June 1st, 2012

The essence of social work with older people - social rehabilitation - is restoration of usual responsibilities, functions, types of activities, and the nature of relationships with people. Overcoming social isolation, increasing the self-esteem of an elderly person, creating conditions for updating his life experience, recognizing his values, realizing his creative potential, is successfully overcome by the use of special technologies, among which the most common are occupational therapy and art therapy. Occupational therapy is an active method of restoring and compensating for impaired functions through various work aimed at creating a useful product. In rehabilitation work with older people, several options for occupational therapy are used, which differ in the main tasks, means and methods of implementation.
1. General strengthening (tonic). It is a means of increasing the general vitality of an elderly person and creates psychological prerequisites for rehabilitation.
2. Self-care training (domestic rehabilitation). This type of occupational therapy can be started as early as possible, because... its goal is to eliminate the helplessness of the old person.
3. Restorative (functional). The goal is to influence the damaged part of the body, organ or system to restore the function disturbed by the pathological process through appropriately selected types of work activity.
4. Entertaining (occupational therapy). Its goal is to reduce the severity of aggravating factors caused by forced prolonged stay in a confined space.
5. Professional focus on restoring production skills or preparing (training) a new profession. With the help of special social services for the employment of elderly and disabled people, they are provided with work with a decrease in its volume, pace and production norm.
Art therapy (concerts, music classes, performing arts, dancing, drawing, etc.) not only increases the emotional charge of an elderly person, but also helps strengthen social contacts. Art therapy can be carried out in social centers, mental health centers or day care hospitals, boarding schools and other social institutions.
Social services are an integral element of the social security system for elderly and elderly citizens. Social service represents the activities of social services for social support, provision of social, social and legal services and financial assistance, carrying out social adaptation and rehabilitation of citizens who were in difficult life situation. If pension provision is aimed at satisfying the material needs of older people, then social services act as a technology for solving the personal problems of an elderly person, from the problem of communication, interaction with other people and to the receipt of social, everyday and other services.
The main laws that formed the legal basis for the functioning of the social service system: Federal Law of December 10, 1995 No. 195-FZ “on the fundamentals of social services for the population in the Russian Federation”; Federal Law of August 2, 1995 No. 122-FZ “On Social Services for Elderly and Disabled Citizens.”
Institutions providing social services to older people include: gerontological centers, comprehensive social service centers, social assistance at home, psychological and pedagogical assistance centers, special homes for single elderly people, inpatient social service institutions, day care departments.
Forms of social services for older people: inpatient services; semi-stationary social services, social and medical services at home; urgent social services, social advisory assistance aimed at adapting elderly citizens and people with disabilities to society, easing social tension, creating favorable relationships in the family, as well as ensuring interaction between the individual, family, society and the state.
a) Social services at home.
Social assistance departments at home, as a rule, are organized at municipal social service centers or local social welfare authorities. The main goal of the social assistance service at home is to maximize the stay of older people in their usual habitat, support their personal and social status, and protect their rights and legitimate interests. Therefore, social services at home are a priority model of social services for elderly and elderly people.
The social assistance service at home provides services to elderly citizens in accordance with the Law “On Social Services for Citizens” and the Decree of the Government of the Russian Federation dated October 25, 1995. “On the federal list of state-guaranteed social services.”
Social services at home can be provided on a permanent or temporary basis (up to 6 months). The department is created to serve at least 60 pensioners living in rural areas, as well as in the urban private sector, and in urban areas - at least 120 elderly and disabled people.
The main activities of the department of social services at home are:
? identification and registration of elderly people in need of services (a registration card is compiled);
? provision of social, domestic and other necessary assistance;
? assistance in providing benefits and benefits to persons served.
b) Urgent social assistance.
The main purpose of urgent social services is to provide emergency one-time assistance to elderly citizens in dire need of social support. The scope of social services is established by the federal list of state-guaranteed social services. It provides the following services: one-time provision of free hot meals or food packages to those in dire need; provision of clothing, footwear and basic necessities; one-time provision of financial assistance; assistance in obtaining temporary housing, emergency psychological assistance, including by telephone helpline; provision of legal assistance within its competence; provision of other types and forms of assistance determined by regional characteristics. These types include free or partially paid repairs of residential premises, cultivation of vegetable gardens, assistance in the preparation of pickles, provision of firewood and coal.
c) Semi-stationary social services
Day (night) departments are a form of semi-stationary social service and play an important role in providing effective social support to older people. They are created on the basis of municipal social service centers or under social protection authorities.
Day care departments are designed for everyday, medical, cultural services for older people, organizing their recreation, attracting them to feasible work, maintaining active image life.
Branches are created to serve at least 30 people. They enroll older people and disabled people who have retained the ability for self-care and active movement. The decision to enroll is made by the head of a social service institution on the basis of a personal written application from an elderly or disabled citizen and a certificate from a health care institution about his state of health.
The day care department provides the following types of services:
? organization of catering, everyday life and leisure (providing hot meals, provision of books, magazines, newspapers);
? social and medical services (assistance in obtaining medical and psychological assistance, provision of sanitary and hygienic services, organization of medical and recreational activities, assistance in obtaining vouchers for sanatorium and resort treatment);
? assistance in organizing legal services;
? assistance in organizing funeral services.
The emerging trend of reduction in the services of inpatient institutions is associated with an increase in the scale of provision of outpatient care to disabled people and the elderly living in ordinary home conditions by non-stationary social service institutions. The latter are represented by social assistance departments at home (including at boarding homes, territorial centers, social protection departments), territorial social service centers and territorial social assistance services (as a rule, on the basis of territorial centers and social assistance departments at home district (city) departments (departments) of social protection of the population).
Social assistance departments at home provide the minimum necessary range of services for the delivery of food, medicine, firewood (coal), payment of housing and communal services and other expenses.
Recently, this organizational form has been complemented by another, caused by the transition to a market economy, when a significant part of the elderly and disabled people found themselves on the brink of poverty, having lost their livelihood, in an extreme life situation. This is an emergency social assistance service. The main types of services of the emergency social assistance service include: provision of food, medicine, clothing, temporary housing, provision of emergency psychological assistance, assistance in identifying disabled people in boarding homes and hospitals, provision of services of hairdressers, repairmen of electrical household appliances, active cooperation with government, public, religious organizations, charitable foundations, the media, government bodies and other institutions to take measures to resolve acute life situations.
The need for the functioning of emergency social assistance services is undeniable, since they develop and complement the services of social assistance departments at home and, most importantly, allow disabled people who are beyond poverty to maintain their existence.
Semi-stationary forms of social services include territorial centers, the advantage of which is the possibility of combining medical and social services for people with disabilities. Territorial social service centers also make it possible to organize meals and create conditions for communication between disabled and elderly people. The latter is an important factor for maintaining the moral tone of people living outside the family.
Initially, the creation of territorial centers was envisaged mainly together with inpatient departments, where conditions were created for temporary stay (5-10 days) of IWs in fairly comfortable conditions and preventive treatment (physiotherapy, phototherapy, massage, psychological relief). However, the creation of territorial centers with stationary services requires additional conditions and, accordingly, more significant costs, for which local social protection authorities do not always have the necessary financial resources.
Territorial social service centers have large reserves to meet the needs of people with disabilities. According to the management of the centers, more than 5% of those served are willing to pay for additional (beyond those provided free of charge) services. But only a few territorial centers and social assistance departments provide paid services at the request of disabled people, and the range of services as a whole is limited to a general set: cooking, washing dishes, delivering laundry to the laundry, washing clothes at home, providing bath services, cleaning the apartment, washing windows, buying groceries, medicines, manufactured goods, walking the dog, etc.
The semi-stationary form of social services in Volgograd is represented by: the Day Care Center for Pensioners and Disabled People, the Center for Social Assistance for Families Raising Disabled Children in the Dzerzhinsky District and the City Center for Social Assistance in the Kirovsky District.
The day care center for pensioners and disabled people, designed for 30 places, is intended for social, medical, cultural services for pensioners and disabled people, organizing their meals, recreation, maintaining an active lifestyle, and attracting them to work. Elderly citizens are accepted for service at the Center: men over 60 years old, women over 55 years old, disabled people of groups I and II for a period of two weeks, who have retained the ability for self-care and active movement.
The Center for Social Assistance for Families Raising Disabled Children of the Dzerzhinsky District was created in 1995. The purpose of the Center is to promote the realization of the right of families and children to protection and assistance from the state, to promote the development and strengthening of the family as a social institution, to improve socio-economic living conditions, indicators of social health and well-being of families and children, to humanize the family’s connection with society and the state , establishing harmonious family relationships: organizing communication and leisure time for children: teaching self-service skills, everyday adaptation, providing advisory assistance.
The City Center for Social Assistance in the Kirovsky District was created in order to protect people who find themselves in extreme conditions without a specific place of residence and occupation, who are in a crisis life situation and to implement rehabilitation measures.
In the issue of developing the principles of the relationship between paid and free services, it is necessary to take a targeted and individual approach. Satisfying a client's specific needs for a reasonable fee should be in addition to meeting his general needs free of charge. The rationale for this approach is confirmed by the experience of foreign social service systems, in particular Finland, where they strive to provide the client with services that promote (stimulate) his independence and serve as a prerequisite for a good moral and psychological state.
In order to further improve the system of social services and in accordance with the order of the Ministry of Social Protection of Russia dated July 20, 1993. social service centers are being created, which are institutions for social protection of the population that carry out organizational and practical activities in the territory of a city or district to provide various types of social assistance to elderly citizens, the disabled and other groups of the population in need of social support. The structure of the center provides for various social service units, including a day care department for the elderly and disabled, social assistance at home, emergency social assistance services and others.
The main tasks of the social service center in joint activities with state and public organizations (health authorities, education, migration services, committees of the Red Cross Society, veteran organizations, societies for the disabled, etc.) include:
- identification of the elderly, disabled and other persons in need of social support;
- determination of specific types and forms of assistance to persons in need of social support;
- differentiated accounting of all persons in need of social support, depending on the types and forms required and the frequency of its provision;
- provision of social services of a one-time or permanent nature to persons in need of social support;
-analysis of the level of social services for the population of the city, region, development long-term plans development of this area of ​​social support for the population, introduction into practice of new types and forms of assistance depending on the nature of the needs of citizens and local conditions;
- involvement of various state and non-state structures in resolving issues of providing social assistance to needy segments of the population and coordinating their activities in this direction.
d) Inpatient social services are aimed at providing comprehensive social assistance to persons who, for health reasons, require constant care and supervision. State inpatient social service institutions include boarding homes for the elderly and disabled, the regulations of which were approved by order of the Ministry of Social Affairs of the RSFSR dated December 27, 1978. In accordance with this order, a “boarding home” is a medical and social institution intended for the permanent residence of elderly and disabled people in need of care, household and medical services. In a boarding home, for the implementation of therapeutic-labor and activating therapy, therapeutic-industrial (labor) workshops are created, and in a boarding home located in a rural area, in addition, a subsidiary farm with the necessary inventory, equipment and transport.
To other institutions of this type also includes a psychoneurological boarding school, defined as a medical and social institution intended for permanent residence of elderly and disabled people suffering from chronic mental illnesses and in need of care, household and medical services.
Residential institutions for the elderly accept citizens of retirement age who do not have able-bodied children who are required by law to support them. On a first-priority basis, disabled people and WWII participants, family members of deceased servicemen, as well as deceased disabled people and war participants are admitted to boarding homes.
One of the indispensable conditions for admission is voluntariness, therefore paperwork is processed only if there is a written application from the citizen. An application for admission to a boarding home with a medical card is submitted to a higher social security organization, which issues a voucher to the boarding home. If a person is incapacitated, then his placement in a stationary institution is carried out on the basis of a written application from his legal representative. The law provides for the right of citizens staying in inpatient social service institutions to refuse services, but provided that they have relatives who can support them and provide the necessary care.
Persons staying in general boarding houses who systematically and grossly violate the internal regulations there may be transferred to special boarding houses by a court decision made on the basis of a proposal from the administration. They are created mainly for elderly and disabled people with previous convictions, vagrancy, sent from institutions of internal affairs bodies and other persons for whom administrative supervision is established in the manner established by the Decree of the Government of the Russian Federation of April 15, 1995 “On the development of a network of specialized boarding houses for the elderly and disabled."
The functioning of boarding homes as one of the main forms of social services for the elderly is associated with a number of serious problems. Among them: the degree of satisfaction of needs in boarding homes, the quality of service in them, the creation of accompanying conditions for living, etc. On the one hand, in a number of territories of the Russian Federation there is a queue of elderly citizens wishing to enter inpatient social service institutions, on the other hand, elderly People are increasingly showing a desire to live in their familiar home environment. The stationary form of social services is presented in Volgograd by the Traktorozavodsky Center for Social Services for Pensioners and Disabled People. The department with a hospital is intended for medical, cultural, consumer services, attraction to feasible work, and maintaining an active lifestyle.
Currently, inpatient facilities are mainly admitted to people who have completely lost the ability to move and require ongoing care, as well as those who do not have housing. An alternative to boarding homes in the near future may be special residential buildings for the elderly (approximate Regulations on a special home for single elderly people, approved by the Ministry of Social Protection of the Population on April 7, 1994), which, despite some shortcomings, still have a number of important advantages.
Today, a significant part of social service centers are multidisciplinary institutions that are able to provide elderly and disabled people with a variety of types and forms of services, including social and medical, social and shopping. The priority direction is the development of models of non-stationary social services (social service centers, social assistance departments at home), which make it possible to maximize the stay of older people in their usual habitat and maintain their personal and social status.
Thus, the main technologies currently are state technologies for social protection of older people - pensions, social services, social assistance. However, the priority direction of social work with older people is the organization of the living environment of aging people, carried out in such a way that an elderly person always has the opportunity to choose ways to interact with this environment, because older people are not the object of activity of various social services, but a subject making decisions. Freedom of choice creates a feeling of security and confidence in the future. This implies the need for alternative technologies for social work with older people. Among which we can highlight charitable assistance, club work, self-help and mutual aid groups.

