Features of social services for the elderly. Social services and provision for the elderly

23.07.2019

Parameter name	Meaning
Article subject:	SOCIAL SERVICE AND WELFARE FOR THE OLDER PEOPLE
Rubric (thematic category)	Psychology

Social services and provision for the elderly include pensions and various benefits; the maintenance and service of the elderly and disabled in special institutions of the bodies of social protection of the population; prosthetics; benefits for the disabled;

helping the homeless.

Social security is carried out by state bodies, enterprises, private individuals, at the expense of contributions (deductions from wages) of workers. In the latter case, the payment from the funds is determined not by the labor contribution and length of service, but by the amount of contributions. This practice is very common in Western countries.

In 1995 ᴦ. In the system of social protection of our country, there were 959 stationary institutions for the elderly and disabled, more than 700 social service centers, 900 departments of social assistance at home, as well as a number of other social assistance institutions (psychological and pedagogical, emergency psychological assistance, etc.). d.).

The most developed network of social services in Chelyabinsk, Samara, Rostov, Vladimir and a number of other regions.

Consider the content of the work of the Center for Social Services (for the elderly and disabled). It usually includes several departments. AT day care unit(designed to support at least 30 pensioners and disabled people) catering, medical and cultural services are organized. Participation in feasible labor activity in special workshops or subsidiary farms is provided.

Department of temporary stay(designed for the maintenance of at least 15 people) carries out health-improving and rehabilitation measures, cultural and consumer services, food in conditions of round-the-clock maintenance.

AT department of social assistance at home(it serves 120 people in the city, 60 people in the countryside) provides permanent or temporary (up to 6 months) social services at home for pensioners and disabled people who need outside help (free of charge or on a paid basis).

Emergency Social Assistance Service The Social Service Center provides a wide range of services: one-time provision of those in dire need of free hot meals or food packages; provision of clothing, footwear and essential items; one-time provision of financial assistance; assistance in obtaining temporary housing; provision of emergency psychological assistance, incl. by ʼʼhotlineʼʼ:

provision of legal assistance within its competence; provision of other types and forms of assistance due to regional and other specifics.

In the context of the crisis situation in Russia, the targeted social protection old people. First of all, it turns out to be the most needy: lonely pensioners, the disabled, the elderly over 80 years old.

Sociological studies in our country have shown that the main areas for ensuring the well-being of the elderly (in their opinion) are: increasing pensions, improving pension provision, developing home care services for them, increasing the number of nursing homes and improving living conditions in them.

Improving pension provision is one of the most important areas of social security in modern states. This problem is solved in different ways.

In some countries, pensioners receive pensions and wages completely regardless of their size and in any sector of the national economy. In other countries, so-called deferred pensions, ᴛ.ᴇ, are widespread. increase in pensions by a certain percentage based on the number of working years after retirement age. It has been practiced and practiced in our country. Voluntary old-age insurance (the right to an additional pension) also has a perspective. Unfortunately, in the 1990s, pension provision in Russia was extremely insufficient. The amount of the pension is much less than the subsistence level, and besides, it is often not paid on time.

In a number of regions of the country, local authorities provide significant assistance to the elderly: differentiated additional payments to non-working pensioners are increased; various categories of the elderly are provided with benefits for paying for housing, telephone, medicines are dispensed free of charge according to doctor's prescriptions, etc.

It is necessary to pay attention to social services for the elderly. Here it is important to provide, taking into account the loss of the ability to self-service, the provision of special comfortable shoes, clothes, various kinds of devices and devices that would make it easier for old people to move along the street, do housework, and perform certain hygiene procedures.

To solve these problems, architects, designers, and gerontologists have long identified promising areas for the development and production of appropriate household appliances. These proposals boil down to creating:

a) automated kitchen complexes that allow programming cooking operations;

b) systems of lifts for the care of bedridden patients and the provision of sanitary and hygienic care to them;

c) special furniture and mechanisms for cleaning premises, taking into account the age specifics of the elderly, etc., as well as a number of simple but very necessary devices and devices that create convenience for the elderly and increase the safety of household operations;

d) systems of handrails and support brackets for an old person to take a bath;

e) special supports that make it easier to put on shoes;

f) gentle ramps instead of rapids, etc.

The proposals are good, but, unfortunately, in our country they are implemented extremely unsatisfactorily.

One of the new forms of service for lonely old people living in remote and sparsely populated areas is the organization of the so-called mercy trains. They include doctors of various specialties, social workers. Οʜᴎ provide a variety of assistance: medical, social, household, advisory, etc. It should be noted that certain elements of such assistance also took place earlier: the arrival of medical specialists in small villages, traveling trade in the countryside, and so on.

Social service and provision for the elderly provides a huge field of activity for the social worker.

Having knowledge and experience, appropriate mental qualities, they can greatly contribute to improving the lifestyle.

older people, ensuring their independence, dignity, helping them to take their rightful place in society. Socionoms have a wide range of such possibilities. The main thing is to implement them.

SOCIAL SERVICE AND PROVISION OF THE ELDERLY PEOPLE - concept and types. Classification and features of the category "SOCIAL SERVICE AND SECURITY FOR THE ELDERLY PEOPLE" 2017, 2018.

One of the main methods of social work with the elderly in non-stationary institutions is home social services. Its main goals are: the maximum extension of the stay of clients in the environment familiar to him, the preservation of their vitality and social tone, the protection of their legitimate rights and interests.

The main social services provided at home usually include:

1. Organization of meals and food delivery to the house;

2. Assistance in the purchase of essential goods, medical supplies and medicines;

3. Assistance in obtaining qualified medical care and organization of escort to medical institutions;

4. Assistance in cleaning and maintaining cleanliness and the required level of hygiene;

5. Assistance in the burial of lonely dead elderly people and the organization of the necessary ritual services;

6. Organization of social services (repair of residential premises, provision of various types of fuel, processing of vegetable gardens and landscape gardening areas (if any), bringing water, chopping firewood, paying utility bills, etc.);

7. Assistance in the preparation of various documents, such as: documents for the establishment of guardianship and guardianship, the exchange and sale of land and living space, placement in stationary social institutions.

