|Natalia L. Goncharova||Peter the Great St. Petersburg Polytechnic University, St. Petersburg, 194021, Russia|
There is a need to achieve complex quality services for people suffering from dementia based on significant reductions in the material and moral capabilities of the family and state in a limited period of time. A method of forming a personal fund is proposed, in which citizens can save their personal funds, and the state will provide quality services in case of illness. Data are presented about three groups of elderly people, whose representatives differ in terms of social activity and health status. It is substantiated that the third group, belonging to the retirement age (people aged 80–85), is burdened to the largest extent by medical and social-care problems, including the susceptibility to dementia. The paper analyzes the volume and structure of financial resources for treatment and presents a forecast of the burden on the able-bodied population of the country for the timely treatment and service of these persons. The proposed creation of citizens’ personal funds makes it possible to transfer the psychophysiological burden experienced by members of society with dementia to specially trained personnel in order to save their families money in the event of an insured event—dementia. This will reduce household costs, ensuring the provision of qualified, comprehensive, high-quality services that not just alleviate the condition of elderly people with dementia but also create guaranteed decent living conditions. The organic blending of this suggestion with the introduction of a new cumulative pension scheme (guaranteed retirement plan, GRP) that envisages numerous tax incentives and state guarantees can ensure the effective support of people with dementia. It will contribute to the fair distribution of responsibilities to finance the social services provided to dementia patients between the families and the state.
Dementia; Family; Guarantee; Personal fund; Service
The aging of the population is a process common for most countries in Europe and North America, which generates a wide range of social, economic, and political problems. The major economic problems include a growing burden on the pension system (Sinyavskaya, 2017), while the social objectives are defined by the need to ensure active longevity (Second World Assembly on Ageing, 2020). The political objectives are preconditioned by a growing share of the elderly-aged electorate and significant risks of remonstrative moods in this group of electors as well as the negative impact on the military-mobilization potential of the state (Erokhin, 2018). One of the factors of the growing burden on the social and economic system is higher costs of services for disabled, elderly people, among which there is a group requiring various expenses. These are people suffering from dementia, who experience a steady, progressive decline in cognitive functions expressed as a loss of existing knowledge, skills and abilities, and mental handicap (Malofeev, 2013; World Health Organization, 2017; Alzheimer’s Disease International, 2019).
According to experts, the proportion of people with dementia in the world increased from 20.2 million in 1990 to 43.8 million in 2016 (2020 XXII Century: Discoveries Expectations Threats, n.d.), increasing by 2.17 times. The average annual growth is 8.3%, and experts believe that the share of patients with dementia is going to double every 20 years. Their number will reach 65.7 million by 2030 and roughly 115 million by 2050. The frequency of registration of new cases of dementia in the world is once every four seconds (Bogolepova, 2015). According to this trend, growth can be forecasted in:
Possible ways to reduce this foreseeable impact are related to the need to transform the labor resources under the “Digital Economy” program (Rudskaia, 2018; Kudryavtseva et al., 2019).
With a growing share of the population in the majority of developed countries becoming “elderly,” the increase in the number of people suffering from dementia will be one more factor reducing the quantity of economically active workers/professionals, which poses a threat to economic growth. This threat cannot be neutralized by increasing the income of the elderly based on non-government retirement plans because the citizens of the country have little trust in the savings schemes of non-government organizations, the stability of the national currency, and the inflation expectations, which can devaluate long-term savings. On the other hand, state funding of the expenses arising from the need to pay for the comprehensive services related to the health care and leisure of elderly dementia sufferers, during a time of a growing pension burden caused by the aging population, does not seem possible at first glance. At the same time, effective organizational and financial mechanisms ensuring citizens' employment during this time of growing retirement age are suggested.
Thus, providing guaranteed, comprehensive, high-quality health care services, medical treatment, and leisure to the elderly is an important issue that, if tackled, will:
This paper aimed to develop an approach providing comprehensive, high-quality health care services to people with dementia (CSPD), including accommodation, care, medical treatment, and leisure at a level guaranteed by the state.
