state and its economic capabilities. society and financial

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80 APPENDIX

81 Appendix 1 Questionnaire (for elderly citizens) Dear respondent! Students and teachers of the Department of Social Work of the National Research University "BelSU" in order to study the problems of organizing social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population ask you to fill out a questionnaire. Circle the answer option that matches your opinion. If you have your own answer, write it in the “other” column. 1. How do you assess your health? 1. Good 2. Fair 3. Poor 4. Other 2. Are you fully aware of the difficulties associated with reaching old age? 1. Yes, I am fully aware 2. I am not fully aware 3. Other 3. Do you often complain about feeling unwell? 1. Often 2. I constantly feel bad 3. I don’t complain, I’m in good health 4. Other 4. What problems worry you at the moment? 1. Material 2. State of health 3. Psychological 4. Other 5. How do you evaluate the quality of social services in the comprehensive center? 1. Good 2. Very good 3. Normal 4. Bad 5. Other

83 13. What would you like to change in the work of this institution? 1._______________________________________________________ 2. Difficult to answer 14. Your gender: 1. Male 2. Female 15. Your age: 1. 55 - 65 2. 66 - 72 3. 72 - 80 4. 80 and older 16. Your education: 1. Secondary 2. Higher 3. Other_________________________________ Thank you for your participation!

84 Appendix 2 Questionnaire (for people with disabilities) Dear respondent! Students and teachers of the Department of Social Work of the National Research University "BelSU" in order to study the problems of organizing social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population ask you to fill out a questionnaire. Circle the answer option that matches your opinion. If you have your own answer, write it in the “other” column. 1. What is your disability group? 1. 1 2. 2 3. 3 2. Are you fully aware of the difficulties associated with disability? 1. Yes, I am fully aware 2. I am not fully aware 3. Other 3. Do you often complain about feeling unwell? 1. Often 2. I constantly feel bad 3. I don’t complain, I’m in good health 4. Other 4. How do you evaluate the quality of social services in the comprehensive center? 1. Good 2. Very good 3. Normal 4. Bad 5. Other 5. What problems concern you currently? 1. Material 2. Disability 3. Psychological 4. Other

86 13. What would you like to change in the work of this institution? 1._______________________________________________________ 2. Difficult to answer 14. Your gender: 1. Male 2. Female 15. Your age: 1. 55 - 65 2. 66 - 72 3. 72 - 80 4. 80 and older 16. Your education: 1. Secondary 2. Higher 3. Other_________________________________ Thank you for your participation!

87 Appendix 3 Questionnaire (expert questionnaire) Dear respondent! Students and teachers of the Department of Social Work of the National Research University "BelSU" in order to study the problems of organizing social services for elderly citizens and people with disabilities in the conditions of a comprehensive center for social services for the population ask you to fill out a questionnaire. Circle the answer option that matches your opinion. If you have your own answer, write it in the “other” column. 1. What are the main problems in the system of social services for elderly citizens and people with disabilities? 1. Insufficient funding 2. Lack of qualified personnel 3. The need to update the material and technical base 4. Imperfection of the regulatory framework 2. Are your clients fully aware of the difficulties associated with reaching old age? 1. Yes, they are fully aware 2. They are not fully aware 3. Other 3. How do you evaluate social services for elderly and disabled citizens? 1. Very high 2. Quite high 3. Quite satisfactory 4. Not high enough 4. What problems are your customers currently concerned about? 1. Material 2. State of health 3. Psychological 4. Other 5. How do you assess the quality of social services in your comprehensive center? 1. Good 2. Very good 3. Normal 4. Bad 5. Other

88 6. Are you satisfied with your relationship with clients? 1. Yes, I’m satisfied 2. No, I’m not satisfied, I would like the attitude to be better 7. Have you ever had conflicts with clients? 1. There were no conflicts 2. There were conflicts, but they were resolved 3. Never happened 4. There were conflicts that remained, not resolved 8. Do you consider loneliness a social problem? 1. Yes 2. No 3. Difficult to answer 9. How would you characterize the living conditions of your clients? 1. I am satisfied with everything 2. I am not satisfied with everything 3. I find it difficult to answer 10. Which services provided by yours do you consider the most significant? 1. Social and household 2. Social and medical 3. Socio-economic 4. Social and legal 11. Are you satisfied with the quality of service in the comprehensive center? 1. Yes, satisfied 2. No, I would like the quality of service to be better 3. Difficult to answer 12. What would you like to change in the work of your institution? 1._______________________________________________________ 2. Difficult to answer 13. Your gender: 1. Male 2. Female 14. Your age: 1.___________

89 15. Your education: 1. Secondary 2. Higher 3. Other_________________________________ Thank you for your participation!

Elderly and disabled people, left without the help of relatives, often cannot cope with ordinary household chores due to their age and poor health. Therefore, they are provided with social and medical services at home - by state budgetary institutions, municipalities, organizations and entrepreneurs. From this article you will learn what social services for the elderly and disabled at home are, who can count on such help, and how to receive the service.