One of the main methods of social work with older people in non-stationary institutions is home-based social services. Its main goals are: maximizing the extension of clients’ stay in their familiar environment, preserving their vital and social tone, protecting their legal rights and interests.

The main social services provided at home usually include:

1. Organization of meals and home delivery of food;

2. Assistance in purchasing essential goods, medical supplies and medicines;

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

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

5. Assistance in burying lonely deceased elderly people and organizing the necessary funeral services;

6. Organization of social services (repair of residential premises, provision of various types of fuel, cultivation of vegetable gardens and gardening areas (if any), carrying water, chopping wood, paying for utilities, etc.);

7. Providing assistance in the preparation of various documents, such as: documents on establishing guardianship and trusteeship, exchange and sale of land and living space, placement in permanent social institutions.

Social workers who are on the staff of all social institutions directly provide services to citizens as close as possible to their place of residence. This approach to the client is caused by several reasons: extension of the work schedule, increase in the number of visits, reduction of transport time. The department of home-based social assistance, as a rule, is organized at municipal social welfare centers.

A department is being created to provide social assistance to at least 60 clients who live in rural areas or in the private sector without proper utilities; in urban areas the number of clients increases to 120 people. Social services at home for older people can be permanent or temporary (up to 6 months).

For clients suffering from severe forms of illness, such as oncology in the later stages of treatment or in need of pre-medical care in addition to social services, there is a special home-based social assistance department, which on average can accommodate 60 people.

In addition to social workers, the department also includes a nurse who carries out medical procedures, such as: measuring blood pressure and body temperature, performing cleansing enemas, applying compresses, bandaging, eliminating bedsores, treating wounds, administering subcutaneous and intramuscular injections as prescribed by a doctor. Nurses also carry out various hygiene procedures with clients - rubbing, special baths, changing linen, and feeding clients weakened by illness. Additionally, social workers provide household services such as cooking, cleaning the apartment, washing clothes, etc.

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

Urgent social services include the following range of services provided by the state:

One-time provision of food packages or hot meals to clients;

Providing basic necessities, clothing and footwear;

One-time provision of financial 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 take immediate measures aimed at maintaining the life of older people who are in dire need of social assistance. The service's activities are based on cooperation with individual citizens, as well as with various public and government organizations.

To provide elderly people with the items they need: food, clothing, shoes, and much more, a natural aid room is created in each non-stationary institution, in which used shoes, clothing, hygiene items, etc. are given to citizens free of charge. This assistance is mainly provided by the population themselves. Thanks to the system of mutual offsets, new things and objects are received from enterprises and organizations. These can be raincoats, jackets, down jackets, bed linen, cereals, sugar, flour and more. Humanitarian aid from foreign countries is also in demand among citizens.

As a rule, humanitarian aid is free of charge. There are special norms and criteria by which humanitarian aid is distributed: priority in this regard is single elderly people who receive an income below the required minimum established by the state. Both the present and the declarative forms are valid. The final result of the distribution of assistance is monitored by specialists from the department that provides urgent services to elderly people in need. The service headquarters also has a full-time lawyer and a psychologist who provide clients with advisory assistance.

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

The following gradation of the life needs of such elderly clients can be distinguished:

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

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

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

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

The proportion of older citizens who need help as they age increases every year. One of the factors requiring the state to spend more on health care and distribute 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 in a country where the share of elderly citizens is 20% will be disproportionately higher than with an indicator of 10%.

Medical and social services define their main areas of activity as follows:

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

Carrying out the necessary patronage for the elderly and disabled using modern types of social support in the form of prevention, treatment and additional diagnostics;

Providing psychological assistance.

Organization of education of sanitary skills among the population, propaganda healthy image life activities, organizing communication clubs to maintain the communicative activity of older people, holding lectures, organizing health schools and other events of a therapeutic and recreational nature.

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

On the basis of centers that provide social services, day care departments for elderly citizens are organized. Such departments are created for socio-cultural, everyday and medical services to clients, introducing them to life activities, 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 necessary premises should have sleeping quarters for rest, a dining room, etc. As a rule, disabled people and elderly people receive help in such departments free of charge. Elderly patients are placed there, regardless of their marital status, and who have retained the ability to self-care and move without assistance, based on the doctor’s conclusion and the client’s personal wishes.

Under the supervision of a healthcare professional and an occupational therapy instructor, clients are special conditions specific work or simply feasible work on a subsidiary farm. Products obtained from subsidiary farms are used to provide food for the elderly, and the surplus is usually sold to obtain additional material resources.

This department may also provide separate paid services: visits to entertainment events, a hairdresser and massage parlour, manual therapy, etc. Material income received for these additional services is transferred to the account of a social institution and directed towards the development of the institution itself and improving the quantity and quality the services they provide.

In social work with elderly clients in non-stationary institutions, they use various techniques and is being implemented a large number of various areas, such as: urgent social services, service and care for clients at home, urgent medical and social assistance, targeted protection and many others.

Related information.

INTRODUCTION

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

Almost the only correct solution was the creation and development of a system of social service institutions that could provide social protection to the poor and elderly population.

State social policy was focused on guaranteed individual assistance and support for those people who found themselves in extreme situations.

These measures were taken on time and played a certain role in the formation and development of a new direction of social services for the population. In the Russian Federation, this sector was established 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 makes it possible to provide 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-care due to old age, illness, orphanhood, neglect, poverty, lack of a specific place residence, conflicts and abuse in the family, loneliness, etc.), which he cannot overcome on his own.

A certain regulatory and legal framework for organizing 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 created 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 December 10, 1995. N195-ФЗ. The relevance of problems associated with the development of the social service system is predetermined by the following factors:

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

Demand by society for a new social policy;

Problematic development of the social service system.

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

The first section of the thesis identifies the most pressing problems of older people. Their essence is revealed: the condition and position of an elderly person in society is examined, the main criteria for assessing the standard of living of elderly 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 identified.

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

The following tasks serve to achieve this goal:

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

Objective prerequisites and ways of developing social protection for older people;

Social problems of older people and their reflection in state social policy;

Conduct an analysis of the effectiveness of social service centers and increasing their role in social services for the elderly (using the example of Moscow);

To propose measures to improve the management of the activities of the Committee for Social Protection of the Population of Moscow and the Social Protection Committee for Social Protection;

New methods of work of social service centers;

Show what social technologies are used in working with older people, what measures are being taken by the Moscow Government and the Moscow Social Protection Committee to provide social assistance to pensioners and the disabled;

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

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

The subject of the research is to study the problems of development and functioning of the system of comprehensive social services for older people using the example of Moscow.

CHAPTER FIRST

STATE SOCIAL POLICY FOR PROTECTION AND SUPPORT OF ELDERLY CITIZENS.

1.1 Objective prerequisites and ways of developing social protection for older people.

The collapse of the Soviet Union resulted in the formation of a new state for our country 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 severance of centuries-old spiritual, economic, political, social and other ties.

The new reality most 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 clear conscience, spiritual harmony, good family and friendly relationships.

