Traditional medicine

Non-state social institutions for the elderly and disabled. Social services for elderly and disabled citizens

From this article you will learn:

What are the principles of social services for older people

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

What forms of social services are provided for older people?

What social service institutions exist for older people?

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

Principles of social services for older people

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

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

continuity between social organizations providing special services to the elderly;

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

strict adherence to guarantees provided by the state;

equalization of opportunities for all applicants for social services;

paying special attention to the adaptation of the elderly in society.

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

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

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

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

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

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

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

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

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

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

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

How social services for older people are organized

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

People who require social services for various reasons and circumstances, have rights to:

Polite and sensitive attitude of social workers towards their clients.

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

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

Refusal to provide these services.

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

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

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

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

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

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

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

Urgent nature.

Advisory nature.

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

The list of services performed at home includes:

supply of necessary products and ready-made hot meals;

maintaining cleanliness of housing in accordance with sanitary standards;

delivery of necessary medications and household goods;

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

organization of legal, ritual and any other necessary services;

a number of other services.

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

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

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

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

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

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

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

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

People who live in such institutions have the right to:

Undergoing rehabilitation and adaptation to society.

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

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

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

Free meetings with relatives and friends.

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

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

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

Obtaining new housing out of turn in the case where an elderly person has written a refusal to receive special social services after 6 months of being in the appropriate institution and has already lost his previous housing.

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

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

This includes a number of services:

food delivery and provision of food packages to wards;

supply of necessary wardrobe items and household goods;

finding a place for temporary residence;

one-time cash payment;

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

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

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

Social service institutions for older people

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

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

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

Elderly people are offered several service options:

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

stay during the rehabilitation period;

permanent residence.

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

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

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

In this regard, in modern conditions, institutions of social services for older people and interdepartmental work on organizing social support for this group of the population are becoming important. This is due not only to the increase in the proportion of older people in the population, but also to the solution of problems arising from this phenomenon: changes in the social status of a person in old age, cessation or limitation of work, transformation of value orientations, the very way of life and communication, as well as the emergence of various difficulties both in social and everyday life and in psychological adaptation to new conditions, which dictates the need to develop and implement specific approaches, forms and methods of social work with pensioners and older people.

Social services for older people are carried out in accordance with the ethical principles of the International Labor Organization.

Personal dignity is the right to decent treatment, treatment, social assistance and support.

Freedom of choice - every elderly person has the right to choose between being kept at home and living in a shelter, temporary or permanent.

Coordination of assistance - assistance provided by various social bodies must be proactive, coordinated and consistent.

Individualization of assistance - assistance is provided, first of all, to the elderly citizen himself, taking into account his environment.

Eliminating the gap between sanitary and social care - given the priority nature of the health criterion, the level of financial assistance cannot depend on the standard of living and place of residence.

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

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

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

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

Not in need of help;

Partially disabled;

In need of service;

Requiring constant care, etc.

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

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

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

The following institutions perform the function of social protection and assistance:

Boarding houses;

Day and night departments;

Special homes for single elderly people;

Hospitals and departments for chronically ill patients;

Hospitals of various types;

Territorial social service centers;

Social assistance departments at home;

Gerontological centers, etc.

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

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

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

Providing favorable conditions for living and self-service;

Providing permanent social, domestic and medical assistance to living elderly citizens;

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

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

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

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

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

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

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

Who can receive this type of support?

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

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

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

Home-based service

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

Home service includes:

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

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

These include:

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

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

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

Social and medical support

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

Semi-stationary type of assistance

This service system allows you to solve the following issues:

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

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

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

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

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

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

Inpatient service

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

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

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

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

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

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

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

Urgent service

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

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

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

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

passport;
work book;
pension certificate;
certificate of disability;
certificate of family composition;
certificate of income for 3 months.

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

Social advisory type of assistance

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

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

Other services

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The social service system for elderly citizens and disabled people in the Russian Federation is a multicomponent structure, which includes social institutions and their divisions (services) that provide services to older people. Currently, it is customary to distinguish such forms of social services as stationary, semi-stationary, non-stationary social services and urgent social assistance.

For many years, the system of social services for older citizens was represented only by stationary social service institutions. It included boarding houses for the elderly and disabled people of general type and partially psychoneurological boarding schools. Psychoneurological boarding schools accommodate both disabled people of working age with corresponding pathologies, as well as older people in need of specialized psychiatric or psychoneurological care. State statistical reporting on psychoneurological boarding schools (form No. 3-social security) does not provide for the allocation of the number of persons over working age in their contingent. According to various estimates and research results, it can be judged that among those living in such institutions, there are up to 40~50% of elderly people with mental disorders.

