Social services for the elderly. Technology of social services for the elderly and disabled in stationary institutions Social service institutions for the elderly and disabled
In recent years, the number of single and lonely citizens of this category has been rapidly increasing, and the possibility of meeting their needs in the above parameters on the basis of intra-family services are increasingly limited. This is due to the high employment of the able-bodied population, as well as the developing process of weakening family ties, separating the younger generation from the older one.
All this served as the basis for the search for new forms of organizing social services for disabled citizens, along with the existing system of placing them in boarding schools. Such forms of social services, including medical, domestic, leisure, psychological and other types of assistance, are provided by social service centers for the elderly and the disabled. The main goal of the activities of these institutions is to maintain a normal level of life of the wards, who do not yet need constant outside care, but who have the physical and mental capabilities to maintain, with periodic assistance from the center's employees, communication with the outside world, their health and optimal living conditions. .
In the Russian Federation, the activities of social service centers for the elderly and disabled are regulated by a number of legislative acts:
· The Constitution of the Russian Federation of 12.12.93;
· Federal Law “On social services for the elderly and the disabled” dated 02.08.95;
· Federal Law "On the basics of social services for the population in the Russian Federation" dated 11/15/95;
· Federal Law "On the social protection of disabled people in the Russian Federation" of December 24, 1995;
· Decree of the President of the Russian Federation of March 25, 1993 No. 394 “On measures for vocational rehabilitation and employment of disabled people”;
· Order of the Ministry of Social Protection of the Population of the Russian Federation No. 137 dated July 20, 1993 “On the Approximate Position of the Center for Social Services”;
· Decree of the Government of the Russian Federation “On the federal list of state-guaranteed social services provided to citizens of retirement age and the disabled by state and municipal social service institutions”.
The Federal Law "On Social Services for Citizens of Retirement Age and the Disabled" regulates relations in the field of social services for elderly citizens and the disabled, which is one of the areas of activity for the social protection of the population, establishes economic, social and legal guarantees for citizens of this category, based on the need for approval principles of philanthropy and mercy in society.
Social services for elderly and disabled citizens is an activity to meet the needs of these citizens in social services. It includes a set of social services (care, catering, assistance in obtaining medical, legal, socio-psychological assistance: in kind, in vocational training, employment, leisure, etc.), which are provided to the specified category of citizens on at home or in social service institutions, regardless of the form of ownership.
The purpose of the CSO is to provide social services to the elderly and the disabled. From this follows a number of tasks, the solution of which depends on the efficiency and quality of the achievement of the goal, namely:
Identification and accounting of citizens in need of various types of social services;
Provision of social, medical, psychological, advisory and other assistance to citizens;
Assistance in optimizing the ability of citizens served by the center to realize their needs;
Providing serviced citizens with their rights and benefits established by the current legislation;
Analysis of the level of social services for the population of the region, development of long-term plans for the development of this area of social support for the population, the introduction into practice of new types and forms of assistance, depending on the nature of the needs of citizens and local conditions;
Involvement of various state and non-state structures in solving the issues of providing social and household assistance to needy segments of the population and coordinating their activities in this direction.
These tasks determine the structural organization of the center, which, in addition to the apparatus, includes the following units: the department of social services at home, the department of day care, the department of emergency social services (Fig.
2.4).
CSO is created for temporary (up to 6 months) or permanent assistance to citizens who have partially lost the ability to self-service and need outside support, social and household assistance in home conditions. The activities of the CSO are aimed at the maximum possible extension of the stay of citizens in their usual habitat and maintaining their social, psychological and physical status.
Servicing citizens at home is carried out by providing them, depending on the degree and nature of their need, with social, advisory and other services included in the list guaranteed by the state, as well as providing additional services at their request that are not included in the list of guaranteed.
The CSO is created to serve 60 citizens living in rural areas and 120 living in houses with all amenities. Servicing of citizens is carried out by social workers, nurses, who are in the headquarters of the center. The position of a social worker is introduced at the rate of serving 4 citizens of rural areas and 8 in a well-maintained urban sector.
The EDP is a semi-stationary structural subdivision of the center and is intended for social, cultural, medical care for citizens who have retained the ability to self-service and active movement, organizing their meals, communication and recreation, engaging them in feasible work activities, maintaining an active lifestyle.
The positions of a cultural organizer, a nurse, a labor instructor, a manager, as well as junior service personnel are being introduced into the staff of the CPD. EDP is created to serve from 25 to 35 citizens. The duration of service in the department is set based on the order of citizens for service, but not less than 2 weeks. Pre-hospital care rooms, club work, libraries, medical and labor workshops, etc. are allotted in the ODP.
Served citizens can, with their voluntary consent and in accordance with medical recommendations, participate in feasible labor activities in specially equipped medical labor workshops or subsidiary farms. Occupational therapy is carried out under the guidance of an occupational instructor and under the supervision of a medical worker.
OSSO is intended to provide elderly citizens and disabled people who are in dire need of social support, one-time or short-term assistance aimed at maintaining their livelihoods.
The positions of a social work specialist, a manager, a medical worker, as well as a psychologist and a lawyer are being introduced to the staff of the OSSO. OSSO employees identify and record citizens who are in dire need of in-kind and other types of assistance, with a view to its subsequent provision. OSSO should have a minimum set of medicines and dressings for the provision of urgent first aid. OSSO activity is based on cooperation with various state institutions, public, charitable, religious organizations and associations, foundations, as well as individual citizens.
The list of services offered by the center includes:
services for catering, everyday life, leisure;
social and medical services;
legal services.
From this article you will learn:
What are the principles of social service for the elderly
What are the conditions for social services for the elderly
What forms of social services are provided for the elderly
What are the institutions of social service for the elderly
Social services for the elderly is a whole group of services designed for the elderly on the basis of specialized institutions or at home. The list includes rehabilitation in society, assistance in economic affairs and in the psychological sphere.
Principles of social service for the elderly
The activities of social service institutions are based on such important provisions as:
the need for strict observance of the freedoms and rights of the wards;
continuity between social organizations involved in the provision of special services to the elderly;
obligatory consideration of the needs and wishes of each, without exception, an elderly person;
strict observance of the guarantees provided by the state;
equalization of opportunities for all applicants for social services;
paying special attention to the adaptation of the elderly contingent 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 or other characteristics.
What are the conditions for social services for the elderly
Social services are considered necessary for persons in whose life there are circumstances that sharply worsen its quality:
the inability to carry out the simplest actions around the house, serve oneself, independently change the position of the body and move around due to serious illness 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 difficulty adapting to society;
the impossibility of daily supervision and care and the lack of care for the disabled and children;
conflict within the family due to violence or with people who suffer from severe mental illness, have alcohol or drug addiction;
the absence of a permanent place of residence for a person, including for 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 of work and financial resources for existence.
But the presence in the life of one or more of the above circumstances only confirms the difficult situation in the life of this person, but does not guarantee the receipt of gratuitous 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 is the organization of social services for the elderly
Citizens of the elderly age group require care and concern from strangers constantly or for some period of time due to the inability to independently change the position of the body, move around 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. The implementation of this activity takes place in accordance with the decision of the social security authorities in subordinate organizations or in accordance with the concluded agreement between these bodies and non-departmental institutions.
People who, for various reasons and circumstances, require social services, have rights to:
Polite and delicate attitude of social workers to the wards.
Independent choice of an institution and type of service in a certain order. It is established by social security authorities at the federal and local levels.
Familiarization with the information material about your rights, as well as the conditions for obtaining service.
Refusal to provide these services.
Maintaining the confidentiality of personal information that the social worker may learn in the course of his work.
Protection of rights, if necessary, it can be carried out in the course of a trial.
Access to information material about the existing types and types of social services, the reasons for which it is provided, and the conditions for making payment for it.
Social services for the elderly and the disabled are based on the wishes of the person and are either permanent or short-term.
At the legislative level, five types of services for the elderly and citizens with disabilities:
Semi-stationary, with accommodation of people on the basis of day or night branches of specialized organizations.
Stationary character 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 the maximum possible time for people to stay in a familiar and comfortable environment for them, 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 the cleanliness of housing, in accordance with sanitary standards;
delivery of necessary medicines and household goods;
accompaniment of wards to medical 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 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 can be provided, but for an appropriate fee.
Social services for the elderly at home can be provided to those who suffer from severe diseases in the terminal stages, mental illness (without exacerbation), inactive tuberculosis. Social assistance is not provided to patients with chronic alcoholism and infectious diseases. This type of service is implemented on certain conditions and in accordance with the procedure established by the regional executive power.
The semi-stationary type of service for the elderly is provided to those who are able to independently change the position of the body, move and perform the simplest actions aimed at meeting the needs of life. This includes medical, social, domestic and cultural services, the purpose of which is to organize ready-made meals for people, varied recreation and leisure, and ensure the participation of a person in feasible work.
Older 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 health. The procedure and conditions for the provision of services are established by the local executive authority.
The stationary type is focused on providing multidirectional assistance to the elderly who have lost the opportunity to serve themselves independently, as well as those who, for health reasons, require daily monitoring and care.
This includes measures to ensure the creation of the most suitable living conditions 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 the elderly is implemented on the basis of stationary departments of specialized organizations.
The people who live in these institutions are entitled to:
Passage of rehabilitation and adaptation in society.
Participation on a voluntary basis in feasible work, taking into account their interests and wishes.
Getting daily care and attention, timely and qualified medical assistance.
Conducting a medical examination, which is necessary to change or confirm the disability group.
Free meetings with relatives and friends.
Organization of visits, if necessary, by lawyers, notaries, priests, etc.
Obtaining free premises with suitable conditions for religious ceremonies. It is important that the created conditions do not contradict the routine within the organization.
Preservation of housing that was rented before entering a social institution for six months if they lived there alone. If relatives of an elderly person also live in this place, then housing is maintained throughout the entire period of the pensioner's stay in the hospital.
Obtaining new housing out of turn in the case when an elderly person has written a refusal of special social services after 6 months of being in the corresponding institution and has already lost his previous housing.
Participation in public commissions, the main purpose of which is to protect the rights of people of the elderly age group.
Social services for the elderly in Russia, provided on an urgent basis, is a one-time emergency and urgent care.
This includes a number of services:
delivery of food and supply of wards with sets of products;
supply of necessary wardrobe items and household goods;
search for a place for temporary residence;
one-time cash payment;
organization of legal assistance, the main purpose of which is to protect the interests and rights of wards;
high-quality assistance of doctors and psychologists in urgent circumstances.
In order to adapt to the society of the elderly contingent, reduce social tension and improve relationships between family members, such a form of assistance as consultations is provided.
Social service institutions for the elderly
Now, social service centers for the elderly are occupying fairly high positions in the structure of the gerontological service. They are based in institutions that have changed, for various reasons, the focus of their work. Former boarding houses, sanatoriums, camps and other similar institutions usually act as such organizations.
In addition to all of the above, the list of social services for the elderly is allowed to include both the organization of ready meals and the supply of necessary goods at the lowest possible cost.
Individuals living alone are assisted through a system of specialized houses, which have a controversial organizational and legal status. These institutions in the state statistical report are taken into account together with non-stationary and semi-stationary organizations. At the same time, such houses should not even be called specialized institutions, but rather a type of housing in which the elderly are located under certain conditions. At homes, a service for social purposes is often created, and branches of social centers are also opened.
There are many pensioners in the country who are not only lonely, but also have certain health problems. Specialized boarding houses can be a good way out for them. The 1990s badly spoiled the reputation of such establishments. But now everything has changed for the better - and first of all, the quality of service. 
The elderly are offered several options for services:
staying in a boarding house for some time, while family members are on vacation or business trip;
stay during the rehabilitation period;
permanent residence.
Branches of our network of private boarding houses "Autumn of Life" 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 time - from 9.00 to 21.00 daily. The map can be found in the section on the official website.
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MINISTRY OF EDUCATION OF THE REPUBLIC OF BASHKORTOSTAN
STATE AUTONOMOUS EDUCATIONAL
INSTITUTION
SECONDARY VOCATIONAL EDUCATION
TUIMAZINSKY STATE LEGAL COLLEGE
DEPARTMENT OF LEGAL DISCIPLINES
Stationary social service
the elderly and the disabled
COURSE WORK
SHAPILOVA NATALIA ALEKSANDROVNA
040401.52 SOCIAL WORK
SCIENTIFIC DIRECTOR:
Minikhanova N.I.
TEACHER
SOCIAL WORK WITH THE ELDERLY AND THE DISABLED
TUIMAZY 2012
Introduction
The system of stationary social services for the elderly and disabled
Institutions of inpatient social services for the elderly and disabled
Stationary social services
Conclusion
List of sources and literature
Introduction
In modern socio-economic conditions, one of the most important tasks of social policy is to support and social protection of the disabled, veterans, elderly citizens, as well as interrelated organizational, legal, socio-economic conditions for the implementation of measures to improve their situation and strengthen social security, taking into account current demographic and socio-economic situation
Stationary social services include measures to create for the elderly and disabled citizens the most appropriate living conditions for their age and health status, rehabilitation measures of a medical, social and medical-labor nature, provision of care and medical assistance, organization of their recreation and leisure.
The problems of stationary social services for the elderly and disabled are very relevant in our time, because stationary institutions for the elderly and disabled are poorly responsive to numerous reforms. Nursing homes perform their functions, focusing more on their own interests than on the interests of the people using their services. Funds from the federal and local budgets are chronically lacking, the number of those who need to be placed in such institutions seriously exceeds the number of places that can accept those who wish. Thus, the situation of boarding schools for the elderly and disabled remains very serious.
The degree of development and theoretical and methodological basis of the study. 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, and others.