On those traditional features Russian thinking has left its mark on many years of life under socialism, when social protection of people existed for more than half a century, confirming confidence in the future. The state to a certain extent provoked dependency. There was no danger of being left without work or, if ill, without a livelihood. There were no doubts about the future of the children and their education. Slowly, but the housing issue was being 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 characteristics, and by the properties of the micro and macro environment, i.e. properties and dynamics of economic, political, spiritual and moral processes occurring in society. In this sense, the transition period that Russians are experiencing is unique in the degree of tension in social and personal relations and in the dynamism of change.

One of the fundamental factors operating within society, determining the socio-economic status of an individual and family, is the state and nature of existing social relations.

In the conditions of the emergence and development of market relations, the most acute problems of social protection of the population from negative impacts market.

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

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

Industrial justice, which contains the requirements of the need for useful activity presented to a person by society, and which cannot be met by those who remain outside of production: the elderly, children, disabled people, etc.;

Distributive justice, which presupposes the responsibility of society to the individual of a civilized civil society.

There are more and more elderly people on Earth every year. The share of elderly people and old age The total population of Russia has grown significantly in recent years and today accounts for approximately 20%. Scientists involved in population problems argue that this process in our country will continue for many decades.

Our country is going through difficult times now and yet, despite great difficulties, pensions that 29 million Russians receive are regularly indexed. More than 2,000 social service institutions are open and functioning. 232 thousand people in need of constant outside assistance live in inpatient 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 more effectively use the funds allocated by the state and quite successfully implement policies regarding the elderly.

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

It should also be recognized that a large group of our citizens, represented by older people, needs thorough material, social and psychological support. After all, these are mostly people who have stopped working (in Russia, by the way, only 15% of retired men and 12% of women continue to work, which is very small). Pensioners have material income several times lower than workers. They are turning from “suppliers”, breadwinners, into consumers, which, of course, changes the position of pensioners in the family and society and makes them vulnerable in many life situations. Therefore, timely support of pensioners by the state, as well as their family enterprises and institutions, and 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 of elderly citizens, as well as the quality of assistance and support provided to them.

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

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

Social service

Organization of pension provision.

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

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

Exacerbation of problems in pension provision was associated with the emergence and rapid growth of pension arrears in previous years, starting in 1995.

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

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

It is possible to prevent the deepening of the crisis of the pension system and create the preconditions for economic growth only through a gradual transition from a universal distribution system to a mixed pension system, in which funded mechanisms for financing pensions play a significant role.

In the long term, as an alternative to the current distribution 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) experience, 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 directing part of the mandatory insurance premiums to accumulation, and from 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, is financed from the federal budget;

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

The development of the situation with pensions in the time that has passed since the Government of the Russian Federation approved the Concept of reform of the pension system in the Russian Federation has led to the need to adjust certain areas of pension reform.

Social services for elderly citizens and people with disabilities are activities to meet the needs of these citizens for 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 their 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 of public associations and other circumstances.

Elderly citizens and people with disabilities are provided with the opportunity to receive social services sufficient to meet their basic living 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 branch, 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 older people and their reflection in state social policy.

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

Average life expectancy is a variable value, indicating the efforts of the state and society aimed at preventing mortality and improving the health of the population. Average life expectancy is a general criterion that determines both the biological laws of aging and death inherent in people, and the influence of social factors: level and lifestyle, state of health care, scientific achievements.

The first half of the 90s 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 shorter life expectancy has led to the fact that among older people there are many single women.

The impact of the sharp deterioration in working and living conditions for many millions of men and women is undeniable, with a particularly strong impact on pensioners.

Old age, as a period of people's lives, absorbs many fundamental problems of both the biological and medical sphere, as well as issues of social and personal life of society and each individual. During this period, many problems arise for older people, since older people belong to the category of the “low-mobility” 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 vulnerability of older people is associated with the presence of a mental disorder, which shapes their attitude towards society and makes it difficult to have adequate contact with it.

Mental problems arise when there is a break in the usual way of life and communication in connection with retirement, when loneliness occurs as a result of the loss of a spouse, when characterological characteristics are sharpened as a result of the development of the sclerotic process. All this leads to the emergence of emotional-volitional disorders, the development of depression, and behavioral changes. The decrease in vitality, which underlies all kinds of ailments, is largely explained by 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 maximizing their independent and active life in old age, caused primarily by the cessation or limitation of work, revisions of value guidelines, the very way of life and communication, as well as the emergence of various difficulties both in social and everyday life. and in psychological adaptation to new conditions.

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

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

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

Chronic diseases reduce the ability to self-care and adapt to changes. Difficulties may arise with others, including loved ones, even with children and grandchildren. The psyche of elderly and elderly people is sometimes characterized by irritability, resentment, and senile depression is possible, sometimes leading to suicide and leaving home. Elderly and senile people are, first of all, lonely - but we must remember that not only the 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, and value orientations are products of the social environment.

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

According to the UN in 1950. There were 214 million people over 60 years of age in the world: according to forecasts in 2000. there will already be 590 million of them, and in 2005. - 1100 million, i.e. The number of elderly people will increase 5 times over these years, while the planet's population will increase 3 times during this time. In this regard, people 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.

Social policy in relation to elderly citizens, like 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 socio-economic and specific socio-political tasks facing society at one time or another. stage of its development. The identification of a special direction in the general structure of social policy - gerontological policy concerning the well-being and health of elderly citizens, 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 state’s social policy in modern conditions is to shift the center of gravity in the implementation of social protection of elderly and old people directly to the localities. Social protection for the coming crisis period provides a set of additional measures to provide material assistance to old people, carried out at the expense of the federal and local budgets, at the expense of specially created funds for social support of the population, in addition to the social guarantees traditionally implemented by the social security system.

The main goal of social protection of the elderly involves liberating them from absolute poverty, providing material assistance in the 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 state’s social strategy is not aimed at an absolute increase in spending on social programs, but mainly for 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 find themselves below the poverty line.

Analyzing the accumulated experience in providing social support to Muscovites in recent years, we can state the following.

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

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

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

The program of social protection measures for Moscow residents planned for 1999 has been fully implemented.

In general, about 45% of all city budget expenditures were allocated for its implementation, including the construction of free municipal housing and the resettlement of residents from areas with five-story buildings - 3.5 billion rubles, subsidies for free pass in urban transport of preferential categories - 3.8 billion rubles, free medicine 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 social protection of Muscovites, additional allocations were allocated for free drug provision and an increase in additional payments to pensions.

Since January 1999, the Federal Law “On Veterans” has been largely implemented in Moscow. An additional 570 thousand war and labor veterans received housing and utility benefits, 1.3 million veterans received benefits for paying for radios and television antennas, for which an additional 460 million rubles were allocated from the city budget, and in total for the implementation of this According to the law, the city spends more than 4 billion rubles. in year. Due to the lack of federal budget funds in 1999, for 1.1 million veterans, the telephone payment benefit was still financed from the income of Moscow City Telephone Network JSC, for which 206 million rubles were allocated.

In 1999, special attention 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 pension supplements 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 people with disabilities with various rehabilitation services and technical means. In 1999, disabled people were given free 2.5 thousand wheelchairs, 150 thousand prosthetic and orthopedic products, 34.2 thousand sanatorium and resort vouchers, and 2.6 thousand Moskvich-Svyatogor cars were also allocated.

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

About the sharp fall standard of living older citizens are evidenced by an almost 1.5-fold increase in requests to organize the burial of deceased pensioners free of charge.

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

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

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

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

To serve single pensioners and disabled people at home, 916 social service departments were created at the CSO, 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 services at home have been developed, which are designed to provide social and medical assistance to single 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 CSC operates 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 food, pre-medical care, exercise therapy, massage, hairdressing services, and cultural and leisure activities.

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

In 1999, work continued to provide low-income citizens with free hot lunches and food packages. 3,985 people receive hot meals every day, and 19 thousand people receive food packages every month. From November 1, 1999, the cost of lunch in day care departments was increased from 16.5 rubles to 25 rubles per 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, workers of the centers conducted a mass examination of all single and elderly people living alone. 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 into social services. Based on the results of the survey, a group of people was identified who do not currently need to be assigned 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 accepting them into social service departments at home, as well as providing other types of social assistance. During the examination, citizens included in the “risk group” received instructions with telephone numbers and addresses of centers to which they can contact in emergency situations.

In the context of the financial and economic crisis, the organization of trade 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 was 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 trade and consumer services for low-income citizens, consolidate various financial resources for this, and attract the attention of charitable and veteran organizations. One of the ways to implement this program is to organize outbound trade and provide personal services in social service centers, social residential buildings and other social protection institutions. The program provides for a reduction in prices for goods and services by at least 15% from the average prices in the city or indicated in the price lists.

Another serious area of ​​social protection is measures for social support and rehabilitation of people with disabilities, ensuring their normal functioning and integration into society. The Moscow government has set the task of comprehensively solving issues of social, medical, professional and labor rehabilitation of disabled people. Since 1995, budgetary indicators have annually provided funds for the implementation of the Comprehensive Target Program for the Rehabilitation of Disabled People in Moscow, which includes a wide range of measures for the rehabilitation and social adaptation of disabled people.

From July 1, 1998, a 50% discount on housing and utility bills was introduced for labor veterans living alone; labor veterans living in families consisting of pensioners, as well as labor veterans living with disabled members families dependent on them. About 200 thousand 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 thousand labor veterans living in families, as well as benefits for paying for a television antenna, radio point and benefits for paying for using a telephone for certain categories of veterans, remain unrealized to this day.

To fully implement the Federal Law “On Veterans” in Moscow, an additional 461.51 million rubles are required. 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 pension provision for 2.3 thousand disabled women of the war compared to women who participated in the Second World War, similar additional payments to pensions were established for them, for which more than 2.2 million rubles were spent. On May 28, 1998, the Mayor of Moscow decided to establish a monthly pension supplement for midgets (dwarfs) in the amount of 100% minimum pension by old age.

From July 1, 1998, monthly supplements to old-age pensions for the parents of deceased conscripts were increased by one and a half times, and at the same time the same supplement was 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 these measures made it possible, along with financing social protection from city sources, to respond more flexibly to the social needs of residents of their territory, providing targeted social support.

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

CHAPTER TWO

ANALYSIS OF THE EFFICIENCY OF THE WORK OF SOCIAL SERVICE CENTERS AND INCREASING THEIR ROLE (using 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 (using the example of the work of the Committee and the Department of Social Protection of the Population of the Northern District).

