Social services for the elderly: conditions and forms of services, as well as institutions that provide them. Social services for the elderly Non-state social institutions for the elderly and disabled

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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!

Types of social services for the elderly and disabled:

1. Social service at home.

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.

Contraindications for admission to the service are: mental illness in the acute stage, chronic alcoholism, venereal, quarantine infectious diseases, bacteriocarrier, active forms of tuberculosis, as well as other serious diseases requiring treatment in specialized healthcare facilities.

On the basis of documents submitted by citizens or their legal representatives (applications, medical reports, income certificates), as well as an act of material and household examination, the Commission for assessing the need for social services makes a decision on acceptance for service.

Home care is provided through the provision of paid social services included in the federal and territorial lists of state-guaranteed social services provided by state institutions, as well as additional social services not included in these lists. These services are performed by a social worker who visits the client.

An agreement for the provision of social services at home is concluded with the person served or his legal representative, which indicates the types and scope of services provided, the time frame in which they must be provided, the procedure and amount of their payment, as well as other conditions determined by the parties.

2. Semi-stationary service.

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

Recipients of the public service may be persons who have retained the ability to self-service and active movement, simultaneously meeting the following conditions:

• 1) the presence of citizenship of the Russian Federation, and for foreign citizens and stateless persons - the presence of a residence permit;
• 2) the presence of registration at the place of residence, and in the absence of the latter - registration at the place of stay;
• 3) the presence of a disability or the achievement of old age (women - 55 years old, men - 60 years old);
• 4) the absence of diseases that are medical contraindications for semi-stationary social services in day care departments.

The decision on enrollment in semi-stationary social services is made by the head of the social service institution 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.

Semi-stationary social services are carried out by departments of day (night) stay, created in municipal centers of social services or under the bodies of social protection of the population.

3. Stationary social service.

Stationary social services for the disabled and the elderly kept in institutions of social protection of the population have the following features:

Stationary social services are provided in nursing homes for the elderly and the disabled, nursing homes for the disabled, psycho-neurological boarding schools.

Citizens of retirement age (women from 55 years old, men - from 60 years old), as well as disabled people of groups I and II over 18 years old, are accepted into boarding schools, provided that they do not have able-bodied children or parents who are obliged to support them;

Only people with disabilities of groups I and II aged 18 to 40 who do not have able-bodied children and parents who are legally obliged to support them are admitted to boarding schools for the disabled;

Children from 4 to 18 years old with anomalies of mental or physical development are admitted to the orphanage. At the same time, it is not allowed to place disabled children with physical disabilities in stationary institutions intended for the residence of children with mental disorders;

Persons suffering from chronic mental illnesses who need care, domestic services and medical assistance are admitted to the psycho-neurological boarding school, regardless of whether they have relatives who are legally obliged to support them or not;

Persons who systematically violate the rules of internal order, as well as persons from among especially dangerous criminals, as well as those engaged in vagrancy and begging, are sent to special boarding houses;

In stationary institutions, not only care and necessary medical care is provided, but also rehabilitation measures of a medical, social, domestic and medical nature;

An application for admission to a boarding house, together with a medical card, is submitted to a higher-level social security organization, which issues a ticket to the boarding house. If a person is incompetent, then his placement in a stationary institution is carried out on the basis of a written application of his legal representative;

If necessary, with the permission of the director of the boarding house, a pensioner or a disabled person may temporarily leave the social service institution for up to 1 month. A temporary exit permit is issued taking into account the opinion of a doctor, as well as a written obligation of relatives or other persons to provide care for an elderly or disabled person.

4. Urgent social service.

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.

The following can apply for help: unemployed, single and living alone, low-income pensioners and the disabled. Families consisting of pensioners, in the absence of able-bodied family members, if the average per capita income for the billing period is below the pensioner's subsistence level, which changes quarterly; citizens who have lost close relatives who do not have a former place of work to process documents for receiving a funeral benefit.

The applicant for help must have the following documents: passport, pension certificate, work book, certificate of disability (for citizens with disabilities), certificate of family composition, certificate of pension for the last three months.

Urgent social services are provided by municipal social service centers or departments created for these purposes under the bodies of social protection of the population.

5. Social advisory assistance.

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.