The work of stationary social institutions is one of the priority areas that determine the modern policy of the state. This is evidenced by regulatory legal acts that reflect the issues of professional activity of social work in working with the elderly and the disabled:
Decree of the Ministry of Labor and Social. protection of the population of the Russian Federation dated 08.08.2002 No. 54;
"Federal List of State-Guaranteed Social Services Provided to Elderly and Disabled Citizens by State and Municipal Social Service Institutions".
The results of our analysis of the scientific literature and legal 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 study: "Social inpatient care for the elderly and disabled."
The object of research is the process of stationary social service for the elderly and disabled.
The subject of the research is stationary 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:
to study the system and principles of stationary social services for the elderly and disabled;
to characterize the institutions of stationary social services;
consider stationary social services;
Research methods. To solve the tasks and verify the initial provisions, a set of complementary research methods was used: analysis, special, pedagogical, psychological, legal literature, legal documents; praximetric (study and generalization of the experience of professional activity of social work).
Theoretical significance of the study. The results of the study expand the scientific understanding of the basic principles of the activities of a social worker. The essential characteristics of the individual concepts of the study will form the basis for the subsequent theoretical understanding of the problem under study. The results of the theoretical study will expand the 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, the main part, which includes three independent paragraphs, a conclusion, and a list of references.
Stationary social service system
Stationary social services are aimed at providing comprehensive social and household assistance to elderly citizens and the disabled, who have partially or completely lost the ability to self-service and who, for health reasons, need constant care and supervision.
Stationary social services for elderly citizens and the disabled are carried out in stationary institutions (departments) of social services, profiled in accordance with their age, health and social status.
Elderly citizens and persons with disabilities who have partially or completely lost the ability to self-service and need constant outside care, from among the especially dangerous recidivists released from places of deprivation of liberty and other persons who are subject to administrative supervision in accordance with the current legislation, as well as elderly citizens and disabled people who have previously been convicted or repeatedly brought to administrative responsibility for disturbing public order, engaged in vagrancy and begging, who are sent from the institutions of the internal affairs bodies, in the absence of medical contraindications and, at their personal request, are accepted for social services in special stationary social service institutions in the order 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 Regulation on a social service institution may, at their request or by a court decision made on the basis of a recommendation from the administration of these institutions, be transferred to special stationary social service institutions. service .
The entire range of social services is received by citizens living in stationary institutions, from medical care to social and labor rehabilitation. Taking into account age, health status and some other factors, various types of institutions are being created: boarding schools for the elderly and disabled, boarding houses for labor veterans, neuropsychiatric boarding schools, orphanages and shelters, etc.
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 legally required to support them, are admitted to stationary institutions for the elderly and disabled. As a matter of priority, invalids and participants in the Great Patriotic War, family members of fallen servicemen, as well as deceased invalids and participants in the war are admitted to boarding schools. If there are vacant places, temporary residence of these persons is allowed for a period of 2 to 6 months.
One of the indispensable conditions for admission is voluntariness, therefore, the execution of documents is carried out only if there is a written application from a citizen, and persons under 14 years of age and persons recognized as incapacitated in the manner prescribed by law - a written application from their legal representatives. At any time, a citizen can refuse stationary services and leave it.
Bacterio - or virus carriers, chronic alcoholics, patients with active forms of tuberculosis, severe mental disorders, venereal and other infectious diseases among the elderly and disabled may be denied social services at home on the basis of a joint conclusion of the social protection authority (administration of the municipal center of social services ) and the medical advisory commission of a healthcare institution.
Persons living in stationary institutions have the right to: living conditions in accordance with sanitary and hygienic requirements; care, 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, a lawyer, relatives and other persons; preservation of the residential premises occupied under a contract of employment or lease in the houses of the state, municipal and public housing stock for 6 months from the date of admission to the hospital, etc.
The hospital administration is obliged to: observe human and civil rights; ensure the inviolability of the person and the safety of citizens; provide spouses with an isolated living space for joint residence; 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 decree “On the procedure for the participation of elderly citizens and disabled people living in stationary 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 the medical and labor activities of elderly citizens and disabled people living in stationary social service institutions (hereinafter referred to as citizens, stationary institutions, respectively) are occupational therapy and improving 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 of a stationary institution (for the disabled - in accordance with the recommendations of the medical labor expert commission).
3. In stationary institutions, various types of medical and labor activities are organized, differing in their nature and complexity and corresponding to the capabilities of citizens with different levels of intelligence, physical defects, and residual working capacity. Therapeutic labor activity can also be organized in the form of work in subsidiary farms of stationary institutions.
4. Medical and labor activity of citizens in stationary institutions is carried out by labor instructors and instructors for training workers in accordance with schedules and individual rehabilitation programs.
Specialists and workers may be involved to perform the work necessary for the organization of medical and labor 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 activities, a doctor of a stationary institution maintains an individual card of medical and labor activities.
7. The determination of the type and duration of medical and labor activity is carried out by a doctor of a stationary institution specifically for each citizen, taking into account his desire, about which an appropriate entry is made in the medical history and an individual card of medical and labor activity.
Financing of stationary institutions of social service, which are in federal or municipal ownership, is carried out at the expense of budgets of various levels.
The following categories of minors have the right to be admitted to the institution: those left without parental care; those in need of social rehabilitation and emergency medical and social assistance; experiencing difficulties in communicating with parents, peers, teachers and others; living in dysfunctional families; subjected to physical or psychological violence; refused to live in a family or institutions for orphans and children left without parental care.
It is not allowed to place in an institution children with diseases requiring active medical intervention, as well as those who are in a state of alcoholic or drug intoxication, mentally ill who have committed a crime.
The source of funding is the budgets of the constituent entities of the Russian Federation.
Crisis centers for helping women are a new social service institution. Stationary departments of the center are created for women to stay in it for a period of not more than 2 months. Women who are in a state of crisis and dangerous to 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 on budget financing. Certain types of assistance may be provided for a fee.
Elderly citizens and disabled people living in stationary social service institutions have the right to:
providing them with living conditions that meet sanitary and hygienic requirements;
care, primary health care and dental care provided in an inpatient social service institution;
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 a 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 of a lawyer in the manner prescribed by applicable law;
providing them with premises for the performance of religious rites, creating appropriate conditions for this, not contradicting the rules of internal order, taking into account the interests of believers of various faiths;
preservation of residential premises occupied by them under a lease or lease agreement in the 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 remain living in residential premises - for the entire time spent in this facility.
In case of refusal of the services of a stationary social service institution after the expiration of the specified period, elderly citizens and people with disabilities who have vacated residential premises in connection with their placement in these institutions have the right to extraordinary provision of residential premises if they cannot be returned to the residential premises they previously occupied .
participation in public commissions for the protection of the rights of elderly citizens and the disabled, 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 the age of 18, are subject to provision of residential premises out of turn by local governments at the location of these institutions or at the place of their former residence of their choice, if an individual rehabilitation program provides for the possibility of self-service;
Disabled children living in stationary social service institutions have the right to receive education and vocational training in accordance with their physical 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 healthcare institutions. Payment for the treatment of elderly and disabled citizens in these healthcare institutions is carried out in accordance with the established procedure at the expense of the relevant budget allocations and medical insurance funds.
Elderly citizens and disabled persons living in stationary social service institutions have the right to be free from punishment. For the purpose of punishing elderly and disabled citizens or creating amenities for the personnel of these institutions, the use of medicines, means of physical restraint, as well as the isolation of elderly citizens and disabled people, is not allowed. Persons guilty of violating this norm shall 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, in addition to cash payments, types of social security, including: the protection of childhood, motherhood, the disabled, medicine, education, etc.
Institutions of stationary social service
Institutions of stationary social services include: psycho-neurological boarding schools; boarding houses; nursing homes (gerontological centers); orphanages for the disabled.
Let's consider some of them:
Psychoneurological boarding school (abbreviated as PNI) - a stationary institution for social services persons suffering from mental disorders who have lost partially or completely the ability to self-service and who, due to mental and often physical health, need constant care and supervision. Psychoneurological boarding schools are part of the general system psychiatric care in Russian Federation and at the same time are institutions social protection population.
The main function currently performed by psycho-neurological boarding schools is to ensure the possibility of living for patients, their social and domestic arrangements. Usually a person has been in PNI for 15-20 years or more, the concept of discharge is practically absent. This leads to a special organization of the life of patients, combining elements of a hospital institution and hostels, as well as involving the patient in labor activity.
Labor activity. For organization occupational therapy PNI traditionally has a material and technical base, represented by medical and labor workshops (LTM), auxiliary agriculture and special workshops. The most common types of work in LTM are sewing, carpentry and cardboard; there are also assembly, shoemaking, basket weaving, etc. After 1992 the change in the socio-economic situation in the country led to the fact that LTM stopped receiving orders and raw materials from the local industry, resulting in a violation of the right to work of many residents.
In addition, the labor activity of PNI patients is often carried out in the following forms:
household activities for servicing the institution (maintaining cleanliness and order in the premises, caring for the seriously ill, unloading products, etc. - this work is not paid and often turns out to be forced, in violation of the rights of workers);
activities as part of mobile teams for field work and construction sites;
activities in full-time positions in the boarding school and beyond;
Educational activities in PNI should be carried out according to specially designed training programs for socially significant professions, taking into account the degree of intellectual defect. Most often, there is a need to train young patients with PNI 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 repair buildings, furniture, kitchen utensils, linen, shoes.
The living conditions in PNI are usually characterized by the monotony of the situation, the monotony of life, the lack of interesting employment, the lack of communication with a healthy environment, dependence on personnel. In many boarding schools, patients live in eight to ten people in a room; the sanitary area for each patient is often 4--5 m², contrary to the standards (7 m²).
Persons living in neuropsychiatric 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, their conditions of detention should be as unrestrictive as possible, etc. Norms on consent to treatment, the right to refuse from treatment, the right to privacy of medical information and other so-called medical rights provided for in Law on Psychiatric Care .
contact the administration of the PNI on issues of treatment, examination, discharge, compliance with the rights provided for by the legislation on psychiatric care;
submit uncensored complaints and statements to the authorities representative and executive authorities, prosecutor's office, court and lawyer;
meet with a lawyer and a clergyman in private;
perform religious rites, observe religious canons, including fast, in agreement with the administration to have religious paraphernalia and literature;
subscribe to newspapers and magazines;
get an education program secondary school or special school for children with intellectual disabilities, if the person is under 18 years of age;
receive, on an equal footing with other citizens, remuneration for labor 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 neuropsychiatric boarding schools. State control over the observance of their rights is often insufficient, and public control is almost completely absent. 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 psycho-neurological institution, but is denied discharge. The most common reason for refusal is the lack of housing and the inability to solve the housing problem; other common reasons are the inconsistency of the existing legal norms regarding incapacitated persons, the difficulty of obtaining a decision from the medical commission on the possibility of independent living. Cases of discharge from psycho-neurological institutions are rare; Once in a psycho-neurological boarding school, patients usually live there all their lives.
According to human rights activists, in relation to PNI patients on the part of employees, illegal seizure of real estate, misappropriation of pensions by illegal means often take place.
The Gerontological Center is designed to provide social services to citizens of older age groups, the purpose of which is to prolong active longevity and maintain a satisfactory life potential for this category of citizens.
The main tasks of the Gerontological Center are:
provision of social services to citizens of older age groups (care, catering, assistance in obtaining medical, legal, socio-psychological and natural types of assistance, assistance in vocational training, employment, leisure activities, funeral services, and others.
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 make 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 in the practice of the Gerontological Center;
interaction with bodies and organizations, including research organizations, institutions of social services for the population, on the organization of social services for citizens of older age groups, including the practical application of social gerontology and geriatrics in social services for citizens of older age groups.
The following structural subdivisions can be created in the Gerontological Center:
for the provision of social services in stationary, semi-residential and home-based conditions (department of mercy, department for the provision of social services to socially and physically active citizens of older age groups, department for day (night) stay, specialized department for home assistance, department for urgent social assistance, and others);
organizational and methodological department;
social rehabilitation department;
gerontopsychiatric department;
socio-psychological department;
socio-medical department;
other divisions and services corresponding to the goals and objectives of the activities 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, ratio of numbers, life expectancy, mortality, fertility), health status, trends and causes of aging (general health, level of medical care provided and decreased physical activity) and other criteria;
drawing up technologies for social services for citizens of older age groups, taking into account the scientific developments of social gerontology and geriatrics, and organizing work to implement them into the practice of the Gerontological Center;
tracking and analysis of scientific developments in social gerontology and geriatrics;
development of directions (forecasts, programs, concepts, strategies, technologies) of the activities of the Gerontological Center for the use 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;
assessment of the effectiveness and quality of social services provided by the Gerontological Center to citizens of older age groups;
interaction with bodies and organizations on issues of social services, as well as social gerontology and geriatrics.
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 prolonging the active longevity of citizens of older age groups;
4) development and implementation of measures aimed at preserving the life of citizens of older age groups at the place of residence and developing their abilities for domestic self-service and organizing feasible labor activities;
development of recommendations and assistance to citizens of older age groups in the formation of behavioral forms, including labor rehabilitation and expansion of individual abilities and opportunities: physical activity, acquisition, restoration and maintenance of work skills, reducing the level of dependence on outside help, and more.
