First 100 Days of long-term care pilot scheme in 6 Russian regions
The charity Joy in Old Age has reviewed the initial results of a project to establish a long-term care system in six Russian regions.
During the first three months of the pilot, experts have been able to gain an understanding of the extent to which the lives of elderly people and those requiring care have changed in Volgograd, Kostroma, Novgorod, Pskov, Ryazan and Tula.
“After years of not being able to leave their wards due to a lack of proper care and having to eat sitting or even lying on their beds, elderly people now have the chance to have their meals together in specially prepared rooms and go for a walk outside. Can you imagine what it must be like having spent long years cooped up indoors to see the sun, the birds and the trees and feeling the wind on your skin? There are now opportunities for the elderly to socialise and be busy during the day, with staff organising a full and interesting range of leisure activities for them to enjoy.
Six regions took part in a pilot scheme run by “Joy in Old Age”, supported by the Ministries of Health and Labour and the Agency of Strategic Initiatives, during the summer. Twenty-one medical bodies and 32 social institutions have so far been involved in the scheme.
Who needs what
Regions are testing different options to determine how many people need long-term care. For example, social work experts in medical institutions in Kostroma have referred 576 people to social agencies. Communication channels between departments in Volgograd are being established to test another system, i.e. home visits to village areas.
How does one know what type of care a person really needs? Type-design procedures are therefore being tested to help with this, i.e. identifying a particular functional group based on their ability to look after themselves and the need for outside help. These tests are carried out by specially trained social workers. The best results have come in Tula where 3,515 people have been assessed, all of whom are in the care of Social Services living in homes and hospitals.
Using this new methodology, Joy in Old Age has also been able to assess the quality of residential care facilities. One of the main problems highlighted by experts has been care standards which are often affected by staff shortages (there are more than 25 “bedridden” people for one member of staff in restricted mobility departments) and a lack of professional care training.
What will help
During times where there’s a lack of available “hands”, it is impossible to organise proper care, say specialists. Grants from the Ministry of Labour should help each region with this. At the beginning of September, more than 60 extra care staff had been brought into regional pilot in-patient facilities. Once financing through these subsidies is no longer available, regions will have to increase their staffing levels and allocate extra resources to make this happen.
New and existing employees receive special training, e.g. learning the correct way to feed and put a patient to bed, as well as carrying out hygiene procedures that maintain the dignity of people who depend on others for help. All such instruction is provided by a training school at Joy in Old Age.
Individual and extended care plans have been drawn up for people living on their own at home. Special schools have been opened in the pilot regions for relatives caring for those requiring help in the home. Two such schools are already operating in Ryazan where 339 people have already received training. Twenty-three people in Kostroma have also been trained in a similar school and a care school for relatives has now opened in Veliky Novgorod.
Day centres for the elderly and people with mental disabilities are also being established. These facilities will enable relatives to take a break from their caring duties. Two day centres for elderly people with dementia have started up in Volgograd, with others in the pipeline in Tula, Ryazan and Kostroma.
“These pioneer regions are just the initial building blocks of an enormous house, i.e. a long-term care system. One the one hand, such construction projects should not be frozen but on the other excessive haste and arrogance won’t make the house strong and secure. Several more regions are expected to join the pilot scheme next year which will help keep up the momentum”, said Elizaveta Oleskina.