“You sit with me!” Choosing a caregiver is a lottery, the price of which is life.

Weekly “Arguments and Facts” No. 48. Not cheap help 01/12/2021

In & nbsp; at the end of November, in & nbsp; Petersburg, the nurse was sentenced & nbsp; & mdash; restriction of freedom for & nbsp; 1 & nbsp; year 4 & nbsp; months and & nbsp; 50 & nbsp; thous. rub. & nbsp; in & nbsp; account of compensation for moral damage. The woman beat her ward & nbsp; & mdash; 98-year-old siege. How to insure against & nbsp; such “ surprises '' and & nbsp; who today decides on & nbsp; this hard work & nbsp; & mdash; take care of & nbsp; helpless patients?

Dear & nbsp; & mdash; and & nbsp; not & nbsp; always reliable

This wild story took place in & nbsp; Petersburg in & nbsp; February.

The conflict between a young woman and & nbsp; her & nbsp; ward happened on the & nbsp; first & nbsp; day of her & nbsp; work & nbsp; & mdash; the nurse went over with & nbsp; alcohol, began to scandal, threaten the old woman with murder, and & nbsp; in & nbsp; in the end she simply beat a helpless woman. The neighbors ran to the & nbsp; cries of the beaten. The nurse was detained. After the case was taken under the personal control of Alexander Bastrykin , she was & nbsp; sent to a pre-trial detention center, and & nbsp; now and & nbsp; sentenced. True, she & nbsp; was credited with the time in custody, so the brawler was released right in the & nbsp; courtroom.

“ No money & nbsp; sorry! ''

Finding a nurse & nbsp; & mdash; it's like looking for a spouse: who's as lucky. And & nbsp; stories, happy and & nbsp; sad, in general, equally divided. “ On a far from & nbsp; beautiful day, my 50-year-old mom passed out. Migraines and & nbsp; used to haunt & nbsp; but & nbsp; there was something strange, & nbsp; & mdash; Olga Zarutskaya, a resident of the capital, shares her experience. & mdash; & nbsp; Did a paid MRI, the results were stunned: a brain tumor. The consultations in & nbsp; Murmansk, where we & nbsp; lived, we were not & nbsp; very satisfied, we went to & nbsp; Moscow, and & nbsp; then, collecting all the savings, & nbsp; & mdash; to & nbsp; Germany. They offered to do an operation, for which we & nbsp; sold the apartment (fortunately, & nbsp; we had another & nbsp; & mdash; tiny one, where we & nbsp; and & nbsp; later moved).

After the operation, my mother lived for almost a year, but & nbsp; externally and & nbsp; internally it was already a completely different person. She & nbsp; could not be left alone, she could & nbsp; turn on the water, stove or kettle. Not & nbsp; could wash myself and & nbsp; even eat. And & nbsp; I had to work so that there was & nbsp; what to buy medicines, food, hygiene items. In a word, without a nurse & nbsp; & mdash; no way! Smart people immediately advised to look in & nbsp; assistants for a person with & nbsp; medical education. Because it was required not & nbsp; only to wash and & nbsp; feed, but & nbsp; and & nbsp; to do dressings, injections, to understand the state of a person by & nbsp; movement of eyes, hands. It was not easy to find such a person, but & nbsp; I & nbsp; knew where. Went to & nbsp; district polyclinics and & nbsp; asked, did not & nbsp; leave & nbsp; whether any of & nbsp; nurses on a & nbsp; pension, does not & nbsp; need & nbsp; does & nbsp; & nbsp; work? I asked about & nbsp; nurses on & nbsp; pensions from friends, doctors, friends, in & nbsp; social networks. And & nbsp; they found me Lyudmila Ivanovna. Her services & nbsp; were almost equal to my monthly salary. She came to & nbsp; 8 & nbsp; in the morning and & nbsp; left only after my return from & nbsp; work. Mom loved her. And & nbsp; I didn’t & nbsp; feel sorry for any money, because I & nbsp; was calm: they would not & nbsp; miss the attack, relieve the pain, feed on time, read, walk. The salary for & nbsp; life was no longer & nbsp; enough, I took out a loan. But & nbsp; nor & nbsp; about & nbsp; which I do not & nbsp; regret, because I did everything for my mother that I could, everything that I should. '' & Nbsp;

