Habilitation - what is it? Let's find out together. A complex of rehabilitation measures for the disabled On financing habilitation programs

On January 1, 2018, a law came into force that defines what habilitation of disabled people is, the conditions for individual programs, and also establishes its differences from the traditional term “rehabilitation”.

These concepts are consonant, but there is a difference between them: rehabilitation is a set of actions aimed at restoring abilities due to illness or injury. Habilitation is the initial formation of any abilities.

Mostly this concept is applied to children at an early age who have deviations, developmental disorders.

Rehabilitation and habilitation - is there a difference?

Habilitation of the disabled - what is it and how does it differ from rehabilitation measures? First you need to determine what rehabilitation involves, the restoration of intellectual, mental, social, mental activity. This is not only their return, but also support, the return of normal life. From the international definition it follows that this is a whole complex, which includes the following components:

social to ensure the restoration of a disabled person as a subject of society;
pedagogical to return a person to normal activities;
mental, used for the rehabilitation of the individual;
medical, providing restoration at the level of biology, that is, returning normal vital activity to the body.

A model that includes all of these components is called ideal, it is suitable for use in the strategic planning of a rehabilitation center.

Habilitation and rehabilitation have a big difference - in the first case, abilities are formed for a disabled person, and in the second, conditions are created for maximum restoration of the lost functionality. Habilitation programs suggest that a person learns to achieve various functional goals through alternative paths when habitual ones are blocked.

Such measures are applied mainly to children, since they are difficult to implement and ineffective in case of late treatment. For example, for children suffering from speech delays, help provided at 11 years old will be late. Positive result only habilitation begun at an early age will bring. These are speech therapy, pedagogical and other activities from the 1st year of life.

Establishing Disability: Major Changes

According to studies, as of January 1, 2018, there were about 13 million people with disabilities in Russia, among which the proportion of children is 605 thousand (what kind of assistance does the state provide to children with disabilities?). Previously, when determining disability, 2 criteria were used:

disorder of body functions;
the level of disability (commissions used such concepts as complete, partial with the loss of the ability to independently organize self-service, loss of motor function, learning ability, etc.).

This procedure was established by the Law on the Protection of Persons with Disabilities (Article 1), but from 01/01/2018

only one criterion will be used, according to which the person is recognized as disabled, after which he is assigned an individual rehabilitation program.

Since 2018, the degree of disability is determined based on the severity of functional disorders, and not on the degree of limitation. The difference is very big:

Under the old order, a subjective assessment was used, that is, the ability to learn, communicate, control behavior (according to the ITU Classifications and Criteria, Section III).
The new system implies an objective assessment of the loss of body functionality, which is detected on the basis of a medical examination.

The concept of "Habilitation of the disabled"

The system for establishing disability, adopted since 2018, is more advanced, it allows not only to make a diagnosis, but also to clarify the nature of individual assistance to a person. Law No. 419-F3 introduces such a new concept as habilitation, that is, a system for the formation of skills that were previously absent from a disabled person.

The main components of the habilitation of persons with disabilities in 2018 are the following activities: prosthetics, orthotics, as well as reconstructive surgery, career guidance, spa treatment, exercise therapy, sports events, medical rehabilitation and others.

Attention!

The recovery scheme will be developed and then implemented according to the rules that are set strictly individually.

The program will be developed by ITU specialists (Bureau of Medical social expertise), in accordance with paragraph 1 of the relevant Procedure.

performers responsible for habilitation will have to report to the bureau.

In its turn, federal agencies SMEs must transfer the received data to special bodies responsible for promoting the employment of people with disabilities (Federal Law No. 419, article 1, clause 2).

Advantages new system Obviously, the developers of the new Federal Law No. 419 are confident that it is precisely such measures that are able to increase the compulsion and effectiveness of the habilitation and rehabilitation measures taken. E.

Klochko, who is one of the authors of the bill, believes that only the new scheme is able to more carefully and fully treat the program for the rehabilitation and protection of the disabled, including children who were not previously provided with assistance in the required amount.

Financing the habilitation program

After defining the concepts of “rehabilitation and habilitation of the disabled”, what it is exactly and what are the differences, it is necessary to touch on the issue of funding.

If earlier technical means and many recovery processes, including expensive treatment, were paid for by parents and the funds created by them, now a certain amount is allocated from the state budget for such purposes. According to the Order dated December 31, 2018 No.

No. 2782-r, in 2018, earmarked funds in the amount of 9.3 billion rubles will be allocated. from the social security fund.

The distribution of funding is controlled by the Government of the Russian Federation, which is determined by the new norm (part 8, article 7 of the Federal Law “On the budget of the Social Insurance Fund Russian Federation»).

According to the law cash can be redirected to provide disabled people with technical means, services required to restore health and certain functions of the body.

The signed Order determines that the funds from the Social Insurance Fund are directed to the following purposes:

provision of technical means and services for rehabilitation and habilitation (7.7 billion rubles);
provision of subventions to the budgets of the constituent entities of the Russian Federation for similar purposes (in the amount of 1.6 billion rubles).

The adopted new program makes it possible to significantly improve the mechanism for distributing assistance and determining its volume, to facilitate the restoration of normal life for disabled people in need of assistance, successful socialization, arrangement of professional and personal life.

Habilitation and rehabilitation in 2018 - what is it, difference, disabled person, concepts, individual program

Result medical and social expertise gives an assessment of the state of health, to establish the degree of limitation of life and the likelihood of bringing the body to normal life.

Its basis is the analysis of a person's condition in the areas of clinical and functional, social, professional, labor and psychological.

If a person has a rehabilitation potential, then a number of measures are applied to him to facilitate its implementation.

What it is

The disability of a certain group is established in the course of a medical and social examination.

Persons who are disabled, regardless of group, due to their state of health, are classified as an unprotected segment of the population.

The state, in order to assist them, has provided special programs for the treatment of body functions.

What is the difference between the concepts

In fact, habilitation is a system of medical and pedagogical procedures that contribute to the prevention and treatment of natural pathological reactions in children with early age.

They occur in the human body under the influence of an infectious agent, which entails disruption of the normal course of life processes.

difference between rehabilitation and habilitation

As for the rehabilitation program, it consists of a number of measures to support the disabled. A person who has passed it finds a job that is accessible to his state of health, masters a profession that meets his interests, learns to manage in everyday life with the physical capabilities that he owns.

It is used from the first days of the onset of the disease or after injury, regardless of its severity. According to it, classes are carried out in stages at regular intervals.

The main purpose of the procedures is to ensure that persons recognized as disabled can properly arrange their lives in society, find a job and start a family.

Sources of financing

As a rule, earlier most of the expenses for the treatment of a disabled person, the purchase of expensive medicines and technical equipment were borne by parents.

In addition to them, funds are provided by non-state charitable foundations. They are doing a great job of creating an accessible social environment for the disabled.

Last year, the federal budget included financial support by the state for habilitation and rehabilitation programs.

The state allocates targeted cash benefits to local self-government bodies of executive power for a certain period, so that they use them to carry out habilitation and rehabilitation measures.

If the state reveals their misuse, they are obliged to return the funds they received. In addition, each region keeps records of disabled people living in their territory.

Regional FSS:

provides disabled people with the necessary medications, prostheses;
organized the work of specialized medical institutions to provide appropriate services to the disabled.