Gerontopsychiatric department is created for:
provision of social services to citizens of older age groups suffering from mental disorders in combination with multiple somatic pathologies;
conducting medical and social rehabilitation in order to prolong active life and maintain a 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 service 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 maintaining a satisfactory life potential of citizens of older age groups;
identifying the needs of citizens of older age groups served in the Gerontology Center in socio-psychological assistance and developing recommendations for the formation of a microclimate in a team of citizens of older age groups, placing them taking into account psychological compatibility;
organization of the service "hotline of the elderly";
carrying out activities for the development of social tourism and recreation for citizens of older age groups;
The socio-medical department is intended for:
interaction with medical and preventive, sanitary-epidemiological and other healthcare 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 medicines to citizens of older age groups who are provided with social services;
development of a list and procedure for providing citizens of older age groups with additional social and medical services.
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 vital needs due to limited ability to self-service and (or) movement and who do not have medical contraindications to service in social service institutions.
Active forms of tuberculosis, chronic alcoholism, quarantine infectious diseases, severe mental disorders, venereal and other diseases that require treatment in specialized healthcare facilities in accordance with the legislation of the Russian Federation may be contraindications for accepting citizens of older age groups for service at the Gerontological Center.
Social services can be provided to citizens of older age groups at the Gerontological Center on the basis of:
a personal written application, and for persons recognized in the established manner as incapacitated - a written application of their legal representatives submitted to the social protection authority 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 the elderly and disabled are provided by 5 nursing homes for the elderly and disabled, 15 psycho-neurological boarding schools and 44 temporary departments within the structure of complex social service centers for the population of districts and cities. More than 7,000 elderly and disabled people (7,100 beds) permanently reside in these social service institutions.
The nursing home for the elderly and disabled is intended for the residence of relevant persons over the age of 45, regardless of the ability to serve themselves or the need for constant outside care; boarding house for the disabled - only for disabled people aged 18 to 45, regardless of the ability to serve themselves; psycho-neurological boarding school (separate for men and women) - for disabled people suffering from mental illness; orphanage - for children with physical disabilities, blind, deaf-mute, deaf-blind, patients with some persistent mental illness, severely mentally retarded children capable of learning according to special programs and methods, as well as for severely mentally retarded children who require only constant care and supervision.
The official website of the Ministry of Labor and Social Protection of the Population provides information on the consumers of the services of boarding schools:
Consumers of the state service for social services for the elderly and disabled in stationary conditions are:
elderly and disabled citizens who have partially or completely lost the ability to self-service and who, for health reasons, need constant outside care and supervision;
elderly citizens and disabled people suffering from chronic mental illness, who have partially or completely lost the ability to self-service and who, for health reasons, need constant care and supervision;
disabled children with mental anomalies, who have partially or completely lost the ability to self-service and who, for health reasons, need care, household and medical care, as well as social and labor adaptation;
disabled children with physical disabilities, who have partially or completely lost the ability to self-service and who, for health reasons, need care, household and medical care, as well as social and labor adaptation [ 8 ].
Boarding houses (D.-i.) are maintained at the expense of the state, enterprises, collective farms or public organizations. Coordinate their activities, regardless of departmental subordination, social security bodies. D.'s main purpose - and. - to 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 the pension.
Boarding houses have subsidiary farms, through which they can be provided with fresh vegetables, fruits, berries, dairy products, honey, etc. Medical care, including regular preventive examinations, in D.-and. organized taking into account its profile and the contingent of residents. Control over 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 people with disabilities - general and vocational training; various cultural events are held. social service elderly gerontological
Admission to a boarding school, a change in habitual life is a critical moment in the life of an elderly person. Unforeseen situations, new people, unusual surroundings, ambiguity of 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. Older people are faced with the question of assessing themselves, their capabilities in a changed situation.
According to the Decree of the Ministry of Labor and Social Protection of the Population of the Russian Federation of 08.08.2002 No. 54 "On approval of guidelines for organizing the activities of the state (municipal) institution "boarding school for mentally retarded children":
The activities of the Institution are aimed at social services for children with disabilities, in connection with which the Institution carries out:
provision of social services to children with disabilities in order to create favorable living conditions for them;
implementation of individual programs for the rehabilitation of disabled people, developed by institutions of the state service of medical and social expertise;
measures for the 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, their integration into society;
organization of care for children with disabilities, leisure activities, health-improving and preventive measures;
organization of physical education of disabled children, taking into account the age and state of health, allowing them to develop their abilities to the maximum extent possible;
social, psychological or other assistance to parents (legal representatives) of children with disabilities to eliminate a difficult life situation;
protection of the rights and legitimate interests of children with disabilities in the manner prescribed by the legislation of the Russian Federation;
organizing the education of disabled children, taking into account their physical abilities and mental abilities in accordance with the legislation of the Russian Federation.
In social services for children with disabilities, it is recommended to use small-scale mechanization and self-service facilities that will allow:
improve the quality of service, maintenance and care for children with disabilities;
use progressive forms and methods of work on social services for children with disabilities;
facilitate the work of service personnel in caring for seriously ill children and instill in children with disabilities self-care skills;
use new rehabilitation technologies that increase the effectiveness of the rehabilitation process of disabled children.
The following structural units can be created in the Establishment: a reception department, a medical and social rehabilitation department, a psychological and pedagogical assistance department, a social and labor rehabilitation department, a social and advisory assistance department, a charity department, a day care group and other departments that meet the goals and objectives of the Institution .
The reception department of the Institution is intended for:
implementation of primary and, if necessary, subsequent admission of disabled children to the Institution, identification of their needs for social services, referral to the relevant functional units of the Institution;
creating a data bank on disabled children who applied to the Institution for help, exchanging the necessary information with interested state and public organizations and institutions;
analysis and forecasting of social processes in the territory served by the Institution.
The Department of Medical and Social Rehabilitation of the Institution is intended for:
development and use of traditional and new effective methods and technologies in carrying out rehabilitation activities;
sending children with disabilities, if necessary and in agreement with the 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 activities 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 medical and physical culture and recreational 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 holding activities to organize the leisure of disabled children together with their parents (legal representatives), conducting medical and social patronage of families with disabled children;
teaching disabled children self-service skills, behavior in everyday life and public places, self-control, as well as communication skills and other methods of household adaptation;
organization of play therapy for children with disabilities;
conducting a detailed diagnosis of the mental development of disabled children in order to determine the forms and methods of psycho-correctional work.
The Department of Social and Labor Rehabilitation of the Institution is intended for:
carrying out activities to provide psychological and vocational guidance services to children with disabilities;
carrying out activities that contribute to the development and mastering of professional skills and abilities by children with disabilities;
organization of occupational therapy and pre-professional 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 department of social advisory assistance of the Institution is intended for:
counseling parents (legal representatives) on psychological and pedagogical issues of family education and personality development of disabled children with developmental disabilities;
providing social and advisory assistance to families raising children with disabilities on issues of social and legal protection and ensuring their livelihoods.
The department of mercy of the Institution is intended for:
organization of rehabilitation groups that unite children with disabilities, taking into account their age and severity of the disease;
implementation of activities of rehabilitation groups on the basis of individual rehabilitation programs for disabled children.
The day stay group of the Institution is intended for:
implementation of individual programs of medical and social, psychological and social, social and pedagogical rehabilitation of disabled children;
ensuring the regime of temporary detention of children with disabilities, taking into account family circumstances and the interests of children with disabilities.
The institution accepts disabled children from 4 to 18 years old with mental disabilities who, for health reasons, need outside care, household services, medical care, social and labor rehabilitation, education and upbringing, and who are in a different difficult life situation.
Disabled children who, according to the conclusion of medical institutions, suffer from mental, oncological, dermatovenerological 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 days 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 authority of the population of a constituent entity of the Russian Federation or by a local government. A voucher for the placement of a disabled child may be issued on the basis of an application from his parents (legal representatives).
For each resident of the Institution, a personal file is opened, in which are stored: a voucher; medical history to which the medical card is attached; a certificate from an institution of the state service of medical and social expertise; 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 the institutions of stationary social services, we can conclude that the institutions of stationary social services are psycho-neurological boarding schools, gerontological centers, boarding houses, orphanages for children with disabilities.
Services of stationary social institutions
According to the “Federal List of State-Guaranteed Social Services Provided to Elderly and Disabled Citizens by State and Municipal Social Service Institutions”
Services provided to elderly citizens and disabled people living in stationary social service institutions:
1. Material and household services:
provision of living space, premises for the organization of rehabilitation measures, medical and labor activities, cultural and community 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;
reimbursement of travel expenses for education, treatment, consultations.
2. Catering, household and leisure services:
preparing and serving meals, including dietary meals;
provision of soft equipment (clothes, shoes, underwear and bedding) in accordance with approved standards;
assistance in writing letters;
providing, upon discharge from the institution, clothes, shoes and cash benefits according to approved standards;
ensuring the safety of personal belongings and valuables;
creation of conditions for the performance of religious rites.
(as amended by Decree of the Government of the Russian Federation of April 17, 2002 N 244)
3. Socio-medical and sanitary-hygienic services:
free provision of medical care in the scope of the basic program of compulsory medical insurance for citizens of the Russian Federation, targeted programs and territorial programs of compulsory medical insurance in state and municipal medical and preventive institutions;
providing health-based care;
assistance in conducting medical and social expertise; carrying out rehabilitation measures (medical, social), including for the disabled on the basis of individual rehabilitation programs;
provision of primary health care and dental care;
organizing medical examinations;
hospitalization of those in need in medical and preventive institutions, assistance in referral, upon the conclusion of doctors, to sanatorium-and-spa treatment (including on preferential terms);
providing psychological support, conducting psycho-correctional 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:
creation of conditions for pre-school education of children and education under special programs; creation of conditions for receiving school education according to special programs.
5. Services related to social and labor rehabilitation:
creation of 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 in matters of pension provision and provision of other social benefits;
assistance in obtaining benefits and benefits established by the current legislation;
assistance in obtaining advisory assistance;
ensuring representation in court in order to protect rights and interests;
assistance in obtaining free assistance from a lawyer in the manner prescribed by applicable law;
assistance in maintaining previously occupied residential premises under a lease or lease agreement in the houses of state, municipal and public housing funds within six months from the date of admission to a stationary social service institution, as well as in extraordinary provision of residential premises in case of refusal of the services of a stationary social service institution after the expiration of the specified period, if the previously occupied premises cannot be returned.
7. Assistance in the organization of ritual services.
Having considered the services of social stationary institutions, we came to the conclusion that these are material and household services for the organization of food, life, leisure; socio-medical and sanitary-hygienic services; organizing education for disabled people, taking into account their physical capabilities and mental abilities; legal services; assistance in organizing funeral services provided by institutions of stationary social services.
Conclusion
Having considered the first section of the study "The system of stationary social services for the elderly and disabled", we can draw the following conclusions:
Stationary social services are the provision of social services: assistance in housekeeping, temporary placement in a social security institution, etc. In a broad sense, social services include other types of social security, in addition to cash payments, including: protection of childhood, motherhood, the disabled, medicine, education, etc.
Elderly and disabled people living in stationary institutions have their own rights, for example: living conditions in accordance with sanitary and hygienic requirements; care, 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, a lawyer, relatives and other persons; preservation of the residential premises occupied under a contract of employment or lease in the houses of the state, municipal and public housing stock for 6 months from the date of admission to the hospital, etc.
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1 Federal State Autonomous Educational Institution of Higher Education “Belgorod State National Research University” (N and U. BelSU) Socio-theological faculty of the Department of Social Work The Organization of Social Services of Elderly and Persons with Disabilities in the Constant Center for Social Service of the Population: Problems and Prospects of the diploma work of a part-time student of the direction 39.03.02. Social work of the 5th year of the group 87001152 Kosenko Svetlana Alexandrovna Scientific adviser Ph.D. Sci., Associate Professor of the Department of Social Work Kulabukhov D.A. Reviewer Director of MBSUSOSSZN "Integrated Center for Social Services for the Population of the Volokonovsky District" L.T. Gamayunova BELGOROD 2016
2 TABLE OF CONTENTS INTRODUCTION 3 1. THEORETICAL FOUNDATIONS OF STUDYING SOCIAL SERVICE FOR THE ELDERLY AND DISABLED CITIZENS IN THE CONDITIONS OF THE INTEGRATED CENTER FOR SOCIAL SERVICE FOR THE POPULATION 10 1.1. Social services for the elderly and disabled: essence and specifics 10 1.2. Forms of social services for elderly and disabled citizens in the conditions of a comprehensive center for social services for the population 28 2. ORGANIZATION OF SOCIAL SERVICES FOR THE ELDERLY AND DISABLED CITIZENS IN THE CONDITIONS OF MBSUSOSSZN "COMPLEX CENTER FOR SOCIAL SERVICES FOR THE POPULATION OF THE VOLOKONOVSK DISTRICT" 36 2.1. Problems of organizing social services for the elderly and disabled in the conditions of a comprehensive center for social services for the population 36 2.2. Recommendations for improving social services for the elderly and disabled in the conditions of an integrated 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 the elderly and disabled are among the priority areas of state social policy. The Belgorod Region has a developed network of social service institutions for the elderly and the disabled. An important role in the development of new technologies for servicing the elderly and disabled belongs to the complex centers of social services for the population. At the same time, the need to coordinate the efforts of state and public structures in solving the socio-economic, family, household, psychological and other problems of the elderly and disabled is becoming more and more obvious. Social services - the activities of social services for social support, the provision of social, social, medical, psychological, pedagogical, social and legal services and material assistance, social adaptation and rehabilitation of citizens in difficult 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 health care, education, culture, housing and communal services, social services are among the branches of the social sphere. The features of economic services cause the device to need a sphere of participation of the social state and philanthropists in the organization and financing of these services. The participation of the state in the provision of social services is designed to ensure the implementation of the principles of social justice and solve the problems of insufficient information and irrational consumer choice.