& quot; Deliver me from & nbsp; her & quot;

А & nbsp; Elvira Kolesnikova from & nbsp; Solnechnogorsk less fortunate. “ Khabiba appeared in & nbsp; our lives through an agency for & nbsp; recruiting caregivers, & nbsp; & mdash; tells Elvira. & mdash; & nbsp; She & nbsp; was & nbsp; 50, mother-in-law, for & nbsp; which required care, & nbsp; & mdash; 93. Khabiba worked & bdquo; with & nbsp; accommodation & ldquo ;. It was convenient for us, because the mother-in-law did not & nbsp; want to move to the & nbsp; children & nbsp; & mdash; it was painful for her to lose her position as a hostess in her own apartment. The nurse's salary was 40 & nbsp; thousand, all the sons of the mother-in-law were dumped.

After 10 & nbsp; months, the mother-in-law in a whisper asked us to rid her & nbsp; of & nbsp; Khabiba. No, she didn't & nbsp; beat our granny, but & nbsp; intimidated that she would take revenge if she told the children something. And & nbsp; lived in & nbsp; my pleasure: ate everything that we & nbsp; brought in & nbsp; mother-in-law's bowls, gave our children our fruits, received guests, slept half a day or chatted on the & nbsp; phone with & nbsp; fellow countrymen. And & nbsp; granny herself cooked porridge for herself, walked on a & nbsp; bench near the entrance. When we & nbsp; said that we were leaving, Khabiba sobbed, screamed that she & nbsp; had nowhere to go. Still & nbsp; where would a loafer quickly find such & nbsp; fools as & nbsp; us, who will provide her & nbsp; food and & nbsp; accommodation? & Raquo; & nbsp;

Where to go for & nbsp; help?

How developed is the social services market in the & nbsp; country? Who and & nbsp; where does the caregiver train? And & nbsp; why are their & nbsp; services so expensive?

Most often it happens suddenly & nbsp; & mdash; when your loved one, until recently active, full of strength, with & nbsp; a bright mind, a person can no longer look after himself, and & nbsp; sometimes and & nbsp; just figure out who he is & nbsp; and & nbsp; where he is. And & nbsp; family members face the most difficult choice: take care of themselves, look for a hospital or hire a nurse.

They were & nbsp; considered & nbsp; parasites

We, living in & nbsp; XXI & nbsp; century, it is a sin to complain & nbsp; & mdash; we have a choice in the & nbsp; principle. And & nbsp; our parents didn’t & nbsp; had & nbsp; & mdash; all care of a seriously ill person fell entirely on the shoulders of relatives. Only a few & nbsp; & mdash; could afford to hire a nurse. simply because their & nbsp; was practically not & nbsp; was. In the & nbsp; USSR, the nurse violated two articles of the law at once & nbsp; & mdash; not only did she make money privately, but also & nbsp; was considered a parasite (since it was impossible to combine many hours of being next to a patient & nbsp; & nbsp; some kind of official job).

In & nbsp; Russia today the situation is difficult & nbsp; and, if we take the regions, heterogeneous, but & nbsp; it is, albeit slowly, but & nbsp; improving. There is a market for nurses, it & nbsp; really functions, and & nbsp; sooner or later it is possible to find a person whose skills and & nbsp; character will satisfy both you and & nbsp; your ward.

The market dictates the price

Cost services of professionals & nbsp; & mdash; just professionals! & mdash; & nbsp; is not cheap. Why? First of all, because good carers are simply not & nbsp; enough, but & nbsp; when demand exceeds supply by & nbsp; times, this is not reflected in & nbsp; prices in the best & nbsp; way.

Why & nbsp; are so few people going to & nbsp; nurses, if their & nbsp; services are so in demand? Because it's hard & nbsp; & mdash; and & nbsp; morally, and & nbsp; physically, you need a special warehouse of character. We must pay tribute to the authorities & nbsp; & mdash; they are trying to come up with ways that would encourage people to acquire this profession. For example, in the & nbsp; framework of the national project “ Demography '' there is a project “ Promotion of employment '', in which for people in & nbsp; age 50 + & nbsp; there is an opportunity to get a new profession “ Caregiver. Assistant for & nbsp; care. De facto, this means a guarantee of employment after training. The very process of learning a new profession usually takes place in patronage schools, and real professionals are trained there.

