Treatment and preventive measures - include the organization of primary and periodic medical examinations, the 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 moral codes social policy states.
Typically, rehabilitation treatment begins in a hospital and then continues at home. Rehabilitation treatment you need to start when the patient is still in bed. 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 maintain physical activity in the patient, as it strengthens the patient, and inaction weakens.
When providing restorative care to a patient, 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 or participate in public life. Change life situation can cause fear, anxiety, and 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, preventive and rehabilitation measures.
Research objectives:
2. Assess rehabilitation measures.
1. TREATMENT AND PREVENTIVE MEASURES
1.1. Basic elements of treatment and preventive activities
The main functions of treatment and preventive activities that closely interact with each other are:
Wellness ( Spa treatment);
Rehabilitation;
Preventive-valeological (prevention of a healthy lifestyle);
Recreational animation.
Each function requires its own specific technologies, which, however, should only be used in a comprehensive manner. In therapeutic functions, priority is given to natural healing factors and unconventional methods aimed at expanding health reserves; in recreational functions - cycles of activities that increase the spiritual health and moral guidelines of society.
In sanatorium-resort institutions, the influence of medical procedures is combined with the powerful effect of the entire amount on the body natural conditions. This includes a long stay in the air, the positive impact of the landscape, the aromas of surrounding flower beds, forests, an active motor mode (alternating rest and measured movement, walks, excursions, hikes).
Mandatory elements of sanatorium-resort treatment are morning hygienic exercises, physiotherapy, measured walking, outdoor sports games. As a rule, patients and vacationers take walks and excursions, and go boating. Other types of active recreation are also organized - tennis, scuba diving, fishing, hunting, rafting, hiking, jeeping, horseback riding; at mountain resorts - descent from the mountains, snowboarding, etc.
Numerous studies have established that the lack 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 physical exercise mental, physiological, biochemical processes unfold in the body 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, training, characteristics of the disease, volume and intensity of exercise. At the same time, adaptive changes affect the entire body, ensuring more coordinated functioning of organs. During the classes, 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 significantly 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 exercise, coordination between ventilation of the lungs and blood circulation improves, breathing rate becomes optimal, and the body is better supplied with oxygen. Profound changes occur in other organs as well. In the liver, glycogen reserves increase, enzyme activity increases, and ligamentous apparatus, muscle mass and volume increase.
Thus, the active motor mode is important factor normalization of disturbed or weakened as a result of illness or irrational lifestyle of the most important physiological processes, a factor in restoring their normal regulation by the central nervous system. In this regard, physical activity acts in the same direction as training the mechanisms for regulating 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 normal reactivity of the body.
Walking is the most popular form physical therapy, develops the ability to cover long distances without fatigue. Walks do not require special preparation and can be used at any time of the year.
Sports games are the most difficult and responsible section of physical therapy work. 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 staying in the water without moving to swimming with maximum speed. Volume is measured by the length of the distance and the duration of the swim. Intensity - the magnitude and nature of changes in the main systems of the body and swimming speed. For patients with a training regime, swimming is recommended at a water temperature of 20°C and above, gentle swimming - 24°C and above.
A properly constructed physical mobility regime creates a positive emotional mood, 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 level solar radiation, the need to overcome obstacles using various means and techniques of movement and insurance, special tactics for completing the route.
Hiking trips are carried out in almost all climatic zones and geographical regions- from the Arctic tundra to deserts and mountains. Their attractiveness and main distinguishing feature is that it is accessible and useful to any practically healthy person, regardless of age and physical development, provides greater freedom in choosing a route in accordance with the aesthetic, educational 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, walking-water, mountain-pedestrian.
1.2.Management of treatment and preventive activities
In Russia, the federal executive body responsible for organizing treatment and preventive activities is the federal executive body, which, within its powers, carries out public administration, intersectoral and interregional coordination in the resort business, in accordance with the regulations approved by the Government of Russia. In the subjects Russian Federation Responsible for the organization of treatment and preventive activities are the executive authorities in the resort sector. Executive authorities in the regions of the constituent entities of the Russian Federation:
Exercise control over the provision of sanatorium and health services during the implementation of therapeutic and preventive activities;
Organize the study, development, rational use of medical and recreational areas;
Create the necessary conditions for the functioning of organizations and institutions carrying out medical and preventive activities;
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 resort medical care are carried out in accordance with paragraph 04.
2. REHABILITATION MEASURES
Rehabilitation or restorative treatment is a process and system of medical, psychological, pedagogical, socio-economic measures aimed at eliminating or possibly more fully compensating for limitations in life caused by health problems with persistent impairment of body functions. Rehabilitation treatment is necessary when the patient has significantly reduced functional abilities, learning abilities, impaired work activity, social relations etc. Rehabilitation treatment is part of your daily care for the sick. Usually, when caring for you, you wash, feed the patient, make his bed and perform other manipulations that ease the course of the disease. In rehabilitative care, your main goal is to help the patient become functional and independent. outside help as much as possible, despite the fact that he cannot be the same as before.