4 All over the state institutions have been created to provide certain types of social services to elderly citizens and the disabled. As a rule, in public institutions, social services are provided free of charge or for a fee that only partially reimburses the costs. Social service systems vary widely across countries. In Russia, social reforms are being carried out at the federal, regional and local levels, which are sometimes carried out without sufficient elaboration of social consequences. They seriously affect the sphere of social services for the elderly and disabled. The organization of social services for the elderly and disabled is becoming increasingly important in our country every year, it is seen as an essential addition to cash payments, which significantly increase the efficiency of the entire state social security system. Social policy in relation to the elderly and the disabled, its scope, direction and content throughout the history of the country were influenced and determined by the socio-economic and specific socio-political tasks facing society at one stage or another of its development. The allocation in the general structure of social policy of a special direction - social services related to the well-being and health of elderly citizens and the disabled, 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 care in boarding schools, home care for those in need of outside 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 senior citizens and disabled people should be focused on ensuring the availability of basic social services and guarantees for senior citizens and disabled people, regardless of their place of residence. The social insecurity of elderly citizens and the disabled is primarily associated with their physical condition, the presence of diseases, a decrease in physical activity, and the presence of a psychological factor that forms contact with the rest of the population. Therefore, the elderly and the disabled are the least protected and most socially vulnerable part of society. The degree of scientific development of the problem. Social work with elderly 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 upon the complex and multifaceted problems of social services for the elderly and the disabled. E.V. Karyuhin, 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 the health disorder of elderly citizens, adaptation of a person to old age, describe the methods and principles of social work and medical and social services for elderly citizens. The 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 the social status of older citizens in different societies and at different historical moments. The above works highlight various aspects of the situation of the elderly and the disabled, the theory and practice of their social services, explore the problems of developing positive attitudes in society towards the elderly and the disabled, and reveal the possibilities for improving their standard of living. A fairly large group of publications on the problem under study is made up of articles in scientific and popular science journals (“Socium”, “Social work”, “Social worker”, etc.), which highlight the problems of the elderly and disabled people and ways to solve them ( T. V. Karsaevskaya, A. Komforsh, E. L. Rosset, E. A. Sigida, V. D. Shapiro, A. T. Shatalov, etc.). The object of the study is the social service for the elderly and the disabled in the conditions of an integrated center for social services for the population. The subject of the study is the specifics of the organization of social services for the elderly and disabled at the municipal level. The purpose of the study: to reveal the specifics of the organization of social services for the elderly and disabled in the conditions of an integrated center for social services for the population and develop recommendations for its improvement. The achievement of this goal is facilitated by the solution of the following tasks: 1) to identify the specifics of social services for elderly citizens and the disabled in the conditions of an integrated center for social services for the population; 2) to study the features of the organization of social services for the elderly and disabled in the MBSUSOSSZN "Comprehensive Center for Social Services for the Population of the Volokonovsky District";
7 3) to 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 main conceptual provisions of the theories about the individual as a subject of activity and the highest social value, the concept of a personality-oriented approach, the ideas of humanization and democratization of the system of social protection of the elderly in modern Russia. As well as sociontal approaches in the history and theory of social work with elderly citizens and the disabled, presented in the studies of I.G. Zainysheva and E.I. Single. The activity approach in the history and definition of the essence of social work with elderly citizens is presented in the concept of L.G. Guslyakova, in her opinion, "social work is defined as a kind of social activity, as a system of social protection, as the activity of state organizations and individuals to provide assistance, as an activity to restore and preserve the psycho-mental and socio-mental connections of an individual with the environment" . Research methods: theoretical - analysis of literature and official statistics on the research topic; analysis of the reports of the work of the MBSUSOSSZN "Complex 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 the sociological study of the author "Problems of organizing social services for the elderly and disabled in the conditions of an integrated center for social services for the population (on the example of the MBSUSOSSZN "Integrated Center for Social Services for the Population of the Volokonovsky District" (November 2015)).
8 - results of a secondary analysis of sociological studies conducted in different years by academic institutions 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 of the study of social services for the elderly and the disabled is reflected in various kinds of instructions, provisions that focus on 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 the Disabled”, “On the Social Protection of the Disabled in the Russian Federation”, directly addressed to the elderly and the disabled. For the development of federal laws, Decrees of the Government of the Russian Federation, departmental regulations governing the provision of social services to elderly citizens and the disabled were adopted. 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 conditions for paying for social services provided by state and municipal institutions of social 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 the social services for the elderly and the disabled in the context of an integrated center for social services for the population.
9 Research materials can be used in teaching courses on social work, social policy, etc. and in the system of training, retraining and advanced training of specialists in social work. Approbation of the research results. The thesis work was commissioned by MBSUSOSSZN "Integrated Center for Social Services for the Population of the Volokonovsky District". Approbation of the results of the study was carried out in the course of undergraduate practice on the basis of the MBSUSOSSZN "Integrated Center for Social Services for the Population of the Volokonovsky District" and recommended for practical use. The structure of the thesis includes: an introduction, two chapters, a conclusion, a list of references and an appendix.
10 1. THEORETICAL FOUNDATIONS FOR STUDYING SOCIAL SERVICE FOR THE ELDERLY AND DISABLED CITIZENS IN THE CONDITIONS OF THE INTEGRATED CENTER FOR SOCIAL SERVICE FOR THE POPULATION 1.1. Social Services for Elderly and Disabled Citizens: Essence and Specificity In Russian literature, older citizens are usually considered as a large social, social or socio-demographic group, and sometimes these definitions are combined. Some authors consider them to be 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 conditions of life of elderly citizens are primarily determined by their state of health. Self-assessment is widely used as an indicator of health status. Due to the fact that the process of aging in individual groups and individuals is far from the same, self-assessments vary greatly. Another indicator of the state of health is active life, which decreases in the elderly due to chronic diseases, deterioration in 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 by their financial situation, the level of inflation, and the high cost of medical care. The financial situation is the only problem that can compete in its importance with health.
11 Modern theories of aging play an important role in the organization of social services for older citizens, because they interpret and generalize experience, information and observation results, help to predict the future. They are needed by the social worker, first of all, in order to organize and streamline their observations, draw up a plan of action and outline their sequence. The choice of one or another theory predetermines the nature and amount of information that the specialist will collect, as well as the methods of organizing an interview with a 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 guidelines, a social worker 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 kindred intervention. Social work with older citizens involves the use of theories of liberation, activity, minorities, subculture, age stratification, etc. According to the liberation theory, in the process of aging, people are alienated from those who are younger; in addition, there is a process of liberation of older citizens from social roles - meaning the roles associated with labor activity, as well as leadership and responsibility. This process of alienation and liberation is conditioned by the social situation in which older citizens find themselves. It can also be considered as one of the ways for older citizens to adapt to the limitations of their opportunities and reconcile with the thought of inevitable impending death. According to the theory of liberation, in the social aspect, the process of alienation of older citizens is inevitable, since the positions they hold
12 must at some point be passed on to younger people who can work more productively. The priority direction of social work with elderly citizens is the organization of 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 sense of security, confidence in the future, responsibility for one's own and others' lives. Old age in real life is often a period when help and support is needed in order to survive. Self-esteem, independence, and help that interferes with the realization of these feelings come to a tragic contradiction. Elderly citizens sometimes have to give up their independence, independence for the sake of a full life, realized in interaction and communication. Elderly citizens also have such a problem as loneliness, the victims of which are more often men than women. It is loneliness that comes 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 generally less susceptible to the effects of aging. Most older women are able to devote 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 markedly. While a retired man loses his role as a "producer" of livelihoods, a woman never leaves her role as a housewife. The socio-medical problems of centenarians (the elderly, the elderly, the old) 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 distinguishes him
13 essentially from all other age groups, and depending on how this particular society relates to old age, the corresponding socio-medical problems are identified and solved. The character of an elderly citizen is already deformed due to aging. This deformation is a rather complex process (how a person lived, so he ages). For the time being, all those who work (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, irascibility, vulnerability, anxiety, pedantry, resentment, emotional lability, hysteria, isolation, exhaustion, captiousness, 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 are much deeper. Only medical genetics could objectively interpret the cardinal changes in the psyche of a long-liver, which are confirmed by social and gerontological studies. An elderly citizen and his family is one of the most urgent problems of our society in general, and social medicine in particular. This problem seems insoluble either by public or by government measures aimed at strengthening the social protection of the population; even less so by medical means. The quality of life of elderly and disabled citizens 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 they have passed and are still passing their lives.
14 Older people and those who will soon cross the age limit separating them from the younger and middle generation associate their social expectations and hopes with significant changes in the field of social services. The lack of sensitivity and attention to the elderly, veterans, perceived by our society, the insufficient consideration of their objective requests and needs obliges us to move from calls for improving their medical care, improving social assistance to radical measures - the creation in the country of a broad system of social services for the elderly as an integral part of a unified state system of social security. Social services include everything that is received by the elderly and the disabled at the expense of public consumption funds in addition to pensions and benefits. The society in this case assumes all or part of the costs associated with paying for the cost of services provided to the elderly and disabled who need certain types of social assistance. At the same time, in the order of social services, the specific needs characteristic of this particular category of citizens are satisfied. The development of social services for the elderly and disabled in our country is becoming more and more important every year, it is seen as an essential addition to cash payments, which significantly increase the efficiency of the entire state social security system. The concept of disability was characteristic of social policy towards people with disabilities (disabled) until the 60s of the twentieth century. Disability was perceived as a personal pathology of a person, and all its problems were understood as a consequence of this pathology. That is, the limited abilities of the individual were considered in the context of the relationship between the person and his disease. All the problems of a disabled person are a consequence of the pathology of health and he must adapt to the world of “normal” people.
15 The concept of disability is described on the basis of the “role of the patient” model, in which the disease is considered as a form of social deviation, where the individual plays a specific role: is released from the usual social duties, is not considered guilty of his illness, seeks to recover and seeks professional help, fulfills appointments competent doctor. Disability (disability) is understood as a consequence of the fact that the social and physical conditions (social culture, psychological climate, social and political organization, etc.) in which a person with poor health lives and works narrow the possibilities of its self-realization, that is disabled people are seen more as an oppressed group. The essence of the problem lies in the inequality of opportunities in the presence of equality of rights. The content of social rehabilitation is the social integration of disabled people and assistance in understanding and exercising their inalienable human rights. That is, unlike the previous understanding, we are talking about the influence of the socio-cultural environment on the life of a person with disabilities. In the course of historical development, a purely 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 prevailing biopsychosocial model of disability, incorporated in the International Classification of the Functioning of Disabilities and Health, which expands the understanding of disability and allows you to study the influence of medical, individual, social, environmental factors on functioning and disability. In R. Barker's dictionary of social work, social services are interpreted as the provision of specific social services to meet the needs necessary for normal development to people who are dependent on others 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, the provision of social, social, medical, psychological, pedagogical, social and 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 stationary conditions, social patronage of citizens, etc. meeting the needs of these citizens in 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 social services for the population without forming a legal entity.” There are two groups of functions of the social service system: 1. Essential and active functions (preventive, social rehabilitation, adaptive, protective and protective, social functions (personal patronage). 2. Moral and humanistic, humanistic, social and humanistic).
17 So, social services for the population include types, types, methods, organizational forms, procedures, technologies, subjects and objects of social services, the result of the provision of social services. The Russian Federation is developing a system of social services for the elderly and disabled, social services are provided by more than 12 thousand institutions - stationary, semi-stationary and non-stationary. Now there are more than a thousand stationary institutions of various types: 406 boarding houses (boarding houses) for veterans of war and labor, 442 psycho-neurological boarding schools, etc. Various services are being created and developed: psychological and pedagogical assistance, socio-psychological, psychological, medical and social, social and leisure , career guidance, rehabilitation, etc. The Federal Law "On Social Services for Elderly Citizens and Disabled People" significantly supplements and specifies the concept of social services for certain social groups in society, regulates relations in the field of social protection of elderly citizens and disabled people. In the Law, the subject of activity is defined as follows: "social services are activities to meet the needs of these citizens in social services." Social services include a set of social services that are provided to elderly citizens and the disabled at home and in social service institutions, regardless of ownership. Provides the possibility of obtaining social services sufficient to meet the basic needs of life, which are included in the federal and territorial state-guaranteed social services: - care; lists
18 - catering; - assistance in obtaining medical, legal, socio-psychological and natural types of assistance; - assistance in vocational training, employment, leisure activities; - assistance in the organization of ritual services and others that are provided to the elderly and the disabled at home or in social service institutions. The federal law uses such basic concepts as: Social service - an enterprise or institution, regardless of the form of ownership, providing social services. A client of a social service is a citizen who is in a difficult life situation, who, in connection with this, is provided with social services. A social service is a service that is provided free of charge or at less than its market price, that is, wholly or partly at the expense of society. A service that is sold as a commodity (material consumer goods or consumer services) is not a social service, even if it is used by citizens in a difficult life situation. A difficult life situation is a situation that objectively disrupts the life of a citizen (disability, inability to self-service due to old age, illness and a number of other circumstances: orphanhood, lack of work, a certain place of residence, loneliness, etc.), which he cannot overcome on your own. The basis for free social services for citizens who are not capable of self-service due to advanced age, illness, disability and who do not have relatives who can provide them
19 assistance and care, serves a low average per capita income, below the subsistence minimum established for the region in which they live. Social services for the elderly and disabled are carried out in accordance with the ethical principles of the International Labor Organization (ILO): - dignity of the individual - the right to decent treatment, treatment, social assistance and support; - freedom of choice - every person of advanced age has the right to choose between home care and living in a shelter, temporary or permanent; - coordination of assistance - assistance provided by various social bodies should be active, coordinated and consistent; - individual nature of assistance - assistance is provided to the elderly citizen or the disabled person, taking into account his environment; Functions of the social service system: - essential-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 the elderly and disabled are: rights of man and citizen; - continuity of all types of social services; - orientation of needs; social services to individual
20 - priority of measures for social adaptation; - the responsibility of public authorities, local governments and institutions, as well as officials in ensuring the rights of elderly citizens and disabled people. Social services have the following characteristics: - targeting - the 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 a citizen, except 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. - observance of human and civil rights, continuity of all types of social services; - conditions for the formation and implementation of human life; - the ratio of freedom and social conditionality of the individual, socially justified (or unjustified) measure of this freedom and the possibility of its implementation in society. All institutions of social service to the population are institutions of an open type. Placement in these institutions of citizens who find themselves in a difficult life situation is carried out with their voluntary consent, on a permanent or temporary basis.
