Stationary social service institutions and the goals of their activities. Inpatient social services

Network of hospitals social services, in which elderly people live, as of 01/01/04, was represented by 1222 institutions. The quantitative ratio of the types of inpatient institutions providing social services to older people is as follows:

56% – boarding homes (DI) for the elderly and disabled ( general type), including 40 special institutions (for the elderly and disabled people who have returned from prison);

36.2% – psychoneurological boarding schools (PNI);

5.8% – boarding houses of mercy (CHM) for the elderly and disabled;

2% – gerontological (gerontopsychiatric) centers (GC).

At the beginning of 2004, according to operational data, approximately 150-160 thousand elderly people lived in inpatient social service institutions, which is slightly more than 0.5% of the total number of older citizens (in countries Western Europe– from 2 to 4%).

Mercy homes and nursing homes existing in different systems are almost no different from each other in the content of their work.

In general, in social institutions where older people live, women predominate, but very slightly - 50.8%, which clearly does not correspond to the structure of the elderly part of our society (in the general contingent of elderly people aged 60 years and older, the ratio of women to men is 2 :1, and at the age of 80 years and older – 4:1). In psychoneurological boarding schools, the opposite is true; The female share is significantly less than the male share - 40.7%. Thus, the usual opinion that the residents of boarding schools are mainly elderly women does not coincide with official statistical data. This is most likely due to the fact that women cope with social and everyday problems relatively easier against the backdrop of serious deterioration in health in old age and retain the ability to self-care longer.

The health status of any person can be assessed according to different parameters, but for people living in a special housing unit, one of the indicators that determines the specifics of their life activity and the characteristics of social services is “bedridden.” A third of residents (33.9%) are on permanent bed rest in inpatient social service institutions. Given that the life expectancy of elderly people in such institutions exceeds the average for this age category, many elderly people remain in this condition for several years. This, of course, worsens their quality of life and poses difficult challenges for service personnel.

Another trend is the development over the last decade specialized institutions – inpatient gerontological (gerontopsychiatric) centers and boarding houses of mercy for the elderly and disabled. Gerontological centers to a greater extent perform the functions of care, providing medical and palliative services, which should rather be typical of compassionate homes, specifically designed to serve those on constant bed rest and in need of care (in the GC - 46.6% of such a contingent, and in the DIM – only 35%). Formally, their status changed from medical-social to socio-medical, but medical care has been and remains dominant over other types of services.

Positions of other social specialists (specialists in social work, psychologists and speech therapists) are not included in the basic staffing schedules at all and are available in very limited quantities.

Not provided staffing schedules and on top of them, but also in a very small number, positions of specialists providing health (rehabilitation) services were introduced (physical therapy doctors, physical therapy instructors and nurses for massage).

Gerontological (gerontopsychiatric) centers (GC) are a special type of social institutions for older people. The GC can provide social services to citizens of older age groups, profiled in accordance with their age, health status, social status and depending on the degree of their need for outside care in stationary, semi-stationary and home conditions. Existing gerontological centers solve mainly everyday, current issues that, as a rule, do not go beyond the competence of a particular institution and are not aimed at solving any general regional problems.

And with the right ideological approach gerontological centers must decide regional problems, related to population aging and not only current, but also future (taking into account the demographic forecast). The centers must engage in scientific developments in the field of social gerontology and carry out scientific and methodological activities. One of the mandatory functions is organizational and methodological work with all gerontological social institutions in the region. In addition, the center should be entrusted with the functions of a coordinating body that ensures the interaction of all state and non-state structures dealing, to one degree or another, with the problems of older people. The gerontological center should be a conductor of regional social policy regarding older people.

In parallel with institutions of health care and social protection of the population, social and medical services are provided to older people by a few non-governmental structures (Mercy Service of the Russian Red Cross, regional fund “Good Deed”, center “Hand of the World”, etc.), but, unfortunately, in very limited scope, since in most regions they do not receive tangible support from executive authorities.

The Ministry of Health and social development Russian Federation, which should act both as an ideological center and as a coordinator of the activities of all interested structures. The merger of departments should push the organizers of social protection of the population and healthcare to eliminate duplication of functions between departments of social and medical services and departments of medical and social assistance.