Legal framework

Issues regarding habilitation and rehabilitation programs are provided for in the following acts:

"Convention on the Rights of Persons with Disabilities". The act entered into force on May 3, 2008;
Federal Law “On Amendments to Certain Legislative Acts of the Russian Federation on the Issues of Social Protection of the Disabled in Connection with the Ratification of the Act “Convention on the Rights of Persons with Disabilities”. The act was issued on December 1, 2014 under the number 419-FZ. It notes that the ambilitation and rehabilitation of disabled people is a set of measures aimed at restoring their lost skills and abilities. With their help, a person adapts in the social sphere;
Order of the Ministry of Labor and Social Protection of the Russian Federation. The act was issued on June 13, 2018 under the number 486;
Order of the Government of the Russian Federation "On the allocation in 2016 of compulsory social insurance funds to financially support the costs of providing disabled people with technical means of rehabilitation and services, providing certain categories of citizens from among veterans with prostheses (except for dentures), prosthetic and orthopedic products." The act was issued on December 31, 2015 under the number 2782-r.

Basic information

The measures of the programs used for the disabled meet the requirements for achieving healthy condition human body associated with violations of his specific educational needs.

main directions of rehabilitation, habilitation

For example, developing residual hearing and teaching the patient how to use it helps the person adapt to the social environment.

Programs for the disabled

For persons with disabilities, the following apply:

social program helps to become a full-fledged member of society;
the psychological program contributes to the return to society of a full-fledged personality;
the medical program contributes to the restoration of the biological functions of the body, without which the normal life of a person is not possible;
the pedagogical program contributes to the return of a person to normal life by the methods of self-determination.

Individual

As practice shows, it is impossible to draw up a single program that is ideal for all disabled people. The circumstance forces the development of an individual program for each individual disabled person.

It takes into account:

mental and physical features organism;
the state of human health;
residual skills and abilities, regardless of the type;
the severity of the onset of the disease or injury received by the body.

In fact, an individual habilitation and rehabilitation program is an official document. It is developed on the basis of the instructions of the regulatory legal acts of the ITU.

It includes a set of rehabilitation measures that are most appropriate for a particular person with a disability. For example, the use of occupational therapy. The IPRA contains the terms for the implementation of measures, their order, types and forms, volume.

They contribute to the restoration of the body, compensate for impaired or lost functions of the body, as a result of which a person begins to perform certain types of activity.

Integrated

In Russia, a system of comprehensive rehabilitation for the adult population and children called up with disabilities has recently been launched. It was introduced in accordance with the provisions of the act "Convention on the Rights of Persons with Disabilities".

As a rule, rehabilitation is carried out in the phase of restoring the viability of the body or the manifestation of the consequences of the disease.

A comprehensive program consists of professional and social, medical rehabilitation activities.

They help to stabilize the pathological process, to prevent complications caused by the disease. For a certain category of patients, it is recommended to use various methods psychological rehabilitation.

Medical

The plan of rehabilitation medical measures is always drawn up individually, taking into account the phase of the development of the disease and the state of health of the patient.

They include the following procedures:

Ergotherapy;
Physiotherapy;
Massage;
Psychotherapy.

Social

A person with impaired body functions is provided with the help of a psychologist who helps him become a full member of society. In terms of social support, the opportunities available to him are determined, which are developed by special methods.

Features of rehabilitation and habilitation for disabled children

Usually born with functional disorders organism, the child cannot develop his abilities to the fullest.

Him in early childhood a diagnosis is made of limited physical and mental capabilities that ensure normal vitality.

One of the important tasks of medicine is the identification of intact analyzers in children, the prevention of the occurrence of secondary deviations in development, their correction and compensation by educational methods.

In practice, habilitation and rehabilitation in special education is widely used for disabled people, represented by an individual and specific process. Its end result determines the nature of deviations in the development of a person, functions and systems of the human body.

Habilitation measures apply exclusively to children who were born with deviations of the system or after birth acquired violations of it in the process of development. They provide for monitoring the functions of the fetus in the process of intrauterine development.

In conclusion, it should be noted that the draft federal budget for next year pledge of 29.3 billion rubles for the implementation of the "ambitization" and "rehabilitation" programs.

Part of the funds is intended for the purchase of technical means used for the restoration process of impaired functions of persons with disabilities. The other part is allocated to pay for the services of personnel for ambilitation measures.

: why an integrated approach is important in the habilitation of children with developmental disabilities

Distinctive features in the implementation of rehabilitation and habilitation activities

The legislation on social support and state protection of the disabled contains the terms habilitation and rehabilitation.

So, what do they mean and what is the difference between these two concepts, we will consider in detail in our article.

Goals and objectives of these events

In accordance with Art. 9 FZ N 181 dated November 24, 1995 under rehabilitation is understood as a system and process that contribute to the partial or complete restoration of abilities previously lost by a disabled person for social, domestic, professional or labor activities.

under habilitation is understood as the process of formation of new abilities that were previously absent for the conduct of labor, social, educational and household activities.

The purpose of the implementation of rehabilitation is the restoration of skills that were lost due to the onset of a permanent health limitation, taking into account the specifics of the trauma suffered by the person.

To rehabilitation tasks include:

Increasing the speed of recovery;
Improving outcome options for injuries resulting from the disease;
Saving the life of a disabled person;
Prevention of the possibility of the appearance of disability or alleviation of its manifestations;
The return of a person to various spheres of life;
Restoration of professional skills.

The purpose of habilitation is the acquisition by persons with disabilities of such skills, which they previously did not have, for their integration into society.

Between the concepts of rehabilitation and habilitation there is significant difference.

As a rule, habilitation procedures are carried out for children, immediately after birth and the detection of a health disorder in them, so that the skills acquired during the habilitation process can be used in life.

Rehabilitation, as a rule, is carried out in order to restore the skills lost as a result of illness or injury.

Individual

Individual rehabilitation program involves the implementation of procedures and measures that include:

Forms of measures aimed at restoring lost functions;
The timing of the implementation of these measures;
Kinds necessary assistance disabled person;
Amount of assistance provided.

It involves the following activities:

Medical (therapy, surgery, spa treatment, obtaining technical equipment);
Social (legal assistance, counseling, psychological and cultural support for families with a disabled person, training, social rehabilitation, physical);
Professional (consulting on available forms of work, recommendations on possible contraindications, orientation, retraining, technical assistance in training or retraining);
Psychological and pedagogical (preschool education, training, provision of technical means for training, adjustment).

Implementations individual rehabilitation is carried out only with the consent of the disabled person.

Individual habilitation program includes the following measures:

restorative (reconstructive) health care, prosthetics, orthotics);
Professional (assistance in finding a job, adaptation measures in a new workplace);
Physical culture and health (attraction to cultural events, participation in competitions);
Social (providing opportunities for self-realization, assisting in the process of entering higher educational institutions, establishing social contacts).

Integrated

Comprehensive rehabilitation- a process in which specialists from different fields participate to restore the skills and abilities acquired earlier.

Directions complex rehabilitation:

Educational - the implementation of programs aimed at changing the attitude of society towards the problem of disability, as well as the implementation of programs aimed at the socialization of people with disabilities in society and changing their attitude towards it;
Leisure - the creation of programs to meet the spiritual and physical needs;
Corrective - the goal is to eliminate or compensate for disability-related disability;
Cognitive - revealing in disabled people the desire for education, work, social activities;
Emotional and aesthetic - the formation of knowledge among the disabled to the desire to explore the world.

Medical

medical rehabilitation- a set of procedures aimed at reducing the severity of restrictions in the process of life in disabled people.