Citizens are directly served by social workers who are as close as possible to their place of residence and who are on the staff of all social institutions. This approach to the client is due to several reasons: the extension of the work schedule, the increase in the number of visits, and the reduction in time for transport. The department of home social assistance, as a rule, is organized at municipal centers for social welfare of the population.

A department is being created to provide social assistance to at least 60 clients who live in rural areas or in the private sector that does not have proper communal facilities; in urban areas, the number of clients increases to 120 people. Social care at home for the elderly can be permanent or temporary (up to 6 months).

For clients suffering from severe forms of diseases, such as oncology in the late stages of treatment or in need of pre-medical care in addition to social services, there is a special home social assistance department, which is designed for an average of 60 people.

In addition to social workers, the department also has a nurse who performs medical procedures, such as: measuring blood pressure and body temperature, performing cleansing enemas, applying compresses, bandaging, eliminating bedsores, treating wounds, introducing subcutaneous and intramuscular injections as prescribed by a doctor. Also, nurses carry out various hygiene procedures with clients - wiping, special baths, change linen, and feed clients weakened by illness. In addition, social workers carry out such household services as: cooking, cleaning the apartment, washing clothes, etc.

Due to the fact that social work includes the provision of assistance to lonely people, the main role in serving the social plan is played by the patronage of older people who are in their usual home environment and are deprived of the care of relatives, and who are practically incapable of self-care and movement. Patronage is today an alternative to placing a client in stationary medical or social institutions. Inpatient placement for many lonely older people causes a negative reaction, because, in their opinion, they lose some independence, their usual social circle and home environment.

The main purpose of urgent social services is to provide one-time emergency assistance to older people who have an urgent need for social support.

Services of an urgent social nature include the following range of services provided by the state:

One-time provision of customers with food packages or hot meals;

Provision of basic necessities, clothing and footwear;

One-time provision of material assistance;

Assistance in obtaining temporary housing;

Providing emergency psychological assistance;

Legal assistance to the client and other forms and types of assistance.

First of all, this service was created to undertake urgent measures aimed at supporting the life of older people who are in dire need of social assistance. The activity of the service is based on cooperation with individual citizens, as well as with various public and state organizations.

In order to provide the elderly with the items they need: food, clothes, shoes, and many others, each non-stationary institution creates a natural assistance room, in which used shoes, clothes, hygiene items, etc. are given to citizens free of charge. This assistance is mainly provided by the population itself. Thanks to the offsetting system, new things and objects come from enterprises and organizations. It can be raincoats, jackets, down jackets, bedding, cereals, sugar, flour and more. Also in demand among citizens and humanitarian assistance from foreign countries.

As a rule, humanitarian aid is free of charge. There are special norms and criteria according to which humanitarian aid is distributed: the priority in this regard is lonely elderly people who receive an income below the required minimum established by the state. There are both unsolicited and application forms. The final result of the distribution of assistance is monitored by specialists from the department dealing with urgent services for the elderly in need. Also at the headquarters of the service there are full-time lawyer and psychologist who provide clients with consulting assistance.

Medical and social rehabilitation is of great importance for older clients. Due to the natural aging process, chronic diseases often appear in older people, resulting in an increasing number of clients who need constant monitoring by neurologists, cardiologists and other specialists.

We can distinguish the following gradation of the vital needs of such elderly clients:

Needs for services: home and inpatient care, physical and occupational therapy, treatment of depressive and unstable conditions, psychocorrection, spoon-feeding, dressing, conversation, personal hygiene, training of speech and auditory receptors, patronage of nurses, provision of transport services.

Assistance with adaptation assistance: canes, hearing aids, glasses, prostheses, wheelchairs, canes, moving, attracting additional staff for this, training in the use of devices for self-feeding.

Development of adaptive skills: dressing and undressing, communication skills, using the toilet, going out and walking, learning to eat independently.

Tracking the physical condition of the client: a visit to the attending physician and doctors of other specializations, regular examinations by nurses, dietary prescription.

The proportion of older citizens who need help with age is increasing every year. One of the factors that requires the state to spend more on health care and allocate resources to the most needy social groups is precisely the aging of the population. This indicator suggests that, under equal conditions, the need for material resources of a country where the proportion of elderly citizens is 20% will be disproportionately higher than with an indicator of 10%.

Medical and social services define the following as their main activities:

Identification and strict accounting of individual citizens and entire families who need social assistance;

Implementation of the necessary patronage of the elderly and the disabled with the use of modern types of social support in the form of prevention, treatment and additional diagnostics;

Providing psychological assistance.

Organization of the education of sanitary skills among the population, promotion of a healthy lifestyle, organization of communication clubs to maintain the communicative activity of the elderly, lectures, organization of health schools and other events of a therapeutic and recreational nature.

First aid is included in the list of mandatory skills that a social worker must have; for this purpose, practical classes are held to provide assistance with fractures, heart failure, fainting, bruises, fractures, bleeding, they show how to properly apply a compress and measure blood pressure.

On the basis of the centers that are engaged in social services, departments for the day stay of the elderly are organized. Such departments are created for socio-cultural, domestic and medical services for clients, familiarizing them with vital activity, feasible work, and organizing recreation. Such branches are created to serve an average of about 30 clients. In such departments, special premises are allocated for: a medical assistance room, work to improve the cultural level of clients, the creation of a library and workshops, and much more. Also, the necessary premises should have sleeping quarters for rest, a dining room, etc. As a rule, the disabled and the elderly receive assistance in such departments free of charge. Elderly patients are placed there, regardless of their marital status, and who have retained the ability to self-service and move without assistance, based on the opinion of the doctor and the personal desire of the client.

