Rest Home

REST HOME, an institution aimed at providing workers and employees the opportunity to restore their strength and energy in the most favorable and healthy conditions during their annual leave. Unlike a sanatorium, a rest home does not aim for special medical treatment of those resting. In the USSR, rest homes originated according to the idea of V. I. Lenin in Petrograd in 1920. For this purpose, in a number of premises left behind by the bourgeoisie, dormitories with enhanced nutrition were founded. Moscow followed Leningrad's example, processing 240 vacationers through rest homes in 1921. The organization of rest homes was then formalized by a decree of the Council of People's Commissars ("Izvestiya VTsIK" of May 19, 1921). From 1921 to 1923, the expansion of rest homes by various organizations (insurance funds, health departments, trade unions), individual departments, and enterprises was observed, both in large centers and in the provinces. The further development of rest homes is determined by growth in both quantitative and qualitative terms. Thus, the rest homes of the Moscow Health Department processed 240 people in 1921, 7,213 in 1922, 17,010 in 1923, 45,562 in 1925, and in subsequent years no less than 50,000 people per year (during the summer). A similar growth is observed throughout the USSR: in 44 points of the Union, there were already 543 rest homes in 1925 with 36,063 beds, processing 321,461 people annually, 66% of whom were factory workers. In large industrial centers, the percentage of factory workers among those who passed through rest homes rises to 79.9% (Moscow), 79.5% (Ivanovo-Voznesensk), and 70.5% (Leningrad). The spontaneous nature of this growth and the resulting tasks were taken into account by the All-Union Central Council of Trade Unions in a special appeal to local trade union bodies (1925), which was the first step toward unifying the work of rest homes on an all-Union scale. In development of this provision, in 1926, the rest homes of individual trade unions and departments were liquidated and transferred to the jurisdiction of social insurance bodies (except for the rest homes of the Moscow Health Department and the rest homes of the Leningrad Provincial Trade Union Council). At present, there are 16,297 rest homes in the USSR with 46,211 beds (compared to 1925, a clear consolidation of rest homes is noted). For 1929, the total number of vacationers is expected to reach 602,000. Of this number, Tsustrakh (the most powerful organization in terms of the number of rest homes) will process: in the RSFSR - 324,917 people, Ukraine - 96,250, Transcaucasia - 17,750, Uzbekistan - 5,676, Turkmenistan - 1,442, Belarus - 9,100, transport - 76,270 vacationers (a total of 531,405 people for Tsustrakh, the cost of maintenance is 14,598,599 rubles per year, the average cost of a bed for 2 weeks is 27 rubles 45 kopecks). Referrals to rest homes are made by trade unions through local labor protection bodies; social selection is also done there. Preference is given to less well-off workers and employees. Medical selection is done in outpatient clinics. Contraindications for referral to a rest home: the possibility of transmitting an infection in any form, the need for bed rest, or any special treatment and care. The problem of annual rest is secured at present in the USSR not only by the nationwide law on vacations but is significantly supplemented by the free provision to workers of the opportunity to strengthen their strength while maintaining their basic salary. In methodological terms, there is still significant variety in the work of rest homes in the USSR at present, therefore, in the following presentation, the experience of Moscow organizations is taken as the basis. Rest homes initially were hotel-type dormitories without a proper regimen, nutrition, or medical supervision. The main tasks of the work of rest homes were not clear, and the methodology of the work was unknown. In order to thoroughly study the issue, the Moscow Health Department opened an experimental-demonstration rest home in 1924, the task of which included the scientific development of the rest home regimen, careful classification of its elements, their standardization, establishment, and medical-laboratory control. The standards of regimen elements, worked out in the experimental-demonstration rest home and verified by laboratory means (on 1,280 test subjects), confirmed the validity and viability of the active rest system. The development of methodological material according to special plans ("grids") for each rest cycle (14 days), the necessity and possibility of precise dosage of sessions for physical culture and educational work, the full use of sun, water, and air, the deepening