From the late 80s - early 90s. last century, when in the country, against the background of the progressive aging of the population, the socio-economic situation of a significant part of the citizens, including the elderly, sharply worsened, there was an urgent need for a transition from the previous social security system to a new one - social protection system.

The experience of foreign countries has demonstrated the legitimacy of using, in order to ensure the full social functioning of the aging population, a system of non-stationary social services that are close to the permanent location of social networks familiar to older people and effectively promote the activity and healthy longevity of the older generation.

A favorable foundation for the implementation of this approach is the UN Principles adopted in relation to older people - “Making fuller lives for older people” (1991), as well as the recommendations of the Madrid International Plan of Action on Aging (2002). The age above the working age (old age, old age) is beginning to be considered by the world community as the third age (after childhood and maturity), which has its own merits. Elderly people can productively adapt to a change in their social status, and society is obliged to create the necessary conditions for this.

According to social gerontologists, one of the main factors for the successful social adaptation of older people is the preservation of their need for social activity, in developing a course for positive old age.

In solving the problem of creating conditions for the realization of the personal potential of older Russians, an important role is given to the development of the infrastructure of non-stationary social service institutions, which, along with the provision of medical, social, psychological, economic and other assistance, should provide support for leisure and other feasible socially oriented activities of older citizens, promote educational and educational work in their environment.

The formation of structures providing urgent social assistance and serving elderly people at home was promptly begun. Gradually they transformed into independent institutions - social service centers. Initially, the centers were created as social services providing home-based services, but social practice put forward new tasks and suggested appropriate forms of work. Semi-stationary social services began to be provided by day care departments, temporary residence departments, social rehabilitation departments and other structural units opened at social service centers.

The complexity of social services, the use of technologies and approaches that are necessary for a particular elderly person and available in the existing social conditions, have become characteristic features of the emerging system of social services for older people. All new services and their structural units were created as close as possible (in organizational and territorial terms) to older people. Unlike previous inpatient services, which were under the jurisdiction of regional social protection authorities, social service centers have both regional and municipal affiliation.

At the same time, the system of inpatient social services underwent transformations: the tasks of providing medical care and care were supplemented with the functions of preserving the social inclusion of older people, their active, active lifestyle; gerontological (gerontopsychiatric) centers and boarding houses of mercy for the elderly and disabled people in need of high-level social and medical services and palliative care began to be created.

With the help of local communities, as well as enterprises, organizations and individuals, small-capacity stationary social institutions are created - mini-boarding schools (mini-boarding houses), in which up to 50 elderly citizens from among local residents or former employees of this organization live. Some of these institutions operate in a semi-stationary mode - they accept elderly people mainly for the winter period, and in the warm season the residents return home to their garden plots.

In the 1990s. In the system of social protection of the population, sanatorium-resort-type institutions appeared - social health (social rehabilitation) centers, which were created primarily for economic reasons (sanatorium-resort vouchers and travel to the place of treatment are quite expensive). These institutions accept elderly citizens referred by social protection authorities for social and medical services, the courses of which are designed to

24-30 days. In a number of regions, such forms of work as “sanatorium at home” and “outpatient sanatorium” are carried out, which provide for the provision of medicinal treatment, necessary procedures, delivery of food to the elderly, veterans and disabled people at their place of residence, or the provision of these services in a clinic or in social service center.

Currently, the social protection system also has special homes for single elderly citizens, social canteens, social shops, social pharmacies and “Social Taxi” services.

Stationary social service institutions for the elderly and disabled. The network of inpatient social service institutions in Russia is represented by over 1,400 institutions, the vast majority of which (1,222) serve elderly citizens, including 685 boarding homes for the elderly and disabled (general), including 40 special institutions for the elderly and disabled who have returned from places of serving sentences; 442 psychoneurological boarding schools; 71 boarding houses of mercy for the elderly and disabled; 24 gerontological (gerontopsychiatric) centers.

Over ten years (since 2000), the number of inpatient social service institutions for the elderly and disabled has increased 1.3 times.

In general, among elderly people living in inpatient social service institutions there are more women (50.8%) than men. Noticeably more women live in gerontological centers (57.2%) and in charity homes (66.5%). In psychoneurological boarding schools, the proportion of women (40.7%) is significantly less. Apparently, women cope with social and everyday problems relatively easier against the backdrop of serious deterioration in health in old age and retain the ability to self-care longer.

A third of residents (33.9%) are on permanent bed rest in inpatient social service institutions. Since the life expectancy of older people in such institutions exceeds the average for this age category, many of them remain in a similar condition for several years, which worsens their quality of life and poses difficult challenges for the staff of boarding homes.