Restorative care reduces the effects of illness and, for people with disabilities, the effects of disability. In restorative care, help your patients, but do not do anything for them. If possible, try to have the patient follow the rules independently general hygiene, for example, brushed his teeth, washed his face, combed his hair, and ate food. Before performing any care activities, ask the patient what he can do on his own and encourage him to do it. Do not forget that due to the disease and its consequences, patients may lose the daily living skills that they had before the disease. Involving the patient in activities will help him acquire the skills and abilities needed 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 learning skills. The patient needs to explain the task that he must complete.
Rules for working with patients
· Use short, specific sentences.
· Give clear instructions to the patient and ask him 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 when teaching him skills.
· Always encourage his participation in learning skills.
· Encourage the patient to complete the task independently.
· Talk to the patient about his abilities and successes in completing the task; Don't focus on the shortcomings.
During the period of rehabilitation treatment, 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 activity in accordance with his needs, range of interests, taking into account the predicted level of his physical and mental state, endurance, etc. The rehabilitation program is drawn up and implemented only with the consent of the patient or his legal representative.
Principles for implementing a rehabilitation program
· Sequence (determining indications for rehabilitation, establishing the patient’s current condition during questioning and clinical examination, as well as during a 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 report team and its recommendations).
· Comprehensiveness (in the process of rehabilitation, issues of treatment, treatment and prophylactic 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, and public life are resolved).
· Continuity (rehabilitation treatment is carried out starting from the moment the illness or injury occurs and until the person’s full return to society using all organizational forms rehabilitation).
Stages of determining a rehabilitation program
· Carrying out rehabilitation expert diagnostics. Thorough examination a sick 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 collecting complaints and medical history of patients, conducting clinical and instrumental studies. A special 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 activity, on the level of his functional capabilities.
· Determination of the rehabilitation prognosis - the estimated probability of realizing the rehabilitation potential as a result of treatment.
· Identification of measures, technical means of rehabilitation and services that allow the patient to restore impaired or compensate for lost abilities to perform everyday, social or professional activities.
Types of rehabilitation programs and conditions of implementation
· Stationary program. Carried out in special rehabilitation departments. It is indicated for patients who require constant monitoring by medical professionals. These programs are usually more effective than others, since in the hospital the patient is provided with all types of rehabilitation.
· Day hospital. Organization of rehabilitation in conditions day hospital boils down 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. Carried out in departments rehabilitation therapy at clinics. The patient is in the clinic department only during rehabilitation activities, for example, massage or physical therapy.
· Home program. When implementing this program, the patient takes all treatment 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 necessary healing procedures. Rehabilitation specialists provide the patient and his family members with the necessary information, give advice regarding the choice of a rehabilitation program and 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, kinesiotherapy).
· Traditional methods of treatment (acupuncture, herbal medicine, manual therapy, occupational therapy).
· Psychotherapy.
· Speech therapy assistance.
· Physiotherapy.
· Reconstructive surgery.
· Prosthetic and orthopedic care (prosthetics, orthotics, complex orthopedic shoes).
· Spa treatment.
· Technical means of rehabilitation.
· Information and consultation on medical rehabilitation issues.
Social rehabilitation
Social and everyday adaptation
· Information and consultation on issues of social and everyday rehabilitation of the patient and his family members.
· Teaching the patient self-care.
· Adaptation training for the patient's family.
· Training sick and disabled people in the use of technical means of rehabilitation.
· Organization of the patient’s daily life (adaptation of living quarters to the needs of the sick and disabled).
· Providing technical means of rehabilitation (the program indicates the necessary measures to create the patient’s everyday independence).
· Audiovisual technology.
· Typhlotechnics.
· Technical means of rehabilitation
Social and environmental rehabilitation
· Conducting socio-psychological and psychological rehabilitation (psychotherapy, psychocorrection, psychological counseling).
· Providing psychological assistance to the family (teaching life skills, personal safety, social communication, social independence).
· Assistance in solving personal problems.
· Consulting on legal issues.
· Training in leisure and recreation skills.
Vocational Rehabilitation Program
· Career guidance (career information, career counseling).
· Psychological correction.
· Training (retraining).
· Creation of a special workplace for disabled people.
· Professional production adaptation.
Rehabilitation specialists
· Doctors - specialists (neurologists, orthopedists, therapists, etc.). They help diagnose and treat diseases that limit the life of patients. These specialists solve problems of medical rehabilitation.
· Rehabilitologist.
· Rehabilitation nurse. Provides assistance to the patient, provides care, and educates the patient and his family members.
· Physiotherapy specialist.
· Specialist in physical therapy.
· Specialists in vision, speech and hearing impairments.
· Psychologist.
· Social worker and other specialists.