All the proposed changes are possible only with a serious revision of the legal framework for ensuring the health of older people, which would not be limited only to the organization of medical care and social and medical services. It should reflect, from a scientific point of view, the issues of organizing nutrition for older people, their health improvement and drug supply, without which it is impossible to maintain health at least at a satisfactory level and, in general, talk about improving the quality of life of representatives of the older generation.

Security questions:

1. What legal documents Russian legislation Do you know about medical care for elderly patients?

2. What diseases and social services for older people are subject to home-based social services?

3. What are the positive aspects of home-based social and medical care for older people?

4. Specify the reasons for the reduction of home care departments.

5. What are the objectives of the Hospice at Home service?

6. What are the benefits of Hospice at Home?

7. What semi-stationary institutions of social and medical services do you know and their functions?

8. What inpatient social and medical care institutions do you know and their functions?

9. What are the tasks and functions of the gerontological center?

TOPIC 3. Features of reactions to illness and stress in elderly and senile people. Basic needs and problems of elderly and senile people. Features of communication, collecting information and performing stages of the nursing process.

On social services for elderly citizens and disabled people

Federal law dated August 2, 1995 N 122-FZ (as amended on January 10, 2003, August 22, 2004)

Article 19. Semi-stationary social services

Semi-stationary social services include social, medical and cultural services for elderly citizens and the disabled, organizing their meals, recreation, ensuring their participation in feasible work activities and maintaining an active lifestyle.

Semi-stationary social services are accepted for elderly citizens and disabled people who need it, who have retained the ability for self-care and active movement, and who do not have medical contraindications for enrollment in social services provided for in part four of Article 15 of this Federal Law.

The decision to enroll in semi-stationary social services is made by the head of a social service institution on the basis of a personal written application from an elderly or disabled citizen and a certificate from a health care institution about his state of health.

The procedure and conditions for semi-stationary social services are determined by the executive authorities of the constituent entities of the Russian Federation.

Article 20. Inpatient social services

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

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

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

It is not permitted to place disabled children with physical disabilities in inpatient social service institutions intended for the accommodation of children with mental disorders.

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

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

Article 21.

Responsibilities of the administration of a stationary social service institution

The administration of a stationary social service institution is obliged to:

respect human and civil rights;

ensure personal integrity and safety of elderly citizens and disabled people;

inform elderly citizens and disabled people living in a stationary social service institution about their rights;

perform the functions assigned to her as guardians and trustees in relation to elderly citizens and disabled people in need of guardianship or trusteeship;

carry out and develop educational activities, organize recreation and cultural services for elderly citizens and disabled people;

provide elderly citizens and disabled people living in a stationary social service institution with the opportunity to use telephone and postal services for a fee in accordance with current tariffs;

allocate to spouses from among elderly and disabled citizens living in a stationary social service institution an isolated living space for joint living;

ensure the possibility of unhindered reception of visitors both on weekends and holidays, and on weekdays in the daytime and evening;

ensure the safety of personal belongings and valuables of elderly citizens and disabled people;

perform other functions established by current legislation.

Federal Law of December 10, 1995 N 195-FZ "On the fundamentals of social services for the population in the Russian Federation"

Article 10. Social services in inpatient institutions

Social services in inpatient social service institutions are carried out by providing social services to citizens who have partially or completely lost the ability to self-care and need constant outside care, and ensure the creation of living conditions appropriate to their age and health status, carrying out medical, psychological, social activities, nutrition and care, as well as the organization of feasible work activities, rest and leisure. 48.

More on the topic Inpatient social services:

4. State regulation of the organization of social services and social protection of the population
Topic 22. State regulation of healthcare, social services and social protection of the population

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Department of Education of the Kemerovo Region

State educational institution

Secondary vocational education

"Kuznetsk Metallurgical College"

Specialty: “Law and organization of social security”

Coursework

In the discipline "Law and Organization" social security»

On the topic: “Inpatient social services”

Completed by student gr. PVS-113

Meshcheryakova E.E.

Checked by: discipline teacher

"social security law and organization"

Trescheva O. Yu.

Novokuznetsk, 2013

Entertion

Chapter 1. Characteristics of certain types of social servicesAnia

1.1 Inpatient social services for disabled and elderly people held in social protection institutions

1.2 Semi-stationary social services for disabled people and elderly people kept in social protection institutions

2. Help for the elderly

2.1 Principles of care for the elderly

2.2 Moving and transporting patients

3. Help for the disabled

Conclusion

Literature

Regulatory acts

Introduction

Relevance of the study dictated by several points:

The problem of medical and social services (MSS) for older people in Russia is becoming more acute in the context of an increasing global trend of population aging. This problem is also updated due to its multidimensional nature. This is a whole range of issues: medical, economic, social, cultural. For this age group characterized by downward social mobility, the loss of many social positions. Pensioners are often the poorest part of the population, marginalized due to the redistribution of traditional roles in society. Elderly people's health deteriorates sharply.