Under the supervision of a medical worker and an occupational therapy instructor, clients carry out specific work activities under special conditions or simply work within the limits of their ability on the farm. Farm produce is used to provide food for the elderly, and the surplus is usually sold to raise additional income.

This department can also provide separate paid services: visiting entertainment events, a hairdresser and a massage room, manual therapy, etc. The material income received for these additional services is transferred to the account of a social institution and directed to the development of the institution itself and improving the quantity and quality the services they provide.

In the work of a social nature with older clients in non-stationary institutions, various methods are used and a large number of different areas are implemented, such as: urgent social services, customer service and care at home, urgent medical and social assistance, targeted protection and many others.

Similar information.

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.

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

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

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

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

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

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

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

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

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

At the same time, the system of stationary social services was also undergoing transformations: the tasks of providing medical care and care were supplemented by the functions of maintaining the social inclusion of older people, their active, active life style; gerontological (gerontopsychiatric) centers, boarding houses of mercy for the elderly and disabled who need high-level social and medical care, palliative care began to be created.

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

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

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

At present, the system of social protection of the population also has special homes for lonely elderly citizens, social canteens, social shops, social pharmacies and Social Taxi services.

Stationary institutions of social service for the elderly and disabled. The network of stationary social service institutions in Russia is represented by over 1400 institutions, the vast majority of which (1222) serve the elderly, including 685 nursing homes for the elderly and disabled (of a general type), including 40 special institutions for the elderly and disabled who returned from places of punishment; 442 psycho-neurological boarding schools; 71 boarding houses of mercy for the elderly and disabled; 24 gerontological (gerontopsychiatric) centers.

For ten years (since 2000) the number of stationary institutions of social service for the elderly and disabled has increased by 1.3 times.

In general, there are more women (50.8%) among the elderly living in stationary social service institutions than men. Noticeably more women live in geriatric centers (57.2%) and in houses of mercy (66.5%). In psycho-neurological boarding schools, the share of women (40.7%) is much smaller. Apparently, women are relatively easier to cope with social and everyday problems against the background of a serious deterioration in health in old age and retain the ability to self-service for a longer time.

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

At present, the legislation enshrines the right of every elderly person in need of constant care to receive stationary social services. At the same time, there are no standards for the creation of boarding schools in certain areas. Institutions are located throughout the country and in individual subjects of the Russian Federation rather unevenly.

The dynamics of development of both the network of stationary social service institutions and their main types did not allow to fully satisfy the need of older citizens for stationary social services, to eliminate the queue for placement in boarding schools, which in general has increased almost 2 times over 10 years.

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

As positive aspects of the dynamics of development of stationary social service institutions, one should point out the improvement in living conditions in them by reducing the average number of inhabitants and increasing the area of bedrooms per bed almost to sanitary standards. There has been a tendency to disaggregate the existing stationary social service institutions, to increase the comfort of living in them. In many ways, the noted dynamics is due to the expansion of the network of boarding houses of small capacity.

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

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

For example, Krasnoyarsk Regional Gerontological Center “Uyut”, created on the basis of a sanatorium-preventorium, provides veterans with rehabilitation and health-improving services, using the form of a semi-permanent service.

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

The functions of the houses of mercy were largely taken over by Gerontological center "Ekaterinodar"(Krasnodar) and gerontological center in Surgut Khanty-Mansi Autonomous Okrug.

Practice shows that gerontological centers perform the tasks of care, provision of medical services and palliative care to a greater extent, which are rather characteristic of mercy houses. In the current situation, persons on bed rest and in need of constant care make up almost half of all residents in geriatric centers, and over 30% in nursing homes specially designed to serve such a contingent.

Part of gerontological centers, for example gerontological center "Peredelkino"(Moscow), Gerontological Center "Vyshenki"(Smolensk region), Gerontological Center “Sputnik”(Kurgan region), perform a number of functions that are not fully implemented by medical institutions, thereby satisfying the existing needs of older people in medical care. However, in this case, their own functions and tasks of gerontological centers, for which they are created, may fade into the background.

An analysis of the activities of gerontological centers allows us to conclude that it should be dominated by scientifically applied and methodological orientation. Such institutions are designed to contribute to the formation and implementation of evidence-based regional social policies for the elderly and disabled. There is no need to open many geriatric centers. It is enough to have one such institution, which is under the jurisdiction of the regional body of social protection of the population, in each subject of the Russian Federation. The provision of current social services, including care, should be carried out by boarding houses of a general type specially designed for this purpose, psycho-neurological boarding schools and houses of mercy.

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

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

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

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

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

There are no calculations of the need of the population for the services of social service centers, there are only guidelines: in each municipality there must be at least one social service center for the elderly and disabled (or an integrated center for social services for the population).

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

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

Specialized departments of socio-medical care at home are developing quite rapidly, providing differentiated medical and other services. The share of people served by these departments in the total number of people served by all departments of home care for the elderly and disabled since the 90s. more than quadrupled in the last century.

Despite the significant development of the network of departments under consideration, the number of elderly and disabled people registered and waiting for their turn to be accepted for home care is slowly declining.

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

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

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

In the mid 90s. of the last century, the network developed rapidly departments of temporary residence, because in the presence of a long queue to state stationary social service institutions, there was an urgent need to find an alternative option.

Over the past five years, the growth rate in the number daycare departments decreased markedly.

Against the backdrop of a decline in the development of day care departments and temporary residence departments, the activity of social rehabilitation departments. Although their growth rates are not very high, the number of clients served by them is growing quite significantly (doubled over the past ten years).

The average capacity of the departments under consideration practically did not change and averaged over the year for day care departments - 27 places, for temporary residence departments - 21 places, for social rehabilitation departments - 17 places.

