Demand for a home nursing service.

Abstract

In the Soviet Union, as other advanced nations, the increasing proportion of elderly people creates problems for families and for society general. That the aging of the Soviet population has occurred relatively recently constitutes one reason for the underdevelopment of community care programmes. Another explanatory factor seems to be the bias the social services that results a low priority tag for innovations intended to benefit people who are no longer economically active. One gap the range of schemes was the subject of an article published last year the Russian language newspaper Nedelya, which is Izvestiya's weekly supplement for women.1 Although the article begins as an anecdotal account of difficulties ex? perienced by its author, taken as a whole it represents a well documented and persuasive argument for the creation of a new state provided author, Svetlana Gladish, is a Muscovite whose mother became almost helpless as the result of a stroke. To look after her at home Svetlana initially took sick leave under the normal arrangement for relatives who have to care for a sick person. Having exhausted that facility, she went on to unpaid leave and finally had to use up her holiday allowance. At the end of that time she wondered whether it would be necessary to give up employment altogether. For some months the family attempted to hire help by displaying a card a kiosk of the city's inquiry and information service?but to no avail. To convey some idea of the imbalance between demand and supply, Svetlana calculated that, for 241 cards requesting help the care of patients, children, and the infirm elderly, only one person had advertised her services. Why did the family not make an approach to the neighbour? hood doctor or policlinic? To that question the text provides the following unequivocal answer: The medical organisations do not have such a service. Home care nurses are available from the semiautonomous Red Cross Society (Red Crescent Muslim areas), but in the main, home care is provided for persons disabled at work who are living alone and for war veterans. only public organisation that Svetlana could turn to was the Consumer Services Production Combine (also known as Dawn), which supplies home helps?in the fullness of time. Families may wait up to two to three months Svetlana's neighbourhood and up to six months elsewhere. Moreover, the service may not be supplied on a continuous daily basis; Svetlana's case it was rationed so as to amount to a total of one month the year. Another drawback of this service is its cost. Varying with the type of case?child minding is cheapest?the charge for a bedbound patient amounts to six rubles 72 kopeks a day, and that frequently represents as much as a day's earnings for one member of the family. actual expenditure tends to be higher because people make additional payments to induce their helps to arrive a little earlier or stay later than inflexible officialdom allows.