Social advisory assistance to disabled people is focused on their psychological support, intensification of efforts in solving their own problems and provides for:

• - identification of persons in need of social and advisory assistance;
• - prevention of various kinds of socio-psychological deviations;
• - work with families in which disabled people live, organization of their leisure;
• - advisory assistance in training, vocational guidance and employment of disabled people;
• - ensuring the coordination of the activities of state institutions and public associations to solve the problems of people with disabilities;
• - legal assistance within the competence of social service bodies;
• - other measures to form healthy relationships and create a favorable social environment for people with disabilities.

The organization and coordination of social advisory assistance is carried out by the municipal centers of social services, as well as the bodies of social protection of the population, which create appropriate divisions for these purposes.

social life rehabilitation

Social technology is a set of techniques, methods and influences used to achieve goals in the process of social planning and development, solving various kinds of social problems, for designing and implementing communicative influences that change people's consciousness, cultural, political and / or social structures, systems or situations.

Stationary social service. 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 organizing rehabilitation activities, 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 training, treatment, consultations;

2) services for catering, everyday life, leisure:

· - preparation and serving of food, including diet food;

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

- provision of leisure (books, magazines, newspapers, board games, excursions, etc.);

· Assistance in writing letters;

· - Provision of clothing, footwear and cash allowance in accordance with approved standards upon discharge from the institution;

- ensuring the safety of personal belongings and valuables;

· - creation of conditions for the performance of religious rites;

3) socio-medical and sanitary-hygienic services:

- free medical care;

- provision of care taking into account the state of health;

· - 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;

- organization of medical examinations;

· - hospitalization of those in need in medical institutions, assistance in referral to sanatorium-and-spa treatment (including on preferential terms);

- providing psychological support, carrying out psycho-correctional work;

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

5) services related to social and labor rehabilitation;

6) legal services;

7) assistance in organizing funeral services.

Types of stationary institutions (departments) of social services for the elderly and disabled:

- boarding house (boarding house) for the elderly and disabled;

· - boarding house (boarding house) for war and labor veterans;

- a special boarding house (department) for the elderly and disabled;

- psycho-neurological boarding school;

· - a rehabilitation center (department) for young people with disabilities;

- boarding house (department) of mercy;

· - gerontological center;

· - gerontopsychiatric center;

- boarding house of small capacity;

- social and health center.

An independent institution of social service for the elderly and disabled may have one of the following names:

- boarding house;

- boarding school;

- boarding house;

· - center;

· - shelter;

- hotel.

Urgent social service. Designed to provide senior citizens and the disabled with social assistance of a one-time nature. Such assistance is provided by only one type of social institution - a service (department) of urgent social services.

Services provided by emergency social assistance departments established under the social protection authorities, or municipal social service centers (urgent social service provides for the provision of one-time services to those in dire need of social support):

- provision of clothing, footwear and other essentials;

- provision of material assistance;

- Assistance in provision of temporary accommodation;

- provision of free hot meals or food packages;

- organization of emergency medical and psychological assistance;

- assistance in finding employment;

· - organization of legal and other consultations.

Such social institutions provide so-called auxiliary social assistance, i.e. when social assistance is not yet needed in full, or the citizen is in such a state that he can fully provide for his life needs on his own, but needs to be helped, “pushed” in the right direction.

Social advisory assistance. Social and advisory assistance provided to the elderly and the disabled. Such assistance is provided to the population for the purpose of psychological support for the disabled and the elderly. However, it affects not only the elderly and disabled people themselves, but also all members of their families, since, first of all, problems with adaptation and getting used to new living conditions begin with a disabled person or an elderly citizen precisely because of the unhealthy perception in the family of such a person who is being tried. not notice, and in some cases even show aggression towards him. Therefore, a certain psychological attitude here must be created not so much for the disabled or elderly citizen himself, but for his family members.

Currently, inpatient institutions are mostly people who have completely lost the ability to move and require constant care, as well as those who have no housing. An alternative to boarding schools in the near future may be special residential houses for the elderly (approximate Regulations on a special house for lonely elderly people, approved by the Ministry of Social Protection of the Population on April 7, 1994), which, despite some shortcomings, still have a number of important advantages.