In Moscow, social protection of the poor is carried out under the direct supervision of the Moscow Committee for Social Protection of the Population together with ten Departments of Social Protection of the Population of Administrative Districts. (Appendix No. 5)

The Committee for Social Protection of the Population of Moscow is a sectoral body of executive power (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 for the social protection of elderly citizens, disabled people, families with minor children , as well as other disabled population groups 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 Management 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, decrees of the Government of the Russian Federation, orders of the Mayor and Vice-Mayor, decrees of the Moscow Government, instructions of the Ministry labor and social development RF, 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 extra-budgetary funds, authorities local government, federal and city public organizations.

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

The Northern District Administration works closely with the Committee and the prefecture of its district; the Committee and the Administration are jointly developing a Program for social support for the poor in the district in connection with the celebration International Year elderly people, 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 material and everyday services for low-income 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 has doubled compared to 1994. Currently, the CSC serves 12,127 people.

In the staff of the Northern District Directorate, in addition to the head of the Directorate, there are two deputy heads for general issues, for coordinating the activities of the Center for Social Protection and the Ministry of Social Protection, two chief specialists in working with the Ministry of Health and Social Protection and the Center for Social Protection, a leading specialist in working with the Bureau of Medical and Social Expertise. The leading specialist in working with persons without a fixed place of residence from among former Muscovites is in constant close contact with the three reception centers in the district. Subsequently, these persons, if they reach retirement age, are issued a pension, and those wishing to be helped to find permanent residence in the Center for Social Rehabilitation. Employees of the Social Rehabilitation Service of the Northern District are fully responsible for the work of subordinate organizations and institutions, carry out constant monitoring of the activities of the CSO services and MUSZN distributes incoming financial resources from the Moscow Branch of the Pension Fund, as well as funds from the Prefecture Fund and controls their use.

The Committee and the Directorate 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 corresponding seals, stamps and forms.

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 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 agencies, then all this can be presented as follows.

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

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

INTRODUCTION

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

Almost the only correct solution was the creation and development of a system of social service institutions that could provide social protection to the poor and elderly population.

State social policy was focused on guaranteed individual assistance and support for those people who found themselves in extreme situations.

These measures were taken on time and played a certain role in the formation and development of a new direction of social services for the population. In the Russian Federation, this sector was established 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 makes it possible to provide 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-care due to old age, illness, orphanhood, neglect, poverty, lack of a specific place residence, conflicts and abuse in the family, loneliness, etc.), which he cannot overcome on his own.

A certain regulatory and legal framework for organizing 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 created 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 December 10, 1995. N195-ФЗ. The relevance of problems associated with the development of the social service system is predetermined by the following factors:

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

Demand by society for a new social policy;

Problematic development of the social service system.

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

The first section of the thesis identifies the most pressing problems of older people. Their essence is revealed: the condition and position of an elderly person in society is examined, the main criteria for assessing the standard of living of elderly 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 identified.

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

The following tasks serve to achieve this goal:

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

Objective prerequisites and ways of developing social protection for older people;

Social problems of older people and their reflection in state social policy;

Conduct an analysis of the effectiveness of social service centers and increasing their role in social services for the elderly (using the example of Moscow);

To propose measures to improve the management of the activities of the Committee for Social Protection of the Population of Moscow and the Social Protection Committee for Social Protection;

New methods of work of social service centers;

Show what social technologies are used in working with older people, what measures are being taken by the Moscow Government and the Moscow Social Protection Committee to provide social assistance to pensioners and the disabled;

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

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

The subject of the research is to study the problems of development and functioning of the system of comprehensive social services for older people using the example of Moscow.

CHAPTER FIRST

STATE SOCIAL POLICY FOR PROTECTION AND SUPPORT OF ELDERLY CITIZENS.

1.1 Objective prerequisites and ways of developing social protection for older people.

The collapse of the Soviet Union resulted in the formation of a new state for our country 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 severance of centuries-old spiritual, economic, political, social and other ties.

The new reality most 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 clear conscience, spiritual harmony, good family and friendly relationships.

These traditional features of Russian thinking have left their mark on many years of living under socialism, when social protection of people existed for more than half a century, confirming confidence in the future. The state to a certain extent provoked dependency. There was no danger of being left without work or, if ill, without a livelihood. There were no doubts about the future of the children and their education. Slowly, but the housing issue was being 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 characteristics, and by the properties of the micro and macro environment, i.e. properties and dynamics of economic, political, spiritual and moral processes occurring in society. In this sense, the transition period that Russians are experiencing is unique in the degree of tension in social and personal relations and in the dynamism of change.

One of the fundamental factors operating within society, determining the socio-economic status of an individual and family, is the state and nature of existing social relations.

In the conditions of the emergence and development of market relations, the problems of social protection of the population from the negative impacts of the market become the most acute.

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

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

Industrial justice, which contains the requirements of the need for useful activity presented to a person by society, and which cannot be met by those who remain outside of production: the elderly, children, disabled people, etc.;

Distributive justice, which presupposes the responsibility of society to the individual of a civilized civil society.

There are more and more elderly people on Earth every year. The share 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 many decades.

Our country is going through difficult times now and yet, despite great difficulties, pensions that 29 million Russians receive are regularly indexed. More than 2,000 social service institutions are open and functioning. 232 thousand people in need of constant outside assistance live in inpatient 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 more effectively use the funds allocated by the state and quite successfully implement policies regarding the elderly.

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

It should also be recognized that a large group of our citizens, represented by older people, needs thorough material, social and psychological support. After all, these are mostly people who have stopped working (in Russia, by the way, only 15% of retired men and 12% of women continue to work, which is very small). Pensioners have material income several times lower than workers. They are turning from “suppliers”, breadwinners, into consumers, which, of course, changes the position of pensioners in the family and society and makes them vulnerable in many life situations. Therefore, timely support of pensioners by the state, as well as their family enterprises and institutions, and 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 of elderly citizens, as well as the quality of assistance and support provided to them.

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

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

Social service

Organization of pension provision.

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

The state level of social protection ensures the guaranteed provision of legally established pensions, services and benefits in accordance with established monetary and social standards. At the regional level, taking into account local conditions and capabilities, issues of additionally increasing the level of provision above the state level are being resolved. 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 emergence and rapid growth of pension arrears 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, and on the other hand, its inconsistency with the changed socio-economic conditions in the country.

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

It is possible to prevent the deepening of the crisis of the pension system and create the preconditions for economic growth only through a gradual transition from a universal distribution system to a mixed pension system, in which funded mechanisms for financing pensions play a significant role.

In the long term, as an alternative to the current distribution 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) experience, 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 directing part of the mandatory insurance premiums to accumulation, and from 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, is financed from the federal budget;

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

The development of the situation with pensions in the time that has passed since the Government of the Russian Federation approved the Concept of reform of the pension system in the Russian Federation has led to the need to adjust certain areas of pension reform.

Social services for elderly citizens and people with disabilities are activities to meet the needs of these citizens for 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 their 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 of public associations and other circumstances.

Elderly citizens and people with disabilities are provided with the opportunity to receive social services sufficient to meet their basic living 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 branch, 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 older people and their reflection in state social policy.

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

Average life expectancy is a variable value, indicating the efforts of the state and society aimed at preventing mortality and improving the health of the population. Average life expectancy is a general criterion that determines both the biological laws of aging and death inherent in people, and the influence of social factors: level and lifestyle, state of health care, scientific achievements.

The first half of the 90s 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 shorter life expectancy has led to the fact that among older people there are many single women.

The impact of the sharp deterioration in working and living conditions for many millions of men and women is undeniable, with a particularly strong impact on pensioners.

Old age, as a period of people's lives, absorbs many fundamental problems of both the biological and medical sphere, as well as issues of social and personal life of society and each individual. During this period, many problems arise for older people, since older people belong to the category of the “low-mobility” 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 vulnerability of older people is associated with the presence of a mental disorder, which shapes their attitude towards society and makes it difficult to have adequate contact with it.

Mental problems arise when there is a break in the usual way of life and communication in connection with retirement, when loneliness occurs as a result of the loss of a spouse, when characterological characteristics are sharpened as a result of the development of the sclerotic process. All this leads to the emergence of emotional-volitional disorders, the development of depression, and behavioral changes. The decrease in vitality, which underlies all kinds of ailments, is largely explained by 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 maximizing their independent and active life in old age, caused primarily by the cessation or limitation of work, revisions of value guidelines, the very way of life and communication, as well as the emergence of various difficulties both in social and everyday life. and in psychological adaptation to new conditions.

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

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

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

Chronic diseases reduce the ability to self-care and adapt to changes. Difficulties may arise with others, including loved ones, even with children and grandchildren. The psyche of elderly and elderly people is sometimes characterized by irritability, resentment, and senile depression is possible, sometimes leading to suicide and leaving home. Elderly and senile people are, first of all, lonely - but we must remember that not only the 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, and value orientations are products of the social environment.

Today, every fifth resident 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 represent a specific object of social work. In Russia, about 23% of the population are elderly and old people, and the trend towards an increase in the proportion of elderly people in the total population continues, it becomes obvious that the problem of social work with older people is of national importance.

According to the UN in 1950. There were 214 million people over 60 years of age in the world: according to forecasts in 2000. there will already be 590 million of them, and in 2005. - 1100 million, i.e. The number of elderly people will increase 5 times over these years, while the planet's population will increase 3 times during this time. In this regard, people 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.

Social policy in relation to elderly citizens, like 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 socio-economic and specific socio-political tasks facing society at one time or another. stage of its development. The identification of a special direction in the general structure of social policy - gerontological policy concerning the well-being and health of elderly citizens, 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 state’s social policy in modern conditions is to shift the center of gravity in the implementation of social protection of elderly and old people directly to the localities. Social protection for the coming crisis period provides a set of additional measures to provide material assistance to old people, carried out at the expense of the federal and local budgets, at the expense of specially created funds for social support of the population, in addition to the social guarantees traditionally implemented by the social security system.

The main goal of social protection of the elderly involves liberating them from absolute poverty, providing material assistance in the 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 state’s social strategy 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 find themselves below the poverty line.

Analyzing the accumulated experience in providing social support to Muscovites in recent years, we can state the following.

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

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

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

The program of social protection measures for Moscow residents planned for 1999 has been fully implemented.

In general, about 45% of all city budget expenditures were allocated for its implementation, including the construction of free municipal housing and the resettlement of residents from areas with five-story buildings - 3.5 billion rubles, subsidies for free travel in public transport of preferential categories - 3 .8 billion rubles, free medicine 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 social protection of Muscovites, additional allocations were allocated for free drug provision and an increase in additional payments to pensions.