of the medical-pedagogical role of the doctor, and the planned nutrition of vacationers—all these issues, being supported by data from medical-laboratory control and observation, strengthened the idea that rest homes represent a special type of mass Soviet prophylactic centers capable of occupying a large place in our healthcare and labor protection system. The expansion of the scope of requirements for the work of rest homes also caused the need for the differentiation of this work. Firstly, with the aim of reducing the cost of a bed, rest homes of various capacities (60, 100, 250, 500, 1,000, and 1,700 beds) were established. Work experience has shown that rest home settlements are the most economical in material terms. Secondly, life demanded the differentiation of rest homes according to other criteria. For intellectual workers, for whom a special approach is required in the field of physical culture and especially cultural-educational work, separate rest homes were organized. For neurasthenics and the over-fatigued, for whom, for the purpose of rest, a sharp change in the surrounding environment and a complete break from ordinary living conditions are required, floating rest homes (on the Volga) were arranged, allowing for the combination of annual rest with a two-week trip. For female workers who cannot use rest homes due to the presence of infants or preschool-aged children, rest homes for mothers with children were organized. The experience of organizing rest homes specifically for adolescents did not justify itself due to difficulties in implementing the regimen. Apparently, adolescents rest better among adults (in Leningrad, there is a rest home for fatigued children). In 1925, as an experiment, Sunday rest homes were opened, where workers arrived on Saturday after work and remained until Monday morning. The goal of Sunday rest homes was the propaganda of the ideas of healthy rest. Subsequently, rest homes were tested as excursion bases for mass Sunday worker excursions from the city to the surrounding areas. Excursionists at the rest homes had the opportunity not only to store their belongings, get tea, etc., but also became acquainted with the tasks of rational rest (a doctor's talk, use of the rest home's physical culture facilities). Along with this, a type of rest home-camp (in tents, in barracks) was proposed, with vacationers staying in the open air 24 hours a day. This form of rest home, implemented in the sanatorium organization for tuberculosis patients, is inapplicable to rest homes for reasons of a methodological and climatic nature (in the central region). A rest home that has (as a base) a solid building for shelter from cold and bad weather, equipped with a sufficient number of rooms for daytime stay, light, water, and sewage, is still the main type of institution of this kind. This is becoming especially relevant in the most recent time, when the period of annual vacations has a tendency to extend to the winter season, in connection with which the number of winter rest homes should increase. Thanks to this, rest homes will turn from seasonal institutions into institutions operating year-round, which will contribute to a significant easing and ordering of their work, an increase in staff qualifications, and further qualitative growth. At the basis of the rest home regimen lies the system of active rest, which aims to achieve the strengthening of the vacationers' strength not by rest, but by the application of various kinds of stimuli, optimally toning the psycho-physical sphere of the fatigued person and alternating in a certain order with rest. Daily schedule: 7:30 AM - getting up, from 7:45 AM to 8:15 AM - morning exercise, 8:30 AM - breakfast, 9-10 AM - free time, 10 AM-12 PM - sun and air baths, bathing, swimming, 12-1 PM - free time (for those who wish - morning cultural-educational session), 1-1:30 PM - lunch, 1:45-3:30 PM - rest in bed ("dead hour"), 3:30-4 PM - free time, 4-4:30 PM - afternoon snack, 4:30-7 PM - outdoor games, rowing, walks, quiet reading room, 7-7:30 PM - free time, 7:30-8 PM - dinner, 8-8:30 PM - free time, 8:30-10 PM - evening cultural session, 10-10:30 PM - free time, walk before sleep, 10:30-11 PM - evening toilet, going to sleep, 11 PM - lights out in the house. Of the listed procedures and sessions, the following are mandatory for vacationers: precise adherence to the hours of meals, rest, and sleep, a doctor's prescription for morning exercise, sun and air baths, and an introductory talk by the doctor with newcomers about the regimen for combating fatigue. The remaining parts of the daily schedule are only recommended. The concept of morning exercise includes exercise gymnastics, rubbing down, morning toilet, and breakfast.