Self-care skills training can also begin in the hospital. For bedridden patients, the recovery process can begin with teaching the patient the skills to wash, brush teeth, comb their hair, eat, and use cutlery. Patients who can sit should be taught 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 to help him walk, such as canes, walkers, crutches, wheelchairs. The use of these devices gives a person the opportunity to move around and be independent of others. To make eating easier, you can use special dishes (plates, cups) and cutlery. There are also special devices that make it easier for the patient to take a bath and 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 healthcare and social security.
Unfortunately, most Russian health resorts do not have specially trained balneologists on their staff. True, certain progress has begun: the Ministry of Education and Science of the Russian Federation has approved the corresponding medical specialty. In this regard, the need to organize a system of retraining of medical personnel is also obvious (with medical universities or basic sanatoriums). Moreover, the heads of sanatorium and resort institutions have realized the relevance of this problem - it is not without reason that they strive to send their specialists for advanced training to various educational and methodological centers.
The Russian health resort complex is a huge health industry, which is materially represented by a powerful network of institutions. The leading role in it is, of course, occupied by sanatoriums, sanatoriums, balneo-mud baths, and health camps. And all of these are medical and preventive institutions, the main activity of which is, first of all, medicine aimed at prevention, and therefore reducing morbidity and disability.
BIBLIOGRAPHY
1. Federal Law of February 23, 2005 No. 26-FZ "On natural and medicinal resources, health-improving areas and resorts".
2. Decree of the Government of the Russian Federation dated December 7, 2006 No. 1426 “On approval of the Regulations on the recognition of territories as medical and recreational areas of federal significance.”
3. Decree of the Government of the Russian Federation of February 2, 2006. No. 101 "On the federal target program "Development of resorts of federal significance."
4. Barchukov I.S. Sanatorium and resort business. - M.: UNITY-DANA, 2006. 303 p.
5. Voloshin N.I. Legal regulation of tourism activities. - M.: "Finance and Statistics", 2008. P. 79
6. Dracheva E.L. Special types tourism. Medical tourism: textbook. - M.: KNORUS, 2008. - 152 p.
7. List of resorts in Russia with justification for their uniqueness in terms of natural healing factors. Tourism. Economics and accounting. - 2008. - No. 3. - P. 70-98.
8. Sergienko V.I. New approaches to the organization of sanatorium-resort treatment by health resorts under the jurisdiction of federal agency on Health and Social Development. Resort Gazette 2005, No. 4 (31)
9. Serebryakov S. Resorts through the prism of sociology. Tourism: practice, problems, prospects. - 2008. - No. 2. - P. 62-65.
10. Handbook of balneology and health resort therapy / Ed. Yu.E. Danilova, P.G. Tsarfis. - M.: "Medicine", 2007. - 648 p.
11. Encyclopedia of tourists / Ch. ed. E.I. There M. - M.: "Big Russian Encyclopedia", 2009. - 607 p.
In order to make the living, work, and education of disabled people as close as possible to their needs, taking into account the characteristics and state of health, restrictions on life and work, measures for rehabilitation and habilitation have been approved by law. Terms valid and used by all government agencies and medical institutions rehabilitation of disabled people and habilitation covered in (Chapter 9).
Rehabilitation- measures intended for the gradual restoration of a disabled person’s ability to work, improve professionalism, and engage in everyday activities. A successfully completed rehabilitation course allows you to achieve the goals set in the IPR. The results are taken into account during re-examination.
Habilitation of disabled people- measures to develop abilities that the disabled person did not have before, additional skills for employment. Purpose of habilitation- give a disabled person a chance to become financially independent, take a worthy place in society and lead a fulfilling lifestyle, become open to communication, and push the boundaries of a narrow familiar circle.
Individual habilitation program for a disabled person in 2019
Until recently, the standard procedure for examining a disabled person meant: a personal certificate would be developed and issued for him individual program rehabilitation of a disabled person- IPR (Article 11 of Federal Law No. 181). With an introduction to the concepts and principles of habilitation, a procedure for creating an individual habilitation program (IAP) will be introduced.
The responsibility for developing the IPA lies with the ITU Bureau. To avoid misunderstandings, the provisions of the IPA are presented personally to the person to whom it is addressed in the most accessible and understandable form. The bureau also sends extracts to the relevant institutions that provide services and habilitation facilities for people with disabilities. Local employment centers, interacting with the ITU bureau, will be involved in the work in this area. All this together will increase effectiveness of the habilitation program.
Sports and recreational activities
An integral part of the rehabilitation plan are sports and physical education. In each case, the composition of the activities is approved by the ITU bureau of the given territorial entity at the regional level. IN composition of the list of physical education and health measures may include:
- Informing people with disabilities and providing them with advice on issues of physical education and sports on the basis of youth sports schools, physical education and sports clubs for people with disabilities.
- Organization of adaptive physical education and sports classes.
- Assistance in organizing and involving disabled people in mass physical culture and sports events with the support of territorial physical education and sports management bodies, sports organizations for people with disabilities, public non-profit associations and structures.