A sociological study of the problem of medical and social services for older people will allow us to analyze the behavioral strategies of older people and explain the reasons for the rejection of institutions created for older people. The study of these problems has practical significance for sociology. Elderly people, who make up a quarter of the Russian population and have high electoral activity, cannot be ignored by politicians and managers when determining social policy. Modern practice shows that quantitative indicators can develop into qualitative indicators at any time. Thus, in Russia, pensioners are self-organizing into a social and political group, often uniting a protest electorate.

Research problem is that inpatient medical and social services require changes at the management level in relation to nursing homes, but the sociology of management has not developed ways and means to improve the activities of inpatient institutions. social services elderly disabled

Purpose of the work is to study the activities of specialists and services for the social adaptation of older citizens in inpatient settings

Job objectives:

1) Give a theoretical analysis of the activities of social services aimed at social adaptation elderly citizens living in inpatient institutions;

Object of study: inpatient facility.

Subject of research: activities of inpatient department specialists, which is aimed at organizing the adaptation of elderly and disabled people to living conditions in this department.

Research methods:

1) Theoretical: analysis scientific literature on the research problem.

1. Characteristics of certain types of socialservice

1.1 Inpatient social services for disabled people andelderly,held in social protection institutions

Inpatient social services for disabled people and elderly people held in social protection institutions have following features: Inpatient social services are provided in boarding homes for the elderly and disabled, boarding homes for the disabled, psychoneurological boarding schools, etc.; Citizens of retirement age (women over 55 years old, men over 60 years old), as well as disabled people of groups I and II over 18 years old, are accepted into boarding homes, provided that they do not have able-bodied children or parents obligated to support them;

Only disabled people of groups I and II aged 18 to 40 who do not have able-bodied children and parents obligated by law to support them are accepted into boarding homes for the disabled;

The children's boarding home accepts children from 4 to 18 years old with mental or mental anomalies. physical development. At the same time, it is not allowed to place disabled children with physical disabilities in inpatient institutions intended for the residence of children with mental disorders;

Persons suffering from mental disorders are admitted to the psychoneurological boarding school. chronic diseases those in need of care, household services and medical assistance, regardless of whether they have relatives obligated by law to support them or not;

Persons who systematically violate the rules are sent to special boarding homes internal regulations, as well as persons from among especially dangerous criminals, as well as those involved in vagrancy and begging;

Inpatient institutions provide not only care and necessary medical assistance, but also rehabilitation measures of a medical, social, domestic and medical-occupational nature; Application for admission to a boarding home along with medical card is submitted to a higher-level social security organization, which issues a voucher to a boarding house. If a person is incapacitated, then his placement in a stationary institution is carried out on the basis of a written application from his legal representative; If necessary, with the permission of the director of the boarding home, a pensioner or disabled person may temporarily leave the social service institution for a period of up to 1 month. A permit for temporary departure is issued taking into account a doctor’s opinion, as well as a written obligation of relatives or other persons to provide care for an elderly or disabled person.

1.2 Semi-stationary social servicesdisabled and elderly people kept ininstitutionssocial protectionpopulation

The features of this type of service are:

Semi-stationary social services are provided for elderly and disabled people who have retained the ability for self-care and active movement and have no medical contraindications to enrollment in such social services, as well as children who find themselves in difficult life situations, and persons without a fixed place of residence and occupation.4

This type of social assistance is provided in semi-inpatient facilities created in municipal social service centers or under social protection authorities, and provides for the provision of social, medical, cultural and advisory assistance to these categories of citizens.

2. Help for the elderly

2.1 Principles of care for the elderly

First of all, one should distinguish between physical and mental assistance. Caring for a somatically weakened sick old man is much easier and qualitatively different than caring for a patient with senile dementia.