Since January 1999, the Federal Law “On Veterans” has been largely implemented in Moscow. An additional 570 thousand war and labor veterans received housing and utility benefits, 1.3 million veterans received benefits for paying for radios and television antennas, for which an additional 460 million rubles were allocated from the city budget, and in total for the implementation of this According to the law, the city spends more than 4 billion rubles. in year. Due to the lack of federal budget funds in 1999, for 1.1 million veterans, the telephone payment benefit was still financed from the income of Moscow City Telephone Network JSC, for which 206 million rubles were allocated.

In 1999, special attention 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 pension supplements 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 people with disabilities with various rehabilitation services and technical means. In 1999, disabled people were given free 2.5 thousand wheelchairs, 150 thousand prosthetic and orthopedic products, 34.2 thousand sanatorium and resort vouchers, and 2.6 thousand Moskvich-Svyatogor cars were also allocated.

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

A sharp drop in the standard of living of elderly citizens is evidenced by an almost 1.5-fold increase in requests to organize the burial of deceased pensioners free of charge.

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

In addition, additional payments have been established for the pensions of certain categories of veterans, taking into account their military and other merits. These categories of veterans include: disabled women and participants of the Great Patriotic War, disabled people of the Great Patriotic War who, due to a serious injury, did not complete the required length of service for the assignment of a labor pension, disabled people from childhood due to injury during the Great Patriotic War, parents of military personnel who died in the army in peacetime, Honorary Donors of the USSR who donated blood during the Second World War.

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

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

To serve single pensioners and disabled people at home, 916 social service departments were created at the CSO, 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 services at home have been developed, which are designed to provide social and medical assistance to single 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 CSC operates 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 food, pre-medical care, exercise therapy, massage, hairdressing services, and cultural and leisure activities.

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

In 1999, work continued to provide low-income citizens with free hot lunches and food packages. 3,985 people receive hot meals every day, and 19 thousand people receive food packages every month. From November 1, 1999, the cost of lunch in day care departments was increased from 16.5 rubles to 25 rubles per 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, workers of the centers conducted a mass examination of all single and elderly people living alone. 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 into social services. Based on the results of the survey, a group of people was identified who do not currently need to be assigned 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 accepting them into social service departments at home, as well as providing other types of social assistance. During the examination, citizens included in the “risk group” received instructions with telephone numbers and addresses of centers to which they can contact in emergency situations.

In the context of the financial and economic crisis, the organization of trade 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 was 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 trade and consumer services for low-income citizens, consolidate various financial resources for this, and attract the attention of charitable and veteran organizations. One of the ways to implement this program is to organize outbound trade and provide personal services in social service centers, social residential buildings and other social protection institutions. The program provides for a reduction in prices for goods and services by at least 15% from the average prices in the city or indicated in the price lists.

Another serious area of ​​social protection is measures for social support and rehabilitation of people with disabilities, ensuring their normal functioning and integration into society. The Moscow government has set the task of comprehensively solving issues of social, medical, professional and labor rehabilitation of disabled people. Since 1995, budgetary indicators have annually provided funds for the implementation of the Comprehensive Target Program for the Rehabilitation of Disabled People in Moscow, which includes a wide range of measures for the rehabilitation and social adaptation of disabled people.

From July 1, 1998, a 50% discount on housing and utility bills was introduced 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 their dependents. About 200 thousand 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 thousand labor veterans living in families, as well as benefits for paying for a television antenna, radio point and benefits for paying for using a telephone for certain categories of veterans, remain unrealized to this day.

To fully implement the Federal Law “On Veterans” in Moscow, an additional 461.51 million rubles are required. 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 pension provision for 2.3 thousand disabled women of the war compared to women who participated in the Second World War, similar additional payments to pensions were established for them, for which more than 2.2 million rubles were spent. On May 28, 1998, the Moscow Mayor decided to establish a monthly pension supplement for midgets (dwarfs) in the amount of 100% of the minimum old-age pension.

From July 1, 1998, monthly supplements to old-age pensions for the parents of deceased conscripts were increased by one and a half times, and at the same time the same supplement was 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 these measures made it possible, along with financing social protection from city sources, to respond more flexibly to the social needs of residents of their territory, providing targeted social support.

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

CHAPTER TWO

ANALYSIS OF THE EFFICIENCY OF THE WORK OF SOCIAL SERVICE CENTERS AND INCREASING THEIR ROLE (using 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 (using the example of the work of the Committee and the Department of Social Protection of the Population of the Northern District).

In Moscow, social protection of the poor is carried out under the direct supervision of the Moscow Committee for Social Protection of the Population together with ten Departments of Social Protection of the Population of Administrative Districts. (Appendix No. 5)

The Committee for Social Protection of the Population of Moscow is a sectoral body of executive power (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 for the social protection of elderly citizens, disabled people, families with minor children , as well as other disabled population groups 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 Management 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, decrees of the Government of the Russian Federation, orders of the Mayor and Vice-Mayor, decrees of the Moscow Government, 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 extra-budgetary funds, local governments, federal and city public organizations.

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

The Northern District Administration works closely with the Committee and the prefecture of its district; the Committee and the Administration are jointly developing a Program for social support for the poor in the district in connection with the celebration of the International Year of Older Persons 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 material and everyday services for low-income 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 has doubled compared to 1994. Currently, the CSC serves 12,127 people.

In the staff of the Northern District Office, in addition to the head of the Office, there are two deputy heads for general issues, for coordinating the activities of the Center for Social Protection and the Ministry of Social Protection, two chief specialists for working with the Ministry of Health and Social Protection and the Center for Social Protection, and a leading specialist for working with the Bureau of Medical and Social Expertise. The leading specialist in working with persons without a fixed place of residence from among former Muscovites is in constant close contact with the three reception centers in the district. Subsequently, these persons, if they reach retirement age, are issued a pension, and those wishing to be helped to find permanent residence in the Center for Social Rehabilitation. Employees of the Social Rehabilitation Service of the Northern District are fully responsible for the work of subordinate organizations and institutions, carry out constant monitoring of the activities of the CSO services and MUSZN distributes incoming financial resources from the Moscow Branch of the Pension Fund, as well as funds from the Prefecture Fund and controls their use.

The Committee and the Directorate 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 corresponding seals, stamps and forms.

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 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 agencies, then all this can be presented as follows.

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

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• 1. Theoretical foundations of social services for older people in the Russian Federation
• 1.1
• 1.2
• 1.3 The main directions and principles of servicing older people at the present stage
• 2. System of social service institutions for older people in the Russian Federation
• 2.1
• 2.2 Semi-permanent social service institutions for the elderly
• 2.3 Social service system for elderly people at home
• Conclusion
• List of used literature

1. Theoretical foundations of social services for older people in the Russian Federation

1.1 System of care for elderly people in Russia

Since ancient times, in Rus' they have provided assistance to those in need. The assistance was therefore varied and often corresponded to actual need. It was expressed in the construction of dwellings, the ransom of prisoners, and the teaching of crafts. This form of public assistance for the sake of one’s own spiritual improvement did not pursue the goals of public improvement, but it undoubtedly had moral and educational significance for the society of that time, which had just been enlightened by the light of Christian doctrine.

The Grand Duke of Kiev Vladimir the Baptist, in the charter of 996, made it the duty of the clergy to engage in public charity for the elderly, establishing a tithe for the maintenance of monasteries, almshouses and hospitals. For many centuries, the church and monasteries remained the focus of social care for the elderly.

In the X-XIII centuries. Church practice of assistance developed not only through monasteries, but also through parishes (the so-called parish assistance).

Unlike the monastery, parish assistance to the elderly was more open. All community, civil and church life was concentrated in it. The activities of parishes are not limited to providing assistance to the elderly; they provide a wide variety of support from material assistance to education and re-education.

The parish was also a territorial, administrative and taxation unit. Monuments of ancient writing indicate that almshouses existed in almost every parish of the church.

Thus, in essence, parish charity was not church, but civil, that is, it pursued not only religious goals - the salvation of the souls of parishioners, but also the goals of social support and assistance to the elderly.

The concentration of charity in state institutions began after the accession of the Romanov dynasty in 1613. The Pharmacy Order was established, and from 1670, under Tsar Alexei Mikhailovich (1645 - 1676), the Order for the construction of almshouses. But this measure, apparently, was not caused by the decision to implement some kind of public charity system, but only by the strengthening of charitable activities of both Tsar Alexei Mikhailovich himself and those closest to him. But already during this period of time there is a need to transition to a system of public charity. At the same time, the system of public charity for the elderly itself begins to emerge more clearly, the tasks of which include not giving them alms, but also other forms of social protection. The zemstvo collection of 1681 (the reign of Fyodor Alekseevich) prompted the government to prepare a special act in 1682, opening up new views on public charity. But, apparently, the death of Fyodor Alekseevich slowed down the action of this act.

Peter's reforms at the beginning of the 18th century significantly changed the system of protection for older people. Society's approach to people is changing. If the medieval concept of man was built on the basis of the denial of the value of the individual, the priority of the values ​​of collectivism, which was consolidated by economic factors (ownership of land property either by a community, or a monastery, or under the patronage of state bodies), then this concept changes its content in the era of the formation of absolutism. The value of a person is considered from the standpoint of his labor value. That is why, under Peter the Great, the policy towards public charity is being intensified, the role of the state is strengthening, and activities aimed at social support are expanding.

To achieve this, a policy of secularization of the monastic estates on which almshouses for the elderly were located was consistently pursued. It was quite consistent and provided for not only material, but also organizational control over the activities of the church. In connection with this, a Decree appeared on the regulation of the life of monasteries. In the “Spiritual Regulations” of January 25, 1725, for the first time the question of almsgiving as a social evil was raised before clergy and it was ordered to eradicate this custom. The clergy is tasked with identifying those aspects of almsgiving to the elderly that benefit society: “to determine the good order of almsgiving.” New directions for the church in the matter of public charity were identified, the construction of hospices and infirmaries at churches, where it was prescribed to collect “the elderly and those who are very deprived of health, and those who are unable to feed themselves...”.

The state itself is beginning to realize its role and mission in helping the elderly. Thus, the regulations, or charter, of the Chief Magistrate of January 16, 1721 define the role of the police in the matter of public charity as one of the subjects of “social policy.” It should be emphasized that “the police look after the poor, the poor, the sick, the elderly... according to the commandments of God, they educate the young in chaste purity and honest sciences.” The Regulations indicate the main institution of care for the elderly: “hospitals” for the care of “elderly people of both sexes”. These “hospitals” were to be built in each province at the expense of zemstvo contributions. Further development of the system of social protection for older people is found in the instructions on the internal regulation of monasteries and on the magistrate.