Urgent social assistance. The most massive form of social support for the population in modern conditions is emergency social service. The relevant departments function mainly in the structure of social service centers, there are such units (services) in the bodies of social protection of the population. It is difficult to obtain exact information on the organizational basis on which this type of assistance is provided, as separate statistical data do not exist.

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

Social health centers. Every year, more and more prominent place in the structure of gerontological service is occupied by social and health centers. Most often, former sanatoriums, rest houses, boarding houses and pioneer camps become the base for them, which, for various reasons, are re-profiling the direction of their activities.

There are 60 social and health centers in the country.

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

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

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

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

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

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

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

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

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

Other forms of social assistance to the elderly. The activities of the social service system for older citizens and the disabled, with certain reservations, include providing older people with free meals and basic necessities at affordable prices.

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

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

The majority of social canteens and social shops are included in the structure of social service centers or integrated social service centers for the population. The rest are under the jurisdiction of social protection authorities or social support funds.

The statistical indicators of the activities of these structures are characterized by a significant scatter, and for some regions - the incorrectness of the information presented.

Despite the growth in the number of citizens living in stationary institutions and served at home, the need for older people in social services is increasing.

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

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

PROBLEMS OF THE DEVELOPMENT OF THE SYSTEM OF SOCIAL SERVICE FOR THE ELDERLY PEOPLE IN MODERN RUSSIA

INTRODUCTION

The new economic course associated with the transition to a market economy is being carried out in the Russian Federation in extremely difficult conditions. The reduction in production volumes, the disruption of production and economic relations led to an economic crisis. The society was divided into rich and poor. The category of low-income citizens has become predominant.

Almost the only right way out was the creation and development of a system of social service institutions that could provide social protection to the poor and the elderly.

The state social policy was focused on guaranteed individual assistance and support to those people who found themselves in an extreme situation.

These measures were taken on time and played a certain role in the formation and development of a new area of social services for the population. In the Russian Federation, this sector was constituted relatively recently, although social services were provided to certain groups of citizens earlier.

Social services for the population can be considered as a social technology that allows providing the necessary support to citizens in a difficult life situation, that is, a situation that disrupts the life of a citizen (disability, inability to self-service due to old age, illness, orphanhood, neglect, low income, lack of a certain place residence, conflicts and abuse in the family, loneliness, etc.), which he cannot overcome on his own.

A certain regulatory framework for the organization of social services for needy citizens began to take shape in our country in the early 1990s. A reorganization took place at the regional and territorial levels, and social service centers for pensioners and the disabled were set up in Moscow and other cities.

The main provisions for the development of new services are enshrined in the Federal Law "On the Fundamentals of Social Services for the Population in the Russian Federation" dated 10.12.95. N195-FZ. The relevance of the problems associated with the development of the social service system is predetermined by the following factors:

Dissatisfaction with the financial situation of the crisis strata of the population;

Demand by society for a new social policy;

Problematic development of the system of social services.

Consequently, the relevance of the thesis is due to the need to strengthen the social support of the population, especially its most vulnerable strata, in the transition period.

The first section of the thesis defines the most acute problems of older people. Their essence is revealed: the condition and position of an elderly person in society is considered, the main criteria for assessing the standard of living of older people are determined, and the tasks of our state in the field of social policy in relation to elderly citizens are also determined.

The second section of the diploma is devoted to the work of social service centers in Moscow. The activities of its structural divisions, their tasks are considered, problems and ways to solve them are determined.

The purpose of this thesis is to reveal the essence of the problems of the development of the system of social services for the elderly in modern Russia and to determine ways to solve them.

The following tasks serve to achieve this goal:

Consider the social policy of the state to protect and support older citizens;

Objective preconditions and ways of development of social protection of the elderly;

Social problems of the elderly and their reflection in the state social policy;

Conduct an analysis of the effectiveness of the work of social service centers and increase their role in the social service of the elderly (on the example of Moscow);

Propose measures to improve the management of the activities of the Committee for Social Protection of the Population of Moscow and the OUSZN for social protection;

New working methods of social service centers;

Show what social technologies are used in work with the elderly, what measures are being taken by the Moscow Government and the Committee for Social Protection of the Population of Moscow to provide social assistance to pensioners and the disabled;

Determine the place and role of social service centers in the system of social services.

The object of the study is the system of social services for the elderly (social service centers in Moscow).

The subject of the study is the study of the problems of development and functioning of the system of comprehensive social services for the elderly on the example of Moscow.

CHAPTER FIRST

SOCIAL POLICY OF THE STATE ON THE PROTECTION AND SUPPORT OF THE OLDER CITIZENS.

1.1 Objective preconditions and ways of development of social protection of the elderly.

The collapse of the Soviet Union turned for our country into the formation of a new state with a smaller population, reduced from 289 to 147 million people, with the dismemberment of the main state-forming ethnic group, with a truncated territory, with a rupture of centuries-old spiritual, economic, political, social and other ties.

The new reality directly affects the content, understanding and perception of the current interests of our country and society as a whole. Russia is characterized by its traditional life values, spiritual and social orientations: rejection of the provisions of pragmatic ethics and the priority of material success, as well as recognition as the main thing in life - to have a calm conscience, spiritual harmony, good family and friendly relations.

Many years of life under socialism left their mark on these traditional features of Russian thinking, when there was more than half a century of social security for people, confirming confidence in the future. The state, to a certain extent, provoked dependency. There was no danger of being left without a job or, having fallen ill, without a livelihood. There were no doubts about the future of children and their education. Slowly, but the housing issue was resolved.

The problem is that in the mechanisms of interaction between the individual, family and society, there are a huge number of unique models of relationships. Their diversity and dynamism are predetermined both by the essential properties of a person, his features, and by the properties of the micro and macro environment, i.e. properties and dynamics of economic, political, spiritual and moral processes taking place in society. In this sense, the transition period experienced by Russians is unique in terms of the degree of tension in social and personal relations, in terms of the dynamism of change.