Today, a significant part of social service centers are multidisciplinary institutions capable of providing the elderly and disabled with a variety of types and forms of services, including social and medical, social and commercial services. The priority direction is the development of models of non-stationary social services (social service centers, departments of social assistance at home), which allow the elderly to stay in their usual environment as long as possible, maintain their personal and social status.

the main technologies at present are state technologies for the social protection of the elderly - pensions, social services, social assistance. However, the priority direction of social work with the elderly is the organization of the living environment of aging people, carried out in such a way that the elderly person always has the opportunity to choose how to interact with this environment, because. older people are not an object of activity of various social services, but a decision-making subject. Freedom of choice gives rise to a sense of security, confidence in the future. Hence the need for alternative technologies of social work with the elderly. Among which are charitable assistance, club work, self-help and mutual aid groups.

The main tasks of a specialist in working with the elderly:

· Identification and registration of lonely elderly and disabled citizens in need of home care;

Establishment and support of communication with the labor collective, where war and labor veterans and disabled people worked;

· Establishing contacts with committees of the Red Cross Society, Councils of War and Labor Veterans, public organizations and foundations.

Social services are a set of social services that are provided to elderly and senile citizens at home or in specialized state and municipal institutions. It includes social assistance and moral and psychological support.
The main principles of activity in the field of social services for the elderly are as follows:

• observance of human and civil rights;
• provision of state guarantees;
• ensuring equal opportunities in receiving social services and their accessibility for old people;
• continuity of all types of social services;
• orientation of social services to individual needs;
• priority of measures for social adaptation of elderly citizens.

The state guarantees the elderly and old people the opportunity to receive social services based on the principle of social justice, regardless of gender, race, nationality, language, origin, property and official status, place of residence, attitude to religion.
By the middle of 1993, several models of social services had developed in the Russian Federation, which were formalized by the Law of the Russian Federation of August 2, 1995 "On social services for citizens, the elderly and the disabled." According to this Law, the system of social services is based on the use and development of all forms of ownership and includes the state, municipal and non-state sectors of social services.

The public sector of social services consists of social service management bodies of the Russian Federation, social service bodies of the constituent entities of the Russian Federation, as well as social service institutions that are federally owned and owned by the constituent entities of the Russian Federation.
The municipal sector of social services includes social service management bodies and institutions of municipal subordination that provide social services.
Municipal centers of social services are the main form of the municipal sector, they are created by local governments in the territories under their jurisdiction and are under their jurisdiction. Municipal social service centers carry out organizational, practical and coordination activities for the provision of various types of social services.
The tasks of the municipal social service center include: identifying old people in need of social support; provision of various social services of a one-time or permanent nature; analysis of social services for the elderly;
involvement of various state and non-state structures in solving the issues of providing social, medical, social, psychological and legal assistance to the elderly and old people.
An analysis of the main activities of municipal social service centers indicates that this model of social service, focused on working with the elderly and old people, has received the greatest distribution and recognition and is the most typical.
The non-state sector of social services unites relevant institutions that are not related to state and municipal ones by the form of ownership, as well as persons engaged in private activities in the field of social services. This sector includes public associations, professional associations, charitable and religious organizations whose activities are related to the social service of the elderly. Federal and territorial lists of state-guaranteed social services have been developed.
The federal list of state-guaranteed social services is a basic one, determined by the Government of the Russian Federation and revised annually; at the same time, the reduction of the volume of social services guaranteed by the state is not allowed. Based on the federal list of social services, a territorial list is established, also guaranteed by the state. This list is approved by the executive authority of the subject of the Russian Federation, taking into account the needs of the population living in the territory of this subject of the Russian Federation.
Women over 55 years of age and men over 60 years of age who need permanent or temporary outside assistance due to partial or complete loss of the ability to independently satisfy their vital needs have the right to social services.
When receiving social services, elderly and old people have the right to:

• respectful and humane attitude on the part of employees of social service institutions;
• the choice of an institution and form of social service in the manner established by the federal body for the social protection of the population and the bodies of social protection of the constituent entities of the Russian Federation;
• information about their rights, obligations and conditions for the provision of social services;
• consent to social services;
• denial of social services;
• confidentiality of personal information;
• protection of their rights and legitimate interests, including in court;
• obtaining information about the types and forms of social services, indications for receiving social services, the rules for their payment and other conditions for the provision of social services.

Social services for old people include stationary, semi-stationary and non-stationary forms.