Restorative medical measures
Part of the IPR are restorative medical measures, which include the following types:
- Reconstructive surgery- makes it possible to restore organ functions by reducing or completely eliminating the consequences of injuries, congenital or acquired defects. Operations of this kind include: organ and tissue transplantation, reconstruction, endoprosthetics, implantation, microsurgery. Available these surgical interventions made for disabled people Federal target program “High-Tech Medicine”.
- Prosthetics and orthotics- are part of rehabilitation programs. Prosthetics involves restoring the body's lost capabilities through the use of prostheses, and orthotics is the replacement of a lost function with an external device (orthosis). Finances the purchase of prosthetics required by a disabled person executive agency GU KRO FSS RF, based on the “On the procedure for providing disabled people with technical means of rehabilitation and certain categories of citizens from among veterans with prostheses (except dentures), prosthetic and orthopedic products.”
- Spa treatment- component of the recovery rate (). It is included in the IPR when its use is indicated for restoring the body and/or reducing disability. Vouchers are paid for by the Regional Branch of the Social Insurance Fund of the Russian Federation (). Certificate required to provide a voucher ( form No. 070/у-04, you can view and download here: ), in 2016, issued after the conclusion of the ITU - VK OOLPP.
Career guidance
Social rehabilitation of disabled people according to the IPR includes the most active support of government agencies in career guidance, which includes:
- - ITU and CZN bureaus provide local assistance to people with disabilities in education from primary (school) level to higher education (universities), while the choice of form of education (full-time, part-time, distance learning) is carried out according to medical indications and on the recommendation of the attending physician.
- Employment assistance- includes collection and provision important information disabled people, assistance in finding a suitable place of work, employment at special enterprises, supported employment and social adaptation to the labor market in this locality, labor adaptation.
- Production adaptation- includes ensuring optimal working conditions, equipping the workplace with special equipment, purchasing technical means of adaptation (hearing and vision limitations), social support when concluding labor contracts, locally after registration, in accordance with the recommendations of the IPR.
Social adaptation
The IPR will certainly include measures for comprehensive social adaptation disabled people, especially children.
Social and pedagogical rehabilitation- methods of education, pedagogical work, designed to form personal qualities, demonstrate a range of opportunities for self-realization in order to integrate a citizen into society and help master self-service skills and get an education. The procedure consists of three stages:
- Diagnostics- identifying the formation of self-awareness of a disabled person, his role in society, establishing professional interests.
- Preparation and practical implementation of IPR for social adaptation of a disabled person, enrollment in educational establishments, employment.
- Post-rehabilitation protection- support in establishing relationships with relatives, society, preventing possible conflicts.
Socio-psychological and sociocultural rehabilitation. The activities of this part of the IPR include:
- Psychodiagnostics.
- Psychotherapy.
- Psychocorrection.
- Consulting.
- Psychoprophylactic work.
Sociocultural rehabilitation uses the possibilities of art and culture to develop various vital skills in a disabled person, improve his life position. Activities may include activities in a variety of creative teams and associations, participation in the organization and conduct of mass cultural events. There are many forms of sociocultural rehabilitation: art therapy, play therapy, hippotherapy.
Social and everyday adaptation is designed to provide disabled people with vital skills and abilities. It includes:
- Consultations.
- Legal support with the participation of social service authorities.
- Organization training sessions in "Schools of Rehabilitation".
- Self-care training sessions.
Conclusion
The basis of the IPR consists of diverse activities, each of which aims to achieve adaptation of a disabled person in the surrounding social environment. The IPR intends to achieve this through:
- Physical education and sports.
- Medicine.
- Career guidance.
- Psychological and social adaptation.
It is not enough to just identify the required measures; it is necessary to spell out in law every aspect of their practical implementation. With entry into force Federal Law No. 419 work on organizing a barrier-free environment and improving the rehabilitation of people with disabilities has only continued, but not completed.
List of laws
Samples of applications and forms
You will need the following sample documents.
Result medical and social examination gives an assessment of the state of health, establishes the degree of disability and the likelihood of bringing the body to normal life.
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It is based on an analysis of the human condition in the following areas: clinical-functional, social-domestic, professional-labor and psychological.
If a person has identified 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 during a medical and social examination.
Persons who are disabled, regardless of group, due to their health status are classified as a vulnerable segment of the population.
In order to assist them, the state has provided special programs that provide treatment for body functions.
What is the difference between the concepts
In essence, habilitation is a system of medical and pedagogical procedures that help prevent and treat natural pathological reactions in children with disabilities. early age.
They arise in the human body under the influence of an infectious agent, which entails disruption of the normal course of life processes.
Photo: the difference between rehabilitation and habilitation
As for the rehabilitation program, it consists of a number of measures to support the disabled person. A person who has passed it finds a job that is accessible to his state of health, masters a profession that meets his interests, and learns to get by in everyday life. physical capabilities which 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 conducted in stages at certain intervals.
