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How state geriatric boarding houses work in Ukraine

Author : Ksenia Tsivirko

Ministry of Social Policy assures there are 286 residential institutions in Ukraine, of which only 90 are designed for the elderly
21:47, 2 October 2018

Almost all elderly people who have moved into nursing homes do not have close relatives or do not receive proper help from them. The only way out for such people is living in a geriatric boarding house or a residential care facility; however, it does not always provide comfortable living conditions. Even the most basic ones. We hope that on October 1, on the International Day of Older Persons, this issue will receive more attention

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According to the Ministry of Social Policy, there are 286 residential institutions in Ukraine, of which only 90 are designed for the elderly. These are geriatric boarding houses, care facilities for elderly people and persons with disabilities, as well as residential facilities for war and labor veterans, which have become a new home for almost 13 thousand old people. "About 90% of them are single people who do not have close relatives. The other 10% are in such a situation that relatives just cannot take full care of them. In this case, the local department of social protection sends a statement to us; we review it and make a decision about the leading such a person in a boarding house," Yuriy Krykunov, head of the Social Policy Department of the Kyiv City Administration, explains. There are only two old people's homes under the capital city administration – the Kyiv geriatric boarding house and the Kyiv residential facilities of labor veterans.

The residents of those facilities live in separate single rooms with their own bathrooms, and the living conditions in Kyiv residential facilities are exemplary. But despite this, about 20% of social protection institutions are free. "Elderly people do not want to leave their home: firstly, they are quite conservative, and it is quite difficult for them to change their permanent habitation. Secondly, the main priority of the Soviet man in the household sense was an apartment and a car, and now they do not want to leave their apartments. Thirdly, older people have many fears and are inclined to believe in the bad news only," Yuriy Krykunov claims. 

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Older people who have their own housing in Kyiv prefer to stay in it. According to the Kyiv City Administration, about 12,000 of them are visited by social workers, who help them around the house: they bring food, clean the apartment, and help pay the bills. But in fact, volunteers say, this work is performed only on paper, but the old people remain abandoned. "Almost everyone applies to the social protection services, except for those who cannot move. The staff at the social protection services is not always polite and attentive to the elderly. Many people are often sent from one office to the other office for obtaining some special documents; the working time is limited, which creates long queues. Usually, people do not want to go there for the second time. I am sure that the employee of the social protection center should go to the elderly person’s home (especially if this person is in her 70-s) and help fill the needed forms on the spot," Zhanna Yaremenko, head of the "Happy People" International Foundation notes.

Exemplary residential facilities

Kyiv geriatric boarding house is situated almost on the outskirts of the city. You cannot see its actual size behind the thick tree foliage.

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After passing a security post, I come across some active grannies who hurry up for a breakfast. One of them laments: "Come to our dining room and see what they feed us. The pea soup again!" They do not look like the stereotypical nursing home residents: slow, indifferent, and abandoned.

"I have been living here for two years, it's all right here. If only they give us some more diverse food... This is summer, they could give us more vegetables, fruits," Zdyslava, a resident of the Kyiv geriatric center, complains. In the past, she was an aerial acrobat and worked under the dome of a circus. Now she lives her days out here.

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The only thing that the locals complain about is the monotonous food. "They would like to eat sausage, meat, and eggs - and that's it. They do not know what to complain about: “Why do we eat cabbage, you should better give us Brussels sprouts.” I understand that this is better, but Brussels sprouts is not included in our norms," the director of the boarding house Antonina Urbanovska explains. According to her, they cannot feed the wards with something else, which is not included in the calculation of the norms established by the Cabinet. This applies to purchases of clothing, household and other goods.

On average, depending on the time of the year, the state allocates from 250 to 350 USD per month for one ward. More than 50% of this amount goes to the salary fund for employees, about 30% - for food, 3% - for medicines (based on the financial report of the boarding house for August).

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Now the main problem of the boarding house director is how to prepare for the winter cold. "We are serviced by a private boiler house because our part of the city does not have the city boiler house. Last year we did not have hot water from May to October, and this year the situation is the same," Antonina Urbanovska says.