Stationary forms of social services include boarding houses for veterans of labor and the disabled, veterans of the Great Patriotic War, certain professional categories of the elderly (artists, etc.); special houses for single and childless couples with a range of social services; specialized boarding houses for former prisoners who have reached old age.
Semi-stationary forms of social services include departments for day and night stay, rehabilitation centers, medical and social departments.
Non-stationary forms of social services include social services at home, emergency social services, social advisory assistance, and socio-psychological assistance.
Social services for old people can be permanent or temporary, depending on their desire. It can be completely free, partially paid or paid.
Stationary social services are aimed at providing comprehensive social and household assistance to elderly and senile citizens who have partially or completely lost the ability to self-service and who, for health reasons, need constant care and supervision. This service includes measures to create the most appropriate living conditions for the age and state of health, rehabilitation measures of a medical, social and medical nature, the provision of care and medical assistance, and the organization of recreation and leisure for the elderly and old people.
Boarding houses for labor veterans (nursing homes) are not a product of our time. For the first time, special houses for old people appeared in ancient times in China and India, and then in Byzantium and the Arab countries. Approximately in 370 from the Nativity of Christ, Bishop Basil opened the first department for the elderly in the hospital of Cappadia Caesarea. In the 6th century, Pope Pelagius established the first nursing home in Rome. Since that time, special rooms and rooms for the elderly poor began to be opened in all monasteries. Large asylums for old sailors were first established in London in 1454 and in Venice in 1474. The first law on the responsibility of the state towards the poor and infirm old people was passed in England in 1601.
In Russia, the first mention of the creation of almshouses are found in the reign of Vladimir in 996. During the years of the Mongol enslavement, the church and Orthodox monasteries built premises for almshouses and charities of the old. In 1551, during the reign of Ivan the Terrible, an Appeal to the Stoglavy Cathedral was adopted, and, according to Chapter 73 "On Alms", as urgent measures, it was necessary to identify "the elderly and lepers" in all cities, build almshouses for them, male and female, to keep them there, providing food and clothing at the expense of the treasury.
During the reign of Alexei Mikhailovich, by his order, the Kondinsky Monastery was built 760 versts from Tobolsk specifically for the care of the old, crippled, rootless and helpless.
Metropolitan Nikon at the same time opened four homes for poor widows, orphans and the elderly in Novgorod. In 1722, Peter I issued an order: to appoint retired soldiers to the vacant places in the monasteries. Service in the army at that time lasted more than 25 years, and it is clear that they were already elderly people. By this order, the king pursued the goal of providing shelter and food for the old and the wounded, who had no means of subsistence.
In the 30s of the 19th century, “houses of industriousness” were opened in Moscow, where the beggars and the elderly lived. In the 60s of the same century, parish guardianships were created, which were also involved in the construction of senile shelters. Admission to shelters was very strict - they were intended only for lonely and infirm old people. These same councils obligated relatives to take care of their parents in old age.
In 1892, there were 84 almshouses attached to Orthodox monasteries, of which 56 were state-owned and monastic dependents, 28 were dependent on individuals and societies.
In Soviet times, the stationary system of social services was decisive in providing social assistance to old people. As a rule, old people who, due to their physical helplessness, were unable to maintain their usual way of life, entered nursing homes for the elderly and the disabled. These boarding houses were practically hospitals for chronically ill and helpless old people. The purpose of the boarding houses was to provide medical care; all work was based on the principle of hospital departments and was entrusted to medical personnel:
doctor - nurse - nurse. The structure and activities of these social security institutions have remained unchanged to the present day.
At the beginning of 1994 there were 352 boarding houses for labor veterans in Russia; 37 specialized boarding houses for the elderly, who have spent their entire adult lives in places of detention and have remained homeless, family, and loved ones in their old age.
Currently, 1,061 stationary social security institutions have been opened in the Russian Federation. The total number of places is 258,500, 234,450 people live in them. Unfortunately, in our time there is not a single nursing home that would be fully maintained by private individuals or any charitable societies.
There are boarding houses for labor veterans everywhere, but most of them are in the Nizhny Novgorod region - 40; in Sverdlovskaya - 30. Until 1992, there was one paid boarding house in Moscow, accommodation in a single room cost 116 rubles a month, in a double room - 79 rubles.
In 1992, the state was forced to take care of it, leaving 30 paid places, but even these places were not willing.
In 1995, only three paid places were filled. This fact especially clearly testifies to the impoverishment of the inhabitants of Moscow and all of Russia.
According to N.F. Dementieva and E.V. Ustinova, 38.8% of the elderly, 56.9% of the elderly and 6.3% of the centenarians live in boarding houses for labor veterans. The overwhelming majority of very old people (63.2%) in stationary institutions of social protection is typical not only for Russia, but is observed in all countries.
The main rule for applicants is that 75% of the pension is transferred to the Pension Fund, and 25% remains for the old people themselves. The cost of keeping in a boarding house is from 3.6 to 6 million rubles (excluding denomination).
Since 1954, all homes for the elderly and the disabled had benefits, could develop their own plots of land, have a subsidiary farm in the countryside, and work workshops. However, after the implementation of social reforms, even these social service institutions were subject to taxes up to the road tax. This led to the fact that in many houses they abandoned labor workshops and subsidiary plots. Currently, boarding houses for labor veterans have only three protected items: food, salaries of employees, and partially medicines.
According to Federal law, old people living in veterans' boarding houses have the right to:

• providing them with living conditions that meet sanitary and hygienic requirements;
• care, primary health care and dental care;
• free specialized assistance, prosthetic and prosthetic-orthopedic;
• socio-medical rehabilitation and social adaptation;
• voluntary participation in the medical and labor process, taking into account the state of health;
• medical and social expertise to establish or change the disability group;
• free visits by a lawyer, notary, clergyman, relatives, representatives of legislative bodies and public associations;
• provision of premises for the performance of religious rites;
• referral, if necessary, for examination and treatment to state or municipal health care institutions.

If desired and necessary for labor, those living in boarding houses for veterans of labor can be hired, available to them for health reasons, on the terms of an employment contract. They are entitled to an annual paid leave of 30 calendar days.
Special residential buildings for old people are a completely new form of stationary social service. It is designed for singles and couples. These houses and their conditions are designed for old people who have retained full or partial ability to self-service in everyday life and need to create facilitated conditions for the realization of their basic life needs.
The main goal of these social institutions is to provide favorable living conditions and self-service, the provision of social and medical assistance;
creation of conditions for an active lifestyle, including feasible labor activity. Pensions living in these houses are paid in full, in addition, they receive a certain amount of additional payment. A prerequisite for obtaining a residence permit is the transfer by old people of their home to the municipal housing stock of the city, region, etc. in which they live.
Specialized nursing homes are designed for permanent residence of citizens who have partially or completely lost the ability to self-service and need constant outside care, from among those released from places of detention, especially dangerous recidivists and other persons who, in accordance with the current legislation, are subject to administrative supervision. The elderly, previously convicted or repeatedly brought to administrative responsibility for violating public order, engaged in vagrancy and begging, sent from the institutions of the internal affairs bodies, are also sent here. Old people living in boarding houses for veterans of labor and constantly violating the procedure for living in them, established by the Regulations on social service institutions, may be transferred to specialized boarding houses at their request or by a court decision made on the basis of the provision of documents by the administration of these institutions.
Old people enter a nursing home for a variety of reasons, but the main one is undoubtedly helplessness or fear of impending physical helplessness. Almost all old people suffer from various somatic diseases that are chronic and usually no longer amenable to active therapy.
At the same time, these old people also suffer various moral, social and family losses, which ultimately are the reason for the voluntary or forced abandonment of their usual way of life. The decision to move into a nursing home is made by an old person as a result of difficulties in self-care. Fear of even greater physical weakness, impending blindness and deafness contribute to such a decision.
The composition of nursing homes is very heterogeneous. And this is understandable. Its definite (ever decreasing every year) part is old people with sufficient physical health who are able to serve themselves. In another case, admission to a nursing home is a manifestation of the altruism of an old person, a desire to free younger family members from the hardships associated with caring for and caring for a helpless old man. In the third, it is a consequence of unsettled relationships with children or other relatives. However, this is always the result of the inability of old people to adapt to new conditions of life in the family and in the familiar home environment. These old people are choosing social assistance and social services as a new way of life.
And yet, in any case, it is not easy for an old person to radically change the former way of life by settling in a nursing home: Oud old people move here extremely reluctantly, yielding to the pressure of external circumstances. The organization of these social institutions, in essence, copies the organization of medical institutions, which often leads to an undesirable and painful fixation on the purely painful side of senile infirmity. The results of a sociological survey conducted in 1993 in Moscow showed that the vast majority of the surveyed - 92.3% - have an extremely negative attitude towards the prospect of a possible move to a nursing home, including those living in communal apartments. The number of people wishing to move to a nursing home has been especially markedly reduced since the establishment of social services at home. Currently, in various regions and cities, this queue is no more than 10-15 people, mostly people of especially old age, completely helpless and often lonely.