There are the following types of medical rehabilitation:

General (use of drugs prescribed by the attending physician, outpatient observation);
Specialized (assistance in specialized medical institutions, prosthetics, operations).

To medical habilitation include:

Prosthetics;
cutting off;
Reconstructive surgery.

Social

Social rehabilitation is a set of procedures and various measures that determine the social regime and the regime of family and domestic relations, taking into account the needs of the disabled person himself.

She represents two sections:

Socio-environmental orientation is a set of measures that help identify the most developed skills of a disabled person, and on the basis of these skills, the most feasible family and social activities are selected;
Social and domestic habilitation is a set of measures by which the most optimal mode of social activity and family life is chosen.

Social adaptation includes:

Counseling for the disabled;
Specialized training for a disabled person and his family members;
Training in self-service procedures;
Adaptation of the premises where the person with handicapped, to his normal life and service ability;

Socio-environmental orientation is a procedure:

obtaining communication skills, teaching social independence, acquiring skills for the implementation of recreational activities;
assistance in resolving personal problems;
psychological support for the family.

Features for kids

For the formation of skills, as well as the restoration of skills previously lost, children with disabilities are used the following forms of rehabilitation and habilitation programs:

Socio-medical (attendance by disabled children of physiotherapy exercises, massage, herbal medicine, physiotherapy, sports and recreational activities);
Social and domestic (implementation of counseling when using rehabilitation means, informing, conducting occupational therapy);
Socio-psychological (diagnostics, correction, formation of self-service skills, personal care);
Correctional and pedagogical (conducting developmental classes);
Sociocultural (holding concerts, excursions, visiting theaters).

feature implementation of these programs for children with disabilities lies in their complexity, since the main goal of implementing programs is restoring health to the child, as well as the development of its functions (mental and physical) to the maximum level.

Sources of financing

Program funding restoring skills and acquiring new skills is carried out through:

the federal budget of the country;
Regional budgets;
other sources.

Measures related to the conduct of medical rehabilitation and habilitation are financed from the federal budget of the Russian Federation, and from the funds of regional health insurance funds.

The implementation of the transfer for use of various technical means is financed from the regional budgets.

Measures aimed at creating jobs and optimal working conditions are financed from the budgets of enterprises and organizations.

Attention!

The implementation of individual programs is allowed at the expense of individuals or the disabled person himself with the subsequent payment of compensation.

O modern approaches for the implementation of these activities in relation to certain categories of people with disabilities, see the following videoconference:

What is habilitation and rehabilitation of the disabled?

From the very beginning of 2017, a special law came into force, which contains information about what constitutes rehabilitation and habilitation of the disabled.

Rehabilitation and habilitation of the disabled

It also prescribes all the conditions that are imposed by various individual programs for people with disabilities. It is in this law that you can find out what is the difference between habilitation and rehabilitation of disabled people:

rehabilitation is a set of special actions that are designed to restore the abilities of a person who has lost them due to any disease or injury;
habilitation is the initial creation of abilities in a person that were completely absent from him.

As a rule, habilitation is aimed at children who were born with any abnormalities or had violations in the process of their development.

Main features of habilitation

Initially, it is important to define what constitutes disability rehabilitation.

It is aimed at restoring mental, mental, social or intellectual activity in a person with disabilities.

It is important not only to return it correctly, but also to constantly maintain it so that another failure does not occur. In this case, the person will be able to return to a normal lifestyle.

Rehabilitation is possible only with the application of a certain set of actions, which include:

social events involve the return of a disabled person to society, where he becomes a full member, and not an outcast;
pedagogical actions are necessary so that a person can return to an optimal lifestyle;
mental measures ensure the restoration of all lost personal characteristics of a person;
medical actions involve the restoration of the body itself, so that a person can normally manage his own body.

For each disabled person in the rehabilitation process, all of the above actions should be applied, since their separate use will not bring the desired result.

Habilitation of disabled people does not involve the restoration of lost skills and abilities, since it is aimed at their formation, therefore, it is assumed that previously the disabled person simply did not have them.

Since it is usually impossible for people with disabilities to develop skills that are common to other people, they are taught to use alternative paths and opportunities that allow them to achieve specific functional achievements.

As a rule, habilitation is applied to children who were born with certain abnormalities or were found to have problems during their development.

Exactly at childhood you can create the necessary skills, but if you miss the moment, then already in adulthood it is often simply impossible to achieve the desired result.

If a child has a lag in speech development, then it should be eliminated before the age of 10, since it will be unrealistic to correct the situation later.

Habilitation should be applied as early as possible, usually immediately after any abnormalities or disorders are detected in the child. As a rule, from the first year of life, various actions and programs with speech therapists and teachers can be applied.

How is disability determined in 2018

It is well known that rehabilitation and habilitation of disabled people in 2018 will be assigned only to those people and children who have necessary documents confirming that they have a disability.

According to statistics, at the beginning of 2015 there were about 13 million disabled people in the country, and only about 600 thousand were children with disabilities. Before the introduction of the new law in 2018, disability was defined by two indicators, which include:

the presence of disorders in the main functions and systems of the human body;
how limited the life process is, and such indicators as partial loss or complete loss, learning ability, etc. were used.

However, disability will now be determined by only one criterion by which it will be possible to determine whether a person or child is disabled or not.

In accordance with this, a specific individual program is assigned, designed to restore the life of a citizen as quickly and efficiently as possible. This criterion is to determine the severity of functional disorders of the human body.

This approach is considered the most objective and rational, since the loss of a certain functionality is assessed, and this can be found out by the results of a medical examination.

What is a habilitation program

The new system that allows you to determine disability has another good feature, which is that you can immediately decide what kind of individual assistance can be provided to a person. If he needs skills and abilities that he did not have at all, then he is assigned habilitation. If you need to restore lost skills, then rehabilitation is carried out.

Habilitation involves the following actions:

prosthetics;
the use of reconstructive surgery;
orthotics;
various methods of vocational guidance;
treatment in sanatoriums and resorts;
all kinds of sports exercises;
medical intervention;

Other measures may also be applied, the choice of which depends on what particular abilities are lacking in a person undergoing habilitation.

The most important thing in the new law is the compilation of an individual program, both for habilitation and rehabilitation.

Initially, a special scheme of actions is created, which is then implemented, and at the same time, numerous conditions established for a particular case are observed.

When a special recovery program for a certain disabled person is created, it is sent to that medical institution, which will be engaged in the implementation of all measures and the provision of the necessary services for the person. These organizations will report for the habilitation of each disabled person to the Bureau of the JME. After these reports are sent to government agencies that are responsible for assisting people with disabilities.

Rehabilitation and habilitation of the disabled in 2018 underwent significant changes, and many experts argue that this will only lead to positive results. Individual programs will be effective for a particular person, so you can expect prompt and high-quality recovery or the formation of skills and abilities.

It is also important to note that if, until 2018, parents and the disabled themselves had to look for funds for rehabilitation and habilitation on their own, for which they could use their own funds or apply to special funds, now funds are allocated for these purposes from the state budget.
Thus, rehabilitation and habilitation are different concepts that are now enshrined in legislation, and in 2018 many innovations were introduced that relate to these processes.

On January 1, 2016, a law came into force that defines what habilitation of disabled people is, the conditions for individual programs, and also establishes its differences from the traditional term “rehabilitation”. These concepts are consonant, but there is a difference between them: rehabilitation is a set of actions aimed at restoring abilities due to illness or injury. Habilitation is the initial formation of any abilities. Mostly this concept is applied to children at an early age who have deviations, developmental disorders.