21 The most important forms of social services are social services at home; semi-stationary service in departments of day (night) stay of social service institutions; stationary social services in boarding schools, boarding houses, etc.; urgent social services; social advisory assistance; provision of living space in special nursing homes, etc. Non-stationary social institutions are a relatively new form of providing social assistance to the older population and the disabled in the Russian Federation. The legislation provides for five forms of social services for the elderly and disabled: social services at home (including social and medical services); semi-stationary social services in departments of day (night) stay of social service institutions; stationary social services in stationary social service institutions (boarding houses, boarding houses and other social service institutions, regardless of their name); urgent social services; social advisory assistance. Social services at the request of elderly and disabled citizens can be carried out on a permanent or temporary basis. Social services at home is one of the main forms of social services aimed at the maximum possible extension of the stay of elderly and disabled citizens in their familiar social environment in order to maintain their social status, as well as to protect their rights and legitimate interests. Home social services guaranteed by the state include: catering, including home delivery of groceries; assistance in the acquisition of medicines, food and industrial essential goods; assistance in obtaining
22 medical assistance, including escort to medical institutions; maintenance of living conditions in accordance with hygienic requirements; assistance in organizing legal assistance and other legal services; assistance in organizing funeral services; other home social services. When serving elderly and disabled citizens living in residential premises without central heating and (or) water supply, the number of home-based social services provided for by the list of state-guaranteed social services includes assistance in providing fuel and (or) water. In addition to the home-based social services listed above, additional services may be provided to the elderly and disabled on the basis of full or partial payment. Social and medical care at home is provided to elderly citizens and disabled people who need home social services, suffering from mental disorders (in remission), tuberculosis (except for the active form), serious diseases (including cancer) in the late stages, with the exception of quarantine infectious diseases, chronic alcoholism, severe mental disorders, venereal and other diseases requiring treatment in specialized healthcare facilities. 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 carried out in semi-stationary institutions: - overnight stays; - social shelters; - social hotels; - centers of social adaptation. and in
23 Semi-stationary social services include social, medical and cultural services for elderly and disabled citizens, organizing their meals, rest, ensuring their participation in feasible work activities and maintaining an active lifestyle. Elderly and disabled citizens who need it and who have retained the ability to self-service and active movement, who do not have medical contraindications for enrollment in social services, are accepted for semi-stationary social services. The decision on enrollment is made by the semi-residential head of the social institution of social services on the basis of a personal written application of an elderly citizen or a disabled person and a certificate from a health care institution on 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 the disabled is aimed at their adaptation in society, easing social tension, creating favorable relations in the family, and ensuring interaction between the individual, family, society and the state. Social services for elderly and disabled citizens are provided by decision of the social protection authorities in institutions subordinate to them or under agreements concluded by social protection authorities with social service institutions of other forms of ownership. The rights of elderly and disabled citizens in the provision of social services to them may be restricted 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-service are recognized as legally incompetent and in accordance with the procedure established (or) active by law. The issue of placing elderly and disabled citizens in stationary 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 bacterial 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 health care institutions may be denied the provision of 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 authority of the population and the medical advisory commission of the healthcare institution. Social services for elderly citizens and the disabled, provided in non-stationary conditions, may be terminated if they violate the norms and rules established by the social service management bodies when providing this type of service. Let us consider in detail the main forms of social services for the elderly and the disabled: 1. Social services for the elderly and the disabled include: 1) social services, medical care); at home (including social
25 2) semi-stationary social services in departments of day (night) stay of social service institutions; 3) stationary social services in stationary social service institutions (boarding houses, boarding houses and other social service institutions, regardless of their name); 4) urgent social service; 5) social advisory assistance. 2. Elderly citizens and the disabled may be provided with living quarters in the houses of the housing fund for social use. 3. Social services at the request of elderly citizens and the disabled may 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 the maximum possible extension of the stay of elderly and disabled citizens in their familiar social environment in order to maintain their social status, as well as to protect their rights and legitimate interests. . 2. Among the social services at home, provided for by the list of state-guaranteed social services, include: 1) catering, including home delivery of food; 2) assistance in the acquisition of medicines, food and industrial essential goods; 3) assistance in obtaining medical care, including escort to medical institutions; 4) maintenance of 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 social services. 3. When serving elderly citizens and disabled people living in residential premises without central heating and (or) water supply, the number of home social services provided for by the list of state-guaranteed social services includes 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 the disabled may be provided with additional services on terms of full or partial payment. 5. Social services at home are carried out in the manner determined by the executive authority of the constituent entity of the Russian Federation. Social and medical care at home is provided for elderly citizens and disabled people who need home social services, suffering from mental disorders (in remission), tuberculosis (except for the active form), serious diseases (including cancer) in the late stages, beyond except for the diseases specified in the fourth part 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 and disabled citizens: 1. Urgent social services are carried out in order to provide urgent one-time 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, footwear and other essentials; 3) one-time provision of material assistance; 4) assistance in obtaining temporary housing; 5) organization of legal assistance in order to protect the rights of persons served; 6) organization of 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 the disabled is aimed at their adaptation in society, easing social tension, creating favorable family relations, as well as ensuring interaction between the individual, family, society and the state. 2. Social advisory assistance to elderly citizens and the disabled is focused on their psychological support, intensification of efforts in solving their own problems and provides for: 1) identification of persons in need of social advisory assistance; 2) prevention of various kinds of socio-psychological deviations; 3) work with families in which elderly citizens and disabled people live, organizing their leisure time;
28 4) advisory assistance in training, vocational guidance and employment of persons with disabilities; 5) ensuring the coordination of the activities of state institutions and public associations to solve the problems of elderly citizens and the disabled; 6) legal assistance within the competence of social service bodies; 7) other measures to form healthy relationships and create a favorable social environment for the elderly and the disabled. The procedure and conditions for the provision of free home, 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 the elderly and disabled are an important factor in improving the system of social protection of the population and the social policy of the Russian state as a whole. Institutions of non-stationary and semi-stationary social services help to establish various forms of social work, to better take into account the interests and needs of the elderly and the disabled 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 children with disabilities) who need permanent or temporary outside assistance in connection with partial or complete loss of the ability to independently satisfy their basic
29 vital needs due to limited ability to self-service and (or) movement, have the right to social services provided in the state and non-state sectors of the social service system. Comprehensive centers for social services to the population are the leading state institutions in the field of non-stationary social services for the elderly and the disabled. The centers help establish various forms of social work, better take into account the interests and needs of various categories of elderly and disabled people in direct contact with them. Centers may have various social service units in their structure: day care units for the elderly and disabled, social assistance at home, emergency social assistance services, etc. At present, social service centers have the following units: - home social services unit; - Department of day care; - Department of temporary residence (mainly in rural areas); - Department of social and medical care at home; - Department of emergency social services; - department of social rehabilitation. The centers are becoming effective non-stationary forms of social support for the elderly and disabled 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 maximize the stay of citizens in their usual habitat, maintain their personal and social status, protect their rights and legitimate interests.
30 Key home-based services guaranteed by the state include: catering and home delivery of groceries; assistance in purchasing medicines, essential goods; assistance in obtaining medical care and accompaniment to medical institutions; assistance in maintaining living conditions in accordance with hygiene requirements; assistance in the organization of ritual services and in the burial of the lonely dead; organization of various social and domestic services (housing repair, fuel supply, processing of personal plots, water delivery, utility bills, etc.); assistance in the preparation of documents, including for the establishment of guardianship and guardianship, the exchange of housing, placement in stationary institutions of social protection authorities. Social services at home are provided free of charge, with partial payment or for full payment. Services are provided free of charge, for example, to single elderly citizens and disabled people who do not receive an allowance for a care pension 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 a given region minimum level. Thus, the main activities of the integrated center of social services for the population are: identifying elderly citizens and disabled people in need of service; provision of social and household and other necessary assistance at home; assistance in providing serviced persons with benefits and benefits established by the current legislation; ensuring to the citizens served their rights and benefits established by the current legislation. Daycare departments, which are also being created on the basis of social service centers for the population, are also developing more and more widely. They are intended for household, medical, cultural services for pensioners and the disabled, organizing their recreation, attracting
31 to work hard, maintain an active lifestyle. These departments are created in accordance with the Regulations for serving at least 30 people. They enroll elderly and disabled people, regardless of their marital status, but who have retained the ability to self-service and active movement, based on personal desire and medical opinion. Pensioners and the disabled are usually served free of charge by the social assistance department. For example, the Department of Urgent Social Services (OSSO) provides emergency social assistance of a one-time nature to elderly citizens and the disabled who are in dire need of social support. Urgent social assistance is the most common type of social support for the older 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 need; - provision of clothing, footwear and essentials; - 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, prohibitive measures, but also explanatory work, promotion of a healthy lifestyle among residents. In the Russian Federation, a system of non-stationary and semi-stationary forms of social services has been developed, including such institutions (departments) of social services as centers for social services for the population (1955 units), including integrated centers for social services for the population (822). AT
The 32 structure of the centers includes departments of temporary residence (684 for 14.4 thousand places) and day stay (1183 for 32.4 thousand places). 21.7 thousand people live in special homes for lonely elderly citizens, where there is a complex of social services (725). The active development of semi-stationary forms of service, including temporary residence departments, contributed to the reorganization of some of them into small-capacity houses - the establishment of an optimal model of relations between residents and staff. The network of non-state stationary institutions is expanding. Social assistance and services in each region of Russia are carried out taking into account their 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 managers and practitioners, organizing a brigade 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 yielding positive results. Practice confirms the expediency and effectiveness of joint actions. The brigade form of assistance to seriously ill patients is becoming more widespread and recognized. Such comprehensive care allows to increase the number of patients served, to expand the types and volumes of services provided to them. So, for example, in the Kirov region, the departmental center for gerontological rehabilitation at the Krasny Yakor Plywood Mill JSC in Slobodskoy operates. In the city of Volgograd, the Hospice House of St. Serafim Sarovsky (social shelter), whose hospital is designed for 35 people. It is inhabited mainly by pensioners and persons 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 highways with targeted, prompt assistance, social protection authorities are actively developing various models of mobile social service. Such service is vital for those elderly and disabled citizens who find it difficult to apply to 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 tariffs prevailing in the area for transport and other services. In order to work out the mechanism of this social technology, within the framework of the federal target program "Older Generation" in the region, an experimental project "Development of an urgent social assistance service on a mobile basis" is being carried out. In the Kirov region for 10 years there has been such a social service as the "Mercy Bus". 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 solving social issues created under municipal governments, or rural mini-centers. There are 384 mini-centers in the Penza region today. Their main tasks include the identification 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, health, preventive and other activities for the population at the 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 consists of 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 travel to sanatoriums, over the past five years a set of measures has been taken to open social and recreational centers and social rehabilitation departments. In Kemerovo, a center has been equipped that fully meets the requirements for independent living of the elderly and disabled, and employees have been trained to identify the needs of elderly and disabled citizens and teach modern methods of working with additional employees. 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 center for the rehabilitation of elderly and disabled citizens has been created in the Samara Region, on the basis of which innovative domestic and foreign technologies and methods for the rehabilitation and integration of elderly citizens and disabled people into society are being developed; analysis and forecasting of the socio-demographic situation in the region; identification of the causes of social maladaptation; studying the need for social services; constant monitoring of the problems that arise in the life 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 specialists in the practical skills of using auxiliary and technical means of rehabilitation, as well as means that make life easier for the disabled, caring for seriously ill people. There are all conditions for training social workers, rehabilitators, 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 and disabled citizens. On the basis of the center, training is organized for elderly citizens, disabled people and their families in methods of caring for people with disabilities, the use of rehabilitation facilities, and the provision of psychological assistance. Thus, the comprehensive centers of social services for the population are the leading state institutions in the field of non-stationary social services for the elderly and the disabled. The centers help establish various forms of social work, better take into account the interests and needs of various categories of elderly and disabled citizens in direct contact with them. Centers can have various social service units in their structure: daycare departments for the elderly and disabled, social assistance at home, urgent social assistance services, etc. Centers are becoming effective non-stationary forms of social service for the elderly and disabled in the Russian Federation.