88% of those in nursing homes suffer from various mental pathologies; in 62.9% - restriction of motor activity; 61.3% are unable to even partially serve themselves. 25% of people die every year.
Of serious concern, especially in the last 5 years, is the unsatisfactory budget financing of boarding houses for labor veterans and the disabled. For this reason, many nursing homes cannot carry out major repairs of their buildings, purchase shoes, clothes, and technological equipment for residents. Currently, the pace of construction of special houses is sharply declining due to the limited funds of local budgets. An equally acute problem is the staffing of nursing homes.
Semi-stationary social services include social, medical and cultural services for the elderly and old people, organizing their meals, rest, ensuring their participation in feasible work activities and maintaining an active lifestyle.
Elderly and senile 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 day care unit is designed to support the active lifestyle of older people. These departments enroll old people (regardless of their marital status) who retain the ability to self-service and active movement, on the basis of a personal application and a certificate from a medical institution on the absence of contraindications for admission to social services.
The length of stay in the department is usually a month. Visitors to the department can, with their voluntary consent, participate in occupational therapy in specially equipped workshops. It is carried out under the guidance of an instructor and under the supervision of a medical professional. Meals in the department can be free or for a fee, according to the decision of the management of the social service center and the local administration, it is possible to provide certain services for a fee (massage, manual therapy, cosmetic procedures, etc.). These departments are created to serve at least 30 people.
The medical and social department is intended for those who experience serious difficulties in organizing their life, running their own household, but for one reason or another do not want to live in nursing homes. On the basis of health care institutions, special departments and wards have been opened, where, first of all, weak old-age pensioners living alone who have lost mobility and the ability to self-service are hospitalized.
In this case, the referral to the medical and social department is given by social service centers in agreement with the district doctor. In recent years, the experience of organizing wards for the planned treatment of old people, where all types of medical procedures are carried out, has become more widespread.
In medical and social departments and wards, lonely, infirm old people are on full social security for a long time, and their pension, as a rule, is received by their relatives and relatives, who often do not even visit the elderly. In many regions, attempts are being made to at least partially reimburse the costs of maintaining the elderly and senile. This is done with the personal consent of the old people by order of the local authorities. These funds are used to purchase clothes and shoes, organize additional meals, part of the funds goes to the improvement of wards and departments.
Medical and social departments are widespread in rural areas. In winter, old people live here, and in spring they return to their homes.
Mercy trains are a new form of service for old people living in remote sparsely populated areas, by teams that include doctors of various specialties and employees of social protection agencies. These trains of mercy make stops at small stations and sidings, during which members of the brigade visit local residents, including elderly people, at home, provide them with all types of medical care, as well as material assistance: they give out medicines, food packages, industrial kits. goods, etc.
Non-stationary forms of social services are designed to provide social assistance and services to old people who prefer to stay in their usual home environment. Among non-stationary forms of social services, social services at home should be put in the first place.
This form of social service was first organized in 1987 and immediately received wide recognition from the old people. Currently, this is one of the main types of social services, the main goal of which is to maximize the stay of old people in their usual habitat, maintain their personal and social status, and protect their rights and legitimate interests.
The main social services provided at home:

• catering and home delivery of groceries;
• assistance in the acquisition of medicines, food and industrial essential goods;
• assistance in obtaining medical care, escort to medical institutions, clinics, hospitals;
• assistance in organizing legal assistance and other legal forms of assistance;
• maintenance of living conditions in accordance with hygienic requirements;
• assistance in the organization of ritual services and in the burial of the lonely dead;
• organization of various social services depending on living conditions in a city or village;
• assistance in paperwork, including for the establishment of guardianship and guardianship;
• placement in stationary social service institutions.