Unfortunately, not all graduates of these schools go to work in the & nbsp; specialty. And & nbsp; the most widespread option on the & nbsp; market is a middle-aged woman who came (as a rule, after & nbsp; children) from & nbsp; some former Soviet republic. Incidentally, the situation with & nbsp; nurses & nbsp; & mdash; the problem is worldwide. In the & nbsp; USA and & nbsp; European countries, most of them are also migrants, in & nbsp; including from & nbsp; Russia and & nbsp; countries of the former socialist camp.

Yes, there are also volunteers and religious women. But the & nbsp; & nbsp; first in & nbsp; mostly visit nursing homes, and & nbsp; the second work in & nbsp; hospitals and & nbsp; & nbsp; in the monasteries themselves, and & nbsp; they have enough work.

What can the government offer?

One of the & nbsp; ways to solve the problem & nbsp; & mdash; the incipient reform of the social service, the formation of the so-called long-term care system (CDS). It is aimed at & nbsp; support for the elderly and disabled people who have partially or completely lost the ability to care for themselves. In addition to medical care, & nbsp; it includes help for a family, in & nbsp; of which there are such patients, and & nbsp; even the allocation of nurses and & nbsp; home patronage. This pilot project has been carried out since & nbsp; 2019 & nbsp;, today two dozen regions of Russia are participating in it. And & nbsp; in & nbsp; June, President Putin instructed the government in & nbsp; as soon as possible & nbsp; & mdash; until & nbsp; end of 2022 & nbsp; g. & mdash; & nbsp; identify funding sources and & nbsp; implement CDS everywhere.

'Therefore, if you & nbsp; first encountered & nbsp; such a disaster, I advise you to first contact the & nbsp; social security authorities, where they can offer you some help, & nbsp; & mdash; says Lena Andrev, lecturer at the Department of Nursing Management, RUDN Medical Institute. & mdash; & nbsp; But & nbsp; the possibilities of & nbsp; regions are different. Yes & nbsp; and & nbsp; state of & nbsp; patients & nbsp; & mdash; too. It is enough for someone that a social worker or a nurse came to & nbsp; a few hours 1 & ndash; 2 times a day & nbsp; & mdash; this gives good budget savings. For & nbsp; more serious cases, study not & nbsp; only the caregiver market, but & nbsp; and & nbsp; those & nbsp; types of assistance to citizens in need of & nbsp; care that work in your area. For example, schools are often opened where relatives are taught how to properly care for & nbsp; such people & nbsp; & mdash; it is a separate science. Semi-stationary services are also being introduced. Usually, these are daytime groups, when relatives can be sure that their ward is under supervision in & nbsp; the time they spend outside the home, at & nbsp; work. Rental centers are being created where you can get a variety of rehabilitation aids. ''

Can you & nbsp; become a nurse for a loved one yourself?

Pushkin told about & nbsp; how the patient's relative feels at the same time: his Eugene Onegin, getting ready to “ sit and & nbsp; day and & nbsp; night '' with & nbsp; dying uncle, I was already determined to “ sigh and & nbsp; think to myself: when & nbsp; will the devil take you! ''. How not to & nbsp; afford to come to & nbsp; such a state & nbsp; & mdash; and & nbsp; really help a loved one?

First of all, you need to learn to “ secret '' methods of working with & nbsp; so-called people with limited mobility. How to turn them over in & nbsp; beds, lift and & nbsp; put them on a chair, how to properly feed, wash and & nbsp; carry out hygiene procedures. This is taught in patronage schools. This is usually a few short lessons, possibly & nbsp; online. All these techniques can be found & nbsp; on the internet and & nbsp; to master them & nbsp; yourself.