One of the fundamental factors operating within society, which determines the socio-economic status of a person and family, is the state and nature of existing social relations.

In the context of the emergence and development of market relations, the most acute are the problems of social protection of the population from the negative effects of the market.

The logic of the development of market relations brings to the fore the social protection of people who are outside the market and do not have the opportunity to exist even at the level of minimum standards of life.

This applies to those who, for objective reasons, do not participate in the sphere of production and stand outside the interrelated moments of social justice that are relevant for all historical periods:

Industrial justice, which contains the demands made on a person by society for the need for useful activity, and which cannot be met by those who are left out of production: the elderly, children, the disabled, etc.;

Distributive justice, which implies the responsibility of society to the person of a civilized civil society.

Every year there are more and more elderly people on Earth. The proportion of elderly and senile people in the total population of Russia has increased significantly in recent years and today is approximately 20%. Scientists involved in population problems argue that this process in our country will continue for more than a decade.

Our country is now going through hard times, and yet, despite great difficulties, pensions are regularly indexed, which are received by 29 million Russians. More than 2,000 social service institutions are open and functioning. 232,000 people in need of constant outside assistance live in stationary institutions. Much more elderly patients are treated in various medical institutions.

It must be admitted that the joint efforts of various departments make it possible to use the funds allocated by the state more efficiently and quite successfully implement a policy towards the elderly.

The year 1999 was declared by the UN as the year of the elderly, which is a recognition of people who have entered the period of "golden autumn", as well as an indicator of the need to improve social, medical and other types of assistance to the elderly from society.

It should also be recognized that a large group of our citizens, represented by older people, needs solid material, social and psychological support. After all, these are mostly people who have stopped working (in Russia, by the way, only 15% of male pensioners and 12% of women continue to work, which is very small). Pensioners have a material income several times lower than those who work. They turn from "suppliers", breadwinners into consumers, which, of course, changes the position of pensioners in the family and society and makes it vulnerable in many life situations. Therefore, the timely support of pensioners by the state, as well as by their native enterprises and institutions, various funds plays a very important role.

The main indicator of a high culture and civilization of a society is social guarantees and social protection for the elderly, as well as the quality of assistance and support provided to them.

Social protection of the elderly and elderly citizens at the present level is carried out in three main areas:

Social protection (providing benefits and benefits to old people),

social service

Organization of pension provision.

The mechanism of social protection of the elderly is implemented at the state (federal) and regional (local) levels.

The state level of social protection ensures the guaranteed provision of statutory pensions, services and benefits in accordance with established monetary and social standards. At the regional level, taking into account local conditions and opportunities, issues of an additional increase in the level of support above the state level are being addressed. At the discretion of local authorities, it is possible to establish regional security standards, but not lower than those enshrined in legislation.

The aggravation of problems in pension provision was associated with the appearance and rapid growth of arrears in the payment of pensions in previous years, starting from 1995.

The objective reason for the financial instability of the pension system is, on the one hand, the crisis of non-payments, on the other hand, its inconsistency with the changed socio-economic conditions in the country.

The current pension system took shape when economic relations were based exclusively on state (public) property and the state strictly regulated all spheres of society and the national economy. Within the framework of the pension system, many tasks that were unusual for it were solved.

It is only possible to prevent a deepening crisis in the pension system and create prerequisites for economic growth through a gradual transition from a universal pay-as-you-go system to a mixed pension system, in which accumulative mechanisms for financing pensions play a significant role.

In the long term, as an alternative to the current pay-as-you-go system, a mixed pension system is proposed, which includes:

State pension insurance is the leading element of the system, according to which the payment of pensions is carried out depending on the insurance (work) length of service, the amount of contributions paid to the state pension insurance budget and is financed both from current revenues to the Pension Fund of the Russian Federation and from funds received from the direction of part of the mandatory insurance premiums for accumulation, and at the expense of investment income from their placement;

State pension provision for certain categories of citizens, as well as for persons who have not acquired the right to a pension under state pension insurance - at the expense of the federal budget;

Additional pension insurance (collateral) carried out at the expense of voluntary contributions from employers and employees, and in cases established by the legislation of the Russian Federation - mandatory insurance contributions.

The development of the situation with pension provision since the approval by the Government of the Russian Federation of the Concept for reforming the pension system in the Russian Federation has led to the need to adjust certain areas of pension reform.

Social services for elderly citizens, the disabled, is an activity to meet the needs of these citizens in social services.

Social services include a set of social services (care, catering, assistance in obtaining medical, legal, socio-psychological and natural types of assistance, assistance in vocational training, employment, leisure activities, assistance in organizing funeral services, etc.), which are provided to elderly citizens and disabled people at home or in social service institutions, regardless of the form of ownership.

The state guarantees elderly and disabled citizens 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, beliefs, membership in public associations and other circumstances.

Elderly citizens and the disabled are provided with the opportunity to receive social services sufficient to meet their basic vital needs, which are included in the federal and territorial lists of state-guaranteed social services.

Thus, the creation of a system of social services that meets the needs of the population is one of the most important tasks of the state during the formation of a socially oriented market economy.

It is necessary to concentrate the efforts of all interested parties - representatives of the legislative authorities, executive bodies, researchers, public associations in order to consistently implement measures to develop and strengthen the system of social services for the population.

1.2. Social problems of the elderly and their reflection in the state social policy.

The structural restructuring of society immeasurably increased the problems of the elderly population of the country, which directly affected the reduction in life expectancy.

Average life expectancy is a variable that indicates the efforts of the state and society aimed at preventing mortality and improving the health of the population. Average life expectancy is a generalized criterion that determines both the biological patterns of aging and death inherent in people, and the influence of social factors: the level and lifestyle, the state of healthcare, the achievements of science.