A seriously ill old person with intact consciousness and orientation should have a well-organized life. Excess furniture should be removed from the patient’s room so that one can move freely in it, use wheelchair or other care device. The room of a chronically ill person should be bright, without dark curtains or drapes. It is advisable to keep the window always open or open the window more often to ventilate the room. The temperature in the room must be maintained at a certain level; the patient should not stay in a hot, poorly ventilated room. In summer, the window should be open constantly, and in winter, the air temperature in the room should be about 18°C. The temperature and humidity in the patient's room are extremely important, and, as a rule, it is easy to maintain the required level.

The bed should be placed so that you can approach the patient from both sides, this will make it easier to care for him, and will also make it easy to change the position of the patient. A bed placed against the wall forces the patient to lie almost constantly on one side - facing the room, which can be detrimental to him, especially if he suffers from chronic vascular insufficiency, as it contributes to the formation of unilateral edema, bedsores, unilateral pneumonia (due to poor ventilation of one lung).

As for the position of the bed relative to the window, you should know that if the patient lies facing the window, then the bright light hits the eyes, this position quickly depresses him, so it is best if the patient lies sideways to the window (right or left).

The bed should occupy a central place in the room. A table or bedside table with items necessary for the patient should be placed near it at arm's length. The table should be covered with a napkin or synthetic tablecloth that is easy to wash. You should not keep many objects on the table, as they will turn over, get confused, and spill. It is better to place flowers, which have such a good effect on the mood, not on the bedside table, but at some distance, but within the patient’s field of vision. There should be newspapers, a book, and handicrafts next to the bed.

The patient’s room should contain his bed linen, underwear, towels and other items necessary for care. If the patient periodically gets dirty bed sheets, then you should use linings, which are usually used for old linen.

In one place, preferably on a rack or on one of the cabinet shelves, you should store all the medications used by the patient, as well as a tray with rubbing liquid, powder and salicylic alcohol. Medicines should be located somewhat away from the patient so that he cannot reach them; this will save the patient from unpleasant mistakes. At the same time, medications that the patient can take himself during the day should be kept on the bedside table. If he takes different medications in different times days, then they can be put into small boxes different colors. This in a simple way mistakes can be avoided when taking medications, since the patient will remember that in the morning he should take medications, for example, from a white box, in the afternoon from a red one, and in the evening from a blue one.

2.2 Moving and transporting patients

But even the most thorough daily toilet does not allow an old sick person to be kept with the proper frequency. It is necessary to wash the patient in the bath at least once a week. However, the elderly themselves often have a negative attitude towards this, and sometimes it is difficult to persuade them to take a bath. It is best to take a bath in the evening. If the patient gets out of bed, he is washed in the bath. To do this, place a small stool in it or place a board on the edges on which the patient sits. Wash the patient with a washcloth, rinsing with a shower hose. After washing, the patient is dried with a fairly hard towel, dressed in clean linen and escorted to bed in a room that has already been cleaned and ventilated. If it is difficult for the patient to get in and out of the bath, then a stool placed in the bath should be used. To enter the bath, the patient sits on a stool, leaving his legs hanging over the edge of the bath, and the person caring for him lifts his legs (both at once or separately), supporting him with his second hand behind his back, and moves them into the bath. Exit from the bath is done in the same way. Seriously ill patients who do not get out of bed are washed in bed, as described above.

Another serious complication is bedsores, which are manifested by necrosis of the skin and subcutaneous tissue, the formation of very slowly healing trophic ulcers and occur as a result of prolonged pressure on these places.

Most often, bedsores occur in places where bones come close to the surface of the body, which compress the tissues and cause their death. Most common reasons The appearance of bedsores is caused by poor care and prolonged immobility. Poor care is, first of all, a poorly made bed with folds, a poorly ironed shirt, a damp bed. The causes of bedsores are also injuries, local and general circulatory disorders, metabolic disorders, in particular diabetes mellitus and obesity.

Plaster casts applied for a long time are also dangerous for old people in terms of bedsores. The most common places for pressure sores to form are the area of the coccyx and sacrum, as well as the areas of the shoulder blades, elbow joints and heels.

If the patient lies on his side for a long time, bedsores form in the area of the hip and knee joints.

A patient prone to bedsores should be washed more often, especially in areas where bedsores are likely to occur, so that sweat and dirt do not accumulate on them. After washing, these places are thoroughly wiped, and then rubbed with alcohol, massaged, sprinkled with talcum powder or lubricated with Vaseline or greasy cream, protecting the skin from moisture. Patients who are at risk of developing bedsores should be provided with a sponge mattress, and if possible, then with a special mattress to prevent bedsores, filled with constantly moving air that massages the body and prevents the formation of bedsores. In untidy patients, the likelihood of developing bedsores increases sharply.