In addition to home-based social services provided for by the federal or territorial lists of state-guaranteed social services, additional services may be provided to old people on the basis of full or partial payment.
Departments of social assistance at home are organized at municipal social service centers or local bodies of social protection of the population. Social services at home can be provided permanently or temporarily - up to 6 months. The branch is created to serve at least 60 people in rural areas and at least 120 people in the city.
Social services at home are provided free of charge:

• for lonely old people;
• for those living in families whose per capita income is below the minimum level established for the region;
• for old people who have relatives who live separately.

Studies have shown that of all types of services, the most important for older people are:

• care during illness - 83.9%;
• grocery delivery - 80.9%;
• drug delivery — 72.9%;
• laundry services - 56.4%.

The list of services provided by social workers at home is regulated by special regulations, in particular by the Order of the Ministry of Social Security of the RSFSR dated July 24, 1987. By the beginning of 1993, 8,000 social service departments at home had been established in the Russian Federation, and the total number of persons served reached over 700,000 people.
Additional services provided by the department of social services at home:

• health monitoring;
• provision of emergency first aid;
• performing medical procedures as prescribed by the attending physician;
• provision of sanitary and hygienic services;
• feeding debilitated patients.

The procedure and conditions for enrollment in home social services: an application addressed to the head of the social protection body is considered within a week; an examination of the living conditions of the applicant is carried out. Based on the results of the examination, an act is drawn up, data on the amount of the pension, a conclusion on the state of health and the absence of medical contraindications are requested, a decision is made on enrollment in permanent or temporary services, on the types of services required.
Withdrawal from social services is carried out on the basis of the order of the director of the social service center in the following cases: at the request of the old person, after the expiration of the service period, in case of violation of contractual terms of payment for services, identification of medical contraindications, malicious violations of the rules of behavior by old people served by social workers.
Social and medical care for old people at home is provided for persons in need of home social services, suffering from mental disorders in remission, tuberculosis, with the exception of the active form, severe somatic diseases, including cancer.
Medical workers are introduced into the staff of social and medical services, whose professional activities are regulated by the legislation of the Russian Federation on the protection of the health of citizens.
Social advisory service (assistance) to citizens of elderly and senile age is aimed at their adaptation in society, easing social tension, creating favorable relations in the family, as well as ensuring interaction between the individual, family, society and the state. Social advisory assistance to people of senile age, focused on their psychological support, intensification of efforts in solving their own problems, provides for:

• identification of persons in need of social and advisory assistance;
• prevention of various kinds of socio-psychological deviations;
• work with families in which old people live, organization of their leisure;
• advisory assistance in training, vocational guidance and employment;
• ensuring coordination of the activities of state institutions and public associations to solve the problems of elderly citizens;
• legal assistance within the competence of social service bodies;
• other measures to form healthy relationships and create a favorable social environment for old people.

Question 74. Social services for the elderly and disabled.

Social services for the elderly and disabled

Regulated by the Federal Law of August 2, 1995 On social services for the elderly and the disabled. this type of social service is a set of social services that are provided to the specified persons at home or in social service institutions, regardless of the form of ownership.

Activities in this area are based on the following principles:

1. Observance of human and civil rights

2. Provision of state guarantees in the field of social services

3. Equality of opportunity to receive social services and their availability

4. Orientation to the individual needs of these individuals

5. Priority of social adaptation measures

6. Continuity of all types of social services

7. Responsibility of state bodies. authorities and institutions, officials for ensuring the rights of these persons in the field of social services.

Women over the age of 55 and men over the age of 60, as well as persons with disabilities (including children with disabilities) who need outside help temporarily or permanently due to the loss of the ability to independently satisfy their life needs (fully or partially) have the right to social services. ).

Social services for these persons are carried out by decision of the bodies of social protection of the population in institutions subordinate to them or under contracts that the bodies of social protection conclude with commercial organizations providing social services.

When receiving social services, elderly citizens with disabilities have the following rights:

1. Respectful and humane attitude on the part of employees of a social service institution

2. to choose an institution and form of social. service

3. information about their rights and obligations, as well as the conditions for the provision of social services.

4. Consent or refusal of social services

5. confidentiality of personal information

6. to protect their rights and interests

Social services are provided with the voluntary consent of the persons themselves, with the exception of:

1. persons under the age of 14

2. persons recognized as legally incompetent in accordance with the law

In this case, consent is given by the legal representative. Consent is expressed in a written application, on the basis of which the person is placed in a social service institution.