Rehabilitation and habilitation - is there a difference?

social to ensure the restoration of a disabled person as a subject of society;
pedagogical to return a person to normal activities;
mental, used for the rehabilitation of the individual;
medical, providing restoration at the level of biology, that is, returning normal vital activity to the body.

A model that includes all of these components is called ideal, it is suitable for use in the strategic planning of a rehabilitation center.

Such measures are applied mainly to children, since they are difficult to implement and ineffective in case of late treatment. For example, for children suffering from speech delays, help provided at 11 years old will be late. A positive result will bring only habilitation, started at an early age. These are speech therapy, pedagogical and other activities from the 1st year of life.

Establishing Disability: Major Changes

According to studies, as of January 1, 2015, there were about 13 million disabled people in Russia, of which 605,000 were children (what kind of assistance does the state provide to disabled children?). Previously, when determining disability, 2 criteria were used:

disorder of body functions;
the level of disability (commissions used such concepts as complete, partial with the loss of the ability to independently organize self-service, loss of motor function, learning ability, etc.).

This procedure was established by the Law on the Protection of Persons with Disabilities (Article 1), but from January 1, 2016, only one criterion will be used, according to which a person is recognized as disabled, after which he is assigned an individual program for the restoration of life. Since 2016, the degree of disability is determined on the basis of the severity of functional disorders, and not on the degree of limitation. The difference is very big:

Under the old order, a subjective assessment was used, that is, the ability to learn, communicate, control behavior (according to the ITU Classifications and Criteria, Section III).
The new system implies an objective assessment of the loss of body functionality, which is detected on the basis of a medical examination.

The concept of "Habilitation of the disabled"

The system for determining disability, adopted since 2016, is more advanced, it allows not only to make a diagnosis, but also to clarify the nature of individual assistance to a person. Law No. 419-F3 introduces such a new concept as habilitation, that is, a system for the formation of skills that were previously absent from a disabled person.

The main components of the habilitation of disabled people in 2016 are the following activities: prosthetics, orthotics, as well as reconstructive surgery, career guidance, spa treatment, exercise therapy, sports events, medical rehabilitation and others.

One of the main features of the new law is an individual program for the rehabilitation and habilitation of persons with disabilities, in accordance with the Law on the Protection of Persons with Disabilities, art.11. The recovery scheme will be developed and then implemented according to the rules that are set strictly individually. The program will be developed by ITU specialists (bureau of medical and social expertise), in accordance with paragraph 1 of the relevant Procedure.

As individual schemes for restorative measures are developed, extracts from such programs will be sent by the Bureau of the SME to state institutions that provide relevant services and measures (Article 5 of the Federal Law No. 419, clause 10). performers responsible for habilitation will have to report to the bureau. In turn, the federal institutions of the SME must transfer the received data to special authorities responsible for promoting the employment of people with disabilities (Federal Law No. 419, article 1, clause 2).

The advantages of the new system are obvious, the developers of the new Federal Law No. 419 are confident that it is precisely such measures that are able to increase the compulsion and effectiveness of the habilitation and rehabilitation measures taken. E. Klochko, who is one of the authors of the bill, believes that only the new scheme is able to more carefully and fully treat the program of rehabilitation and protection of the disabled, including children who were not previously provided with assistance in the required amount.

Financing the habilitation program

After defining the concepts of “rehabilitation and habilitation of the disabled”, what it is exactly and what are the differences, it is necessary to touch on the issue of funding. If earlier technical means and many recovery processes, including expensive treatment, were paid for by parents and the funds created by them, now a certain amount is allocated from the state budget for such purposes. According to Order No. 2782-r dated December 31, 2015, earmarked funds in the amount of 9.3 billion rubles will be allocated in 2016. from the social security fund.

The distribution of funding is controlled by the Government of the Russian Federation, which is determined by the new norm (part 8, article 7 of the Federal Law "On the budget of the Social Insurance Fund of the Russian Federation"). In accordance with the law, funds can be redirected to provide disabled people with technical equipment, services required to restore health and certain functions of the body. The signed Order determines that the funds from the Social Insurance Fund are directed to the following purposes:

provision of technical means and services for rehabilitation and habilitation (7.7 billion rubles);
provision of subventions to the budgets of the constituent entities of the Russian Federation for similar purposes (in the amount of 1.6 billion rubles).

1. Stationary program. It is carried out in special rehabilitation departments. It is indicated for patients who need constant monitoring. medical workers. This program is usually more effective than others, since the patient is provided with all types of rehabilitation in the hospital.

2. Day hospital. The organization of rehabilitation in a day hospital is reduced to the fact that the patient lives at home, and is in the clinic only for the duration of treatment and rehabilitation measures.

3. outpatient program. It is carried out in the departments of rehabilitation therapy at polyclinics. The patient is in the outpatient department only during ongoing rehabilitation activities, such as massage or exercise therapy.

4. home program. When implementing the program, the patient takes all medical and rehabilitation procedures at home. The program has its advantages, as the patient learns the necessary skills and abilities in a familiar home environment.

5. Rehabilitation centers . They are multidisciplinary and complex, their structure includes all types of rehabilitation: medical, social and vocational. Patients in these centers, participate in rehabilitation programs, take the necessary healing procedures. Rehabilitation specialists provide the patient and his family members with the necessary information, give advice on the choice of a rehabilitation program, the possibility of its implementation in various conditions.

Usually, rehabilitation treatment begins in a hospital and then continues at home. Rehabilitation treatment should be started when the patient is still in bed. The correct position, turns in bed, regular passive movements in the joints of the limbs, breathing exercises will allow the patient to avoid complications such as muscle weakness, muscle atrophy, bedsores, pneumonia, etc.

Types of rehabilitation

1. Medical rehabilitation:

1) physical methods of rehabilitation (electrotherapy, electrical stimulation, laser therapy, barotherapy, balneotherapy);

2) mechanical methods of rehabilitation (mechanotherapy, kinesitherapy);

3) massage;

4) traditional methods of treatment (acupuncture, herbal medicine, manual therapy, occupational therapy);

5) psychotherapy;

6) speech therapy assistance;

7) physiotherapy exercises;

8) reconstructive surgery;

9) prosthetic and orthopedic care (prosthetics, orthotics, complex orthopedic shoes);

10) sanatorium treatment;

11) technical means of rehabilitation;

12) informing and consulting on the issues of medical rehabilitation.

2. Social rehabilitation.

3. Social adaptation:

1) informing and consulting on issues of social and domestic rehabilitation of the patient and his family members;

2) teaching the patient self-care;

3) adaptive education of the patient's family;

4) teaching the patient and the disabled to use the technical means of rehabilitation;

5) organization of the patient's life in everyday life (adaptation of the living quarters to the needs of the patient and the disabled);

6) providing technical means of rehabilitation (the program indicates the necessary measures to create the patient's everyday independence);

7) sound equipment;

8) tiflotechnics;

9) technical means of rehabilitation.

4. Social and environmental rehabilitation:

1) carrying out socio-psychological and psychological rehabilitation (psychotherapy, psychocorrection, psychological counseling);

2) implementation psychological help family (life skills training, personal security, social communication, social independence);

3) assistance in solving personal problems;

4) legal advice;

5) training in leisure and recreation skills.

5. Vocational rehabilitation program:

1) vocational guidance (professional information, vocational counseling);

2) psychological correction;

3) training (retraining);

4) creation of a special workplace for a disabled person;

5) professional and industrial adaptation.