Goals and objectives of these events
The main goal of the procedures is to ensure that persons recognized as disabled can properly arrange their lives in society, find employment and start a family.
Sources of financing
As a rule, earlier most The costs of treating a disabled person and purchasing expensive medications and technical equipment were borne by the parents.
In addition, funds are provided by non-state charitable foundations. They carry out enormous work to create a social environment accessible to people with disabilities.
Last year, the federal budget included state financial support for habilitation and rehabilitation programs.
The state allocates targeted cash benefits to authorities local government executive power for a certain period of time, so that they can use them to carry out habilitation and rehabilitation measures.
If the state reveals that they have misused them, they are obliged to return the funds they received. In addition, each region keeps records of disabled people living on its territory.
Regional FSS:
- provides disabled people with what they need medications, prostheses;
- organized the work of specialized medical institutions to provide them with appropriate services to people with disabilities.
Legal basis
Questions regarding habilitation and rehabilitation programs are provided for in the following acts:
- "Convention on the Rights of Persons with Disabilities". The act came into force on May 3, 2008;
- Federal Law “On Amendments to Certain Legislative Acts of the Russian Federation on Issues social protection disabled people in connection with the ratification of the “Convention on the Rights of Persons with Disabilities” act. The act was issued on December 1, 2014 under number 419-FZ. It notes that ambilation and rehabilitation of disabled people is a set of measures aimed at restoring lost skills and abilities. With their help, a person’s adaptation in the social sphere occurs;
- Order of the Ministry of Labor and Social Protection of the Russian Federation. The act was issued on June 13, 2019 under number 486;
- Order of the Government of the Russian Federation “On the allocation of compulsory social insurance funds in 2016 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 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 people with disabilities maximally satisfy the requirements for achieving healthy condition human body associated with violations of his specific educational needs.
Photo: main directions of rehabilitation, habilitation
For example, developing residual hearing and teaching the patient how to use it helps a person adapt to a social environment.
Programs for the disabled
For persons with disabilities the following applies:
- a social program helps to become a full-fledged member of society;
- the psychological program promotes the return of a full-fledged individual to society;
- medical program promotes recovery biological functions organisms, without which normal human life is not possible;
- The pedagogical program promotes a person’s return to normal life activities through methods of self-determination.
Individual
As practice shows, it is impossible to create a single program that is ideally suited for all people with disabilities. Circumstances force the development of an individual program for each individual disabled person.
It takes into account:
- mental and physical features body;
- state of human health;
- residual skills and abilities, regardless of type;
- the severity of the disease or injury received by the body.
In essence, an individual habilitation and rehabilitation program is an official document. It is developed based on the instructions of ITU regulations.
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 timing of the implementation of measures, their order, types and forms, and volume.
They contribute to the restoration of the body, compensate for impaired or lost body functions, as a result of which a person begins to perform certain types activities.
Comprehensive
In Russia, a system of comprehensive rehabilitation for adults and children called up as disabled people was recently launched. It was introduced in accordance with the provisions of the Convention on the Rights of Persons with Disabilities.
As a rule, rehabilitation is carried out in the phase of restoring the vitality of the body or the manifestation of the consequences of the disease.
The comprehensive program consists of professional, social and medical rehabilitation activities.
They help stabilize pathological process, to prevent complications caused by the disease. For separate category Patients are recommended to use various methods of psychological rehabilitation.
Medical
Rehabilitation plan medical events is always compiled individually, taking into account the phase of development of the disease and the patient’s health status.
They include the following procedures:
- Occupational therapy;
- 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 respect of social support the capabilities available to him are determined and developed using special methods.
Features of rehabilitation and habilitation for disabled children
As a rule, a child born with functional disorders of the body cannot develop his abilities to the fullest.
In early childhood, he is diagnosed with limited physical and mental capabilities that ensure normal vitality.
One of the important tasks of medicine is to identify intact analyzers in children, prevent the occurrence of secondary developmental disorders, and correct and compensate for them using educational methods.
In practice, habilitation and rehabilitation in special education, represented by an individual and specific process, is widely used for people with disabilities. His final result determines the nature of deviations in human development, functions and systems of the human body.
Habilitation measures are applied exclusively to children who were born with system deviations or who acquired system disorders after birth during the development process. They involve monitoring the functions of the fetus during intrauterine development.
In conclusion, it should be noted that the draft federal budget for next year includes 29.3 billion rubles for the implementation of “ambiliation” and “rehabilitation” programs.
On January 1, 2016, a law came into force defining what habilitation for people with disabilities is, the conditions of individual programs, and also establishing its differences with 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. This concept is mainly applied to children at an early age who have deviations and developmental disorders.
Rehabilitation and habilitation - is there a difference?
Habilitation of disabled people - 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 that includes the following components:
- social to ensure the restoration of the disabled person as a subject of society;
- pedagogical for returning a person to normal activities;
- mental, used for personal rehabilitation;
- medical, providing restoration at the level of biology, that is, returning normal functioning to the body.