A patient who cannot sit up in bed must still perform passive and active movements of the arms and legs, while taking several deep breaths to ventilate the lungs, which is preventive measure regarding possible complications from the lungs. The patient should perform such exercises 2-3 times a day.

All these simple activities play a very important role in maintaining at least minimal physical fitness, because nothing worsens the physical and mental state more than immobility. Very careful care and constant assistance to the patient in performing any actions and movements are not always beneficial. The chronically ill person must be forced to participate in activities for his care and the range of this participation must be gradually expanded.

Shoulder elevation using a manual block for patients.

It is used when lifting a patient in bed with one person, provided that one side of the patient’s body is healthy, he can help you, and there are no contraindications to this.

Stand on the side of the patient where he has the lesion. The patient bends his unaffected knee and places his unaffected arm behind him, using a hand block to prop himself up. Perform the lift as described for the shoulder lift, asking the patient to push off with the heel of the good leg, resting their hand on the block. Movement can be carried out in stages over a short distance.

Turning the patient in bed.

Turning occurs by rolling or smoothly moving the patient towards you, but never away from you. Do not reach forward to lift a patient who is some distance away from you.

In most cases, the patient will have to be rolled onto his back and then moved to the edge of the bed until he is back in the middle of the bed, jerking back to his original position. To move a person to the edge of the bed, first move his head and shoulders, then his legs, and then his torso. To perform each of these movements, place your arm under the patient on the side of the bed to which you are moving him or her, stand in a leg position for balance, and roll the patient to the edge of the bed. If the patient is obese, you may need two people to move the patient's torso and hips; stand side by side and turn the patient using a taut sheet, alone or with two people.

Imagine that you have just moved a patient to the edge of the bed following instructions. Now you can roll him to the middle on his right side: first prepare the patient's head and shoulders and make sure that the arm is free. Using your knee and shoulders as leverage, roll your torso toward you.

Lifting by rocking.

Used to help the patient stand up and move to another place, provided that the patient can participate in the movement and control the position of his head and arms.

You can reduce the effort of lifting the patient by gently rocking him. Start by helping him move to the edge by gently rocking him from side to side and alternating his feet forward. The patient's knees are at a 90° angle with the knees and feet together. Stand with one foot next to the patient and the other in front of him, locking his knees. In this position, you can help the patient stand up, move him at an angle of 90° from a chair to a wheelchair, etc., turn him 180° from a wheelchair.

In each case, the swing follows the same principle; begin the movement rhythmically, moving your body weight back and forth, keeping the patient close to you. By doing this, you transmit the impulse of rocking back and forth to the patient. There is no need to lift the patient: with the help of your body weight, enough kinetic energy to move. Do a few preparatory rocking motions to establish the rhythm, then move more intensely, stimulate the patient (“get ready, get ready, do”) and the movement is accomplished. You can use the axillary grasp or pelvic or waist-belt hold to help the patient stand or move him or her from a 90° sitting position to another position. For the last movement, for example moving with wheelchair on the toilet seat, move both seats together, corner to corner, block the wheels and remove the backrests.

To transfer a patient from a height-adjustable bed to a chair, place the chair next to the bed with no space between them. If possible, lower the bed and move the patient as described above.

Methodology carried out by three persons.

It is used when lifting a patient from a bed to a gurney and vice versa only in the absence of a lifting mechanism or stretcher and aids for smoothly rolling the patient from one surface to another.

Position the gurney at an angle of at least 60° to the bed.

If possible, place the bed on maximum height and put the gurney and bed on the brake. The staff should stand on the side of the gurney that faces the bed, facing the patient, with the strongest nurse in the center. Place one leg forward, bend your knee, and stand as close to the bed as possible. Step your other leg back to maintain balance.

Gently place your arms up to the elbows under the patient. The nurse, positioned at the patient's head, lifts the head and supports the shoulders and upper back. The center nurse supports the lower back and buttocks, and the third nurse supports the knees and legs. If the patient is very sick, more people may be needed and the workload will have to be redistributed.