Rehabilitation professionals:

1) medical specialists (neuropathologists, orthopedists, therapists, etc.). They help to diagnose and treat diseases that limit the life of patients. These specialists solve the problems of medical rehabilitation;

2) a rehabilitation specialist;

3) rehabilitation nurse. Provides assistance to the patient, provides care, educates the patient and his family members;

4) physiotherapist;

5) a specialist in physical therapy;

6) specialists – ophthalmologists; otolaryngologists; audiologists;

7) psychologist;

8) psychotherapist;

9) social worker and other specialists.

Contraindications for medical rehabilitation:

Acute and subacute stages of the underlying disease requiring medical intervention;

Any paroxysmal and progressive diseases with a tendency to frequent exacerbations or relapses, diseases with frequent decompensations requiring hospital treatment;

Malignant neoplasms in the active phase, cachexia of any origin, active phase of tuberculosis, extensive trophic ulcers and bedsores, purulent-necrotic diseases, acute infectious and venereal diseases before the end of the treatment period.

Tasks of the state service of medical and social expertise in the field of rehabilitation of the disabled.

The main tasks of the activities of the ITU service are defined by the Federal Law of the Russian Federation "On social protection Disabled Persons in the Russian Federation”, Decree of the Government of the Russian Federation No. 965 dated 13.08.96, which approved the “Regulation on Recognizing a Person as a Disabled Person” and “Approximate Regulation on Institutions of the Public Service of Medical and Social Expertise” “other regulatory and instructive documents. The ITU service agencies are entrusted with the following tasks in the field of rehabilitation of disabled people:

· Determining the needs of disabled people in social protection measures, including rehabilitation, based on expert rehabilitation diagnostics;

development of individual rehabilitation programs with the definition of specific types, forms, methods, performers and procedures for the implementation of rehabilitation measures;

· rendering assistance to the disabled in the implementation of the IPR;

· monitoring the implementation of rehabilitation measures in the form of dynamic monitoring of the completeness and quality of the implementation of the IRP, as well as the final assessment of the effectiveness of the rehabilitation of people with disabilities based on the results of the implementation of the IRP;

accounting, generalization and analysis of the needs of disabled people in various measures of rehabilitation assistance and their provision, as well as the results of rehabilitation at the regional and municipal levels;

Carrying out information and educational work on the rehabilitation of disabled people;

· submission of proposals to the legislative and executive authorities on the study of rehabilitation services for the disabled;

· participation in the development of comprehensive programs in the field of disability prevention, medical and social expertise, rehabilitation and social protection of the disabled.

Within the framework of expert rehabilitation work, as well as as an independent area of activity, certain types of rehabilitation assistance are provided to disabled people in the ITU Bureau.

Rights of ITU institutions.

In accordance with paragraph 18 of the "Approximate regulation on institutions of the state service of medical and social expertise", approved by Decree of the Government of the Russian Federation of August 13, 1996 No. 965, ITU institutions have the right to exercise their powers

Send persons undergoing a medical and social examination for examination in order to clarify their clinical and functional diagnosis and professional capabilities in medical and preventive institutions of the state and municipal health care systems, rehabilitation and other state and municipal institutions operating in the field of medical and social examination and rehabilitation of the disabled;

Request and receive from organizations of all forms of ownership the information necessary for making decisions and performing other functions assigned to institutions;

Conduct control examinations of disabled people for dynamic monitoring of the implementation of measures provided for by individual programs for the rehabilitation of disabled people;

Send specialists to organizations of all forms of ownership in order to study the working conditions of disabled people, monitor the implementation of rehabilitation measures and in other cases necessary to perform the functions assigned to institutions.

Individual Rehabilitation Program for the Disabled (IPR)- developed on the basis of the decision of the State Service for Medical and Social Expertise, a set of rehabilitation measures that are optimal for a disabled person, including certain types, forms, volumes, terms and procedures for the implementation of medical, professional and other rehabilitation measures aimed at restoring, compensating for impaired or lost body functions , restoration, compensation for the ability of a disabled person to perform certain types of activities (Article 1 of the Federal Law of the Russian Federation "On the Social Protection of Disabled Persons in the Russian Federation").

The program contains both rehabilitation measures provided to a disabled person free of charge in accordance with the federal basic program for the rehabilitation of disabled people, and rehabilitation measures that are paid for by the disabled person himself or other persons or organizations, regardless of organizational and legal forms and forms of ownership.

The volume of rehabilitation measures provided for by an individual rehabilitation program for a disabled person cannot be less than the established federal program rehabilitation of the disabled.

The individual rehabilitation program is advisory in nature. The disabled person has the right to refuse one or another type, form and volume of rehabilitation measures, as well as the implementation of the program as a whole, can independently decide on the choice and provision of a specific technical and other means or type of rehabilitation, including cars, wheelchairs, prosthetic and orthopedic products, printed publications with a special font, sound amplifying equipment, signaling devices, video materials with subtitles, and other similar means.

If the technical or other rehabilitation means or service provided for by the individual rehabilitation program cannot be provided to the disabled person, or if the disabled person has purchased the appropriate means or paid for the service at his own expense, then he is paid compensation in the amount of the cost of the technical or other rehabilitation means, services that must be provided to the disabled .

The refusal of a disabled person or a person representing his interests from an individual rehabilitation program as a whole or from the implementation of its parts releases the relevant state authorities, local governments, as well as organizations, regardless of organizational and legal forms and forms of ownership, from responsibility for its implementation and does not give the disabled person the right to receive compensation in the amount of the cost of rehabilitation activities provided free of charge.

In accordance with Articles 11, 12, 16, 18, 20, 23 of the Federal Law of the Russian Federation “On the Social Protection of Disabled Persons in the Russian Federation”, the IPR is mandatory for the relevant state authorities, local governments, as well as organizations, enterprises, institutions, regardless of organizational - legal forms and forms of ownership, institutions of the state service for the rehabilitation of the disabled, non-state rehabilitation institutions, educational institutions, which are determined by the performers of specific rehabilitation measures.

Financing of an individual rehabilitation program.

IPR is financed from the federal budget, the budgets of the constituent entities of the Russian Federation, state funds and other sources not prohibited by the legislation of the Russian Federation.

The federal budget finances the implementation of rehabilitation measures, the provision of technical equipment and the provision of services included in the federal basic program for the rehabilitation of disabled people.

In accordance with Article 13 of the Federal Law of the Russian Federation “On the Social Protection of the Disabled in the Russian Federation”, medical rehabilitation measures are carried out within the framework of the federal basic program of compulsory medical insurance of the Russian Federation at the expense of federal and territorial compulsory medical insurance funds.

In accordance with Article 22 of the Federal Law of the Russian Federation “On the Social Protection of Disabled Persons of the Russian Federation”, at the expense of enterprises, institutions and organizations, regardless of their organizational and legal forms and forms of ownership, the creation of special jobs for persons who have become disabled due to an accident at work or occupational disease. In this case, the disabled person is paid compensation in the amount of the cost of the rehabilitation measure, technical means, provision of services, which must be provided to him in accordance with the IRP. IPR financing is also allowed on the basis of co-operation between budgetary and non-budgetary funds.

The procedure and conditions for the development and implementation of individual programs for the rehabilitation of disabled people.