The Law of the Russian Federation of July 2, 1992 On Psychiatric Care and Guarantees of the Rights of Citizens in its Provision provides for the possibility of placing an elderly citizen or a disabled person in a social service institution without their consent.

As a general rule, these persons may refuse social services, while social service workers should explain to them the negative consequences of the decision. In this case, the persons draw up a waiver of social services in writing.

Elderly citizens and the disabled may be provided with housing in the houses of the housing fund for social use. At the same time, at the request of the persons themselves, their social services can be provided both on a permanent and temporary basis.

Social services at home is aimed at the maximum possible extension of the stay of elderly and disabled citizens in their familiar environment in order to maintain their social status. The list of state-guaranteed social services among home-based services includes:

1. catering, including home delivery of groceries

2. assistance in the acquisition of medical supplies, food and industrial essential goods.

3. assistance in obtaining medical care, including transfer to medical institutions.

4. maintaining living conditions in accordance with hygiene requirements

5. assistance in providing legal assistance and legal services

6. assistance in organizing funeral services.

7. If these persons live in residential premises without central heating and / or water supply, then the list of guaranteed services includes the provision of fuel or water.

In addition, other services may be provided to these persons additionally on the basis of partial or full payment.

If elderly or disabled people suffer from mental disorders, cancer, tuberculosis, venereal diseases, chronic alcoholism and other similar diseases that require treatment, they may be denied social services at home and are referred to health facilities.

Semi-residential social service: includes social, medical and cultural services for elderly and disabled citizens, organizing their meals, recreation, ensuring their feasible work activities and maintaining an active lifestyle. Persons who are capable of self-service and active movement and who do not have medical contraindications are accepted for semi-stationary social services. Semi-stationary social services can be provided in day and night homes. These social service institutions are created primarily for people without a fixed place of residence. Persons who applied both independently and sent there by the social authorities are accepted into the night stay house. protection or ATS. Some individuals may be provided with these services (listed above) according to international indications.

Stationary social service is aimed at providing social and household assistance to citizens who have lost the ability to self-service or who need it for health reasons. This type of social service includes rehabilitation measures of a medical, social, medical and labor nature, appropriate for age and health, provision of care, medical care, and organization of recreation and leisure. These persons have the following rights:

1. ensuring living conditions that meet sanitary and hygienic requirements

2. primary health and dental care

3. socio-medical rehabilitation and social adaptation

4. voluntary participation in the medical labor process

5. the right to a medical and social examination carried out for medical reasons

6. have the right to free visits by lawyers, notaries, representatives of public associations, legal representatives, relatives and clergy.

7. are entitled to free legal assistance in accordance with the Federal Law on free legal assistance in the Russian Federation of November 21, 2011.

8. the right to provide them with premises for the performance of religious rites by believers of all denominations.

9. the right to retain the residential premises occupied by them under a lease or lease agreement for 6 months from the date of receipt for social services, if these are state / municipal property. If family members remained in the premises, they remain for the entire period.

10. participation in public commissions for the protection of the rights of citizens.

11. Disabled children staying in stationary social service institutions have the right to receive education and vocational training.

12. Disabled children with physical disabilities and disabled children suffering from mental disorders are placed in different social service institutions.

Elderly citizens and disabled people who are in stationary social service institutions are given the right to hire them in accordance with their state of health, while if an employment contract is concluded with them, they have the right to leave 30 calendar days.

Urgent Social Services is carried out in order to provide emergency assistance of a one-time nature, if they are in dire need of social support. Urgent social services include:

1. one-time provision of hot meals or food kits

2. provision of clothing, footwear and other essential goods

3. one-time financial assistance

4. assistance in obtaining temporary accommodation

5. organization of legal assistance in order to protect them

6. organization of emergency medical and psychological assistance with the involvement of psychologists and clergy.

Social advisory assistance is aimed at the adaptation of the elderly and the disabled, at easing social tension, creating favorable conditions in the family, ensuring interaction between the individual, family, society and the state. Social advisory assistance provides for:

1. identification of persons in need of this assistance

2. prevention of socio-psychological deviations

3. work with families in which these citizens live

4. organization of leisure,

5. consultation in training, career guidance and employment.

6. legal assistance within the competence of the social authorities. service.

7. Ensuring coordination of activities of public associations and social service institutions.