A model that includes all of these components is called ideal; it is suitable for use in strategic planning 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 the maximum restoration of lost functionality. Habilitation programs involve a person learning to achieve various functional goals using alternative pathways when the usual ones are blocked.
Such measures are applied mainly to children, since if they are applied late, they are difficult to implement and ineffective. For example, for children suffering from delays in speech development, assistance provided at 11 years of age will be late. Positive result Only habilitation started at a very early age will bring. These are speech therapy, pedagogical and other activities from the 1st year of life.
Determination of disability: main changes
According to research, as of January 1, 2015, there were about 13 million disabled people in Russia, among whom the share of children was 605 thousand (what assistance does the state provide to disabled children?). Previously, when determining disability, 2 criteria were used:
- disorder of body functions;
- level of disability (the commissions used concepts such as complete, partial with loss of the ability to independently organize self-care, 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 functions. Since 2016, the degree of disability is determined based on the severity functional disorders, and not on the degree of restriction. 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 Classifications and ITU criteria, Sect. III).
- The new system involves an objective assessment of the loss of functionality of the body, which is revealed on the basis of a medical examination.
The concept of “Habilitation of a disabled person”
The system for determining disability, adopted in 2016, is more advanced; it allows not only to make a diagnosis, but also to clarify the nature of the disability. individual assistance to a person. Law No. 419-F3 introduces a new concept such as habilitation, that is, a system for developing skills previously absent from a disabled person.
The main components of habilitation for disabled people in 2016 are the following activities: prosthetics, orthotics, as well as reconstructive surgery, methods of vocational guidance, spa treatment, exercise therapy, sports events, medical rehabilitation and others.
One of the main features of the new law is an individual rehabilitation and habilitation program for disabled people, in accordance with the Law on the Protection of Disabled Persons, Article 11. The restoration scheme will be developed and then implemented according to the rules that are established strictly individually. The program will be developed by specialists from the ITU (Bureau of Medical and Social Expertise), in accordance with paragraph 1 of the relevant Procedure.
As individual schemes of restoration measures are developed, the SME Bureau will send extracts from such programs to government agencies providing relevant services and measures (Article 5 of Federal Law No. 419, clause 10). those responsible for habilitation will have to report to the bureau. In its turn, federal institutions SMEs must transfer the received data to special bodies responsible for promoting the employment of people with disabilities (Federal Law No. 419, Art. 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 can increase the commitment and effectiveness of habilitation and rehabilitation measures taken. E. Klochko, one of the authors of the bill, believes that only new scheme able to take a more attentive and complete approach to the program for the recovery and protection of people with disabilities, including children who previously did not receive assistance to the required extent.
Financing the habilitation program
After defining the concepts of “rehabilitation and habilitation of people with disabilities”, what exactly it is and what the differences are, it is necessary to touch upon the issue of financing. 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, target funds in the amount of 9.3 billion rubles will be allocated in 2016. from the social insurance 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”). According to the law cash can be redirected to provide disabled people with technical means and services required to restore health and certain body functions. The signed Order determines that funds from the Social Insurance Fund are aimed at the following purposes:
- provision of technical means and services for rehabilitation and habilitation (RUB 7.7 billion);
- provision of subventions to the budgets of constituent entities of the Russian Federation for similar purposes (in the amount of 1.6 billion rubles).
Accepted new program allows us to significantly improve the mechanism for distributing assistance and determining its volume, facilitating the restoration of normal life for disabled people who need help, successful socialization, and organization of professional and personal lives.
On January 1, 2016, the law on the habilitation of disabled people came into force. A new concept has appeared, consonant with the familiar term “rehabilitation”. However, there is still a difference between them. In short, habilitation (lat. habilis - to be capable of something) is the initial formation of the ability to do something.
The term is applied primarily 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.
General concepts on the rehabilitation of persons with limited health functions In the standard rules for ensuring equal opportunities for persons with disabilities (UN General Assembly Resolution 48/96, adopted at the forty-eighth session of the UN General Assembly on December 20, 1993), in the section “Basic concepts in policy regarding persons with disabilities,” the commonly used concept of rehabilitation based on the ideas of the World Program of Action for Disabled Persons. Rehabilitation is a process that aims to help people with disabilities regain their optimal physical, intellectual, mental and/or social levels activities and support them by providing them with rehabilitation tools to change their lives and expand their independence.
From this international definition of “rehabilitation” follows a certain analytical scheme of the rehabilitation process itself, which includes the following components (rehabilitation constructs):
- Social rehabilitation, ensuring the rehabilitation of a person with disabilities as a social subject;
2. Pedagogical rehabilitation, ensuring the rehabilitation of a person as a subject of activity;
3. Psychological rehabilitation, which provides rehabilitation of a person with a disability at the personal level;
4. Medical rehabilitation, which provides rehabilitation at the level of the biological human body. All of the above components constitute 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?