The first half of the 1990s was marked in the Russian Federation by a sharp drop in the average life expectancy of the population.

In 1992-93. the average life expectancy for men was 59 years and for women 78.7 years. According to this main indicator of the state of quality of life, Russia was in last place in Europe for men and one of the last places for women. The trend towards shortening life expectancy has led to the fact that among the elderly there are many single women.

There is no doubt the impact of a sharp deterioration in working and living conditions for many millions of men and women, which has especially affected pensioners.

Old age, as a period of people's lives, incorporates many fundamental problems of both the biological and medical sphere, and issues of the social and 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. In addition, the social insecurity of older people is associated with the presence of a mental disorder that forms their attitude towards society and makes it difficult to adequately contact with it.

Mental problems arise when a habitual way of life and communication is broken due to retirement, when loneliness sets in as a result of the loss of a spouse, when characterological features are sharpened as a result of the development of a sclerotic process. All this leads to the emergence of emotional-volitional disorders, the development of depression, behavioral changes. The decrease in vitality, which underlies all kinds of ailments, is largely due to a psychological factor - a pessimistic assessment of the future, a hopeless existence. At the same time, the deeper the introspection, the more difficult and painful the mental restructuring.

The main difficulty lies in changing the status of older people and the maximum extension of their independent and active life in old age, caused primarily by the termination or restriction of labor activity, revisions of value orientations, the very way of life and communication, as well as the emergence of various difficulties both in social and domestic and in psychological adaptation to new conditions.

The increased social vulnerability of older citizens is also associated with economic factors: the small amount of pensions received, low employment opportunities both at enterprises and in obtaining work at home.

An important social problem of the elderly is the gradual destruction of traditional family foundations, which has led to the fact that the older generation does not occupy an honorable dominant position. Very often, older people generally live separately from their families, and therefore they are unable to cope with their ailments and loneliness, and if earlier the main responsibility for the elderly lay with the family, now it is increasingly being taken over by state and local bodies, social protection institutions.

In the conditions of our country, when the average life expectancy of women is about 12 years longer than that of men, an elderly family most often ends in female loneliness.

Chronic diseases reduce the possibility of self-care, adaptation to change. Difficulties may arise with others, including with loved ones, even with children and grandchildren. The psyche of the elderly and old people is sometimes distinguished by irritability, resentment, senile depressions are possible, sometimes leading to suicide, leaving home. Elderly and senile people are, first of all, lonely - but you need to remember that not only an elderly person needs help, but also his family.

The onset of maturity and old age is an inevitable process, but the objective situation, as well as their experience, views, value orientations, are products of the social environment.

Today, every fifth inhabitant of Russia is an old-age pensioner. In almost all families, at least one of the family members is an elderly person. The problems of third generation people can be considered universal. Elderly people need increased attention from society and the state, and are a specific object of social work. In Russia, about 23% of the population are elderly and old people, and the trend of increasing the proportion of elderly people in the total population continues, it becomes obvious that the problem of social work with the elderly is of national importance.

According to the UN in 1950. in the world there were 214 million people over 60 years old: according to forecasts in 2000. there will already be 590 million of them, and in 2005. - 1100 million, i.e. the number of older people will increase by 5 times over these years, while the population of the planet will increase by 3 times over this time. In this regard, they began to talk about the "aging" of society. In our country, according to the same forecasts in 2000. 25% of the population will be over 50 years old.

The social policy in relation to the elderly citizens, as well as the social policy of our state as a whole, 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 in one or another stage of its development. The allocation in the general structure of social policy of a special direction - gerontological policy relating to the well-being and health of the elderly is due to rather specific conditions and lifestyle, the characteristics of their needs, as well as the level of development of society as a whole, its culture.

A feature of the social policy of the state in modern conditions is the transfer of the center of gravity in the implementation of social protection of the elderly and old people directly to the field. Social protection for the next crisis period provides a set of additional measures to provide financial assistance to old people, carried out at the expense of the federal and local budgets, at the expense of specially created social support funds for the population, in addition to social guarantees traditionally implemented by the social security system.

As the main goal, the social protection of the elderly involves getting rid of absolute poverty, providing material assistance in extreme conditions of the transition period to a market economy, and facilitating the adaptation of these segments of the population to new conditions. Unfortunately, at present, the social strategy of the state is not aimed at an absolute increase in spending on social programs, but mainly at the redistribution of available funds in order to provide social assistance, primarily to the most needy citizens of society, which traditionally include old-age pensioners who are below the poverty line.

Analyzing the accumulated experience of work on the social support of Muscovites in recent years, we can state the following.

The measures taken by the Government of Moscow for a number of years to provide social support to the residents of the city made it possible to form a stable, guaranteed system of social protection of the population at the city and district levels, which has a purposeful, targeted character.

In modern socio-economic conditions, unfortunately, the standard of living of the “economically inactive part of the population” is constantly decreasing, and in Moscow this is almost every third inhabitant (only 3.5 million recipients of pensions and benefits are registered with the social protection authorities). The socially oriented policy pursued by the Government of Moscow makes it possible to maintain the necessary social stability in the city.

The main measures of social support implemented by the Government of Moscow were reflected in the Comprehensive Program of Measures for Social Protection of Moscow Residents for 1999.

The program of measures for the social protection of the inhabitants of Moscow, planned for 1999, has been fully implemented.

In general, about 45% of all budget expenditures of the city were directed to its implementation, including the construction of free public housing and the resettlement of residents from areas with five-story buildings - 3.5 billion rubles, a subsidy for free travel in preferential categories of urban transport - 3 .8 billion rubles, free drug provision - 2.1 billion rubles, payment of benefits to families with children and various additional payments - 1.1 billion rubles. In the process of budget execution, in order to ensure the social protection of Muscovites, additional allocations were directed to free medicines and an increase in additional payments to pensions.