Lift the patient in two stages: first, gently roll him to the edge of the bed, then lift him and transfer him to the gurney. When one of the nurses gives the command, shift your body weight from your forward leg to your backward leg to smoothly roll the patient to the edge of the bed. Pause to change your position of holding the patient and your posture for the lift itself. On the second command (coherence of movements is crucial), roll the patient onto you - press him to your chest and lift him. The closer you can hold the patient while lifting and stand straighter, the less physical activity. Then move backwards. One of the nurses, holding her legs, takes longer steps while everyone else stands parallel to the gurney. On the third command, bend your knees and carefully lower the patient onto the gurney.

Note. Manually lifting the patient out of the bath is necessary only in emergency cases, if the patient becomes ill, loses the ability to move, or under other circumstances. Because of the awkward position you assume due to the shape of the bathtub and the possibility of slipping, there is always a danger when lifting a patient out of the bathtub by hand. If a bedridden patient cannot be bathed without appropriate aids or lifting devices, the patient should be washed in bed, in a shower stall or under a portable shower. In emergencies, it is good to still have water in the bath, partly because it gives the patient buoyancy.

Method of carrying out the procedure by two persons.

If there is access to the tub from both sides and the patient is able to firmly grasp your wrist, you can use a modified overhand grip. Stand on either side of the tub and use an overhand grip. Place your supporting hand on the edges of the tub. If a bathtub seat is available, use it to perform the lift in two stages. If the bathtub is located against a wall, one of the nurses could step into the bathtub with or without shoes, whichever is less slippery (remember, you will only do this in emergency). An overhand grip may be the best solution when one of you is in the bath and the other is out. If you have a colleague to help you, one of you can stand with both feet in the tub and the other can lift the patient's legs when the nurse in the tub gives the command. Lift the patient high enough to sit on the edge of the tub with their legs dangling, then transfer them to a gurney, stretcher, or chair using the techniques described above.

You will often be expected to assist a patient as they begin to walk after a period of bed rest, such as after a severe injury or stroke.

First, carefully assess what the patient can do independently or with the assistance of one or more persons, using assistive devices such as a cane, crutches, or when a support structure can be used. When you decide to help, stand close to the patient and apply a thumb grip: hold the patient's right hand in yours right hand and do the same with the left. The patient's arm should be straight, with the palm resting on your palm with the thumbs clasped together. You can use your other hand to avoid unnecessary stress on your back and also to support the patient. If he feels unsure, support him by the waist and use it to secure his knees while moving with your leading leg. In this position, you can keep the person from falling with minimal effort.

When you lift or support a patient, unfortunately, not everything can go as expected and you will not be able to hold him. When this happens, don't get lost: it is safer if the patient falls to the floor slowly and gently.

Let it slide down along your body without straining yourself. This fall is controlled. You can then try to help the patient lie on their side or sit up with a pillow or blanket while you seek help.

Method for two people.

If there is no danger to the patient and he can assist you, then one of the nurses can lift the patient using an arm grab while the other lifts the legs. You both bend your knees and carefully straighten up. Alternatively, you can use a modified shoulder lift technique. For the first stage of lifting - from the floor to a low chair - you may find it most comfortable to kneel, but at each stage of the lift you need to be sure that you have a firm support for your non-lifting arms. Patients who are only partially ambulatory are sometimes able to cope with minimal assistance; they may first roll onto their side (maybe with your help), then lean their shoulder on a low stool, chair, or bed to kneel , from this position they can sit or lie down.

If the patient cannot or does not need to be seated and there is no hoist, stretcher or lifting aid available, the patient must be lifted from the floor manually.

In this case, the patient is lifted by 3 people. This requires great care. This technique involves bending forward and lifting the front of your knees, so it is potentially dangerous. Put yourself physically strong man in the middle so that he takes on the heaviest part of the load. Coherence of movements is important; If inexperienced persons assist in lifting, ensure that they are properly instructed.

Of course, these practical developments can help both in helping patients at home and in the hospital.

3. Help for people with disabilities and their families

The personality and character of the person in trouble, as well as the person caring for him, are the main sources in overcoming the problems of disability, but what makes sense for the first, for the second, quite likely will not be so.

One of the foreign scientists proposed the following definition of disability: it is the insufficiency of work or the inability to do it of certain parts of the body or head. Everyday things that come easily to most people require the greatest effort, and doing them certain functions turns out to be impossible. Walking, talking, looking, listening, bathing, eating, communicating, understanding; may be violated or simply impossible without special devices.