The procedure and conditions for the development and implementation of an individual rehabilitation program for a disabled person are determined by a decree of the Ministry of Labor and social development RF "On Approval of the Approximate Regulations on the Individual Rehabilitation Program for a Disabled Person" dated 12/14/96 No. 14.

IPR are developed by institutions of the State Service for Medical and Social Expertise. During the initial and repeated examination of citizens in order to determine disability, the institutions of the state service of medical and social expertise must determine the need and expediency of carrying out rehabilitation measures.

Specialists of the State Service for Medical and Social Expertise are obliged to explain to the examined person the goals, objectives, predicted results and social and legal consequences of rehabilitation measures and make an appropriate entry in the examination report on the date of the interview.

The IPR must be developed by an institution of the State Service for Medical and Social Expertise no later than one month after the examination of the person was recognized as disabled.

The development of an IPR consists of the following stages: conducting expert rehabilitation diagnostics, assessing the rehabilitation potential, rehabilitation prognosis and determining measures, technical means and services that allow a disabled person to restore impaired or compensate for lost abilities to perform household, social and professional activities.

The development of the IPR is carried out by specialists of the institution of the State Service for Medical and Social Expertise, with the involvement, if necessary, of specialists from healthcare institutions, the employment service and other bodies and institutions operating in the field of rehabilitation, with the obligatory participation of the applicant. In cases requiring the use complex types expert and rehabilitation diagnostics, a disabled person may be sent for the development or correction of an IPR to a higher institution of the State Service for Medical and Social Expertise.

The formed IPR is signed by the head of the State institution. Service of Medical and Social Expertise and a disabled person, certified by the seal of the institution of the State Service of Medical and Social Expertise and issued to the handicapped. If the disabled person or his legal representative refuses to sign the drawn up IPR, the program is attached to the examination certificate at the institution of the State Service for Medical and Social Expertise and is not handed over to the disabled person, a copy of the approved IPR is sent to the social protection authority within 3 days.

The implementation of the IRP is carried out by organizations, enterprises, institutions, regardless of their organizational and legal forms and forms of ownership, institutions of the state service for the rehabilitation of the disabled, non-state rehabilitation institutions, educational institutions.

Coordination of the implementation of the IRP and the provision of the necessary assistance to a disabled person is carried out by the social protection authority.

The assessment of the results of medical, social and vocational rehabilitation measures is carried out by specialists of the State Service for Medical and Social Expertise at the next examination of a disabled person or in the course of his dynamic observation. The final assessment of the results of the implementation of the IPR is made after a collegial discussion by the relevant specialists, approved by the head of the State Service for Medical and Social Expertise and carried out to the attention of the disabled person in an accessible form.

In case of disagreement with the content of the IPR, a disabled person may submit a written application to a higher institution of the State Service for Medical and Social Expertise. The main bureau of medical and social expertise of the subject of the Russian Federation, no later than one month on the date of receipt of the application, makes a final decision.

Heads of enterprises, institutions, organizations that do not carry out the activities specified in the IPR are liable in accordance with the provisions of Articles 16, 21, 22, 24, 32 of the Federal Law of the Russian Federation "On the Social Protection of Disabled Persons in the Russian Federation" and other legislative acts of the Russian Federation.

In the event of a conflict situation between the disabled person and the IRP executors, the dispute is resolved in court at the request of the plaintiff.

A new concept has appeared, consonant with the term "rehabilitation" familiar to us. However, there is still a difference between them.

In short, habilitation (from lat. habilis - to be capable of anything) is the initial formation of the ability to do something. The term applies predominantly to young children with developmental disabilities, in contrast to rehabilitation - the return of the ability to do something, lost as a result of illness, injury, etc. [pedagogical terminological dictionary].

General concepts of the rehabilitation of persons with disabilities

In the standard rules for ensuring equal opportunities for persons with disabilities (Resolution of the UN General Assembly 48/96, adopted at the forty-eighth session of the UN General Assembly on December 20, 1993), in the section "Basic concepts in policies regarding persons with disabilities", the commonly used concept of rehabilitation, based on the ideas World Program of Action for Persons with Disabilities.

Rehabilitation is a process that aims to help people with disabilities reestablish their optimal physical, intellectual, mental and/or social levels of performance and support them by providing them with rehabilitative means to change their lives and expand the scope of their independence.

From this international definition of “rehabilitation”, a certain analytical scheme of the rehabilitation process itself follows, which includes the following components (rehabilitation constructs):

1. Social rehabilitation, which ensures the rehabilitation of a person with a disability as a social subject;
2. Pedagogical rehabilitation, which ensures the rehabilitation of a person as a subject of activity;
3. Psychological rehabilitation, which provides rehabilitation of a person with a disability at the individual level;
4. Medical rehabilitation, which provides rehabilitation at the level of the human biological organism.

All of the above components make up an ideal model of the rehabilitation process. It is universal and can be used in the strategic planning of any center or institution for the rehabilitation of a person with a disability, which aims to provide the most complete range of rehabilitation services.

What does the term "habilitation" mean?I"?

When a child is born with a functional limitation, this means that he will not be able to develop all the functions necessary for a normal life, or perhaps the functionality of this child will not be developed in the same way as the functionality of his peers. A child, no matter what, remains a child: with the need for love, attention and education according to his unique nature, and he must be treated, first of all, as a child.

The word "habilitation" comes from the Latin "habilis", which means "to be able". To habilitate means "to make wealthy" and is used instead of the word "rehabilitate", which is used in the sense of restoring a lost ability.\

That is, habilitation is a process whose purpose is to help acquire or develop still unformed functions and skills, in contrast to rehabilitation, which offers the restoration of lost functions as a result of injury or disease.

Hence it turns out that this process is most relevant in relation to children with disabilities. Although it applies to other people whose moral health is undermined (for example, convicts). Habilitation means not only seeking to treat or modify physical or mental disorders, it also means teaching the child to achieve functional goals in alternative ways, if the usual ways are blocked, and to adapt environment to compensate for missing features.

It should be noted that habilitation started late may be ineffective and difficult to implement. This may be the case, for example, if children with cerebral palsy and gross delays in speech development begin to receive appropriate assistance only at the age of eight to eleven years. An experience recent years suggests that a complex of therapeutic, pedagogical, speech therapy and other activities should be started already in the first year of life.

Rehabilitation activities begin from the first days of illness or injury and are carried out continuously, subject to the phased construction of the program.

Habilitation activities can begin with monitoring the condition of the expectant mother and nursing a child with developmental disabilities.

Habilitation is a multi-faceted process that addresses multiple aspects at the same time to enable the child to lead a life that is as close to normal as possible. normal life, in this context means the life that a child would have in the absence of their functional limitations.

Habilitation and rehabilitation is a set of measures aimed at adapting to society and overcoming pathological conditions people with disabilities.

The task of both habilitation and rehabilitation is to help disabled people to socialize as successfully as possible, to arrange both personal and professional life.

Therapeutic and preventive measures - include the organization of primary and periodic medical examinations, organization of therapeutic and preventive nutrition.

Health is the most important property of a living organism; in relation to a person, it is a measure of spiritual culture, an indicator of the quality of life and, at the same time, the result of the moral codes of the state's social policy.

Usually, rehabilitation treatment begins in a hospital and then continues at home. Rehabilitation treatment should begin when the patient is still in bed. The correct position, turns in bed, regular passive movements in the joints of the limbs, breathing exercises will allow the patient to avoid complications such as muscle weakness, muscle atrophy, bedsores, pneumonia, etc. Always keep the patient physically active, as it strengthens the patient, and inaction weakens.