Since January 1999, the Federal Law "On Veterans" has been basically implemented in Moscow. Housing and communal benefits were additionally received by 570 thousand veterans of war and labor, benefits for paying for radio points and television antennas - 1.3 million veterans, for which an additional 460 million rubles were allocated from the city budget, and in total for the implementation of this law, the city spends more than 4 billion rubles. in year. Due to the lack of funds from the federal budget in 1999, for 1.1 million veterans, the benefit for paying for the telephone was still financed from the income of JSC "Moscow City Telephone Network", for which 206 million rubles were allocated.

Particular attention in 1999 was paid to material support for pensioners. The increase in the "social norm" (twice during the year) contributed to bringing pensions closer to the subsistence level. From November 1, 1999, it amounted to 575 rubles. per month. The number of recipients of city additional payments to pensions up to the "social norm" reached 1,730 thousand people by the end of the year, and the amount of expenses for their payment in 1999 exceeded 2 billion rubles.

Work continued to provide disabled people with various rehabilitation services and technical means. In 1999, 2,500 wheelchairs, 150,000 prosthetic and orthopedic products, 34,200 sanatorium and resort vouchers, and 2,600 Moskvich-Svyatogor cars were allocated free of charge to the disabled.

For targeted social support of low-income persons and families with children in 1999, extra-budgetary funds were actively attracted from the prefectures of administrative districts, district administrations, charitable, non-profit organizations and extra-budgetary state social funds - social insurance, employment, pension. More than 1.2 billion rubles were allocated for these purposes.

A sharp drop in the living standards of older citizens is evidenced by an almost 1.5-fold increase in applications for organizing the burial of deceased pensioners on a gratuitous basis.

In 1999, the payment of city supplements to the burial allowance and the provision of individual free funeral services to the State Enterprise "Ritual" continued. About 53 million rubles were allocated for these purposes from the city budget.

In addition, additional payments have been established for pensions for certain categories of veterans, taking into account their combat and other merits. These categories of veterans include: disabled women and participants in the Great Patriotic War, disabled veterans of the Great Patriotic War who, due to a severe injury, did not work out the required length of service for the appointment of a labor pension, disabled since childhood due to injury during the Second World War, parents of servicemen who died in the army in peacetime, Honorary donors of the USSR who donated blood during WWII.

To ensure a decent life for the elderly in the system of social protection, social service centers have proven themselves very positively, helping lonely elderly and disabled people to adapt in a difficult life situation.

In 1999, the task of creating social service centers in every district of the city continued. To date, the work on the implementation of the Program for the Development of a Network of Social Service Centers has been almost completed in the city. At present, 112 social service centers, 11 branches and 1 Experimental Complex Center for Social Protection of the Population in the South-Eastern Administrative District have been established in Moscow.

To serve at home single pensioners and disabled people, the CSO created 916 social service departments, which in 1999 provided various social services at home to more than 115 thousand (Appendix No. 1 and No. 2) single citizens in need of outside help. In recent years, departments of social and medical care at home have been developed, which are designed to provide social and medical assistance to lonely pensioners and disabled people suffering from severe forms of illness. In total, 19 such departments have been created in the city, which provide assistance to almost 1,200 people.

Currently, the CSO has 140 day care departments (Appendix No. 2), which are visited daily by about 4 thousand pensioners and disabled people, where they are provided with free meals, first aid, exercise therapy, massage, hairdressing services, cultural and leisure activities.

Almost all social service centers have urgent social service departments. In 1999 more than 350 thousand people applied to these departments, of which 93% of citizens received various targeted assistance (clothes, food, legal, legal) - Appendix No. 3.

In 1999, work continued to provide low-income citizens with free hot meals and food packages. 3,985 people receive hot meals every day, and 19,000 people receive food packages every month. Since November 1, 1999, the cost of lunches in day-care departments has been increased from 16.5 rubles to 25 rubles a day per person, and the cost of a food package - from 72 to 108 rubles (i.e., 1.5 times).

In order to identify those in need of social services, in 1999 the employees of the centers conducted a mass survey of all lonely and lonely elderly people. A total of 81.5 thousand people were examined. As a result of the work carried out, more than 9 thousand single pensioners were additionally taken for social services. Based on the results of the survey, a group of people was identified who currently do not need to be attached to a social worker, but at any time they may need this type of service. Social service centers monitor citizens belonging to this category with a view to admitting them to social service departments at home, as well as providing other types of social assistance. Citizens included in the "risk group" during the examination received memos with telephone numbers and addresses of centers they can contact in emergency situations.

In the context of the financial and economic crisis, the organization of commercial and consumer services for low-income citizens at reduced prices is of particular relevance. The program of trade and consumer services for low-income citizens at reduced prices was developed by the Committee for Social Protection of the Population together with interested departments and committees of the Moscow Government, veterans and other organizations, and considered at a meeting of the Moscow Government on December 8, 1998. The main goal of the program is to create a unified system of commercial and consumer services for low-income citizens, to consolidate various financial resources for this, and to attract the attention of charitable and veteran organizations. One of the ways to implement this program is the organization of outbound trade and the provision of personal services in social service centers, social residential homes and other social protection institutions. The program provides for a reduction in prices for goods and services by at least 15% of the average prices in the city or those indicated in the price lists.

Another serious area of social protection is measures for social support and rehabilitation of the disabled, ensuring their normal life and integration into society. The Moscow government has set the task of comprehensively addressing the issues of social, medical, professional and labor rehabilitation of disabled people. Starting from 1995, budget indicators annually provide funds for the implementation of the Comprehensive Target Program for the Rehabilitation of the Disabled in Moscow, which includes a wide range of measures for the rehabilitation and social adaptation of the disabled.