When disabled people appeared on the streets, it became obvious that it was necessary to provide them with amenities in public buildings, at work, in transport, on planes, trains, and buses. Individual remedies were in most cases unavailable. You can, of course, talk to the people on whom the free issuance of individual funds depends, but people will most likely refuse to help.

There is a tendency among the public to overestimate what is available to a disabled person, and sometimes this overestimation creates feelings of resentment.

When we are struck by misfortune, we first become numb, then furious, and then afraid. Emotions are strong, violent and over time overwhelm us. You need to learn to manage them, turning their flow into a means of your own life.

It is difficult to predict which people will behave how. But people with disabilities and those caring for them must adhere to the rule: make their own decisions and make own mistakes. The one who does nothing makes no mistakes. Mistakes are an extremely important part of our life and development.

Whether a disability suddenly befalls someone or their health status deteriorates gradually, whether this deterioration ends or never stops, in all cases, for the victim and those caring for him there is a devastating moment of shock, an unexpected perception. Some consulting specialists understand well how powerful a blow can be inflicted, and speak in a language understandable to the uninitiated. Others use professional terminology, preferring to cite research, and are frustrated by their own powerlessness to cure the disease. Consulting specialists are usually available to help by answering questions and repeating medical details.

Such specialists look at the family as a whole, and a doctor who can listen to you will know what help and when to offer it.

Conclusion

Strengthening the sense of security among older people and disabled people requires constant changes in the set of social services provided to them. At the same time, when taking new steps, it is necessary to calculate each time how this change will affect the situation of other members of society - children, women, youth, the well-being of families, and relations in society, the economy and the state. Not only in our country, but also in many countries, allocations for social services are limited by the real possibilities of the budget and the need to implement a balanced state social policy.

In these conditions, solving the problems of social protection of older people and disabled people requires more active participation society because the costs of indifference, passivity or inaction towards dependent older fellow citizens are too high. One form of public participation in the future could be a foster family for an elderly or disabled person. The foster family model for children is well known abroad, as well as the practice of accepting elderly people and disabled people into families with the condition that the state pays for the services provided. The example of France is especially convincing in this regard.

An elderly person enters a foster family with the hope of overcoming loneliness, receiving care, maintaining dignity in old age and a sense of usefulness to others while remaining in the familiar home environment.

At the other extreme of the problem is a family that is ready to accept an old or disabled person and provide him with care and support on a contractual basis.

The relationship between the parties is based on the principle of “deferred payment” for the services provided to an elderly person that the foster family receives (transfer of ownership of movable and immovable property, such as housing), as well as the principle of reciprocity, which allows for normal conditions, life for all involved. The current socio-economic situation in Russia makes it possible to involve families in this kind of relationship various categories: students, military personnel, discharged from military service, graduates of orphanages and other categories of families and citizens, many of whom need, in particular, to resolve housing problems.

A foster family for an elderly or disabled person should certainly receive the right to exist. This is supported by the fact that, according to the latest statistics, we already have about 17 thousand lonely old people who cannot cope with the difficulties of life and are on the waiting list for boarding homes. For last year More than a hundred small-capacity and temporary institutions opened. They are focused on individual interests client. This is both good and bad, because in principle they are not designed to satisfy mass demand for inpatient care. And at the current pace of network development, it will be possible to satisfy it only in 20-30 years. More than a million people are served in their homes, although the need is much higher. At the same time, more than one hundred thousand families of former military personnel are in need, judging by press reports, of improved living conditions.

In the model about which we're talking about, the state, as a rule, does not take part in reimbursing the costs of the adoptive family and acts only as a guarantor of the rights of the parties, which does not exclude (under certain circumstances) reimbursement to the family of part of the costs associated with serving the elderly person. For example, for a family taking care of a seriously ill person waiting for a place in a boarding home, an additional payment for care services may be established.

The existence of a foster family for an elderly person (or a married couple, or a disabled person) is possible only subject to strict legislative regulation of all actions of the contracting parties and control by authorized government bodies.

The only norm of the Civil Code of the Russian Federation that regulates issues of providing assistance to the elderly and protecting their interests is Article 41 “Patronage over capable citizens.” At the request of a competent citizen who, for health reasons, cannot independently defend his rights, as well as fulfill his duties, guardianship in the form of patronage may be established over him. The trustee (assistant) performs his duties on the basis of an agency agreement or an agreement on trust management of property, which is concluded by the ward himself. The trustee can carry out any administrative transactions provided for in the agreement in relation to the property of the ward, thereby providing him with assistance in the implementation property rights. In the cases provided for in the contract, the trustee must deliver food and medicine to the ward, and create normal living conditions.