Social services for the elderly and disabled at home: types of social services

Citizens who meet the legal requirements for recipients of social services at home can count on the following types of assistance:

• accompaniment to places of recreation, sanatoriums, medical institutions, state and municipal institutions;
• assistance in paying utility bills;
• assistance in organizing everyday life, arranging housing, carrying out cosmetic repairs, washing things, cleaning the house;
• water delivery, heating of the stove (if the beneficiary lives in a private house without central water supply and heating);
• cooking, organizing everyday life and leisure, going to the grocery store and pharmacy.

If a person cannot take care of himself independently, a social worker must help. The following services can also be provided depending on the citizen’s health status:

• joint visits to clinics;
• psychological support, assistance in sanatorium-resort treatment, hospitalization and in-patient care;
• assistance in carrying out social and medical rehabilitation, in passing the medical examination;
• assistance in obtaining medical services;
• implementation of medical procedures and manipulations, hygiene procedures;
• assistance in paperwork;
• legal and legal services;
• assistance in obtaining secondary and higher education (for people with disabilities).

Who has the right to social services for the elderly and disabled at home

The following categories of persons have the right to invite a social worker to your home:

1. Citizens of retirement age (women over 55 years old and men over 60 years old).
2. People with disabilities (disabled people of all three groups).
3. People who are temporarily disabled and do not have assistants.
4. Citizens who find themselves in a difficult situation due to alcohol or drug addiction of a family member.
5. Some other categories of persons, for example, orphans without a place of residence.

Social services at home can be provided free of charge, on a partial payment basis or for payment in full.

Payment for social services	Recipient categories
For free	Disabled people of the Second World War, war veterans, spouses and widows of combatants, former prisoners of concentration camps, former residents of besieged Leningrad, Heroes of the USSR and the Russian Federation, Heroes of socialist labor. Disabled people and pensioners who do not belong to special categories of citizens (federal beneficiaries), but have an income below 1.5 times the regional subsistence minimum.
Partial payment	Citizens who are not disabled or pensioners, but need the help of a social worker and have an income below 1.5 times the regional minimum wage (the size of the discount depends on social status).
Full price	In all other cases.

How to register for social services for the elderly and disabled at home, in what cases the service may be refused

Important! To apply for social services at home, you must contact the regional office of social protection authorities.

Before an application for assistance is approved, social service employees must check the documents in order to assess the degree of need of the citizen to receive help from a social worker (since there are many people who want it, but there are usually not enough resources), and check the living conditions of the person applying. The law provides for the following cases when an applicant may be denied social services:

1. If there are contraindications to social assistance. This refers to the presence of factors that could jeopardize the life and health of a social worker:
   • presence of severe mental disorders,
   • drug addiction,
   • alcohol addiction,
   • taking psychotropic drugs,
   • presence of quarantine diseases,
   • the presence of severe infectious pathologies;
   • the presence of an open form of tuberculosis;
   • the presence of any diseases requiring specialized treatment.
2. The applicant's application to the State Police in a drunken or inappropriate state.
3. High employment of the organization, lack of free social workers.
4. The applicant is a person of no fixed abode.

When applying to social security authorities, you will need the following documents:

• conclusion of a medical and social examination on assignment of a disabled group;
• a certificate from a medical institution confirming the absence of diseases for which it is impossible to receive social assistance;
• pension certificate;
• certificate of family composition;
• certificate of income.

Expert opinion on the issue of social services for the elderly and disabled at home

Participants took part in last year’s seminar-meeting on issues of social services for elderly and disabled citizens, which was held at the Ministry of Social Development and Labor of the Kamchatka Territory Minister of Social Development and Labor I. Koirovich, Deputy Minister E. Merkulov, Head of the Social Services Department N. Burmistrova, heads of social protection bodies and heads of social services organizations for disabled and elderly citizens.

The economic, organizational, and legal foundations of social services, the rights and obligations of recipients and service providers, and the powers of government authorities established by Federal Law No. 442-FZ dated December 28, 2013 were discussed. The main attention was paid to the following issues:

• Citizens with an income below 1.5 monthly wages in the region have the right to receive free social assistance at home (previously, the pension had to be below 1 monthly wage);
• a detailed approach to the approval of a set of social services taking into account the needs of the citizen was introduced;
• citizens received the right to independently choose their social service provider;
• Now not only pensioners and disabled people can apply for social services at home, but also citizens who are temporarily disabled, faced with intra-family conflicts (related to drug addiction, alcoholism in relatives), who need help caring for a disabled child and have no place residence (if you are an orphan).

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MINISTRY OF EDUCATION OF THE REPUBLIC OF BASHKORTOSTAN

STATE AUTONOMOUS EDUCATIONAL

INSTITUTION

SECONDARY VOCATIONAL EDUCATION

TUYMAZINSKY STATE LAW COLLEGE

DEPARTMENT OF LEGAL DISCIPLINES

Inpatient social services

elderly and disabled people

COURSE WORK

SHAPILOVA NATALIA ALEKSANDROVNA

040401.52 SOCIAL WORK

RESEARCH SUPERVISOR:

MINIKHANOVA N.I.