36 2. ORGANIZATION OF SOCIAL SERVICES FOR THE ELDERLY AND DISABLED CITIZENS UNDER THE CONDITIONS OF MBESOSSSZN "COMPLEX CENTER FOR SOCIAL SERVICES FOR THE POPULATION OF THE VOLOKONOVSK DISTRICT" 2.1. Problems of organizing social services for the elderly and disabled in the context 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 disabled people. On the territory of the district, the Budgetary Institution of Social Services of the System of Social Protection of the Population "Integrated Center for Social Services for the Population" of the Volokonovsky District (hereinafter referred to as the Center) operates. It is intended for comprehensive social services for citizens in need of social support, through the provision of timely and qualified social assistance of various types, the creation of individual citizens who find themselves in a difficult life situation, assistance in the implementation of legitimate rights and interests, assistance in improving their social and financial situation. The structure of the Center includes: four departments of social services at home for elderly and disabled citizens created to serve citizens living in urban areas and citizens living in rural areas or the urban sector that does not have public amenities; department of temporary residence of elderly and disabled citizens; urgent social service department; advisory department. In accordance with the objectives of its activities, the institution provides the following types of social services:
37 1. social and household 2. socio-medical 3. socio-psychological 4. socio-pedagogical 5. social and legal. Department of social services for the elderly and disabled. The main task of the department is to provide social assistance at home to elderly and disabled citizens who need permanent or temporary outside assistance due to the partial loss of the ability to be independent due to the satisfaction of the limitation of the basic ability for self-care and (or) movement. Functions of the department: - informing and advising citizens on issues of social services; - collection and preparation of documents for social services; - acceptance of documents from citizens; - execution of the decision on enrollment (queuing) or denial of social services with the obligatory informing of the applicant; - admission to social services (conclusion of a contract on social services) with the subsequent provision of state-guaranteed social services, as well as additional social services; - calculation (recalculation) for social services; - maintenance of documentation, services provided, according to the implementation of the schedule of control checks, quality reporting. Social services provided by the state, social services included in (hereinafter referred to as the list - guaranteed social services),
38 are provided to elderly and disabled citizens 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 with an income (average per capita income) below the subsistence level established for the relevant socio-demographic population groups in the Belgorod Region; - elderly citizens living alone and disabled people who have relatives who, due to advanced age, disability, illness, being in prison, permanent residence outside the Belgorod Region and other objective reasons, documented, cannot provide them with assistance and care , provided that the amount of income received by these citizens is below the subsistence level established for the relevant 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 minimum established for the relevant socio-demographic groups in the Belgorod Region. Social services at home are provided on the basis of partial payment: - to single elderly citizens (single married couples) and disabled people who receive 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 Belgorodskaya areas; - elderly citizens living alone and disabled people who have relatives who cannot due to advanced age, disability, illness, being in prison,
39 permanent residence outside the Belgorod region and other objective reasons, documented, 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 relevant socio-demographic groups of the population in the Belgorod region areas; - families consisting of elderly citizens and (or) disabled people, provided that the average per capita income of the family is from 100 to 150 percent of the corresponding subsistence minimum, the socio-demographic established groups 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 the full payment for services. Social services at home are provided on a full payment basis: - to single elderly citizens (single married couples) and the disabled, if their income (average per capita income) exceeds 150 percent of the subsistence level established for the relevant socio-demographic groups of the population of the Belgorod Region; - elderly citizens living alone and disabled people who have relatives who, due to advanced age, disability, illness, being in prison, permanent residence outside the Belgorod Region and other objective reasons, documented, cannot provide them with assistance and care , provided that the amount of income received by these citizens exceeds 150 percent of the subsistence minimum established for the relevant socio-demographic groups of the population of the Belgorod Region;
40 - to families consisting of elderly citizens and (or) disabled people, provided that the average per capita income of the family exceeds 150 percent of the subsistence level established for the relevant 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 and disabled citizens, the Department of Social Services for Senior Citizens and Disabled People provides the following services at home: 1. Catering services (provided taking into account the state of health): - assistance in cooking, including dietary nutrition; - purchase and home delivery of food, hot meals from the canteen (in the area where the client lives). 2. Household services: - water delivery; - firing of 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 (documentation, payment of bills, ensuring control over the delivery of fuel); - purchase and home delivery of essential industrial goods (in the area where the client lives); - delivery of things for washing, dry cleaning, repair and their return delivery (in the absence of enterprises providing these services, washing and repair at home in the area of residence of the client); - assistance in organizing housing repairs (determination of the scope of work, organization of repair work, assistance in the purchase, delivery of materials for repairs);
41 - assistance in paying for housing and utilities (filling out receipts, checking documents for settlements, paying bills); - assistance in organizing the provision of services by trade enterprises, public utilities, communications and other enterprises providing services to the population. 3. Leisure services: - 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; - Accompanying outside the home. 4. Socio-medical and sanitary-hygienic services (care is provided taking into account the state of health): - cleaning of the living quarters (taking out the garbage, dusting the floors, walls, furniture, etc.); - assistance in the provision of medical care in the scope of the basic program of compulsory medical insurance for citizens of the Russian Federation, targeted programs and territorial programs of compulsory medical insurance provided by state and municipal medical and preventive institutions; - assistance (accompaniment in the conduct of medical and social institutions and expert examination of the social and medical commission within the settlement, assistance in processing documents for disability); - assistance in providing medicines and medical products (within the limits of the settlement) at the conclusion of doctors;
42 - provision of psychological assistance (conversations, if necessary, consultations with a psychologist); - assistance in hospitalization, escort to medical and preventive institutions (within the limits of the settlement); - visits to stationary health care institutions in order to provide moral and psychological support to those served; - assistance in obtaining vouchers for sanatorium 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, orthopedist). 5. Legal services: - assistance in paperwork; - assistance in obtaining benefits and established benefits by the current legislation (organization of specialist consultations); - providing assistance in matters of pension provision and provision of other social benefits (assistance in paperwork, consulting); - assistance in obtaining legal assistance and other legal services (organization of specialist consultations). 6. Funeral services. The Department of Temporary Residence of 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: - medical procedures: inhalation, magnetotherapy, electrotherapy, lymphatic drainage, turman mat; manual and hardware massage; turpentine, pearl, salt baths; circular shower, mud therapy;
43 - a room for psychological unloading with medical devices, where classes, psychological trainings, and the provision of psychological assistance are organized; - varied high-quality 4 meals a day; - a rich leisure program: competitions, quizzes, karaoke and singing to a musical instrument, performances by creative teams, 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 club of the elderly "Ray of Hope", the club of wheelchair users "Cheerful". The activity of the department is aimed at the direct participation of elderly citizens in cultural, social and rehabilitation activities, as well as at strengthening health, increasing physical activity and improving social well-being. In the club of the elderly "Ray of Hope" there are 4 sections of interest: amateur art; skillful hands; intellectual outlook, healthy lifestyle. Club meetings are held 1-2 times a week. Meetings in the club of wheelchair users are held once a quarter and are thematic in nature. Excursions are conducted around the territory of the region according to the developed routes. Department of emergency social services. The main task of the department is to provide urgent social assistance to citizens in dire need of social support, emergency assistance for one-time life activities. nature, aimed at maintaining their
44 Functions of the department: - taking urgent measures aimed at temporarily supporting the life of citizens who are in need of social support by providing various types of assistance; - identification and registration of citizens who are in dire need of social assistance outside the territory of the municipal district "Volokonovsky district"; - providing the necessary information and consultations on the provision of measures of social support for the low-income population and privileged categories of citizens; - collection of necessary documents for financial assistance; - assistance in preparing documents for sending citizens to boarding schools, geriatric centers; - assistance in providing citizens who find themselves in a difficult life situation: with clothes, shoes, and other essentials; - 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 of the Volokonovsky district; - provision of additional services, in accordance with the "Tariffs for additional social services provided to citizens of the elderly and disabled 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 Department of Urgent Social Services provides assistance to the following categories of citizens: the disabled; senior citizens; victims of fires, natural disasters, radiation and man-made disasters; refugees and forced migrants; large families; low-income and incomplete families; families raising children
45 disabled people; citizens living alone, of working age, who have partially lost the ability to self-service due to a prolonged (more than one month) illness, relatives who, for objective reasons, do not have the opportunity 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 relevant socio-demographic groups of the population of the Belgorod region. Procedure for the provision of services: 1. Social services for citizens in the Urgent 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 a document proving their identity, and a written application addressed to the head of the USZN. 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 for pensioners and disabled people in assistance. Payment procedure for services: 1. Urgent social services are provided free of charge: - providing the necessary information and consultations on the provision of social support measures for the low-income population and privileged categories of citizens; - collection of necessary documents for financial assistance; - assistance in preparing documents for sending citizens to boarding schools, geriatric centers; - assistance in providing citizens who find themselves in a difficult life situation: with clothes, shoes, and other essentials; - 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 of March 24, 2008 No. 265 “On the procedure for providing the “Social taxi” service in Volokonovsky area". 3. Additional social services are provided on terms 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 Urgent Social Services Department of the MU "KCSON of the Volokonovsky District" operates an outbound complex team "Mercy", which includes: - heads of departments of social services at home; - social workers; - social work specialists; - carpenters; - medical worker; - Appliance repair specialist. 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 via electronic communication channels. - ensuring the 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 activities of the Institution, organizing a prompt response to critical publications, speeches, messages, etc. Functions of the advisory department: - carries out work on the introduction of 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 "Integrated 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 subdivisions of the Institution with means of 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, maintenance of directories, testing, indexing, elimination of system errors during the operation of the software, restoration of information in case of errors). - performs administration of a local area network with dedicated servers (configuration, testing, troubleshooting in
48 networks, restoration and correction of information in case of errors in the process of work). - instructs the specialists of the institution on the operation of hardware and software. - administers the reference terminal and the official website of the Office. - provides technical support for the activities carried out by the Department. - collects and transfers 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 structure of the Department of Social Protection of the Population of the Administration of the Volokonovsky District. In general, the work of the Administration of the Volokonovsky Social District with the protection of citizens, the population with disabilities (disabled people) and the elderly is aimed at developing and implementing innovative programs, technologies for organizing social and social and legal orientation, labor and counseling, vocational rehabilitation people with disabilities. Thus, in 2015, 236 disabled people, including 102 families with children with disabilities, received methodological and advisory assistance. In addition, the Department of Social Protection of the Population of the Administration of the Volokonovsky District carries out systematic work with the disabled. The program of cooperation with the Department of Culture of the Administration of the Volokonovsky District "Step into the World" assists 98 disabled children in social rehabilitation and their integration into society. As part of the program, there is a communication club "Nika", where monthly classes are held that contribute to the disclosure and development of creative
49 abilities of children with disabilities. Within the framework of the club, there is a school for parents "The Art of Education", where seminars, lectures, trainings, debates, consultations (with the participation of doctors, psychologists, teachers, lawyers) are held. In 2015, 9 club meetings were held. On the website of the USZN of the administration of the Volokonovsky district, 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 children with disabilities have been prepared and designed. Activities for the rehabilitation of disabled children were organized with the provision of various types of charitable assistance to them 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 Residential Home for the Elderly and Disabled, located in the village of Pogromets, is currently home to 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 recreational procedures, a rich cultural program is carried out for the elderly and the disabled. Such integrated programs as "Youth Promenade", "Let's Talk About Love", "We Rest in Russian", "Interesting Facts", "Sixty Plus", "Diet Secrets", "Flow Song", "Anniversary Dates", "Russian Lotto", etc. The main goal is to reveal and maintain the individual creative abilities of elderly and disabled citizens who are in the Department. Such song gatherings as: “To the sounds of the accordion”, “Song crossroads” have become traditional.
50 For elderly and disabled citizens, field trips to rural areas and walking tours through the center of the Volokonovka village with a visit to the local history museum are conducted. There are two points for the rental of rehabilitation equipment for the disabled: in the USZN administration of the Volokonovsky district and the BROOOO "Russian Red Cross" in the Volokonovsky district. Wheelchairs are in high demand. USZN administration of the Volokonovsky district provides services free of charge, according to the contract. BROOOOO "Russian Red Cross" in the Volokonovsky district provides wider rental services, you can take: strollers, walkers, crutches, canes, blood pressure monitors. In order to ensure the availability of facilities and services for the elderly and disabled in priority areas of life, 62 social infrastructure facilities of the district were certified. On the basis of accessibility passports, information was filled in the "Interactive Map of Accessibility of Objects" module on the "Learning to Live Together" website in the information and telecommunication network Internet for the elderly and the disabled to receive information about the possibility of visiting social infrastructure facilities. A roadmap action plan has been developed to increase the values of accessibility indicators for the elderly and disabled of facilities and services in the field of social protection, healthcare, education, culture, transport services, communications and information. The purpose of the "road map" is to ensure unhindered access to facilities and services in priority areas of life for people with disabilities and other people with limited mobility (people who have difficulty moving independently, obtaining services, necessary information) in the Volokonovsky district. Terms and expected results of the implementation of the "road map": increase in the share of social, engineering and transport facilities accessible to disabled people 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 Administration of the Volokonovsky District provided material assistance to 98 citizens with disabilities in the amount of 421.0 thousand rubles. from the funds of the regional and local budgets. Monthly monetary compensation payments 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 allowances were paid for 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 Administration of the Volokonovsky District carried out certain work aimed at caring, protecting and supporting the low-income population, pensioners, children, lonely elderly citizens and everyone who needs social protection. 149 employees work in the system of social protection of the population of the Volokonovsky district. The average salary for the department of social protection of the population of the district administration is 17616.00 rubles, including the average salary of a social worker 17014.00 rubles, employees of a boarding school - 16532.00 rubles. The structure of the Department of Social Protection of the Population of the Volokonovsky District Administration includes the Volokonovsky Residential Home for the Elderly and the Disabled. In 4 departments of social assistance at home in the district, 49 social workers work, who serve 394 single pensioners, 18 of them free of charge, 376 people on payment terms. 1082 additional services rendered for the amount of 151.9 thousand rubles.
