Alexandra Vladimirovna, who is 74, hasn`t been able to leave her bed on the 8th floor of a nursing home in southwest Moscow for two years. A broken hip has made her left leg contorted and useless.
Though she is in nearly constant pain, she has had no physical therapy and has been visited by a specialist just once in that time.
She is cared for by a nurse, who also must look after about 120 other patients on the top four floors of House of Labor Veterans No. 6.
”I`ve watched others in this room die,” she said with a sigh one recent warm spring evening as she waited-ultimately in vain-for someone to change the sheets she had soiled.
Yet Vladimirovna is lucky to be in this nursing home. Though overcrowded and unsanitary, it is among the best in a nation where facilities for the elderly are so meager that there is only one doctor for every 200,000 to 500,000 people over age 60.
Pressed by a deepening economic crisis that affects nearly every aspect of Soviet life, the government is struggling to cope with the problem of caring for the nation`s 40 million old people.
Now demographers say the elderly population will double by early in the next century. The government, admitting for the first time since the 1917 Bolshevik Revolution that the state alone cannot handle the burden, is trying to enlist the help of churches, charities and families.
The realities of life in a Soviet nursing home, even one of the nation`s best, are grim.
The stench of urine pervades House of Labor Veterans No. 6. It won`t go away, staffers say, because there is a critical shortage of bedding and keeping patients clean is impossible.
Four or five people occupy a single room, the oldest and most feeble barely able to lift their heads from their pillows. Bedpans sit on the floor waiting for someone to come and deal with them. Old men, some missing an arm or leg, stare out the window.
Walkers are generally unavailable. Some patients have regular wheelchairs; others move about in ordinary chairs with tiny wheels fitted on each leg. They navigate the corridors precariously by pushing their hands along the walls.
Before admission to a nursing home, old people must turn over their entire pensions to the institution and surrender their apartment to the state. In return they are provided with a bed, food and minimal care. Each month, 10 percent of their pension is returned to buy what they need to supplement what they are given.
Since pensions for the old people at No. 6 vary between 30 and 130 rubles, that monthly allowance amounts to 3 to 13 rubles, or 50 cents to $2.
Most of the dozen people interviewed at No. 6 said they had come there because they had no one to care for them. But the vast majority of people surveyed recently by a panel from the Soviet Academy of Medical Sciences said they would do anything to avoid having to go to a nursing home.
A new law has increased the pensions paid to most retirees. The government hopes that will encourage people to stay at home and care for themselves.
The government also is soliciting the help of churches and fledgling private charities that are growing in the USSR now that such work is no longer banned by authorities.
”Only joint efforts will produce results,” said four prominent scientists in a letter published in the Soviet newspaper Nedelya.
The four, members of the Academy of Medical Sciences, which is working on plans to deal with the growing numbers of old people in the Soviet Union, said the level of professionalism of those charged with geriatric care is appalling.
The basic problem with the existing system, they concluded, was that geriatric care simply does not exist or is insufficient for many who need it. Maria Dobokhotova is one of those who is prepared to do anything she can to avoid a nursing home.
”I would never go there,” said Dobokhotova, who at 70 suffers from acute asthma and an undiagnosed disease that causes her feet and legs to swell. ”I would lose my independence.”
She has her own room in a dingy four-room flat in central Moscow that she shares with her daughter, her grandson and his wife, 10 dogs, 2 birds and a cat.
”My pension would be all right if I did not have to care for the animals,” she said.
On her pension of 70 rubles a month, or less than $11, Dobokhotova is able to buy what she needs but doesn`t have even a kopek left at month`s end. Her salvation is that she lives with family and the state provides her asthma medicine free.
Struggling to stay active and independent, she does volunteer work for a group that seeks to preserve historic monuments. The group is sponsored by the Russian Orthodox Church.
Like many elderly Soviets, she sees her pension not as something she earned for a lifetime of work but as a gift from a benevolent government.
”I see it as a kindness of the state,” she said.