When a child is born with a functional limitation, it means that the child will not be able to develop all the functions necessary for a normal life, or perhaps the child's functionality will not develop as well as that 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 must be treated, first of all, as a child. The word “habilitation” comes from the Latin “habilis”, which means "to be capable of". Habilitate means “to make prosperous” 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 goal is to help acquire or develop 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 health. Although it also applies to other people whose moral health is undermined (for example, convicts). Habilitation not only means trying to treat or modify physical or mental impairments, it also means teaching the child to achieve functional goals through alternative routes when habitual routes are blocked, and to adapt the environment to compensate for missing functions.
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 rough delays speech development They begin to receive appropriate assistance only at the age of eight to eleven years. The experience of recent years suggests that a complex of therapeutic, pedagogical, speech therapy and other measures should begin 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 staged construction of the program.
Habilitation measures can begin with monitoring the condition of the expectant mother and nursing a child with developmental disabilities. Habilitation is a multifaceted process that simultaneously addresses various aspects to enable the child to lead a life that is as close to normal as possible. A normal life, in this context, means the life that a child would have in the absence of his functional limitations.
Habilitation and rehabilitation are a set of measures aimed at adapting to society and overcoming pathological conditions of people with disabilities. The task of both habilitation and rehabilitation is to help people with disabilities socialize as successfully as possible and arrange their personal and professional lives.
Article 9. The concept of rehabilitation and habilitation of disabled people
(see text in previous)
(as amended by Federal Law dated October 23, 2003 N 132-FZ)
(see text in previous
Rehabilitation of disabled people is a system and process of full or partial restoration of the abilities of disabled people for everyday, social, professional and other activities. Habilitation of disabled people is a system and process of developing the abilities that disabled people lack for everyday, social, professional and other activities. Rehabilitation and habilitation of people with disabilities are aimed at eliminating or, as fully as possible, compensating for the disabilities of people with disabilities for the purpose of their social adaptation, including their achievement of financial independence and integration into society.
(part one in ed.
(see text in previous)
The main areas of rehabilitation and habilitation for people with disabilities include:
(as amended by Federal Law dated December 1, 2014 N 419-FZ)
(see text in previous)
medical rehabilitation, reconstructive surgery, prosthetics and orthotics, spa treatment;
Federal Law of December 1, 2014 N 419-FZ)
(see text in previous)
professional guidance, general and professional education, professional education, assistance in employment (including in special workplaces), industrial adaptation;
(as amended by Federal Law dated December 1, 2014 N 419-FZ)
(see text in previous)
social-environmental, socio-pedagogical, socio-psychological and sociocultural rehabilitation, social and everyday adaptation;
physical education and health activities, sports.
The implementation of the main directions of rehabilitation and habilitation of disabled people involves the use of technical means of rehabilitation by disabled people, the creation necessary conditions for unhindered access of disabled people to social, engineering, transport infrastructure facilities and use of means of transport, communication and information, as well as providing disabled people and their family members with information on rehabilitation and habilitation of disabled people.
(Part three as amended by Federal Law dated December 1, 2014 N 419-FZ)
Chepuryshkin I.P.
Society and the state today face the extremely important task of acting as a guarantor of the social protection of children with disabilities, taking upon themselves the responsibility of providing them with conditions for a normal life, study and development of inclinations, professional training, adaptation to the social environment, that is, for their habilitation. Analysis of the historical prerequisites for the formation modern system management of the quality of education in a boarding school showed that the idea of habilitation for children with disabilities, as a process of restoring their physical and mental abilities, has a fairly long history and dates back several centuries.
The concept of “habilitation” also has ambiguous interpretations. To date, there is no agreement among authors addressing this concept. The concept of “habilitation” is close in meaning to the concept of normalization used in Denmark and Sweden. Translated from Latin, habilitation literally means “providing rights, opportunities, ensuring the formation of abilities” and is often used in child psychiatry in relation to persons suffering from an early age from any physical or mental defect.
IN medical literature The concept of habilitation is often given in comparison with the concept of rehabilitation. According to L.O. Badalyan: “Habilitation is a system of therapeutic and pedagogical measures aimed at preventing and treating those pathological conditions in young children who have not yet adapted to the social environment, which lead to a permanent loss of the opportunity to work, study and be a useful member of society. We should talk about habilitation in cases where a pathological condition that disables the patient arose in early childhood. This child does not have self-care skills and has no experience of social life.
In the materials of the manual “Improving Education”. National Institute improving urban education in the United States, it was noted that schoolchildren learn and use their acquired knowledge in different ways. However, the purpose of education is for all students to achieve a certain social status and establish their social significance. Inclusion is an attempt to give students with disabilities confidence in their abilities, which motivates them to go to school with other children: friends and neighbors. Children with special educational needs not only need special treatment and support, but also to develop their abilities and achieve success in school. The materials of the referenced manual emphasize that latest edition federal law The USA "On the Education of People with Disabilities" supports the practice of inclusion. The new law on education advocates for the inclusion of children with disabilities in the educational environment, for them to undergo general education program. The conclusion of the advisory commission, when transmitted to the US Congress, explained the goals and objectives of legislators as follows: inclusion is “acceptance of every child and flexibility in approaches to learning.”