Secondly, it is necessary to correctly select the means of small rehabilitation & nbsp; & mdash; from & nbsp; cutlery and & nbsp; dishes helping people with & nbsp; trembling in & nbsp; hands, impaired fine motor skills, weakness and & nbsp; deformation of the hands, to & nbsp; lifts and & nbsp; special means for moving patients. But & nbsp; the main thing & nbsp; & mdash; it is a warning for bedsores. “ Usually they immediately try to get an anti-bedsore mattress, & nbsp; & mdash; says Lena Andrev, lecturer at the Department of Nursing Management, RUDN Medical Institute. & mdash; & nbsp; But & nbsp; it & nbsp; will & nbsp; help if you use it & nbsp; wrong. After all, a person still needs to be turned over every 2 & nbsp; hours. Now mattresses that take the shape of the body and & nbsp; relieve pressure on the skin are considered more effective. Many people need a good functional bed and & nbsp; devices to move a person from & nbsp; bed to & nbsp; chair or wheelchair and & nbsp; back. From & nbsp; vehicles to & nbsp; mainly use walkers or rollators. The latter seem to me to be optimal.

In order for the means of minor rehabilitation to really help, they must be & nbsp; selected for the needs of a particular person and & nbsp; dimensions of the apartment. Many devices look very attractive, but after the purchase they remain unclaimed. I advise & nbsp; rent them. If something doesn’t fit (for example, the gurney doesn’t & nbsp; pass through the door), it’s easy to hand it back. ”

How to choose a good nurse?

Coordinator of the Attention & Nbsp; Care School of Nursing Elena Sukhacheva advises paying attention to & nbsp; such aspects.

Where & nbsp; to look for it?

Good carers usually go from & nbsp; one family to & nbsp; another through & nbsp; acquaintance. Therefore, one of the & nbsp; safest ways to find & nbsp; & mdash; through the recommendations of friends. You & nbsp; will be able to personally talk with & nbsp; her & nbsp; past employers, learn how to build relationships with & nbsp; how much to pay, & nbsp; what it is & nbsp; to ask for. These are important questions if this is your first time hiring a caregiver. To find such a professional, you need the widest possible circle of contacts. Therefore, share your problem on & nbsp; social networks, especially in & nbsp; profile groups. I know that maternity groups are very responsive. Plus, search not & nbsp; only among friends, colleagues, neighbors, but & nbsp; and & nbsp; among the acquaintances of your acquaintances, the parents of your child's classmates. It works!

The second way & nbsp; & mdash; aggregators for & nbsp; home recruitment. In their & nbsp; base there can be & nbsp; excellent nurses who know their worth, and & nbsp; beginners. But & nbsp; for the caregivers themselves, these services are not & nbsp; very profitable, since they take a percentage of & nbsp; earnings.

The third way & nbsp; & mdash; through patronage agencies. They take on possible risks, suggest which nurse is better to choose for a particular person, look for a replacement for her, if the employee recommended by them does not & nbsp; fit, is ill, or for some reason cannot & nbsp; work. This saves time and & nbsp; nerves, minimizes the risk that a dishonest person gets into the & nbsp; house.

What should she & nbsp; be able to do?

A professional nurse knows how to work with & nbsp; all patients. She knows how to turn a person in the & nbsp; bed, how to transfer to a & nbsp; chair (there are special techniques for this); how to feed if the swallowing process is disturbed; how to avoid bedsores and & nbsp; how to care for & nbsp; them, if they already exist. She should be able not to & nbsp; only change a diaper, but & nbsp; and & nbsp; to provide assistance in & nbsp; any hygiene procedures, because & nbsp; people can have special catheters, gastro- and & nbsp; nephrostomy and & nbsp; t. & Nbsp; etc. And, most importantly, she knows how to communicate with & nbsp; such wards delicately, respecting their dignity.

How to communicate with & nbsp; her?

This is a very important point! Do not & nbsp; need to make the relationship with the & nbsp; nurse conflictual, taking the position & laquo; we & nbsp; pay you & nbsp; & mdash; you & nbsp; have to endure everything. '' She has a tough job. And & nbsp; do not & nbsp; forget that & nbsp; your loved ones because of a serious illness, too, often changes not & nbsp; for the & nbsp; better side. Therefore, in case of her & nbsp; conflict with the patient, try to listen to both sides. Remember that the & nbsp; caregiver has a personal life and & nbsp; she & nbsp; also needs rest so that she becomes a good helper for your relative.

