Accompanied living: a needs assessment

Authors:

Ishutina Inna Sergeevna, PhD in Medical sciences, Head of the Department at medical support early care and assistance of the Institute of Early Care and Assistance, Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: in.ishutina@yandex.ru; https://orcid. org/0000-0002-6640-904X.

Averochkina Eleonora Nikolaevna, Deputy General Director for Financial and Economic Affairs — Chief Accountant, Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation.

Khodakovskii Matvei Dmitrievich, junior researcher at the Department of medical support early care and assistance of the Institute of Early Care and Assistance, Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: hodak200@yandex.ru; https://orcid.org/0000-0001-6953-5191.

Sokurov Andrei Vladimirovich, Grand PhD in Medical sciences (Dr. Med. Sci), Director of the Institute of Early Care and Assistance, Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: ansokurov@yandex.ru; https://orcid.org/0000-0002-3736-2895.

Ermolenko Tatiana Valerievna, PhD in Medical sciences, Deputy Director of the Institute of Early Care and Assistance, Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: tatvalerm@yandex.ru; https://orcid.org/0000-0002-3903-5417.

Pavlova Stefanida Vasilevna, PhD in Medical sciences, Head of the Department of early care to children and their families of the Institute of Early Care and Assistance, Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: stefanida-pavlova@yandex.ru; https://orcid.org/0000-0003-4353-8823.

Shabanova Oksana Antonovna, PhD in Medical sciences, leading researcher at the Department of medical support early care and assistance of the Institute of Early Care and Assistance, Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: expert-oksana@mail.ru; https://orcid.org/0000-0002-8019-8963.

Kantemirova Raisa Kantemirovna, Grand PhD in Medical sciences, chief researcher at the Department of medical support early care and assistance of the Institute of Early Care and Assistance, Head of the Department of Therapy of the Institute for Medical and Social Rehabilitation Training, Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; Professor of the Department of Hospital Therapy of the St. Petersburg University, 7-9 Universitetskaya Embankment, 193079 St. Petersburg, Russian Federation; e-mail: terapium@yandex.ru; https://orcid.org/0000-0002-1287-486X.

Annotation:

Introduction. The Government of the Russian Federation prepared a Concept for the Development of a System for Comprehensive Rehabilitation and Habilitation of Persons with Disabilities, where special attention is paid to the development of inpatient-substituting technologies and the socialization of persons with mental disabilities, taking into account an integrated, interagency and consolidated approach in various areas of life activities. The plan for the Concept specifies measures for the development and implementation of programs to prepare persons with mental disabilities for assisted living. At the same time, there is no assessment of the need for a person with a mental disability to live with accompanied living.

Aim. Approbation of criteria for evaluating the need for accompanied living for people with mental disabilities.

Materials and methods. The methodology of the study was based on the study and generalization of data on the features of patients with mental disabilities. In approbation of the Criteria participated 331 disabled people with mental disabilities living in psychoneurological boarding institutions of the Voronezh region. The validation was conducted with the help of multidisciplinary teams. During the approbation the following research methods were used: interviewing the subjects and their environment, medical examination, data collection. Methods of descriptive statistics (absolute, relative, mean values, mean error) were used. Correlation analysis was performed using the Spearman rank correlation method. Statistical processing was performed using STATISTICA 12.5.

Results. According to individual rehabilitation and abilitation programs for persons with disabilities (IPRA), 200 (60%) persons with mental disabilities can lead an independent life only with the help of others, 125 (38%) clients of psychoneurological residential facilities cannot lead an independent life, and only 6 (2%) persons with mental disabilities are noted to be able to perform self-care and lead an independent life. Only 22 (6.6%) disabled persons with mental disabilities have contraindications to accompanied living based on the results of a medical examination. Depending on the number of points scored, the degree of a person’s autonomy impairment is evaluated, which affects the volume and duration of companion services, as well as their type. The degree of impairment of a disabled person’s autonomy is evaluated in points, ranging from 26 to 296 points.

Discussion. 90.6% of people with disabilities living in psycho-neurological residential facilities require daily accompaniment. In this connection, it is necessary to develop services of assisted living and accompaniment by a personal assistant. Based on the results of the pilot testing, a criterion was proposed for establishing the need for assisted living for people with mental disabilities aged 18 and older. A correlation was revealed between the disability group and the type of accompaniment.

Summary. Approbation of the criteria has shown that this tool can be used to assess the ability of people with mental disabilities to live with accompanied living.

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