Currently, the law enshrines the right of every elderly person in need of constant care to receive inpatient social services. At the same time, there are no standards for the creation of boarding houses in certain areas. Institutions are located quite unevenly throughout the country and individual constituent entities of the Russian Federation.

The dynamics of development of both the network of stationary social service institutions and their main types did not allow us to fully satisfy the needs of older citizens for stationary social services, or to eliminate the waiting list for placement in boarding homes, which in general has almost doubled over 10 years.

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

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

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

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

A similar approach is practiced along with scientific, organizational and methodological activities and Novosibirsk Regional Gerontological Center.

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

Practice shows that gerontological centers to a greater extent perform tasks of care, provision of medical services and palliative care, more likely to be characteristic of compassionate homes. In the current situation, people on bed rest and in need of constant care make up almost half of all residents in gerontological centers, and over 30% in boarding homes specially designed to serve such a contingent.

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

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

Non-stationary and semi-stationary forms of social services for the elderly and disabled. The vast majority of older people and disabled people prefer and receive social services in the forms of non-stationary (home-based) and semi-stationary social services, as well as urgent social assistance. The number of elderly people served outside of inpatient institutions is over 13 million people (about 45% of the country’s total elderly population). The number of older citizens living at home and receiving various types of services from social-gerontological services exceeds the number of elderly residents of inpatient social service institutions by almost 90 times.

The main type of non-stationary social protection services in the municipal sector are social service centers, implementing non-stationary, semi-stationary forms of social services for elderly and disabled citizens and urgent social assistance.

From 1995 to the present, the number of social service centers has increased almost 20 times. In modern conditions, there is a relatively low growth rate of the network of social service centers (less than 5% per year). The main reason is that municipalities lack the necessary financial resources and material resources. To a certain extent, for the same reason, existing social service centers began to be transformed into comprehensive social service centers for the population, providing a range of social services to all categories of low-income and socially vulnerable citizens.

In itself, the quantitative reduction in the network of social service centers is not necessarily an alarming phenomenon. Perhaps the institutions were opened without proper justification, and the population of the respective regions does not need their services. Perhaps the absence of centers or a reduction in their number when there is a need for their services is due to subjective reasons (the use of a social service model that differs from the generally accepted one, or the lack of necessary financial resources).

There are no calculations of the population’s need for the services of social service centers, there are only guidelines: each municipality must have at least one social service center for elderly and disabled citizens (or a comprehensive social service center for the population).

Accelerating the development of centers is possible only with high interest from government agencies and appropriate financial support from municipalities, which today seems unrealistic. But it is possible to change the guidelines when determining the need for social service centers from the municipality to the number of elderly people and disabled people in need of social services.

Home-based form of social service. This form, preferred by older people, is most effective in terms of the “resources-results” ratio. Home-based social services for the elderly and disabled are implemented through social service departments at home And specialized departments of social and medical care at home, which are most often structural divisions of social service centers. Where there are no such centers, departments operate as part of the social protection authorities and, less often, within the structure of stationary social service institutions.

Specialized departments of social and medical care at home are developing quite quickly, providing differentiated medical and other services. The share of persons served by these departments in the total number of people served by all departments of home care for the elderly and disabled since the 90s. last century increased more than 4 times.

Despite the significant development of the network of the branches in question, the number of elderly people and disabled people who are registered and waiting their turn to receive home-based services is decreasing slowly.

A serious problem of social services at home remains the organization of the provision of social and socio-medical services to elderly people living in rural areas, especially in remote and sparsely populated villages. In the country as a whole, the share of clients of social service departments in rural areas is less than half, of clients of social and medical service departments - a little more than a third. These indicators correspond to the settlement structure (ratio of urban and rural population) of the Russian Federation; there is even some excess in services provided to the rural population. At the same time, services to the rural population are difficult to organize; they are the most labor-intensive. Social service institutions in rural areas have to provide heavy work - digging up gardens, delivering fuel.

Against the backdrop of the widespread closure of rural medical institutions, the most alarming situation seems to be the organization of home-based social and medical services for elderly villagers. A number of traditionally agricultural territories (Republic of Adygea, Udmurt Republic, Belgorod, Volgograd, Kaluga, Kostroma, Lipetsk regions), although there are departments of social and medical services, do not provide rural residents with this type of service.

Semi-stationary form of social service. This form is presented in social service centers by day care departments, temporary residence departments and social rehabilitation departments. At the same time, not all social service centers have these structural units.

In the mid-90s. last century, the network developed at a rapid pace temporary residence departments, since, given the large waiting list for state inpatient social service institutions, there was an urgent need to find an alternative option.

Over the past five years, the growth rate in the number day care departments decreased noticeably.