The research hypothesizes that the participation of citizens and guarantees of the state are a mandatory component for providing comprehensive, high-quality services that ensure comfortable living, care, medical treatment, and leisure to the elderly, including those suffering from dementia, in cases where personal savings are established by citizens.
In practice, the idea of forming a personal fund for the provision of the CSPD is very problematic due to the following reasons: (a) The population has very little trust in making long-term savings without being able to withdraw the deposits due to the high instability of the financial and pension systems of the country over the last 30 years; (b) So far, the citizens of Russia, especially the youth, have not overcome the low level of personal responsibility for the formation of their own healthcare capital; (c) It is essential to expand the legislative environment for the formation, use, and inheritance of a means of personal CSPD funding, as well as the conditions for obtaining the CSPD in case of disability of the person who has initiated the personal account.
The calculations show that if citizens with above-average incomes allocate 1% to the personal CSPD fund, they can receive this service in case of disease under the state's guarantees. However, citizens with a low income are unlikely to form such funds because it is far more important for them to resolve their current needs rather than view this problem, which may or may not arise, from the long-term perspective.
Nevertheless, the approach
suggested helps transfer the burden of extreme psychological and physiological
stress experienced by the family members of patients with dementia to specially-trained
personnel in order to reduce the costs of households and ensure rendering of
qualified services that help ease the condition of elderly dementia patients.
It simultaneously takes into account the possibilities of sustainable
development of technologies and their scaling (Berawi, 2019), including smart home services.
If this proposal is organically blended with the new pension saving plan
(guaranteed retirement plan, GRP), which envisages numerous tax incentives and
state guarantees, it will be possible to effectively support people suffering
from dementia (RG, n.d.). Given the abilities of the
state during this time of economic digitalization, it will be possible to
account or the incomes of the entire families rather than individual citizens,
which will help to impartially distribute the responsibilities related to the
funding of social services between the family members of patients with dementia
and the state (Interfax, 2020).
This research work was supported by the Academic Excellence Project 5-100 proposed by Peter the Great, St. Petersburg Polytechnic University.
2020 XXII Century: Discoveries Expectations Threats. n.d. During 26 Years the Number of Dementia Sufferers in the World Has Increased by 117%
Alasheev, S.Y., Kuteinitsyna, T.G., 2016. Senior Citizens Aged 80 Years and Older: Opportunities, Needs and Wellbeing. Monitoring of Public Opinion: Economic and Social Changes, Volume 2(132)
Alzheimer’s Disease International, 2019. World Alzheimer Report 2019: Attitudes to Dementia. Alzheimer’s Disease International (ADI), London, UK, p. 166
Berawi, M.A., 2019. Managing Nature 5.0 in Industrial Revolution 4.0 and Society 5.0 Era. International Journal of Technology, Volume 10(2), pp. 222–225
Berawi, M.A., 2020. Empowering Healthcare, Economic, and Social Resilience during Global Pandemic Covid-19. International Journal of Technology, Volume 11(3), pp. 436–39
Bogolepova, A.N., 2015. People’s Knowledge about Dementia. Korsakov Journal of Neurology and Psychiatry, Volume 115(6), pp. 97–102
Erokhin, N., 2018. Aging of the Population in Russia as a Political Problem. Bulletin of the Moscow State Regional University, Volume 2
Federal law No. 350-FZ of 03.10., 2018, n.d. Amendments to Certain Legislative Acts of the Russian Federation on the Appointment and Payment of Pensions Information for Russian-speaking relatives of patients suffering from dementia in the Saarland. n.d. “Coverage of Expenses under the Insurance in Case of Need for Outside Care.”