The instructions to magistrates (dated January 31, 1724) emphasized that the care of “elderly and decrepit citizens” lies directly with the magistrates. For these purposes, they should be added to city almshouses, and not live off the “feeding of citizens.” However, charity for “outside elderly citizens,” that is, persons not from a given city, was strictly prohibited. It was forbidden for all classes to look after and give alms to “stranger elderly citizens.”

Thus, under Peter I, a fairly extensive system of social protection for the elderly was established. It includes:

a) central bodies - first the Patriarchal and Monastic Orders, from 1712 - the Holy Synod, and from 1724 the Chamber Office;

b) City magistrates.

Characteristic in this regard are institutions for the care of the elderly - hospitals. They were intended for the charity of orphans, the poor, the sick, the crippled, the elderly, that is, those people who, due to various circumstances, could not feed themselves.

During the reign of Elizabeth Petrovna from 1741, a further reorganization of public charity took place. Almshouses for the elderly remain under the jurisdiction of the Holy Synod, but funding for monastic almshouses is carried out in accordance with the states. Unused funds for the maintenance of the elderly are taken into account, they propose to transfer them to nursing homes, and put the rest in the bank at interest.

Changes are also taking place in local charity management. In 1741, the State College replaced the bodies of state control over public charity. Based on the decision of the Senate, it is obliged to maintain almshouses for the elderly in the provincial, provincial and voivodeship offices. In general, the source of payments changes, but not the financing system and the attitude towards public charity. In 1763, public charity, or rather the financing of almshouses and nursing homes, again came under the jurisdiction of the College of Economy, where they remained until the formation of a special body - the orders of public charity. They were organized by Catherine II on November 7, 1775 in connection with the adoption of a new administrative code on provinces. According to the code, in each province one order of public charity was established under the chairmanship of a civil governor. Orders of public contempt included both institutions of support and institutions of control for the contempt of the elderly.

The administrative system provided for a population coverage of 300 to 400 thousand people. Accordingly, orders of public charity should have covered that part of the elderly who needed help, support and some control. From the revenues of the provinces it was allowed to provide 15 thousand rubles “once”. for the content of orders. Moreover, this money could be pledged to individuals at interest or to a bank for a period of no more than one year, with the condition that the borrower take no less than 500 and no more than 1000 rubles. It was allowed to increase capital from private contributions, as well as from income from pharmacies.

From 1810, orders came under the jurisdiction of the Ministry of Police and then the Ministry of the Interior. Since 1818, government officials have been included in the orders - inspectors of medical boards. However, each province had its own characteristics in the administration of orders. Thus, in the Kiev, Belorussian, Polish and other orders under the control of governors, “the members were provincial marshals or leaders of the nobility and inspectors of medical boards.

With the establishment in 1864 of zemstvos, and in 1870 of city local governments, the charity system was reformed. Zemstvos were entrusted with local economic and administrative functions: arrangement and maintenance of local communications, hospitals, shelters; promoting local trade and industry; maintenance of the veterinary service; organization of mutual insurance; resolving the food issue locally; building churches; maintenance of prisons, almshouses and nursing homes, etc.

Thus, in the “Regulations on Zemstvo Institutions with all related legislation” it was especially noted that the responsibility of zemstvos includes “care for the poor and elderly, management of charitable and medical institutions, participation in measures to protect public health, development of medical care for the population and finding ways to improve local sanitary conditions."

At the same time, zemstvos were not introduced everywhere, but only in 34 of the 55 Russian provinces. And if in the zemstvo provinces the matter of charity was transferred to the hands of provincial and district zemstvos (“pending a radical revision of the Charter on public charity”), then in the provinces where zemstvos were not established, orders for public charity were retained. Thus, in Russia there are two types of state care for the elderly:

1) zemstvo-state (in 34 provinces);

2) “mandatory”, or actually state (in 21 provinces).

If orders were obliged to engage in charity, then zemstvos, whose expenses for providing social assistance were classified as “optional,” only had the right to work in the field of charity.

Orders of public charity, as a rule, dealt mainly with the “decrepit and wretched” who, due to their age, could not find food for themselves and therefore required charity in the narrowest sense of the word (food and shelter).

Zemstvo charity in the second half of the 19th century. went further and developed in the following directions:

1. Expansion of the charity system through its extension to those in need who, being “decrepit”, did not have their own shelter and shelter. For these purposes, day and night shelters, as well as overnight houses, were created in zemstvo provinces.

2. Attempts to prevent the “impoverishment” of the elderly. This type of social assistance was completely new for Russia; its main goal was to prevent the development of poverty among the elderly.

3. Reorganization of almshouses and division of “almshouses” into two groups: 1) “almswells” themselves, that is, those disabled due to old age; 2) elderly people capable of light work. It was for the second group that “craft almshouses” were organized, in which zemstvo shops were opened to sell manufactured goods.

4. Organization of special pension funds.

In addition to zemstvo and city institutions, there was a local parish charity for the elderly.

Institutions “managed on special grounds”, that is, their activities are regulated and legalized, also received further development at the beginning of the twentieth century. These include: the Imperial Humane Society, the Guardianship of Labor Assistance, the Department of Institutions of the Empress Maria.

Private charity was of particular importance in the matter of social support for older people.

Large charitable activities to support the elderly were carried out by representatives of the numerous Morozov family. One of them, D. A. Morozov, was the grandson of the famous S. V. Morozov, the founder of the commercial and industrial company “Savva Morozov, Son and Co,” who owned land and a weaving factory in Yamskaya Sloboda. After the death of Savva Vasilyevich, his fortune was divided between Timofey Savvovich and his two grandsons. In 1887, being at an advanced age, D. A. Morozov submitted to the merchant council an application of his intention to donate his plot of land and, in addition, half a million rubles to establish a charitable institution for the elderly in his name. 200 thousand were intended for the construction of the building and 300 thousand for the maintenance of the establishment with interest. Initially, it was planned to establish an almshouse and an orphanage in the same building. In 1891, the almshouse was opened. It accepted poor elderly people of both sexes of all classes in the amount of up to 100 people.

Subsequently, the almshouse gradually expanded, facilitated by additional charitable contributions. The largest among them was the donation of the wife of the founder of the almshouse, Elizaveta Pavlovna Morozova, who in 1896 and 1897 contributed 179 thousand rubles, which made it possible to increase the number of elderly people under care to 200 people.

That. The system of care for the elderly has undergone many changes and transformations. The problem of helping older people already at that time, starting in 996, from spiritual - parish charity, by the 19th century a certain branched structure of institutions for older people had already developed:

medical institutions (hospitals);

institutions of contempt (almshouses, nursing homes);

Institute of Pensioners;

local charities.

1.2 Social services for older people during the Soviet period

Formation of a new geopolitical space of the USSR in the period 1917-1991. associated with changes in political and ideological systems, management and economic structures, and with the formation of new social relations. These large-scale changes could not but affect the system of public charity, which at the previous stage had a tendency to unite and centralize public and state structures.

The new structure, first the Ministry and then the People's Commissariat of State Charity (NKGP), pursues a policy of abolishing existing bodies for assistance to the elderly with the redistribution of funds and property to needs determined by new state needs.

Thus, on November 19, 1917, charitable institutions and societies for helping the elderly and disabled were abolished, and on December 1, 1917, the departments of the Empress Maria's institutions were abolished. Instead of the abolished departments, departments were established in the NKGP that oversaw, to one degree or another, the problems of social assistance for this category of people in need. For example, on January 25, 1918, a department for caring for the elderly was created. By decisions of the NKGP, social support departments are created not only in his department, but also in other state institutions (in connection with the abolition of provincial and district presences, pension departments are established under local Councils).

In addition to departments under the NKGP, other executive and administrative organizations, independent executive committees are established.

By March 1918, the main directions of activity in the field of state social security for older people were gradually being formalized: issuing rations, providing shelter and assigning pensions; supervision of educational institutions of state care for the elderly.

Due to the large volume of events, the problem of their financial and material support was particularly acute. It is possible to identify a fairly wide range of actions by the NKGP in this direction. He used various measures - from the targeted redistribution of material resources, the organization of charitable lotteries to the introduction of certain taxes. Thus, in January 1918, a tax was introduced on public spectacles and entertainment, where a charitable fee was established for each ticket sold, and the funds were used to support the elderly and other categories of people in need.

However, targeted state support for the elderly as a means of implementing state social policy began to be actively implemented in April 1918, when the People's Commissariat of Social Security (NKSO) was formed. The government agency has defined a new social assistance strategy based on the objectives of building a socialist society.

With the introduction of a new state policy in the field of social assistance, a class approach in providing various types of assistance begins to take shape. According to the provisions on social security for workers, the right to receive assistance from the state was given to persons “whose livelihood is their own labor, without exploiting the work of others.” The new legislation established the main types of social security that the population of old age could count on: medical care, provision of benefits and pensions (old age).

The administrative system of social security for older people is gradually being formalized. A significant role in this was played by the First Congress of Social Security Commissioners, held in Moscow on June 25, 1918. The Congress determined the organizational structure of social security management, its central, provincial and district bodies. Many questions were devoted to the delimitation of powers in the relations of the NCSO with other commissariats.

With the end of the civil war and the introduction of a new economic policy, social security in Soviet Russia entered a new period of its development. The restoration of multi-structure and commodity-money relations, the transfer of enterprises to economic accounting, the abolition of labor conscription, the revival of the categories of “hired workers” and “entrepreneurs” among the employed population put on the agenda the issue of restoring social insurance, including the elderly employed labor .

By the decree of the Council of People's Commissars of November 15, 1921, both the issuance of benefits in case of illness and the appointment of pensions were introduced for the elderly. In general, after the adoption of this decree, state pension provision for older people began to be provided through the social insurance system.

In line with the new social protection policy, the Soviet government adopted a number of regulations during the recovery period. According to the resolution of the Council of People's Commissars "On social security of the disabled" (December 8, 1921), all workers and employees, as well as military personnel, received the right to a disability pension in the event of disability due to an occupational disease, work injury, general illness or old age.

The tasks of social assistance to elderly peasants who needed it were solved in a different form. State social security was used only by those peasants who were impossible to reach through peasant mutual aid or employment in artels or cooperatives of disabled people.