52 The department of urgent social assistance, designed to provide citizens in dire need of social support, one-time assistance aimed at maintaining their livelihoods, for 2015 provided assistance in the form of: 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 pieces; - used items - 9 people. (20 units). Disabled people of the district were provided with 793 Social Taxi services. The "Mercy" brigade provided social assistance at home to 34 elderly citizens of the district. 8837 citizens of preferential categories are registered with the Department of Social Protection of the Population of the Volokonovsky District Administration, of which 5947 are federal beneficiaries, 2890 are regional ones. The title "Veteran of Labor" was awarded to 40 citizens. Monthly cash payments (UDV) were made to: - veterans of labor - 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; - war children - 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; - the widow of the Hero of Socialist Labor - 1 person. in the amount of 69.6 thousand rubles. Compensation payments were made in 2015: - in compensation for damage to the disabled people of the Chernobyl nuclear power plant - 2 people. and 1 widow of the deceased in the amount of 623.7 thousand rubles; - food for the disabled and participants in the liquidation of the Chernobyl accident in 1986-1987. - 17 people in the amount of 112.5 thousand rubles;
53 - for the rehabilitation of disabled people and participants in the liquidation of the Chernobyl accident - 23 people. in the amount of 17.4 thousand rubles. An additional payment was made to the pension: - 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. Issued tickets for travel in the suburban railway transport "Veteran of Labor" - 10 people. Vouchers issued to the sanatorium "Krasivo" - 21 people. Subsidies for housing and communal services were assigned and paid to 252 families in the amount of 2266.5 thousand rubles. Monthly monetary compensation payments were made to preferential categories of citizens for housing and utilities for 8837 people. in the amount of 42,991.0 thousand rubles, including: - federal beneficiaries in the amount of 33,492.0 thousand rubles; - regional beneficiaries in the amount of 9499.0 thousand rubles. Unified social travel tickets, in accordance with 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 of the federal level - 76 tickets; - beneficiaries of the regional level - 37 tickets; - nurses of the BROOOO "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 the 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 insurance of civil liability of vehicle owners in the amount of 6.1 thousand rubles. In 2015, the specialists of the Center for Social and Psychological Assistance to the Family and Family Placement of Children Left Without Parental Care conducted: - consultations – 915 people; - diagnostic examination - 58 people; - psycho-correctional and developing classes - 352; - visiting 173 families. 1317 people applied for socio-psychological and legal assistance to the Center for socio-psychological assistance to the family and family placement of 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 the relaxation room. In 2015, 11 meetings of the Nika communication club for children with disabilities were prepared and held, which were attended by 67 children and 48 parents. To study the problems of organizing social services for the elderly and disabled, the author conducted a sociological study "Problems of organizing social services for the elderly and disabled 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 the social services for the elderly and the disabled in the conditions of a comprehensive center for social services for the population, which will help improve the quality of life of the elderly and the disabled, create conditions for optimizing
55 their way of life and solutions to various problems related to social services and health maintenance. The purpose of the study was to identify the problems of organizing social services for the elderly and disabled in the context 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 the elderly and the disabled in the MBSUSOSSZN "Integrated Center for Social Services for the Population of the Volokonovsky District". 2. To diagnose the problems of organizing social services for the elderly and disabled 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 the elderly and disabled in the conditions of a comprehensive center for social services for the population. Subject of study: the specifics of the organization of social services for the elderly and disabled at the municipal level. The most important forms of social services are such as social services at home; semi-stationary service in departments of day (night) stay of social service institutions; stationary social services in boarding schools, boarding houses, etc.; urgent social services; social advisory assistance; provision of living space in special nursing homes, etc. Comprehensive social service centers for the population are the leading state institutions in the field of non-stationary
56 social services for pensioners and disabled people. The centers help establish various forms of social work, better take into account the interests and needs of various categories of elderly and disabled people in direct contact with them. The difficult socio-economic situation in the organization of social services for the elderly and the disabled is intended to be mitigated by non-stationary social service institutions that help improve the quality of life of the elderly and the disabled, create conditions for optimizing their lifestyle and solving various problems, maintaining related health. It is assumed that the comprehensive service and the study of the organization of social services for the elderly and disabled in the conditions of a comprehensive center of social services for the population will identify the problems of its organization, ways to solve them, and as a result, the prospects for the development of the organization of social services for the elderly and disabled. To solve the tasks set, a set of research methods was used that mutually check and complement each other: the method of expert survey, questioning; study and analysis of the documentation of the MBSUSOSSZN "Integrated 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 of the MBSUSOSSZN "Integrated Center for Social Services for the Population of the Volokonovsky District"; elderly citizens living in the Volokonovsky district; disabled people living on the territory of the Volokonovsky district. Characteristics of the methods used to collect primary sociological information: the author used an expert survey to collect primary sociological information. survey methods, interviews,
57 The scope 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 the difficulties associated with age and disability (62%). Limitation of opportunities and old age by these groups of respondents is perceived as a negative period of dependence on close and not very close people. A significant part of the respondents (38%), who have not yet felt the approach of problems associated with old age and disability, lead an active lifestyle, are not limited in finances and decisions. The majority of elderly and disabled citizens put financial problems in the first place - 52%, considering them as the main ones that limit them today. Difficulties related to health status are also important - 34%. However, respondents put them in second place, obviously, thereby believing that some of the health problems can be solved with more funding. Psychological difficulties (11%) are noted by a relatively small group of respondents. Diagram 1. Indicate the problems that are most acute for you: 60% 50% 40% 30% 52% 20% 34% 10% 11% 3% 0% fundamental problems of both the biological and medical sphere, and issues of social and
58 personal life of society and each individual. During this period, many problems arise for the elderly, since the elderly belong to the category of the “low mobile” 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, chronic diseases reduce the possibility of self-service, adaptation to changes. Difficulties may arise with others, including with loved ones, even with children and grandchildren. The psyche of the elderly and resentment, old people may differ in senile sometimes depression, irritability, sometimes leading to suicide, leaving home. Elderly citizens and the disabled are characterized by faith in the power of the state and their dependence on it (54%). Most respondents believe that the state can and should solve their problems. Elderly citizens and the disabled 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 of the MBSUSOSSZN "Comprehensive Center for Social Services for the Population of the Volokonovsky District", directly working with the elderly and the disabled (12 people). Within the framework of the study, several blocks of problems were identified: - The quality of social services for the elderly and the disabled; - The need of elderly and disabled citizens for specific types of social services. As a result of a survey of experts, the following data were obtained:
59 Diagram 2. Indicate the problems that arise in the social services for the elderly and disabled: 50% 45% 40% 35% 30% 25% 47% 20% 34% 15% 10% 12% 5% 7% 0% Material In assessment Math.-tech. base of the main problems, Personnel shortage inherent in the system of social services for the elderly and disabled, the main part of the experts noted insufficient funding - 47% and a lack of qualified personnel - 12%, 34% of experts indicated the need to update the material and technical base of the system of social services for citizens elderly and disabled, 7% noted the imperfection of the legal framework for social services. Obviously, the financing of social institutions does not allow dynamic development of social services, expanding 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. Respondents' answers to the question "How do you assess the level of social services for the elderly and disabled" were distributed as follows:
60 Diagram 3. 80% Level of social services for the elderly and disabled 70% 60% 50% 40% 72% 30% 20% 10% 0% 18% 7% High 3% Fairly high Satisfactory Low Very high – 7% Fairly high - 18% Quite 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 social services of the required level to clients. To improve efficiency, it is necessary to increase the funding of social services for the elderly and 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 the elderly and the disabled to be disastrous. It can be concluded that the respondents equally appreciated the need for elderly citizens and disabled people in all types of social services that will help improve the financial situation of elderly citizens and disabled people, as well as in social assistance services.
61 The analysis of the results shows that, in general, the services that they need are provided to the elderly and people with disabilities, but it is alarming that these services are not fully provided. After analyzing the data of statistical reports on the work of the USZN administration of the Volokonovsky district and the data obtained in the course of the study, we can conclude that the organization of social services for the elderly and disabled in the context of a comprehensive center for social services for the population has some problems: - the ongoing growth of the elderly population increases the burden to social services; - the lack of sufficient information among the elderly and disabled about the forms and institutions of social services; - some forms of social services for the elderly and the disabled are not effective enough; - insufficient accessibility of the social environment for the elderly and the disabled; - the impossibility of continuing the labor activity of elderly citizens, while maintaining physiological well-being; - problems of interdepartmental interaction in the social sphere; - unsatisfactory financial, logistical support for the activities of social service institutions; - unsatisfactory personnel and information support for the activities of social service institutions; - Elderly citizens and disabled people often have problems that require specific assistance, so it is quite difficult for a client who has a number of problems to provide full and effective assistance. Questionnaires for senior citizens, disabled people and experts are in the appendix (appendices 1-3).
62 2.2. Recommendations for improving the social services for the elderly and the disabled in the conditions of a comprehensive center for social services for the population from the implementation of social partnership approaches and mutual responsibility of the state, employers, and society. Much depends on an adequate legal and regulatory framework, wage increases and the prestige of social workers. The developed recommendations for improving the social services for the elderly and the disabled in the conditions of the integrated center for social services for the population are complex: 1. It is necessary to coordinate the efforts of state and public structures in solving socio-economic, family, household, psychological and other problems of the elderly and disabled , as well as further steps to delineate the obligations and powers of the authorities in the field of social services for citizens. With regard to the activities of public authorities, it is necessary to improve the political and legal support of the system of social services for the elderly and the disabled. An important direction in the development of state social policy in relation to elderly citizens and disabled people should be a set of measures of a political, legal, economic, medical, social, scientific, cultural, outreach and personnel nature, aimed at achieving elderly citizens.
63 age and disabled material well-being and social well-being, creating conditions for active participation in society and longevity. For this, the following measures are necessary: - overcoming stereotyped views on old age; - overcoming negative attitudes towards disabled people; - sustainable improvement of the level and quality of life of elderly and disabled citizens on the basis of social solidarity and justice; - formation of a positive assessment of the role of the older generation in society as a carrier of moral, aesthetic cultural values and the main link in their transfer to younger generations; - increase in funding for the media that systematically cover the problems of the elderly and the disabled; - strengthening the material base of social service institutions for the elderly and disabled through increased interaction with non-governmental structures and charitable organizations. There is also a need for targeted activities to further strengthen the system of social services working with elderly and disabled citizens, develop a 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 for caring for elderly family members and the disabled, especially for the elderly and centenarians. These strategies should take into account the interests of women of all ages who are traditional caregivers of dependent family members. It is necessary to make a number of changes to the legislation on social services for the elderly and disabled, specifying 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 the prescribed manner. It is necessary to provide legal guarantees to elderly citizens and the disabled in order to ensure equal opportunities in the exercise 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 the socio-economic problems caused by the aging of the population and disability requires finding material and other resources, focusing them on priority goals, coordinating programs implemented in the interests of the elderly and disabled with general strategies for sustainable development. Recommendations for solving the socio-economic problems of social services for the elderly and disabled in the conditions of a comprehensive center for social services for the population are largely as follows: - it is necessary to diversify funding sources; - it is necessary to introduce elements of budget management; - it is necessary to restructure the network of social institutions; - 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 the elderly and disabled. It is the interaction of the state, society and citizens of the older generation in the implementation of activities aimed at the well-being and social well-being of elderly and disabled citizens, constant cooperation with the family, public associations and other social partners that provide elderly citizens and disabled people with protection, assistance and services. .
65 Elderly citizens and the disabled, as a rule, have limited physical and material opportunities for an active life, and get used to 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 stock of knowledge, skills and abilities, support the solidarity of generations and are the guardians of spiritual and moral values. 3. It is necessary to involve elderly citizens and disabled people - clients of the system of social service institutions in cooperation and development of social development strategies through meetings with the heads of the regional administration, enterprises, institutions, organizations. In addition, to conduct written and oral public opinion surveys (in particular, the disabled and the elderly), which allow them to be involved in the development and implementation of new models and forms of social services, allow them to participate in the planning of services. Feedback enables older people to successfully fulfill 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 the social services for the elderly and the disabled: - implementation of scientific and methodological support for the activities of social services; - introduction of new social technologies and new forms of work with the elderly and the disabled; - carrying out socially-oriented educational work with elderly citizens and the disabled;
66 - development and improvement of the implementation of social, new social programs of 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 the accumulated world and domestic experience, the study and generalization of cultural and historical traditions should become the basis for the training of professional workers for the social sphere. It is also important to note the prospects for the development of social services for the elderly and the disabled. The modern system of social services has been formed over the past decades. Social services for the elderly and disabled have now become an integral part of social security, one of its rapidly developing elements. At present, in connection with the processes of reforming the economic and social life in the country, the sphere of social services for the elderly and the disabled is continuously and dynamically developing. But, despite the large number of normative legal acts regulating relations for social services for the elderly and disabled, it is worth emphasizing that they still do not fully meet the requirements of society and do not meet the tasks that the state has set for itself. Therefore, it is necessary to further actively develop a system for providing elderly and disabled citizens with assistance to maintain their health and material
67 levels. To help in the further development and improvement of the sphere of social services for the elderly and disabled, of course, can competently drafted legislation. Obviously, after a certain time, a new model of social services for the elderly and disabled will be formed, which will simultaneously meet the objective needs of Russian society and the financial and economic capabilities of the state. Thus, it can be said that in the past few years a breakthrough has been made towards the effective and productive functioning of the entire social service system as a whole, as well as the system of social services for the elderly and disabled. The successful development of social services for the elderly and the disabled can be positively affected by the implementation of the recommendations developed by the author to improve the social services for the elderly and the disabled 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 the elderly and disabled in the Russian Federation is given more and more importance every year. Social policy in relation to the elderly and the disabled, its scope, direction and content throughout the history of the country were influenced and determined by the socio-economic and specific socio-political tasks facing society at one stage or another of its development. The allocation in the general structure of social policy of a special direction - social services related to the well-being and health of elderly citizens and the disabled, 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 the elderly and disabled 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 care in boarding schools, home care for those in need of outside 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, not guaranteed to absolutely every elderly and disabled person. Social services for senior citizens and disabled people should be focused on ensuring the availability of basic social services and guarantees for senior citizens and disabled people, regardless of their place of residence.