What to do if you like the nurse, but & nbsp; doesn’t & nbsp; know much?

If & nbsp; she has a trusting relationship with & nbsp; your loved one and & nbsp; you like her too, then & nbsp; you can improve her & nbsp; qualification in the & nbsp; school of home nursing. There are two ways to do this. The first & nbsp; & mdash; let her go there & nbsp; for & nbsp; training. The second & nbsp; & mdash; invite the coach home to teach her & nbsp; directly on & nbsp; your loved one.

Who is not & nbsp; worth taking?

Poor Russian speakers & nbsp; & mdash; this will make it difficult to communicate both & nbsp; with & nbsp; you, and & nbsp; in & nbsp; first of all with & nbsp; ward. Untrained nurses. Without & nbsp; knowing the techniques necessary to work with & nbsp; sedentary people, they can & nbsp; only harm them, sometimes seriously. If a person subjectively does not & nbsp; like & nbsp; & mdash; this is also a reason for refusal.

If the nurse is not & nbsp; satisfied with your conditions, but & nbsp; has no choice & nbsp; and therefore she agrees, it's better not to & nbsp; & nbsp; do not & nbsp; hire her, as, most likely, everything will end in a conflict.

Love & nbsp; like a native

The essence of a nurse's work & nbsp; & mdash; turn her life into a & nbsp; happy life for her & nbsp; ward.

Elvira Verwein, volunteer with & nbsp; 15 years of experience, Ulyanovsk :

& mdash; Since childhood, I have always tried to help abandoned and crippled animals. Having matured and & nbsp; getting married, going through the loss of loved ones, she began to help weak, abandoned children in orphanages, especially children with & nbsp; disabilities. By & nbsp; education, I am & nbsp; teacher of additional education. While still working at the & nbsp; school, I organized a volunteer group to surround such children with care and & nbsp; help.

I was never & nbsp; shy about any work. She was a nurse, nurse, nurse. And & nbsp; in & nbsp; 45 & nbsp; years she moved to get a job in a boarding house for seniors near Moscow and & nbsp; to earn money for volunteering.

In & nbsp; home to & nbsp; my current ward & nbsp; & mdash; The 86-year-old general, who needed care after a hip fracture, was & nbsp; hit by a & nbsp; recommendation. Was ready for & nbsp; everything, because & nbsp; to. & Nbsp; in & nbsp; nursing home “ met '' and & nbsp; with & nbsp; bedsores, and & nbsp; with & nbsp; abscesses, and & nbsp; most important & nbsp; & mdash; with the pain of & nbsp; loneliness.

They say that money is not easy. Yes, the job of a nurse is not & nbsp; sugar. There are different wards: someone does not & nbsp; sleeps at night and & nbsp; is constantly torn somewhere, someone is aggressive, & nbsp; someone has problems with & nbsp; memory. But & nbsp; to & nbsp; everyone needs to find an approach and & nbsp; to calm down. It's good when the family sees how you & nbsp; work, understands you and & nbsp; gives time for & nbsp; rest. It can be emotionally difficult, burnout can occur. Therefore, if you & nbsp; dared to become a nurse and & nbsp; want to avoid it, become your ward a friend. Every day I ask my grandfather what we are going to do today: read, draw, sing, watch the news. He has a clear & nbsp; mind, excellent memory and & nbsp; his own world, which he shares with & nbsp; me. When I appear at the & nbsp; doorstep, he smiles. He & nbsp; taught me to sing military and & nbsp; Ukrainian folk songs, I & nbsp; his & nbsp; & mdash; paint.

This is very difficult & nbsp; & mdash; to love the ward as a loved one. But & nbsp; if you & nbsp; do not & nbsp; find kindness in & nbsp; an old man is a burden to you, you & nbsp; are & nbsp; ready to & nbsp; a hundred times to listen to endless stories from & nbsp; his past life, then & nbsp; it is better not & nbsp; to be & nbsp;/p>

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