Against the backdrop of a decline in the development of day care departments and temporary residence departments, the activities of social rehabilitation departments. Although their growth rate is not very high, the number of clients they serve is growing quite significantly (doubling over the last ten years).

The average capacity of the units under consideration practically did not change and amounted to an average of 27 places for the year for day care departments, 21 places for temporary residence departments, and 17 places for social rehabilitation departments.

Urgent social assistance. The most massive form of social support for the population in modern conditions is urgent social services. The corresponding departments operate mainly in the structure of social service centers; there are such divisions (services) in the social protection authorities. It is difficult to obtain accurate information about the organizational basis on which this type of assistance is provided; separate statistical data does not exist.

According to operational data (there are no official statistics) obtained from a number of regions, up to 93% of recipients of urgent social assistance are elderly and disabled.

Social and health centers. Every year, social and health centers occupy an increasingly prominent place in the structure of gerontological services. The base for them most often becomes former sanatoriums, rest homes, boarding houses and pioneer camps, which for various reasons repurpose the direction of their activities.

There are 60 social and health centers operating in the country.

The undisputed leaders in the development of a network of social health centers are the Krasnodar Territory (9), the Moscow Region (7) and the Republic of Tatarstan (4). In many regions such centers have not yet been created. Basically, such institutions are concentrated in the Southern (19), Central and Volga (14 each) federal districts. There is not a single social and health center in the Far Eastern Federal District.

Social assistance for elderly people without a fixed place of residence. According to operational data from the regions, up to 30% of elderly people are registered among persons without a fixed place of residence and occupation. In this regard, social assistance institutions for this population group also deal with gerontological problems to some extent.

Currently, there are over 100 institutions for persons without a fixed place of residence and occupation in the country with more than 6 thousand beds. The number of persons served by institutions of these types increases quite noticeably from year to year.

Social services provided to older people and people with disabilities in such institutions are complex in nature - it is not enough to simply provide care, social services, treatment and social and medical services. Sometimes elderly people and disabled people with severe psychoneurological pathology do not remember their name or place of origin. It is necessary to restore the social and often legal status of clients, many of whom have lost their documents, do not have permanent housing and therefore have nowhere to send them. Persons of retirement age, as a rule, are registered for permanent residence in boarding homes or psychoneurological boarding schools. Some older citizens of this group are capable of social rehabilitation, restore their work skills or acquire new skills. Such people are provided with assistance in obtaining housing and work.

Special houses for lonely elderly people. Lonely elderly people can be helped through system of special houses, the organizational and legal status of which remains controversial. In state statistical reporting, special houses are taken into account together with non-stationary and semi-permanent structures. Moreover, they are more likely not institutions, but a type of housing in which only older people live under agreed conditions. Social services can be created at special houses and even branches (departments) of social service centers can be located.

The number of people living in special residential buildings, despite the unstable development of their network, is slowly but steadily growing.

Most special homes for single elderly citizens are low-capacity homes (less than 25 residents). Most of them are located in rural areas, only 193 special houses (26.8%) are located in urban areas.

Small special houses do not have social services, but their residents, like older citizens living in other types of houses, can receive services from social and socio-medical services at home.

Not all subjects of the Russian Federation have special houses yet. Their absence to some extent, although not in all regions, is compensated by the allocation social apartments, the number of which is over 4 thousand, more than 5 thousand people live in them. More than a third of people living in social apartments receive social and socio-medical services at home.

Other forms of social assistance for the elderly. The activities of the social service system for older citizens and disabled people, with certain reservations, include: providing elderly people with free food and essential goods at affordable prices.

Share social canteens in the total number of public catering establishments engaged in organizing free meals is 19.6%. They serve about half a million people.

In the social protection system, the network is successfully developing social stores and departments. Over 800 thousand people are attached to them, which is almost one third of the people served by all specialized stores and departments (sections).

Most social canteens and social shops are part of the structure of social service centers or comprehensive social service centers for the population. The rest are managed by social protection authorities or social support funds for the population.

Statistical indicators of the activities of these structures are characterized by significant scattering, and in some regions, the information provided is incorrect.

Despite the increase in the number of citizens living in inpatient institutions and receiving services at home, the need of older people for social services is increasing.

The development of the social service system for the population in all its diversity of organizational forms and types of services provided reflects the desire to meet the various needs of older citizens and disabled people in need of care. The full satisfaction of justified social needs is hampered, first of all, by the lack of resources in the constituent entities of the Russian Federation and municipalities. In addition, a number of subjective reasons should be indicated (methodological and organizational inadequacy of some types of social services, lack of a consistent ideology, a unified approach to the implementation of social services).

Tomilin M.A. The place and role of social services in modern conditions as one of the most important components of social protection of the population // Social services of the population. 2010. No. 12.S. 8-9.