In restorative care, pay attention not only to his physical, but also to his emotional state. Remember that as a result of illness or disability, a person has lost the ability to work, to participate in public life. Change life situation can cause fear, anxiety, lead to the development of depression. Therefore, it is important to create an atmosphere of psychological comfort around the patient.

The purpose of the work is to consider treatment-and-prophylactic and rehabilitation measures.

Research objectives:

2. Give an assessment of rehabilitation measures.

1. THERAPEUTIC AND PREVENTIVE MEASURES

1.1. The main elements of treatment and prevention activities

The main closely interacting functions of therapeutic and preventive activities are:

Wellness (sanatorium treatment);

Rehabilitation;

Preventive-valeological (prophylaxis healthy lifestyle life);

Recreational animation.

Each function requires its own specific technologies, which, however, should only be used in combination. In therapeutic functions, priority is given to natural healing factors and non-traditional methods aimed at expanding health reserves; in recreational functions - cycles of classes that increase the spiritual health and moral guidelines of society.

In sanatorium-and-spa institutions, the influence of medical procedures is combined with a powerful effect on the body of the total amount of natural conditions. This includes prolonged exposure to air, positive impact landscape, aromas of the surrounding flower beds, forests, active motor mode (alternation of rest and measured movement, walks, excursions, hikes).

Mandatory elements of spa treatment are morning hygienic exercises, physiotherapy, dosed walking, outdoor sports games. As a rule, patients and vacationers take walks and excursions, go boating. Other types are organized active rest– tennis, scuba diving, fishing, hunting, rafting, hiking, jeeping, horseback riding; in mountain climatic resorts - descent from the mountains, snowboarding, etc.

Numerous works have established that the absence of the necessary minimum of movement leads to the development of a number of metabolic diseases (obesity, gout, cholelithiasis and kidney stones, etc.), functional, and then organic disorders of cardiac activity develop.

Under the influence of exercise in the body, mental, physiological, biochemical processes are deployed that positively affect the functional state of the main systems and organs. The complex of processes that occur in response to physical activity depends on age, gender, fitness, characteristics of the disease, volume and intensity of exercise. At the same time, adaptive changes capture the entire body, ensuring a more coordinated functioning of organs. In the course of classes, the strength, mobility and balance of excitation processes in the central nervous system are improved, pathogenic inhibition is reduced or removed, new systems of temporary connections are formed that contribute to the formation of motor skills and reactions with a higher level of functioning of physiological systems. The cardiovascular system is most affected. In the heart muscle, the intensity of oxidative processes increases, the use of energy sources brought by the blood increases, the elasticity of blood vessels increases, and contractions of the heart muscle increase.

Under the influence of physical exercises, coordination between ventilation of the lungs and blood circulation improves, the respiratory rate becomes optimal, the body is better supplied with oxygen. Profound changes are taking place in other organs as well. In the liver, glycogen stores increase, enzyme activity increases, the ligamentous apparatus strengthens, muscle mass and volume increase.

Thus, the active motor mode is an important factor in the normalization of the most important physiological processes disturbed or weakened as a result of a disease or an irrational lifestyle, a factor in restoring their normal regulation from the side of the central nervous system. In this regard, physical activity acts in the same direction as training the mechanisms of regulation of heat exchange in the body. Both of these factors contribute to the suppression of pathological connections created as a result of the disease, and the restoration of the normal reactivity of the organism.

Walking - the most popular form of physical therapy, develops the ability to overcome long distances without fatigue. Walks do not require special preparation and are used at any time of the year.

Sports games are the most difficult and responsible section of work in physiotherapy exercises. The amount of load here depends on the state of health, the type of game and the number of actions.

Swimming is a special form of exercise therapy that allows you to widely vary the amount of load from being in the water without moving to swimming at maximum speed. Volume is measured by the length of the course and the duration of the swim. Intensity - the magnitude and nature of changes in the main body systems and the speed of swimming. For patients with a training regimen, swimming is recommended at a water temperature of 20 ° C and above, sparing - 24 ° C and above.

A properly built regimen of physical mobility creates a positive emotional mood in patients and vacationers, confidence in a favorable outcome of treatment.

Hiking in the mountains is characterized by: large volume physical activity on the body at low atmospheric pressure and high levels of solar radiation, the need to overcome obstacles using a variety of means and methods of movement and insurance, special tactics for passing the route.

Hiking is carried out in almost all climatic zones and geographic regions - from the arctic tundra to deserts and mountains. Their attractiveness and the main distinguishing feature is that it is accessible and useful to any practically healthy person, regardless of age and physical development, provides great freedom in choosing a route in accordance with the aesthetic, cognitive and cultural needs of the travel participants. If there are a large number of various natural obstacles on the route, a hiking trip can turn into a combined one, for example, pedestrian-water, mountain-pedestrian.

1.2.Management of medical and preventive activities

In Russia, the federal executive body is responsible for organizing medical and preventive activities, exercising, within its powers, state administration, intersectoral and interregional coordination in the resort business, in accordance with the regulation approved by the Government of Russia. In the constituent entities of the Russian Federation, the executive authorities in the field of the resort sector are responsible for organizing medical and preventive activities. Executive authorities in the region of the constituent entities of the Russian Federation:

Exercise control over the provision of sanatorium and health services in the implementation of medical and preventive activities;

Organize the study, development, rational use of health-improving areas;

Create the necessary conditions for the functioning of organizations and institutions that carry out medical and preventive activities;

They monitor compliance with regulations and industry standards by resort organizations.

The performance of work and the provision of services in the specialties of sanatorium-and-spa medical care are carried out in accordance with paragraph 04.

2. REHABILITATION MEASURES

Rehabilitation or restorative treatment is a process and a system of medical, psychological, pedagogical, socio-economic measures aimed at eliminating or possibly more fully compensating for life limitations caused by a health disorder with a persistent disorder of body functions. Rehabilitation treatment is necessary when the patient's functional abilities, learning abilities, work activity, social relationships, etc. are significantly reduced. Rehabilitation treatment is part of your daily care for the patient. Usually, when leaving, you wash, feed the patient, make his bed and perform other manipulations that facilitate the course of the disease. In restorative care, your main goal is to help the patient become as functional and independent as possible, even though they may not be the same as before.

Restorative care reduces the effects of illness and, in people with disabilities, the effects of disability. In restorative care, help your patients, but don't do anything for them. If possible, try to ensure that the patient independently follows the rules of general hygiene, for example, brushing his teeth, washing, combing his hair, eating. Before performing any caregiving activities, ask the patient what he can do on his own and encourage him to do so. Do not forget that in connection with the disease and its consequences, patients may lose the everyday household skills that they possessed before the disease. Involving the patient in activities will help him acquire the skills and abilities necessary to overcome life's problems. Therefore, the patient must be gradually taught these skills and given the opportunity to adapt to the disease and live more fully. In cases where the patient's ability to express his needs and desires is limited, you need to help the patient increase his participation in the development of skills. The patient needs to explain the task that he must perform.

Rules for working with a patient

Use short, specific sentences.

· The patient should be given clear instructions and asked to repeat your instructions to see if he understood them.

· Sometimes the patient needs to demonstrate a particular procedure so that he can reproduce it.

· Be patient with the patient while teaching his skills.

· Always encourage him to participate in learning the skills.

· Encourage the patient to complete the task independently.

Talk to the patient about his abilities and successes in completing the task; do not focus on the shortcomings.