From July 1, 1998, a 50% discount was introduced on housing and utility bills for labor veterans living alone; labor veterans living in families consisting of pensioners, as well as labor veterans living with disabled family members who are dependent on them. Approximately 200,000 pensioners - labor veterans - received the right to these benefits.

Today, more than 3 billion rubles are spent on the implementation of social benefits provided for by the Law of the Russian Federation "On Veterans". in year.

At the same time, benefits for 530,000 labor veterans living with families, as well as benefits for paying for a TV antenna, a radio station, and benefits for paying for using a telephone for certain categories of veterans, remain unrealized to this day.

An additional 461.51 million rubles is required for the full introduction of the Federal Law "On Veterans" in Moscow. in year. The issue of including these expenses in the city budget for 1999 has not yet been finally resolved.

Since February 1, 1998, in order to eliminate the disproportion in the level of pensions of 2.3 thousand women with war disabilities compared to women participating in the Second World War, they have been given similar supplements to pensions, for which more than 2.2 million rubles have been spent. On May 28, 1998, the Mayor of Moscow decided to establish a monthly supplement for Lilliputians (dwarfs) in the amount of 100% of the minimum old-age pension.

Since July 1, 1998, monthly supplements to old-age pensions for the parents of dead military servicemen have been increased by one and a half times, and at the same time the same supplement has been extended to the parents of military personnel who served under a contract and died in the line of duty (2 million rubles). .

The implementation of the above measures made it possible, along with the financing of social protection from city sources, to respond more flexibly to the social needs of the inhabitants of their territory, providing targeted social support.

The study showed that the system of emergency services for the elderly is one of the important, integral parts of the social protection of the population, state social policy. The existing legislative and legal acts on the organization of social services and pensions for citizens require revision and improvement. The study of the effectiveness of the system of social services for the elderly shows that it is necessary to take measures to improve it, as there is an increase in the number of older people in need of social assistance.

CHAPTER TWO

ANALYSIS OF THE EFFICIENCY OF THE WORK OF SOCIAL SERVICE CENTERS AND INCREASING THEIR ROLE (on the example of Moscow)

2.1. Improving the management of the activities of the Committee for Social Protection of the Population of Moscow and the District Departments of Social Protection of the Population for social protection (on the example of the work of the Committee and the Department of Social Protection of the Population of the Northern District).

In Moscow, the social protection of the poor strata of the population is carried out under the direct supervision of the Committee for Social Protection of the Population of Moscow, together with ten Departments of Social Protection of the Population of Administrative Districts. (Appendix #5)

The Committee for Social Protection of the Population of Moscow is a branch executive body (city administration), in turn, the Department of Social Protection of the Population of the Northern District is a management body that jointly ensures, within its competence, the implementation of a unified state policy of social protection of the elderly, disabled people, families with minor children , as well as other disabled groups of the population in need of social support.

The Committee and the Administration, as well as other bodies and institutions of social protection, form a unified state system of social protection in Moscow.

The Committee and the Department act on the basis of the approved Regulations and are guided in their activities by the Constitution of the Russian Federation, Federal laws and laws of the city of Moscow, decrees and orders of the President of the Russian Federation, orders of the Government of the Russian Federation, orders of the Mayor and Vice Mayor, orders of the Government of Moscow, instructions of the Ministry labor and social development of the Russian Federation, as well as its Regulations.

The Committee carries out its activities in cooperation with the Moscow City Duma, executive authorities of Moscow, the Moscow branch of the Pension Fund of the Russian Federation, state non-budgetary funds, local governments, federal and city public organizations.

The Department carries out its activities under the guidance of the Committee, provides it with financial and other types of reporting on the activities of the Departments of Social Protection of the Population (USZN), Municipal Departments of Social Protection of the Population (MUSPN), Social Service Centers (SSO) and the Bureau of Medical and Social Expertise.

The Northern District Office works in close contact with the Committee and the prefecture of its district, the Committee and the Office jointly develop a program for social support for the poor in the district in connection with the celebration of the International Year of the Elderly, in 1997. a comprehensive program was developed to develop a network of social service centers, strengthen the material and technical base of social protection institutions

to improve the material and consumer services for the poor groups of the population for 1997-2000. The need to develop this program and create new centers is explained primarily by the fact that, for example, the number of citizens in need of social services at home in the Northern District, compared to 1994, has doubled. To date, 12,127 people are serving in the CSO.

The staff of the Northern District Administration, in addition to the head of the Administration, has two deputy heads for general issues, for coordinating the activities of the CSO and the MUSSP, two chief specialists for working with the MUSSP and the CSO, and a leading specialist for working with the Bureau of Medical and Social Expertise. The leading specialist in work with persons without a fixed place of residence among former Muscovites is in constant close contact with the three reception centers of the district. In the future, these persons, if they reach retirement age, are issued a pension, those who wish are helped to settle permanently in the Social Rehabilitation Center. MUSZN, distribute the incoming financial resources from the Pension Fund Department in Moscow, as well as the resources of the Prefecture fund and control their use.

The Committee and the Administration are legal entities, have an independent balance sheet, current and settlement accounts in banking institutions, a seal with the image of the Coat of Arms of Moscow and its name, as well as appropriate seals, stamps and letterheads.

Together with the Bureau of Medical and Social Expertise, the Department organizes work in accordance with the new Regulations on the district (interdistrict) Bureau of Medical and Social Expertise, approved by the order of the Committee dated November 25, 1997. N227, take measures to staff the Bureau with qualified specialists, such as a rehabilitation doctor, psychologist, social worker, in connection with the new functions assigned to the Bureau for the formation and adjustment of individual rehabilitation programs for people with disabilities, as well as monitoring their implementation.

If we consider the problem of staffing in social protection bodies, then all this can be represented as follows.

Information about employees of the system of social protection of the population L (L) [+/-] for 1999.