TEACHER

SOCIAL WORK WITH ELDERLY AND DISABLED PEOPLE

TUYMAZY 2012

Introduction

System of inpatient social services for the elderly and disabled

Institutions for inpatient social services for the elderly and disabled

Inpatient social services

Conclusion

List of sources and literature

Introduction

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

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

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

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

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

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

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

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

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

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

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

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

The following tasks follow from this goal:

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

characterize inpatient social service institutions;

consider inpatient social services;

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

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

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

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

Inpatient social service system

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

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

Elderly citizens and disabled people who have partially or completely lost the ability to self-care and need constant outside care, from among particularly dangerous repeat offenders released from prison and other persons for whom administrative supervision has been established in accordance with current legislation, as well as elderly citizens and disabled people who have previously been convicted or have been repeatedly brought to administrative responsibility for violating public order, engaged in vagrancy and begging, who are sent from institutions of the internal affairs bodies, in the absence of medical contraindications and at their personal request, are accepted for social services in special inpatient social service institutions in the manner , determined by the executive authorities of the constituent entities of the Russian Federation.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

It is not allowed to place in an institution children with diseases that require active medical intervention, as well as those who are under the influence of alcohol or drugs, or the mentally ill who have committed a crime.

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

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

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

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

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

socio-medical rehabilitation and social adaptation;

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

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

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

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

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

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

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

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

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

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

Inpatient social service institutions

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

Let's look at some of them:

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

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

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

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

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

activities as part of visiting teams for field work and construction sites;

activities in regular positions in the boarding school and beyond;

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

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

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

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

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

meet with a lawyer and a clergyman alone;

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

subscribe to newspapers and magazines;

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

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

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

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

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

The main objectives of the Gerontological Center are:

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

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

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

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

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

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

organizational and methodological department;

social rehabilitation department;

gerontopsychiatric department;

socio-psychological department;

social and medical department;

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

The organizational and methodological department is created for:

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

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

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

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

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

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

The social rehabilitation department is created for:

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

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

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

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

The gerontopsychiatric department is being created for:

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

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

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

The socio-psychological department is created for:

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

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

organizing a “helpline for older people” service;

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

The social and medical department is intended for:

interaction with treatment-and-prophylactic, sanitary-epidemiological and other health care institutions on the organization of the provision of social and medical services to citizens of older age groups;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

measures for social and labor rehabilitation of children with disabilities in order to restore or compensate for lost or impaired abilities for everyday, social and professional activities, and their integration into society;

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

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

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

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

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

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

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

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

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

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

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

The reception department of the Institution is intended for:

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

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

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

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

mastering and using traditional and new effective methods and technologies in carrying out rehabilitation activities;

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

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

carrying out therapeutic and physical education activities with disabled children.

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

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

conducting psychological and correctional work with disabled children;

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

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

organizing play therapy for disabled children;

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

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

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

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

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

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

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

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

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

The charity department of the Institution is intended for:

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

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

The day care group of the Institution is intended for:

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

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

The Institution accepts disabled children from 4 to 18 years of age with disabilities in mental development who, for health reasons, require outside care, household services, medical care, social and labor rehabilitation, training and education, and who are in other difficult life situations.

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

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

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

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

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

Services of stationary social institutions

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

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

1. Material and household services:

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

provision of furniture for use in accordance with approved standards;

assistance in organizing the provision of services by trade and communication enterprises;

compensation for travel expenses for training, treatment, consultations.

2. Services for organizing catering, everyday life, and leisure:

preparing and serving food, including dietary nutrition;

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

providing assistance in writing letters;

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

ensuring the safety of personal belongings and valuables;

creating conditions for the performance of religious rites.

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

3. Social, medical and sanitary services:

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

providing health-sensitive care;

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

provision of primary health care and dental care;

organization of medical examination;

hospitalization of those in need in medical institutions, assistance in referral, based on doctors’ conclusions, for sanatorium-resort treatment (including on preferential terms);

providing psychological support, conducting psychocorrectional work;

assistance in obtaining free dentures (with the exception of dentures made of precious metals and other expensive materials) and prosthetic and orthopedic care;

provision of technical means of care and rehabilitation;

ensuring sanitary and hygienic requirements in residential premises and common areas.

4. Organization of education for disabled people, taking into account their physical capabilities and mental abilities:

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

5. Services related to social and labor rehabilitation:

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

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

6. Legal services:

assistance in paperwork; providing assistance on pensions and other social benefits;

assistance in obtaining benefits and advantages established by current legislation;

assistance in obtaining advisory assistance;

ensuring representation in court to protect rights and interests;

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

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

7. Assistance in organizing funeral services.

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

Conclusion

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

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

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

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