Summarizing the above and relying on the author’s work experience, we believe that a habilitation and educational space should be created in a boarding school for children with disabilities. In the context of the economic crisis in society, creating a sustainable education system that could integrate all impacts on children is almost impossible. Current reality clearly demonstrates that even a special boarding school with the latest system education, humanistic relations, various creative activities, entering into competition with a bright and colorful environment, replete with ultra-modern “values”, often fails.
And, as it seems to us, there is only one way out of this. First of all, it is necessary to improve the lives of children in the boarding institution itself; make it bright, emotional, saturate it with interesting, extraordinary events. Moreover, the school must be attractive to both children and adults; it should organically coexist traditionality and innovation, the absence of excessive guardianship and care. In this case, the school becomes competitive in the environment surrounding the child; and all the norms and values put forward by the school infrastructure can become internal beliefs and their own norms for the child. Events of a cultural, sports or other nature taking place in the surrounding area are introduced into the life of the school community. At the same time, the implementation of the task of creating such a space faces the difficult task of habilitation of children with disabilities. This means that in this space the child must learn to do something that he was deprived of since childhood. In this question lies the contradiction. It would seem that the individual correctional activities of physicians should come first here. Based on this, many experts conclude that “full assistance to a child with disabilities should include not only a system of habilitation activities, but also comprehensive psychological, medical and pedagogical work to build such a space of life and activity that the best way will encourage the child to use acquired functions in natural conditions. Tasks for organizing the child’s directed activity, creating his motives for performing actions, causing difficulties, to overcome their own difficulties are included in the sphere of pedagogy and psychology and are solved through the construction of a special pedagogical space. How earlier child Having received help, he will have the opportunity to actively act in an adequately organized space, the better the result will be for his further development.
It should be noted that currently in Russia there is a transition to a new stage in the state’s attitude towards persons with disabilities.
The quality of education in a boarding school for children with disabilities is considered as a pedagogical problem and direction of educational policy.
The historical prerequisites for the formation of a modern education quality management system in a boarding school for children with disabilities were: firstly, the development and implementation of projects to create a common integrated school that unites students with different educational abilities; secondly, the formation of habilitation centers that ensure an increase in the quality of life of children with disabilities, and the creation of inclusive schools in which all students have equal access to the learning process during the school day and equal opportunities to establish and develop important social connections.
BIBLIOGRAPHY
- Badalyan L.O. Neuropathology. - M., 2000. - P.337-347.
- Chepuryshkin I.P. Modeling the educational space of boarding schools for children with disabilities: Author's abstract. dis...candidate of pedagogical sciences. - Izhevsk, 2006.- 28 p.
- Improving Education.
T he Promise of Inclusive Schools.
Bibliographic link
Chepuryshkin I.P. HABILITATION OF CHILDREN WITH LIMITED HEALTH OPPORTUNITIES // Advances in modern natural science. – 2010. – No. 3. – P. 53-54;
URL: http://natural-sciences.ru/ru/article/view?id=7865 (access date: 06/05/2018).
By and large, habilitation of the disabled is almost very similar to the rehabilitation we are already familiar with. In its purpose, habilitation differs from rehabilitation only in the subject - the person, the disabled person, in relation to whom it is carried out.
This term means the adaptation of disabled people to life in conditions of disability in an environment that is unsuitable or poorly adapted for this. But if rehabilitation provides for the return to a person of the opportunities lost due to disability that he previously possessed before disability, then habilitation is the process of primary formation of such skills in a person who is disabled from childhood and who simply does not have the skills to live without disability.
The process of habilitation, like rehabilitation, includes both the development and training of the necessary skills in the disabled person himself (in this the differences can be very large, since new skills need to be taught to a person who has never possessed them at all), and adaptation of his environment to more acceptable conditions for him - the so-called creation of an “accessible environment” - this is a whole complex of social, medical, technical, legal and other activities.
By the way, habilitation is not as new as it seems. Also in Soviet times disabled children with birth defects that prevent them from living normal life, quite successfully taught the necessary skills. There were special methods even for teaching deaf-blind children, and they were very effective. True, over the last quarter of a century, these methods, it seems to me, have been lost, but experience and specialists still remain...
As for habilitation programs for such disabled people, I have not yet heard of any new provisions in this matter, and until now this process has proceeded in the same way as when developing a rehabilitation program - the program is developed on the basis medical indications during the period of disability assignment and is issued to the disabled person, his guardian or social worker at the time of disability assignment.
There is an acquaintance with an expert
What is “habilitation of a disabled person”?
Which disabled people does the new term apply to?
When will habilitation programs for people with disabilities be drawn up and issued? What is required under such a program?
Will funds be provided for habilitation, and what kind?
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