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According to the observers of the National Preventive Mechanism, the Kyiv geriatric boarding house is one of Ukraine's best facilities in terms of living conditions. At the same time, in regions where the money for the work of nursing homes is allocated by district and regional councils, the National Preventive Mechanism identifies the following human rights violations:

  1. There is no normative regulation of application of physical restriction and isolation of wards in psycho-neurological nursing homes. In fact, in every institution there are barred rooms, where people are kept;
  2. Insufficient heating;
  3. Wards are often forced to work in the household economy of the institution or of the institution’s private administration;
  4. Unsuitable clothes and bed linen. Even when the institution has everything necessary, the staff keeps it in warehouses. Also, there were cases of general use of clothing and underwear;
  5. Personal funds of able wards are kept by the staff. At the same time, there is no civil contract for their storage;
  6. In psychoneurological boarding schools, there are sometimes cases of the humiliation of wards and even cases of trauma;
  7. A common problem for all institutions of the social protection system is the formal conduct of annual medical examinations;
  8. Violations of compliance with sanitary and hygienic standards in premises.

"According to our data, only two persons are involved in the issue of nursing homes in the Ministry of Social Policy: they cannot monitor the situation on the ground qualitatively," explains the chairman of the board of the Let's help organization and the observer of the National Preventive Mechanism Olha Bondarenko.

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Stand and deliver

According to the monitoring of the National Preventive Mechanism, the main reason for the problems of such institutions is the lack of proper financing and a shortage of qualified personnel.

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The Ministry of Social Policy reported that 42,8 million USD was last year the maintenance of residential homes for the elderly was sent from local administrations (about 285 USD per person per month). At the same time, social institutions of this type have other compulsory sources of financing.

"If the wards have relatives, then they are obliged to fully compensate for their living expenses, but in some cases, when relatives do not have such an opportunity, the department's board can make a separate decision, for example, about paying 50% of the established amount or cancel the payment for them. In general, the home of the elderly has two sources of funding: the municipal budget and pension receipts. 75% of the wards’ pensions are deducted for the work of the institution, but according to the law, this money can be spent only in agreement with the Supervisory Board and only for the needs of their wards," director Yuriy Krykunov states.

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The financing issue is closely related to the qualifications of the staff. "None of the experienced workers will work for a salary of 95 USD per month. This is the salary of a nurse, and her work is very difficult, and I am not just talking about physical work, but also about the psychological one. It is very difficult to talk to people with dementia and be patient with them. Usually people without education apply for this job, and as a result, attitudes toward wards in nursing homes are not good. In my opinion, the salaries of such employees should be at least 260 USD," says Olha Bondarenko.

According to experts, private care homes for the elderly provide more attractive living conditions. There are no more than 15 such establishments in Ukraine, and the cost of a "single room" per is more than 715 USD month. "If there were more such private care homes, I would initiate the situation so that this service could be purchased, so that there would be competition in this market," Yuriy Krykunov believes. According to him, the conditions provided by the capital's boarding houses for the elderly in Europe would cost more than 3 thousand euros. "In Ukraine, we have about one nurse sister per 10 people; she cleans the room, talks to a person, and looks after her. In Poland, for example, up to 6 serving staff people look after one person. Proportions are quite different," Olha Bondarenko admits.

 

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People who need help from a social worker at home is just another story. As practice shows, low salaries of employees do not motivate them to provide full or minimal support. In this case, they wait for the help of the volunteers. According to Zhanna Yaremenko, the employees of the social department do not conduct any operations to search for incapable elderly people. Only those old people who have personally applied to the bodies of the social services are lucky enough to get help from the state. "For example, a granny, who needs to do dental prosthetics, has applied to us. Her pension of 89 USD. The social center does not accept her, as they can only provide for prosthetic services for those old people who receive a pension up to 88 USD only," Zhanna Yaremenko claims.

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According to her, not only lonely old people experience the self-service difficulties, but also those who have close relatives: children and grandchildren. All of them are busy with their lives and there is not enough time to care for the older generation. In the next year, Kyiv City Administration is going to initiate a new format of social services, which would allow avoiding putting a person into a nursing home. "The Kyiv authorities are now working on institutions that can be called ‘kindergartens for the elderly.’ It is intended for people who are not completely independent, are prone to dementia, so that they do not have to be alone all the time. The project should have been launched this year, but we simply do not have time. I think next year, one or two such kindergartens to open in Kyiv," Yuriy Krykunov predicts.

Read the original text at 112.ua.

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