During the period of rehabilitation treatment, the implementation of rehabilitation measures should be started as early as possible. For each patient, an individual rehabilitation program is drawn up, which is a list of rehabilitation measures aimed at restoring the patient's abilities for everyday, social, professional activities in accordance with his needs, range of interests, taking into account the predicted level of his physical and mental state, endurance, etc. d. The rehabilitation program is drawn up and implemented only with the consent of the patient or his legal representative.

Principles of implementation of the rehabilitation program

Sequence (determining indications for rehabilitation, establishing the patient's present condition during questioning and clinical examination, as well as during psychological and social examination, determining the goals and objectives of rehabilitation, drawing up a rehabilitation plan, checking the effectiveness of rehabilitation and its correction, achieving the planned goals of rehabilitation, concluding a rehabilitation team and its recommendations).

Complexity (in the process of rehabilitation, issues of a medical, treatment and preventive plan, problems of determining the patient's ability to work, his employment, labor training and retraining, issues of social security, labor and pension legislation, relationships between the patient and his family, social life) are solved.

· Continuity (rehabilitation treatment is carried out from the moment the disease or injury occurs and up to the person's full return to society using all organizational forms of rehabilitation).

Stages of determining a rehabilitation program

· Carrying out rehabilitation-expert diagnostics. A thorough examination of the patient or disabled person and the determination of his rehabilitation diagnosis serve as the basis on which the subsequent rehabilitation program is built. The examination includes the collection of complaints and anamnesis of patients, the conduct of clinical and instrumental studies. A feature of this examination is the analysis of not only the degree of damage to organs or systems, but also the impact of physical defects on the patient's life, on the level of his functional capabilities.

· Determination of the rehabilitation prognosis - the estimated probability of the realization of the rehabilitation potential as a result of the treatment.

· Determination of measures, technical means of rehabilitation and services that allow the patient to restore impaired or compensate for the lost ability to perform household, social or professional activities.

Types of rehabilitation programs and conditions

Stationary program. It is carried out in special rehabilitation departments. It is indicated for patients who need constant monitoring by medical professionals. These programs are usually more effective than others, since the patient is provided with all types of rehabilitation in the hospital.

day hospital. The organization of rehabilitation in a day hospital is reduced to the fact that the patient lives at home, and is in the clinic only for the duration of treatment and rehabilitation measures.

Outpatient program. It is carried out in the departments of rehabilitation therapy at polyclinics. The patient is in the outpatient department only for the duration of the ongoing rehabilitation activities, such as massage or exercise therapy.

home program. When implementing this program, the patient takes all medical and rehabilitation procedures at home. This program has its advantages, as the patient learns the necessary skills and abilities in a familiar home environment.

· Rehabilitation centers. In them, patients participate in rehabilitation programs, take the necessary medical procedures. Rehabilitation specialists provide the patient and his family members with the necessary information, give advice on the choice of a rehabilitation program, the possibility of its implementation in various conditions.

Types of rehabilitation

medical rehabilitation

· Physical methods of rehabilitation (electrotherapy, electrical stimulation, laser therapy, barotherapy, balneotherapy).

· Mechanical methods of rehabilitation (mechanotherapy, kinesitherapy).

· Traditional methods of treatment (acupuncture, herbal medicine, manual therapy, occupational therapy).

· Psychotherapy.

Speech therapy help.

· Physiotherapy.

· Reconstructive surgery.

Prosthetic and orthopedic care (prosthetics, orthotics, complex orthopedic shoes).

· Spa treatment.

· Technical means of rehabilitation.

Informing and consulting on medical rehabilitation issues.

Social rehabilitation

Social adaptation

· Informing and consulting on issues of social rehabilitation of the patient and his family members.

Teaching the patient self care.

· Adaptive education of the patient's family.

· Teaching the patient and the disabled to use the technical means of rehabilitation.

Organization of the patient's life in everyday life (adaptation of the living quarters to the needs of the patient and the disabled).

Provision of technical means of rehabilitation (the program indicates the necessary measures to create the patient's everyday independence).

· Surdotechnique.

· Tiflotechnics.

· Technical means of rehabilitation

Socio-environmental rehabilitation

· Carrying out socio-psychological and psychological rehabilitation (psychotherapy, psychocorrection, psychological counseling).

· Implementation of psychological assistance to the family (training in life skills, personal security, social communication, social independence).

Assistance in solving personal problems.

· Legal advice.

· Teaching leisure and recreation skills.

Vocational Rehabilitation Program

· Vocational guidance (professional information, vocational counseling).

· Psychological correction.

· Training (retraining).

Creation of a special workplace for the disabled.

· Professional production adaptation.

Rehabilitation professionals

Doctors - specialists (neuropathologists, orthopedists, therapists, etc.). They help to diagnose and treat diseases that limit the life of patients. These specialists solve the problems of medical rehabilitation.

· Rehabilitator.

Rehabilitation Nurse. Provides assistance to the patient, provides care, educates the patient and his family members.

· Physiotherapist.

· Specialist in physical therapy.

Specialists in visual, speech and hearing disorders.

· Psychologist.

· Social worker and other professionals.

Self-care skills training can also begin at the hospital. For bedridden patients, the recovery process can begin with teaching the patient the skills to wash, brush their teeth, comb their hair, eat, and use cutlery. Patients who can sit should be taught how to dress and undress independently. In restorative care, it is recommended to use technical rehabilitation aids that help the patient with walking, eating, bathing, going to the toilet, etc. For example, due to illness or disability, the patient may need to use devices that help him walk, such as canes, walkers, crutches, wheelchairs. The use of these devices enables a person to move around and be independent from others. To facilitate eating, you can use special dishes (plates, cups), cutlery. There are also special devices that make it easier for the patient to take a bath, go to the toilet.

CONCLUSION

Thus, the functioning of the health complex directly affects the economic situation of the country as a whole, since, by restoring the working capacity of the working population, it reduces the costs of health care and social security.

Unfortunately, most Russian health resorts do not have specially trained balneologists in their staff. True, some progress has begun: the Ministry of Education and Science of the Russian Federation approved the corresponding medical specialty. In this regard, the need to organize a system of retraining of medical personnel (at medical universities or basic sanatoriums) is also obvious. Moreover, the heads of sanatorium-resort institutions have realized the urgency of this problem - it is not for nothing that they seek to send their specialists for advanced training to various educational and methodological centers.

The sanatorium and resort complex of Russia is a huge health industry, which is financially represented by a powerful network of institutions. The leading role in it is occupied, of course, by sanatoriums, sanatoriums, balneo-mud baths, sanatorium camps. And all these are medical and preventive institutions, the main activity of which is, first of all, medicine aimed at prevention, and hence the reduction of morbidity and disability.

BIBLIOGRAPHY

1. Federal Law No. 23 February 2005 No. 26-FZ "On natural and medicinal resources, health-improving areas and resorts".

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5. Voloshin N.I. Legal regulation of tourist activity. - M.: "Finance and statistics", 2008. S. 79

6. Dracheva E.L. Special types of tourism. Medical tourism: textbook. - M.: KNORUS, 2008. - 152 p.

7. List of resorts in Russia with the rationale for their uniqueness in terms of natural healing factors. Tourism. Economics and Accounting. - 2008. - No. 3. - S. 70-98.

8. Sergienko V.I. New approaches to the organization of sanatorium treatment by health resorts subordinate to the Federal Agency for Health and Social Development. Kurortnye Vedomosti 2005, No. 4 (31)

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