The effectiveness of comprehensive rehabilitation of citizens living in long-term care institutions

Authors:

Tsyndin Dmitrij Vladimirovich — Head of the gerontopsychiatric department, geriatrician, St. Petersburg State Budgetary Inpatient Social Service Institution “Boarding Home for the Disabled and Elderly N 1”, 52 Poklonnogorskaya Street, 197341 St. Petersburg, Russian Federation; e-mail: dipi1.therapist@mail.ru.

Sevastyanov Mkhail Aleksandrovich — Grand PhD of Medical sciences (Dr. Med. Sci), Associate professor, Director of St. Petersburg State Budgetary Inpatient Social Service Institution “Boarding Home for the Disabled and Elderly N 1”, 52 Poklonnogorskaya Street, 197341 St. Petersburg, Russian Federation; e-mail: mike-seva1972@yandex.ru; https://orcid.org/0000-0002-3441-6712.

Luchkevich Vladimir Stanislavovich — Grand PhD of Medical sciences (Dr. Med. Sci), Professor, Professor of the Department of Public Health, Economics and Health Care Management Federal State Budgetary Institution of Higher Education “NorthWestern State Medical University named after I.I. Mechnikov” of the Ministry of Health of Russia, 41 Kirochnaya Street, 191015 St. Petersburg, Russian Federation; e-mail: luchkevich@mail.ru; https://orcid.org/0000-0002-9737-8960.

Annotation:

Introduction. The rapid development of medicine in recent decades has contributed to the emergence of a large number of therapeutic options for diseases previously considered incurable, which has simultaneously led to an increase in the overall life expectancy of the population. The older a citizen gets, the more difficult it is for him to perform everyday, familiar actions. Carrying out activities aimed at maintaining active longevity is becoming increasingly important.

Aim. To analyze the effectiveness of social services provided in the process of comprehensive rehabilitation of citizens living in a long-term care facility.

Materials and methods. The authors carried out a continuous observational study, during which a survey of 296 recipients of social services was conducted. The survey was conducted twice with an interval of one year, according to the questionnaire of basic functional activity (Barthel Index), the scale of useful activities in daily life (Lawton Scale) and the scale for assessing the need for social and domestic assistance.The methods of descriptive statistics were used during the analysis. The standard “Analysis Package” for Microsoft Excel was used to evaluate the average values, standard deviation and the level of reliability of the average values. To assess comorbidity (CCI), the standard Charlson questionnaire was used.

Results. A total of 296 people took part in the study, of which 160 were men (54.1%) and 136 women (45.9%). The average age of the subjects was 70±11.9 years. The average CCI (Charlson Comorbidity Index) value in the group was 6±2.4 points. After receiving a set of social rehabilitation services, during a year of stay in a long-term care facility, there was an improvement on the scale of basic functional activity in 47 people (15.9%), on the scale of useful activities and daily activity — in 21 people (7.1% ), according to the scale of need for social and domestic assistance — in 24 people (8.1%)

Discussion. Despite the progressive course of diseases and the high comorbidity index in elderly and senile people, regular and systematic implementation of comprehensive rehabilitation measures can improve basic functional activity and activity in everyday life in domains related to changing and maintaining body position (d410, d415, d420), carrying and moving objects (d445), walking and movement, including using passenger transport (d450, d460, d465, d470), self-care (d510, d520, d530, d540, d550, d560), housekeeping (d630, d640) and economic (d860) life.

Conclusion. The provision of social services provided in the process of comprehensive rehabilitation of citizens living in a long-term care facility allows them to increase their level of activity and participation in various spheres of everyday and public life.

List of cited literature:

1. Hickman Michael J. How Medical Advances Have Shaped the Course of Human Longevity. The Milbank Quarterly. 2018;96(2):221-40.

2. Petrun’ko IL, Sergeeva NV, Markushina NA, Cherkasova AA. Kak izmenilis’ pokazateli invalidnosti vsledstvie zabolevanij kostno-myshechnoj sistemy [How have the indicators of disability changed due to diseases of the musculoskeletal system]. Dnevnik kazanskoy meditsinskoy shkoly [Diary of the Kazan Medical School]. 2022;36 (2):8-14. (In Russian).

3. Gusejnova RK, Osmanova AV. Rasprostranennost’ i pervichnyj vyhod na invalidnost’ ot serdechno-sosudistyh zabolevanij sredi gorodskogo naseleniya [Prevalence and primary access to disability from cardiovascular diseases among the urban population]. Ural’skij medicinskij zhurnal [Ural Medical Journal]. 2019;178(10): 113-4. (In Russian).

4. Rukovodstvo po gerontologii i geriatrii: v 4-kh t. T.2: Vvedeniye v klinicheskuyu geriatriyu. pod red.: VN Yarygina, AS Melent’yeva [Handbook of Gerontology and Geriatrics: in 4 volumes. Vol. 2: Introduction to Clinical Geriatrics. Edited by Yarygin VN, Melent’ev AS]. M.: GEOTAR-MEDIA,2010.

5. Olenskaya T, Konovalova N, Proschaev K, Kozlov K et al. [Possibilities of individualization of treatment and rehabilitation programs in geriatrics]. Vrach [Doctor].
2017;6:47-51. (In Russian).

6. Il’nitskiy AN. Medsestra i reabilitatsiya v geriatrii [Nurse and rehabilitation in geriatrics]. Meditsinskaya sestra [Nurse]. 2017; 5:4-7. (In Russian).

7. Ponomareva IP, Frashchayeu KI, Ilnitski AN. Osobennosti palliativnoj pomoshchi licam pozhilogo i starcheskogo vozrasta s tochki zreniya sovremennoj koncepcii geriatrii [Features of palliative care to persons elderly and senile age from the point of view of modern concept of geriatrics.] Palliativnaya meditsina i reabilitatsiya [Palliative medicine and rehabilitation]. 2017;1:21-5. (In Russian).