In this case, the main motive of the trustee is to receive remuneration, while the property of the ward may not go to him.

The legal design of the institution of patronage, which to a certain extent meets the goal of protecting the property rights of older people, can hardly be considered sufficient to regulate the relationship between an elderly person or a disabled person and his adoptive family. Because in this case, the responsible person in the foster family will protect the rights and manage the movable and immovable property of the elderly person without receiving remuneration for this.

Development new form social services for older people and disabled people is possible on the basis of introducing into current legislation the institution of a foster family for an elderly person or disabled person as such. The introduction of this form must go a certain way from experiment to widespread practical application in order to accumulate experience suitable for generalization.

At a minimum, the experiment should develop the following questions: a system of requirements for a foster family and an elderly or disabled person; procedures related to the preparation and conclusion of the contract; selection of participants; organization of monitoring and control over the actions of the parties.

Organizational issues of the institution of a foster family for an elderly person should be within the competence of social protection authorities as a universal intermediary and guarantor. Their activities should help maintain the trust of the parties, for which a probationary period may be established.

The development of the institution of foster family will significantly improve the social well-being of older people and strengthen the connection between generations. And it’s better not to delay with this.

In the next decade and a half, the indicators characterizing the aging process of the Russian population will remain virtually unchanged. The aging process will not stop, but will proceed smoothly. The long-term perspective is associated exclusively with the inevitability of population aging. The most conservative scenario for the forecast until 2055 is 25 percent of the population is elderly, and the most likely scenario for the development of the demographic situation in our country is that the share of people of retirement age will approach 40 percent. Therefore, our time is one of the most favorable periods from a demographic point of view for the development and implementation of new social technologies.

Literature

Ananyeva G. In the elders there is wisdom, and in the long-lived there is wisdom. // Social protection. - 1998. - No. 8 (77).

Isherwood M.M. Full life of a disabled person. -M.: Pedagogy, 1991.

Bondarenko I. Foster family for an elderly person // Social protection. - 1998. - No. 11-12.

Buyanova M.O., Kondratyeva Z.L., Kobzeva S.I. Social security law. Special part: Tutorial. -M., Publishing house "College", 1997.

Tuchkova E.G. Social Security Law: Methodological materials to study the course. -M., Publishing house "URAO", 1998.

Movement and transportation of patients // Social protection. - 1999. -No. 6 (87).

Social Security Law (lecture notes in outlines). - M.: Publishing House "Prior", 1999.

Social services at home. Hygienic care for seriously ill patients // Social protection. - 1998. - No. 9 (78).

Regulatory acts

Federal Law of August 2, 1995 No. 122-FZ "On social services for elderly citizens and the disabled."

Regulations on the provision of free social services and paid social services by state social services, approved by Decree of the Government of the Russian Federation of June 24, 1996 No. 73.

Regulations on the procedure and conditions for payment for social services provided to elderly citizens and disabled people at home, in semi-stationary and stationary conditions by state and municipal social service institutions, approved by Decree of the Government of the Russian Federation of April 15, 1996 No. 473.

Regulations on the provision of free social services and paid social services by state social services, approved by Decree of the Government of the Russian Federation of June 24, 1996 No. 729.

1 Ananyeva G. In the elders there is wisdom, and in the long-lived there is understanding. // Social protection. - 1998. - No. 8 (77). - P. 36. 2 Aisherwood M.M. Full life of a disabled person. -M.: Pedagogy, 1991. Pp. 5. 3 See: Federal Law “On Social Services for Elderly and Disabled Citizens” dated August 2, 1995 No. 122-FZ. 4 See: Decree of the Government of the Russian Federation of June 8, 1996 No. 670. 5 The rules for caring for the elderly were taken from practical experience and developments of the humanitarian charity center "Compassion" // Social protection. - 1998. - No. 8. - P. 40-43. 6 See: Social services at home. Hygienic care for seriously ill patients // Social protection. - 1998. - No. 9 (78). - P. 63. 7 Examples taken from work experience social workers Center for Social Assistance in Moscow // Social Protection. - 1999. - No. 6. - P. 34-39. 8 Aisherwood M.M. Full life of a disabled person. -M.: Pedagogy, 1991.

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