The Ministry of Health took up the elderly
And is preparing to protect them from discrimination and domestic violence
In 2016, a full-fledged medical and social service may appear in Russia, dealing with a complex of problems of elderly and not very healthy people. The staff of the patronage service will be able not only to provide assistance at home, but also to communicate regularly with an elderly person isolated from the world and often a victim of domestic violence.
About the fact that not only children and women are subjected to domestic violence in Russia, but also old people who are tormented by their own children, at the conference "Elderly patient. The quality of life" was told by Leonid Lazebnik, head of the Department of Therapy, Geriatrics and Apitherapy of the Moscow State Medical and Dental University. Bruises, strange falls, changes in gait – all this, according to Mr. Lazebnik, doctors constantly meet in their practice. "Elderly people do not complain, they keep everything to themselves," he says, but it is such signs that often indicate that an elderly person is subjected to at least psychological violence in the family. The gerontologist notes with regret that violence has become a background in society's attitude towards the elderly.
Cruelty to people who are weaker in all respects than their abusers, first of all, is shown by the state: the domestic health care system has been designed for an able-bodied patient since the post-war baby boom, or at least for a child. As a result, the elderly are treated according to the residual principle. "Elderly people constantly complain to us that an ambulance either does not come to them at all or goes for a very long time," employees of the hotline of the League for the Protection of Patients' Rights told Kommersant.– They often say in plain text: first we'll stop by a 40-year-old man, and then, Grandma, we'll come to you."
"There should be no discrimination against the elderly, they should be provided with all types of medical care, including high–tech, age cannot be a reason, for example, to refuse hospitalization or treatment with expensive medications," is the official position of the Ministry of Health. At the conference, she was once again repeated by the director of the Russian Gerontological Research and Clinical Center (the main institution in the field of care for the elderly.– “Kommersant") Olga Tkacheva. But she immediately recognized that it is impossible to treat all the diseases of elderly patients, which grow with age like a snowball, by the forces of conventional healthcare.
"We have geriatric departments and even whole geriatric hospitals, but no one really knows how they differ from ordinary ones," says Ms. Tkacheva. According to her, in Russia there is an idea that a geriatrician is an ordinary therapist who treats only the elderly, although in Western practice it is more like a curator of an elderly patient who chooses the optimal drug strategy, a form of social service for him, and also directs him to specialized specialists. This supervision is often vital, given that overdoses and the wrong combination of medications that the elderly take literally by the handful are not uncommon. In addition, it is the geriatrician who will be able to observe an elderly patient for a long time and find out how he lives, how his relatives treat him.
The draft order of the Ministry of Health "On approval of the procedure for providing medical care to the population in the geriatrics profile", prepared by the Ministry of Health, was published on the department's website back in June 2015 and is now undergoing public discussion. In addition to the medical component, the document provides for the creation of a patronage service, whose employees will provide assistance to elderly people at home. According to Olga Tkacheva, the Ministry of Health expects to adopt by the end of 2015 a new procedure for providing care to the elderly, as well as standards and clinical recommendations for the treatment of senile asthenia syndrome. Since the standard is nothing more than an economic justification for the procedure for providing a certain type of medical care, on its basis it will be possible to understand how much money will be needed to support elderly patients at home, the department believes. Officials expect that as a result, a market for the provision of services to the elderly will appear in Russia in 2016. "We are talking about the use of public-private partnership mechanisms in the organization of assistance to the elderly. While we see individual companies whose work is paid from social insurance funds, we can consider them pilot projects," Olga Tkacheva notes."Over time, we hope to include medical and social patronage in the tariff of compulsory medical insurance on the model of the system that works in Israel."
Already today, most of the medical services in Russia are provided to people of retirement age. According to the Ministry of Health, 70% of people over 70 years of age are hypertensive, 50% of elderly patients have diseases of the musculoskeletal system, 40% suffer from coronary heart disease. Among newly identified chronic diseases, more than 40% are patients of retirement age, while among newly diagnosed cardiovascular pathologies, 65% are elderly people, neoplasms – 50%. The majority of patients with type II diabetes mellitus are elderly. Their share among patients will only grow.
Galina Papernaya
According to the information: Коммерсант.Ru
Portal "Eternal youth" http://vechnayamolodost.ru
06.10.2015