Interfax, 2020. Mishustin Promised to Unite All Households in a System of Income Control. Available Online at https://www.interfax.ru, Accessed on January 1, 2020
711, 2020. Dementia Insurance Is a New Product for Japan’s Aging Population. Available Online at https://711.ru, Accessed on March 3, 2020
Ivanov, M., Kobyshev, K., Sokolitsyna, N., Kobysheva, M., 2019. Development of a Conceptual Model of the Public-Private Partnership Resource Center in Housing and Communal Services (Case Study: St. Petersburg). In: Proceedings of the 33rd International Business Information Management Association Conference, IBIMA 2019: Education Excellence and Innovation Management through Vision 2020, Soliman, K.S., (ed.), IBIMA, Granada, Spain, pp. 8736–8742
König, H.H., 2013. Demenz Und Ihre Kosten - Pflege Erfolgt Zunehmend in Der Familie (Dementia and Its Costs - Care Increasingly Takes Place in the Family). Bundesministerium für Bildung und Forschung (Federal Ministry of Education and Research), Volume 63
Kudryavtseva, T., Skhvediani, A., Arteeva, V., 2019. Theoretical Analysis on the Effect of Digitalization on the Labor Market. In: European Conference on Knowledge Management. Academic Conferences International Limited, pp. 672–XXVI
Kuzenkova, N.N., Nevzorova, D., Arakelov, S.J., Kostjuk, G.P., 2017. Medico-Social Aspects of Palliative Care in Dementia. Bulletin of the National Medical and Surgical Center. NO Pirogov, Volume 12(1)
Malofeev, I.V., 2013. Services in the System of Social Service: Theory and Practice. Interregional Public Organization, Association of Social Service Workers
Puzin, S.N., Shurgaya, M.A., Toropova, O.M., 2015. Current Issues of Medico-Social Rehabilitation on an Outpatient Basis: Dementia Patients. Journal of Medical and Social Expertise and Rehabilitation, Volume 18(1), pp. 4–9
RG, n.d. The Ministry of Finance Will Submit a Bill to the Government on a New Pension Scheme. Availabe Online at https://RG.ru, Accessed on May 5, 2020
Rodionov, D.G., Kudryavtseva, T.J., Skhvediani, A.E., 2018. Human Development and Income Inequality as Factors of Regional Economic Growth. European Research Studies Journal, Volume 21(2), pp. 323–337
Rudskaia, I., 2018. Transformation of Manpower Resources within the Digital Economy Program. In: Proceedings of the 32nd International Business Information Management Association Conference, IBIMA 2018-Vision 2020: Sustainable Economic Development and Application of Innovation Management from Regional expansion to Global Growth, Soliman, K.S., (ed.), IBIMA, Seville, Spain, pp. 3627–3631
Second World Assembly on Ageing, 2002. Political Declaration and Madrid International Plan of Action on Ageing, Madrid, Spain
Sinyavskaya, O.V., 2017. The Russian Pension System in the Context of Demographic Challenges and Restrictions. HSE Economic Journal, Volume 21(4), pp. 562–591
Vorob’eva, O., 2014. The Problem of Dementia Should Be Addressed at the State Level. Remedium. Magazine about the Russian Market of Medicines and Medical Equipment, Volume 11
Welford, C., 2014. Attitudes and Knowledge in Older People’s Care. Nursing Times, Volume 110(34–35), pp. 22–24
World Health Organization, 2017. Draft Global Action Plan on the Public Health Response to Dementia: Report by the Director-General. Doc. number A70/28, p. 28. Available Online at https://apps.who.int/iris/handle/10665/274881, Accessed on May 5, 2017
Zaborovskaya, O., 2020. Innovative Directions for the Development of Social Services. In: Novellas of law, Economics and management 2019. In: Collection of Scientific Papers on the Materials of the V International Scientific and Practical Conference, Makhotaeva, M.Y., (ed.), Atlantis Press, Volume 90, pp. 339–43
Zhilyaeva, I.A., Rodionov, D.G., 2016. Problems and Mechanisms for Adaptive Management of Sphere of Services of Mass Consumption in the Cities of the Russian Federation. Economy And Entrepreneurship, Volume 10(1), pp. 163–167