The Decree of the Council of People's Commissars of May 14, 1921 directed the Soviet authorities in the center and locally to the fact that the main burden of caring for the social security of the elderly in the countryside should be borne by the peasantry itself by organizing public mutual assistance. Thus, the state actually admitted that it is not able to support elderly peasants at the expense of the state budget.

Peasant committees were entrusted with such responsibilities as organizing mutual assistance, establishing public labor mutual assistance and direct targeted assistance to the elderly.

Based on the decree of the Council of People's Commissars of May 14, 1921, Soviet authorities carried out significant work to create peasant mutual aid committees. According to I. N. Ksenofontov, by October 1924, over 50 thousand committees were organized in the RSFSR. To fulfill the functions assigned to them in providing social assistance, peasant committees received the right to use self-taxation of the peasantry as a source of formation of financial and natural funds. In 1924, the monetary fund of peasant committees amounted to 3.2 million rubles, in September 1924 - about 5 million rubles.

Peasant mutual aid societies operated in various regions until approximately 1930-1931. With the creation of collective farms, the need for labor assistance from peasant societies disappeared. Gradually, peasant mutual aid societies are being replaced by mutual aid funds for collective farmers. Their existence was legally enshrined in a resolution of the All-Russian Central Executive Committee and the Council of People's Commissars on March 13, 1931. It approved the Regulations on cash funds for public mutual assistance of collective farmers. This regulatory document granted the funds the right to create homes for the elderly and provide them with financial and in-kind assistance in case of illness.

Significant socio-political and economic changes that took place in the country during the implementation of the first and second five-year plans made it possible to secure in the Constitution of 1936 the right of all citizens to social security in old age. The most important step forward was the establishment of equal rights of all citizens to pension provision. According to the new Constitution, pensions for workers and employees due to old age and disability were assigned on the same terms. Restrictions on pension provision that applied to persons deprived of voting rights due to social origin or status were abolished.

During the Patriotic War, the government's main attention was mainly focused on organizing social security for military personnel and their families, rather than the elderly.

After the war, with the restoration of the national economy, the administrative system for managing social security was also transformed. So, in 1949 Instead of the NKSO, the Ministry of Social Welfare is formed, whose activities unfold over the next decades.

The end of the 50s can be considered a new stage in the development of social security. On July 14, 1956, the Supreme Soviet of the USSR adopted the Law on State Pensions, which not only expands the circle of persons to whom pensions are provided, but also makes social security legislation a separate branch. The beginning has practically been made of universal state pension provision for persons reaching old age.

In January 1961, the regulations on the Ministry of Social Security of the RSFSR were changed, where its functions were significantly expanded compared to 1937. According to the resolution of the Council of Ministers of the RSFSR, the Ministry was entrusted with the following functions: payment of pensions; organization of medical labor examination for the elderly; provision of prosthetic and orthopedic care. In 1964, the Law on Pensions for Collective Farm Members was adopted. Thus, the country implements universal state pension provision.

Among the types of material support for the elderly, the leading place in the conditions of the Soviet state was occupied by pension provision. As the right to use pensions was granted to an increasingly wider range of people, the number of people receiving pensions steadily increased. In 1941, the number of citizens receiving pensions was 4 million people, in 1967 - 35 million people, in 1980 - about 50 million people, including 10 million old-age people and collective farmers - 12 million people. Accordingly, the state constantly increased allocations for social insurance and social security for the elderly. If in 1950 expenditures from the state budget for these purposes were expressed in the amount of 4 billion rubles, in 1970 - 23 billion rubles, then in 1980 they reached 45 billion rubles.

Thus, in comparison with pre-revolutionary Russia, social security in the Soviet period for older people rose to a qualitatively new level, turning into a unified state system that acted in several organizational and legal forms. Thanks to the deep and targeted reform of social assistance in the country, full social security for workers was introduced for all types of disability, unemployment, old age or disability.

While appreciating the positive aspects of Soviet social security, at the same time one cannot idealize it and not see its serious shortcomings and negative features that deserve criticism. Under the administrative-command system, a state monopoly on social insurance was established. The nationalization of social security was accompanied by the unjustified liquidation of the charitable societies of “old” Russia that had long arisen and brought great benefit and the deprivation public organizations Soviet period opportunities to participate in social assistance to those in need. As a result, public charity was reduced to social security, many types of social support for older people in difficult situations were lost.

1.3 The main directions and principles of social services for older people at the present stage

In modern conditions, an extremely important area of ​​social protection is social services for elderly citizens of the Russian Federation, since in Russia, as well as throughout the world, there is an increase in the number of elderly people.

The demographic aging of the population in our country is caused mainly by a decrease in the birth rate. In 2003, there were 29.9 million people in Russia over working age (20.4% of the total population), including 12.5 million people aged 65 years and older. Since 1990, there has been a steady downward trend in the number of young people aged 10-15 years, and the number of older people has increased by 2.26 million people. In the future, this excess will grow.

In our country, the ratio of the number of people of working age and people disabled by age, including children and the elderly, clearly reflects the course of demographic processes.

Over the past decade, a temporary decline in the dependency ratio has occurred as the burden of persons over working age has decreased. This figure will reach its minimum value for Russia in 2007 - 569 people of disabled age per 1000 people of working age.

Most older people live in cities, but the socio-economic problems of the elderly population are especially acute in rural areas.

This situation reinforces the importance of state support for families that include elderly people and are simultaneously experiencing socio-economic difficulties: poverty, unemployment, large families, illness, relocation, and others.

Modern social work with the elderly in the Russian Federation is built in accordance with the UN principles regarding older people in 2001: “Make full life for the elderly.” This document recommends that governments of all countries take the following measures in the field of social support for older people: develop a national policy for the elderly, thereby strengthening the connection between generations; encourage charities; protect older people from economic shocks; ensure quality of life in specialized institutions for the elderly; fully provide an elderly person with social services regardless of his place of residence - in his homeland or in another country.

The essence of social services for older people and the principles of social work with the elderly are disclosed in the federal laws “On the Fundamentals of Social Services for the Population in the Russian Federation” and “On Social Services for Elderly Citizens and Disabled People,” adopted in 1995.

The Federal Law “On the Fundamentals of Social Services for the Population in the Russian Federation” emphasizes that “social services are the activities of social services for social support, provision of social, social, medical, psychological, pedagogical, social and legal services and material assistance, social adaptation and rehabilitation of citizens in difficult life situations."

The Federal Law of the Russian Federation “On Social Services for Elderly Citizens and Disabled Persons” significantly complements and concretizes the ideas about social services for certain social groups of our society. It is intended to regulate relations in the field of social services for elderly citizens and the disabled, which is one of the areas of activity for the social protection of older people.

At the same time, the Law defines its subject as follows: “Social services are activities to meet the needs of these citizens for social services.” Social services include a set of social services that are provided to elderly citizens and the disabled at home and in social service institutions, regardless of their form of ownership. There is an opportunity to receive social services sufficient to meet the basic needs of life, which are included in the federal and territorial lists of state-guaranteed social services.

Modern Russian state social policy regarding older people is aimed at, firstly, preparing society for the ongoing demographic changes; secondly, improve the quality of life of older people; thirdly, to develop social services in accordance with the needs and requirements of this category of the population.

According to estimates, approximately 5 million older citizens in Russia may need various types of assistance. Of these, 1.5 million people need constant assistance and social services due to poor health or old age. Among them are about 300 thousand people who need social and medical services at home.

What should you pay attention to first of all in this regard?

At the All-Russian Congress of Social Workers in Samara in November 2002, it was noted that many older people need not only adequate care, but also a variety of public assistance to establish a full life, which is associated with the task of reassessing views on their needs and requirements. This also applies to the arrangement of the material living environment and the refurbishment of housing in accordance with the functional capabilities of older people. The first one to see and say that living conditions an elderly person requires improvement - this is a social worker who comes to the home.

Secondly, the emergence of an increasing number of centenarians who need care at a qualitatively new level and who at the same time do not want to move to inpatient social service institutions, leads to a significant increase in the burden on those providing home care for elderly and elderly relatives.

However, an ordinary Russian family does not have sufficient financial resources, the opportunity to purchase at an affordable price or rent modern technical means that facilitate care, receive advice from specialists on organizing care, as well as professional assistance from specialists. Social services are completely underutilizing their capabilities to work with such families.

As for the provision of social services and inpatient services, despite the huge volume of social services provided, the demand for them is not fully satisfied.

The infrastructure of the social service system for older people in the Russian Federation is determined by a combination of stationary, semi-stationary and non-stationary forms of social service.

Rapid development in the 80s and 90s. non-stationary forms of social service (at home, temporary stay in a hospital and urgent social assistance), along with the stable growth of the network of stationary social service institutions, played a major role in the formation of the modern type of social service.

Currently, there are about 3 thousand independent social service institutions, as well as over 16 thousand different units providing social services to older people.

Every year, more than 14 million elderly people (46% of the number of elderly citizens) receive social services in one form or another. At the same time, only about 200 thousand people live in stationary social service institutions (boarding homes).

Originated in the mid-80s. social services at home include social, social, medical, psychological, legal and other services. While continuing to live in their usual home conditions, they receive social services annually:

in emergency social assistance departments - 12.6 million people,

in social service departments at home - 1.1 million people. .

In parallel with services providing social services at home, a network of municipal centers for social services for elderly citizens and the disabled is rapidly developing. Since 1987, 1,833 social service centers have been created, and about 600 centers have temporary (2-3 months) residential departments. Social service centers for elderly citizens are being transformed into comprehensive institutions according to the types of services and at the same time covering various categories of the population with services (elderly, children, adolescents, women).

Social service centers are playing an increasingly important role in providing targeted assistance to pensioners and disabled people and providing them with social services in accordance with individual needs. In recent years, the increase in new centers has been up to 50 units annually. Almost half of the centers are comprehensive, providing a full range of social services, including medical, utilities and shopping, to everyone who finds themselves in a difficult life situation, regardless of age. In the republics of Adygea, Kabardino-Balkaria and Mordovia, in the Perm, Pskov, Saratov, and Chelyabinsk regions, all centers operate as integrated centers.

The structure of the centers includes gerontological departments, psychological relief rooms, helplines, self-supporting departments of social and domestic assistance, social pharmacies, libraries, laundries, shoe and clothing repair shops, household appliances, communication clubs, banks of things, rental points for medical and rehabilitation equipment , durable goods, mini-bakeries, mini-poultry farms, subsidiary farms.

It should be noted the popularity of temporary residence units for the elderly operating within the structure of social service centers or municipal social service departments. They allow older people to maintain family and social ties that have developed over the years.