69 The social insecurity of elderly and disabled citizens is primarily associated with their physical condition, the presence of diseases, a decrease in physical activity, and the presence of a psychological factor that forms contact with other segments of the population. Therefore, the elderly and the disabled are the least protected and most socially vulnerable part of society. The Belgorod Region has a developed network of social service institutions for the elderly and the disabled. An important role in the development of new technologies for servicing the elderly and disabled belongs to the complex centers of social services for the population. At the same time, the need to coordinate the efforts of state and public structures in solving the socio-economic, family, household, psychological and other problems of the elderly and disabled is becoming more and more obvious. After analyzing the statistical data obtained in the course of the study, we came to the conclusion that the organization of social services for the elderly and disabled in the conditions of a comprehensive center for social services for the population has some problems: - the ongoing growth of the elderly population increases the burden on social services; - the lack of sufficient information among the elderly and disabled about the forms and institutions of social services; - some forms of social services for the elderly and the disabled are not effective enough; - insufficient accessibility of the social environment for the elderly and the disabled; - the impossibility of continuing the labor activity of elderly citizens, while maintaining physiological well-being; - problems of interdepartmental interaction in the social sphere;
70 - unsatisfactory financial, logistical support for the activities of social service institutions; - unsatisfactory personnel and information support for the activities of social service institutions; - Elderly citizens and disabled people often have problems that require specific assistance, so it is quite difficult for a client who has a number of problems to provide full and effective assistance. To solve the existing problems, the author developed recommendations for improving the social services for the elderly and the disabled in the conditions of an integrated center for social services for the population, which are complex in nature: and other problems of elderly and disabled citizens, as well as further steps to delineate the obligations and powers of the authorities in the field of social services for citizens. With regard to the activities of public authorities, it is necessary to improve the political and legal support of the system of social services for the elderly and the disabled. An important direction in the development of state social policy in relation to elderly citizens and disabled people should be a set of political, legal, economic, medical, social, scientific, cultural, outreach and personnel measures aimed at achieving material well-being and social well-being for older citizens and disabled people. well-being, creating conditions for active participation in society and longevity. For this, the following measures are necessary: - overcoming stereotyped views on old age; - overcoming negative attitudes towards disabled people;
71 - sustainable improvement of the level and quality of life of elderly and disabled citizens on the basis of social solidarity and justice; - formation of a positive assessment of the role of the older generation in society as a carrier of moral, aesthetic cultural values and the main link in their transfer to younger generations; - increase in funding for the media that systematically cover the problems of the elderly and the disabled; - strengthening the material base of social service institutions for the elderly and disabled through increased interaction with non-governmental structures and charitable organizations. It is necessary to make a number of changes to the legislation on social services for the elderly and the disabled, specifying the conditions for the provision of social, rehabilitation and other services to these persons 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 and disabled citizens in order to ensure equal opportunities in the exercise 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 the socio-economic problems caused by the aging of the population and disability requires finding material and other resources, focusing them on priority goals, coordinating programs implemented in the interests of the elderly and disabled with general strategies for sustainable development. Recommendations for solving the socio-economic problems of social services for the elderly and disabled in
72 conditions of a comprehensive center of social services for the population are largely reduced to the following: - it is necessary to diversify sources of financing; - it is necessary to introduce elements of budget management; - it is necessary to restructure the network of social institutions; - 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 the elderly and disabled. It is the interaction of the state, society and citizens of the older generation in the implementation of activities aimed at the well-being and social well-being of elderly and disabled citizens, constant cooperation with the family, public associations and other social partners that provide elderly citizens and disabled people with protection, assistance and services. . 3. It is necessary to involve elderly citizens and disabled people - clients of the system of social service institutions in cooperation and development of social development strategies through meetings with the heads of the regional administration, enterprises, institutions, organizations. In addition, to conduct written and oral public opinion surveys (in particular, the disabled and the elderly), which allow them to be involved in the development and implementation of new models and forms of social services, allow them to participate in the planning of services. Feedback enables older people to successfully fulfill 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 the elderly and disabled:
73 - implementation of scientific and methodological support for the activities of social services; - introduction of new social technologies and new forms of work with the elderly and the disabled; - carrying out socially-oriented educational work with elderly citizens and the disabled; - development and improvement of the implementation of social, new social programs of 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 the accumulated world and domestic experience, the study and generalization of cultural and historical traditions should become the basis for the training of professional workers for the social sphere. Social services for the elderly and disabled have now become an integral part of social security, one of its rapidly developing elements. At present, in connection with the processes of reforming the economic and social life in the country, the sphere of social services for the elderly and the disabled is continuously and dynamically developing. It is obvious that in the near future a new model of social services for the elderly and the disabled will be formed, which will simultaneously meet the objective needs of the Russian economic opportunities of the state. society and financial
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80 APPENDIX
81 Appendix 1 Questionnaire (for senior 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 the elderly and disabled in the conditions of a comprehensive center for social services for the population, ask you to fill out a questionnaire. Circle the answer that matches your opinion. If you have your own answer, write it in the "other" column. 1. How do you rate your state of health? 1. Good 2. Satisfactory 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 feel bad all the time 3. I don't complain, I'm in good health 4. Other 4. What problems are you currently worried about? 1. Material 2. State of health 3. Psychological 4. Other 5. How do you assess the quality of social services in the complex center? 1. Good 2. Very good 3. Normal 4. Poor 5. Other
83 13. What would you like to change in the work of this institution? 1._______________________________________________________ 2. Don't know 14. Your gender: 1. Male 2. Female 15. Your age: 1. 55 - 65 2. 66 - 72 3. 72 - 80 4. 80 and over 16. Your education: 1. Secondary 2. Higher 3. Other__________________________________ Thank you for participating!
84 Annex 2 Questionnaire (for the disabled) 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 the elderly and disabled in the conditions of a comprehensive center for social services for the population, ask you to fill out a questionnaire. Circle the answer 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 feel bad all the time 3. I don't complain, I'm in good health 4. Other 4. How do you rate the quality of social services in the complex center? 1. Good 2. Very good 3. Normal 4. Bad 5. Other 5. What problems are you currently experiencing? 1. Material 2. Disability 3. Psychological 4. Other
86 13. What would you like to change in the work of this institution? 1._______________________________________________________ 2. Don't know 14. Your gender: 1. Male 2. Female 15. Your age: 1. 55 - 65 2. 66 - 72 3. 72 - 80 4. 80 and over 16. Your education: 1. Secondary 2. Higher 3. Other__________________________________ Thank you for participating!
87 Annex 3 Questionnaire (questionnaire of an expert) 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 the elderly and disabled in the conditions of a comprehensive center for social services for the population, ask you to fill out a questionnaire. Circle the answer 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 the elderly and disabled? 1. Insufficient funding 2. Lack of qualified personnel 3. The need to update the material and technical base 4. Imperfect legal framework 2. Do your clients fully understand the difficulties associated with reaching old age? 1. Yes, fully aware 2. Not fully aware 3. Other 3. How would you rate social services for the elderly and disabled? 1. Very high 2. Sufficiently high 3. Quite satisfactory 4. Not high enough 4. What are the problems your customers are 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 complex center? 1. Good 2. Very good 3. Normal 4. Poor 5. Other
88 6. Are you satisfied with your relationship with clients? 1. Yes, satisfied 2. No, not satisfied, I would like the attitude to be better 7. Have you 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 unresolved 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'm satisfied with everything 2. I'm not satisfied with everything 3. It's difficult to answer 10. What services do you consider to be the most significant? 1. Social and domestic 2. Socio-medical 3. Socio-economic 4. Socio-legal 11. Are you satisfied with the quality of service in the complex center? 1. Yes, I am 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. Don't know 13. Your gender: 1. Male 2. Female 14. Your age: 1.___________
89 15. What is your education: 1. Secondary 2. Higher 3. Other__________________________________ Thank you for your participation!
Legal basis for social assistance to the elderly and disabled
The main directions of social services for disabled people are enshrined in the Federal Law of 08/02/1995, as amended on 08/22/2004 "On social services for elderly citizens and disabled people". According to this law, persons with disabilities in need of permanent or temporary outside assistance due to partial or complete loss of the ability to independently satisfy their basic life needs due to limited ability to self-service and (or) movement, have the right to social services provided in the public and non-public sectors of the system social service.
Social services for persons with disabilities are carried out by decision of the social protection authorities in institutions subordinate to them or under agreements concluded by social protection authorities with social service institutions of other forms of ownership.
Social services are provided subject to the voluntary consent of persons with disabilities to receive social services. Social services at the request of disabled people can be carried out on a permanent or temporary basis.
Disabled persons, as well as their legal representatives, have the right to refuse social services, with the exception of cases specifically provided for by the Federal Law of 08/02/1995, as amended on 08/22/2004 "On social services for elderly citizens and disabled people". In case of refusal of social services, the disabled, as well as their legal representatives, are explained the possible consequences of their decision.
The refusal of disabled people from social services, which may lead to a deterioration in their health or a threat to their lives, is documented in a written application by the disabled or their legal representatives, confirming the receipt of information about the consequences of the refusal.
Restrictions on the rights of persons with disabilities in the provision of social services to them are allowed in cases where they are deprived of care and support from relatives or other legal representatives and, at the same time, are not able to independently satisfy their vital needs (loss of the ability to self-service and (or) active movement) or are recognized in legally incompetent. The issue of placing disabled people in stationary 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 stationary social service institutions for disabled people who have lost the ability to satisfy their basic vital needs or have been recognized incapacitated in accordance with the procedure established by law, is made upon a written application of their legal representatives if they undertake to provide these persons with care and necessary living conditions.
Persons with disabilities who are bacterial 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 health care institutions, may be denied social services at home. Such a refusal is confirmed by a joint conclusion of the body of social protection of the population and the medical advisory commission of the healthcare institution.
Forms of social service:
1. social services at home (including social and medical care);
2. semi-stationary social services in departments of day (night) stay of social service institutions;
3. stationary social services in stationary social service institutions (boarding houses, boarding houses and other social service institutions, regardless of their name);
4. urgent social services;
5. social advisory assistance.
Disabled persons may be provided with housing in the houses of the housing fund for social use.
Social service at home is one of the main forms of social service aimed at the maximum possible extension of the stay of disabled people in their usual social environment in order to maintain their social status, as well as to protect their rights and legitimate interests.
The following social services are guaranteed by the state for home care:
1. catering, including home delivery of groceries;
2. assistance in the acquisition of medicines, food and industrial essential goods;
3. assistance in obtaining medical care, including escort to medical institutions;
4. maintaining living conditions in accordance with hygiene requirements;
5. assistance in organizing legal assistance and other legal services;
6. assistance in organizing funeral services;
7. other home social services.
When servicing disabled people living in residential premises without central heating and (or) water supply, the number of home social services provided for by the list of state-guaranteed social services includes assistance in providing fuel and (or) water.
Other out-of-home services may be provided to persons with disabilities on terms of full or partial payment.
Social and medical care at home is provided for people with disabilities in need of home social services, suffering from mental disorders (in remission), tuberculosis (except for the active form), serious diseases (including cancer) in the late stages, with the exception of persons who are bacterio- 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 facilities.
Urgent social services are carried out in order to provide emergency assistance of a one-time nature to disabled people who are in dire need of social support. In this regard, the following services can be provided:
1. one-time provision of free hot meals or food packages to those in dire need;
2. provision of clothing, footwear and other essentials;
3. one-time provision of material assistance;
4. assistance in obtaining temporary accommodation;
5. organization of legal assistance in order to protect the rights of persons served;
6. organization of 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 to persons 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.
This assistance is focused on their psychological support, intensification of efforts in solving their own problems and provides for:
1. identification of persons in need of social advisory assistance;
2. prevention of various kinds of socio-psychological deviations;
3. work with families in which people with disabilities live, organizing their leisure time;
4. advisory assistance in training, vocational guidance and employment of disabled people;
5. ensuring the coordination of the activities of state institutions and public associations to solve the problems of disabled people;
6. legal assistance within the competence of social service bodies;
7. other measures to form healthy relationships and create a favorable social environment for people with disabilities.
The procedure and conditions for the provision of free home, 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.
According to the Federal Law of 17.07. 1999, as amended on November 25, 2006, “On State Social Services”, persons with disabilities can apply for the provision of the following set of services:
1. additional free medical care, including providing the necessary medicines by prescription, providing, if there are medical indications, vouchers for sanatorium-and-spa treatment, carried out in accordance with the legislation on compulsory social insurance;
2. free travel on suburban railway transport, as well as on intercity transport to the place of treatment and back.
In the provision of social services, persons with disabilities who have a III degree disability have the right to receive, under the same conditions, a second voucher for sanatorium treatment and free travel on suburban railway transport, as well as on intercity transport to the place of treatment and back for person accompanying them.
The list of medicines, as well as the list of sanatorium-resort institutions, were approved by the relevant orders of the Ministry of Health and Social Development.
Accounting for the right of citizens to receive social services is carried out at the place of residence of a citizen from the moment a monthly cash payment is established to him.
Social services are provided for a calendar year. If a disabled person has acquired the right to receive social services during a calendar year, then the period for the provision of social services to him is the period from the moment of acquiring the right to receive social services until December 31 of the current year.
Payment for social services is made by deducting a certain amount from the monthly cash payment (MCU). For example, if a disabled person refused free travel in railway transport, then 97.53 rubles will be deducted from his monthly cash payment, the amount of which depends on the degree of restriction of the ability to work.