The development of specialized departments for social and medical services at home continues. In total there are 1.5 thousand departments, staffed by 7.2 thousand nurses serving 120 thousand seriously ill elderly and disabled people.

A significant amount of work was carried out by emergency social service departments and services, the number of which exceeded 2 thousand units. These services provided one-time assistance to more than 13 million people during the year.

Day care units are very popular among older people. On the basis of former sanatoriums and boarding houses, semi-permanent social and health centers (50 institutions in total) are emerging for rehabilitation activities among the elderly and disabled, strengthening their health, and increasing physical activity.

A new form of improving the living conditions of single elderly people, such as a social apartment, is popular. The total number of social apartments has reached 2.3 thousand, housing 3.1 thousand elderly citizens. At the same time, 1.2 thousand residents of social apartments are served by departments of social services at home and specialized departments of social and medical services at home. This area of ​​social services is actively developing in Moscow (362 apartments), Sverdlovsk region (298), Krasnoyarsk Territory (202).

That. A promising model for the life support of older people in the context of an aging population has become special boarding houses for single elderly people, social apartments, gerontological centers, specialized departments of social and medical care at home, social service centers, inpatient and semi-inpatient departments, where older people receive various types of assistance, which they need.

2. System of social service institutions for older people in the Russian Federation

2.1 Inpatient social service institutions for older people

Social work with older citizens in inpatient social service institutions in modern conditions is of particular importance. This is due to a number of circumstances, namely:

- serious health condition (on average, each resident has more than 7 diseases);

- limited ability for self-care; those who are incapable and partially care for themselves make up 62.3% of residents;

- limited ability to move; persons unable to move and performing physical activity within the ward make up 44.6% of the population of boarding homes;

Changes in the psyche in old age are manifested in memory impairment for new events while the reproduction of old ones is intact, in attention disorders (distractibility, instability), in a slowdown in the pace of thought processes, in disturbances in the emotional sphere, in a decreased ability to chronological and spatial orientation, in motor skills disorders ( pace, smoothness, accuracy, coordination);

- personality changes characteristic of old age; polar, contrasting features were identified: increased suggestibility, coexisting with rigidity, pronounced sensitivity with an increase in callousness, emotional “dryness”. Age-related personality traits also include touchiness and egocentrism.

Admission to a boarding home and a change in usual life activities is a critical moment in the life of an elderly person. Unforeseen situations, new people, unusual surroundings, ambiguity social status-- these life circumstances force an elderly person not only to adapt to the external environment, but also to respond to changes occurring in themselves. Elderly people are faced with the question of assessing themselves and their capabilities in a changed situation. The process of personality restructuring is very painful and difficult.

It is known that in old age there is a weakening of memory, attention, a decrease in the ability to navigate in new conditions, an anxious background of mood and lability of emotional processes. One of the main characteristics of aging people is psychological vulnerability and increasing inability to cope with various stresses. Therefore, older people are particularly sensitive to attention and moral and psychological support.

Moving to a boarding house leads to a sharp change in the usual ways of adaptation, which, along with social isolation, increases the risk of cardiovascular diseases and even deaths in older people.

Since the main stressor, which is the very fact of admission to a boarding home, cannot be eliminated, the expected help and support from the staff of the boarding home is of paramount importance. In these conditions, targeted work on the socio-psychological adaptation of older people to the conditions of a boarding house takes on special importance.

The initial period of residence of elderly people in a boarding house consists of three main stages: admission and stay in the reception and quarantine department, resettlement for permanent residence, the period of the first six months of residence.

Each of these stages is characterized by its own characteristics and differs in goals and objectives in the implementation of socio-psychological work with older people.

These circumstances determine the functions of a social worker in organizing the adaptation of older people in a boarding home. The activity of a social worker and its content depends on the stage of “passing through” the socio-psychological adaptation of elderly people in a boarding home.

There are 3 categories of reasons for elderly people entering a boarding home:

- admission is related to health status;

- admission is associated with a conflict situation in the family;

- admission is associated with the desire to maintain independence from the immediate family environment.

Information about these institutions plays an important role for the subsequent socio-psychological adaptation of older people in boarding homes.

By the time they entered the boarding home, most elderly people had basic information about this institution, obtained from various sources (from relatives and close friends, doctors and social security workers). The information was formal, and in some cases, distorted (the idea of ​​a boarding home was identified with the hospital routine, with daily rounds of doctors, constant daily supervision of nursing staff). Ideas about consumer services, organization of work and leisure were incomplete. Insufficient information caused and maintained increased anxiety and uncertainty about the future in older people, which in turn adversely affected their subsequent adaptation to new conditions.

Despite the fact that the decision to enter a boarding home was made independently and consciously, more than half of the elderly people who entered the reception and quarantine department of the boarding home experienced hesitation and doubts about the correctness of the step taken until the last moment. These hesitations are associated with two motives: fear of change and ignorance of specific living conditions.

The role of a social worker during the stay of elderly people in the reception and quarantine department of a boarding house is to explain the functions of this institution, familiarize those admitted with the daily routine, the location of household services and medical offices, the administration’s opening hours, etc.; conduct a conversation, familiarize yourself with the living conditions in a boarding home for elderly people who decide to enter these institutions, which can largely reduce the state of uncertainty and anxiety.

More complete information about the boarding home for older people from the first days of their stay in this institution can be facilitated by the presence of a stand reflecting the main sections of the work, an album with photographs of the residents, their employment, leisure activities, etc. To avoid a complete break with the previous habitual lifestyle, in order to make it possible to obtain information about social life in the reception and quarantine department, radios (preferably with headphones), a TV, large Wall Clock with large numbers, wall calendars, newspapers. The implementation of these activities makes the role of a social worker in a boarding home even more relevant, and especially in the first stage of an elderly person’s stay there.

After a two-week stay in the reception and quarantine department, older persons are resettled at the place of their main residence in the boarding house. This stage is characterized by additional emotional stress for an elderly person. He faces the problem of forced adaptation to new conditions with a long-term perspective. Searching for a new life stereotype, forced communication with strangers, not always nice people, strict regulation of the daily routine - all these circumstances lead to a crisis in the first month of adaptation. The first 3-4 weeks of staying in a boarding house, associated with transfer to permanent residence, are the most difficult for older people. During this period, 70% of them easily develop colds, exacerbation of existing chronic pathology. The emotional state is characterized by the appearance of a feeling of hopelessness of what is happening.

For the successful socio-psychological adaptation of an elderly person, his successful “settlement”, i.e. placement in a department, is important. When transferring an elderly person to a department and placing him in a room with neighbors, difficulties often arise in living together. They may be related to the concept of “crowding.” Its psychological essence lies in the formation of ideas about “one’s own” and “alien” territory. Invasion of another’s “own” territory can cause acute stress, manifested by sharp negative emotional experiences.

Undesirable consequences can be caused by placing two people with strong leadership traits in the same room. It is known that during forced close communication, one of the subjects, as a rule, takes on the role of a follower. For a person who has a tendency to lead, the option of constantly being in the role of a follower is an excessive psychological burden, which can result in an emotional breakdown.

During this period, the attitude of the staff, which is associated with the outside world, begins to take on special importance. If the staff of the boarding home does not pay attention, it is possible that these emotional manifestations become more intense and fixated on, and maladjustment reactions occur with a depressive mood background.

The role of the social worker is to ensure the adaptation of the elderly person to new conditions. This requires information about the characterological characteristics of an elderly person, inclinations and interests, attitudes and habits. Clarification of these circumstances is also important for the creation of microsocial groups, which also have the goal of improving the socio-psychological adaptation of older people.

In addition to studying personality characteristics and other circumstances, a social worker can and should teach an elderly person to communicate, the ability to understand a person more frail than himself, to understand the situation of living together, etc.

In these circumstances, a social worker, having certain knowledge and practical experience, acts both as a social psychologist and as a social educator. At the same time, the social worker communicates with the doctor and medical personnel, using data from the medical history, about the past life of the elderly person, and gets acquainted with the state of his health, his ability to move and the degree of safety for self-care.

From the reception and quarantine department, older people should enter a calm, well-organized environment of adaptation influence, which is formed by the joint efforts of a doctor, a floor nurse, a labor instructor, a cultural worker, and a librarian. Each of these specialists must understand their tasks in adapting older people to the conditions of a boarding home.

An elderly person transferred to a permanent place of residence from the reception and quarantine department should receive increased attention from all employees, which will help him find his place in the team of residents and weaken the negative impact associated with a sharp change in life pattern and the resulting emotional stress.

The role of a social worker as a specialist who has basic knowledge of gerontopsychology, deontology and social pedagogy is also increasing due to the need to train staff of boarding homes in a differentiated approach to older people.

After 6 months of staying in a boarding house, older people are faced with the problem of a final decision: to live in a boarding house permanently or to return to their usual environment. At this time, there is a critical assessment of both the conditions of the boarding house and one’s capabilities for adapting to them.

A survey of older people after 6 months of living in a boarding house showed that their expectations associated with entering these institutions were not met in 40.4%. The situation in the boarding house was perceived as more difficult than they had previously imagined. Only 7.7% of elderly people rated life in a boarding home as higher than their expectations.

The main reasons for dissatisfaction are related to the poor organization of life in the boarding home, the inattentive, formal attitude of the staff, and the unfavorable psychological climate.

The positive leisure and recreational setting available in the reception and quarantine department is not fully realized. This is explained by the fact that the main form of organized leisure is passive listening to radio broadcasts (90.7%). The inability to spend meaningful leisure time causes a state of dissatisfaction in older people. Communication between older people in a boarding home is passive, situational in nature; the circle of communication between older people is limited to the staff and people living in the boarding home.

It is known that one of the reasons for emotional stress can be too close forced communication between people. The traumatic impact in this case is determined by the fact that narrowing the circle and deepening communication quickly exhausts the information value of each member of the group, which ultimately leads to tension and the desire for isolation.

At this stage important acquires the so-called environmental therapy, which includes the creation of a favorable psychological microclimate, maintaining the appropriate activity of older people, and preventing painful reactions. These goals are achieved by organizing comfortable living conditions, employment, and meaningful leisure. Rationally organized environmental therapy helps maintain mental tone, establish and strengthen interpersonal relationships, and fill life with positive emotions and meaningful content. The importance of environmental therapy becomes clear if we bear in mind the setting of a boarding home, characterized by limited social connections of older people and contacts with the outside world.

This stage, as well as the subsequent period of life in a boarding home for the elderly, represents a wide field of activity for a social worker and poses several tasks for resolution together with a psychologist:

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