Morning exercises in the Rest Home represent a slightly modified (in the number of movements and tempo) and supplemented scheme of the five-minute home gymnastics of Müller and consist of eight exercises: 1) 'mill' (rotation of arms with deep breathing), 2) 'pendulum' (tilting the torso to the sides), 3) 'mower' (rotation of the torso along the vertical axis imitating the movements of a mower), 4) 'woodcutter' (imitation of wood-chopping movements, connected with active exhalation), 5) 'spring' (energetic squatting), 6) 'rowers' (jerks of arms spread to the sides backwards), 7) 'full speed' (gymnastic running or accelerated walking), 8) 'cleaning' (breathing exercises with active exhalation). The exercises are adapted for easy application at home in our living conditions. With a duration of 4-5 minutes, they give an average increase in pulse of 75-90% (against the initial frequency) at the height of the exercises; 30% at the end of the exercises. After 60-90 seconds, the pulse returns to the initial frequency. Doctors, when making prescriptions, divide vacationers into three groups, differing in the intensity of the load. A special preparatory lesson is conducted for beginners. Rubdowns following the morning exercises are prescribed (with special exceptions) to all vacationers. Breakfast is included in the concept of 'morning exercises' to introduce this concept and its significance into daily life. Sunbaths are conducted in three groups according to the doctor's prescription. The coefficients of solar exposure for each side of the body are 4 min., 8 min., 12 min. (respectively for the weak, medium, and strong groups). Following the sunbaths is bathing (usually in a natural body of water), then, in the immediate vicinity of the water body, mandatory rest in the shade. Returning to the Rest Home is done in a column, with songs. In large Rest Homes, there are water stations with swimming instruction, diving towers, etc. Physical culture in the evening hours consists mainly of outdoor active games—mass and sports. Mass games are very diverse in content (various types of group relays, ball games, imitation games, dance steps, etc.), are simple to learn, do not require preparation, and are emotional in content. Among team sports games, Italian lapta, Russian lapta, and volleyball are practiced. Playing football is prohibited. The selection of mass games is produced according to a specific physiological curve, calculated for a gradual rise, a peak, and a slow decline in load towards the end of the games. In addition, games of a so-called 'passive' nature are available to vacationers, not requiring special guidance or special tension: croquet, ring toss, graces, skittles, ping-pong. All methodological work on physical culture is carried out by special instructors according to the aforementioned methodological plans ('grids'), precisely providing for the content of sessions, their quality, quantity, and dosage for every day and hour of the entire fourteen-day rest cycle. All vacationers receive special costumes for physical culture. Cultural-educational work in the Rest Home strives to tone the psyche of vacationers through entertainment (without elements of overexcitement) on the one hand, and to provide information on caring for one's health on the other. The weekly 'grid' of cultural-educational work on average contains: cinema (1-2 evenings), a play-concert (1 evening), 2 evenings of amateur performance, 2 evenings with sanitary-educational content (in various formats). The choice of films is subject to careful medical censorship. Usually, one of the films has social-everyday, political, or comedic content; the other is of the nature of a purely cultural film. The program of plays and concerts must be built on a careful combination of 'major' and 'minor' components with the calculation that the entire session ends necessarily in a major key. The programs of amateur evenings are diverse in form and content: cultural games, evenings of collective creativity, campfire evenings. The basis of their construction is analogous to concert evenings. Sanitary education evenings include lectures-conversations, film-lectures, sanitary lotteries, sanitary courts. Recommended topics: fatigue and the fight against it, rational nutrition, the mechanics of mental life (without pathology). Evenings dedicated to individual diseases (tuberculosis, venereal diseases, abortion) are either poorly attended (due to the dissemination of these topics in city clubs) or unnecessarily traumatize the exhausted. In sanitary lotteries, prizes are awarded (physical culture costume, personal hygiene items, etc.) for the best performance of morning gymnastics, the best explanation of ways to fight fatigue, etc. Sanitary courts are held over alcoholics and violators of the regime. Before leaving the Rest Home, special memos are available to vacationers, in which all skills subject to implementation in daily life are collected, as well as addresses of physical culture consultations, sports stations, city dispensaries, etc. In the morning hours (12:00-12:30), short musical morning performances and a daily session of 'what's new in the world' (storytelling based on newspapers) are held. In addition to the library (with a loud and quiet reading room) and radio installations, the Rest Home has exhibitions on sanitary education, Osoaviakhim, etc. Nutrition in the Rest Home must pursue the goals of moderate fattening, if one considers that about 70% of the total mass of vacationers arrives with a weight deficit (in relation to height, according to Broca). Rest Homes strive to fight the habitual habit of vacationers for voluminous nutrition, for a heavy meat table, for tasty but low-value dishes in a hygienic sense. A healthy mixed table is necessary with the daily serving of vegetables (salads, side dishes) and fruits or fruit juices. Protein minimum—100 g, fats for the table—50 g, carbohydrates—600 g. It is necessary to monitor the sufficient representation of basic radicals in the table. Caloric content is on average 4,000-4,300 net calories. In most Rest Homes, there is one common table for everyone. The so-called 'tavern' system is implemented only in isolated Rest Homes (mainly due to material difficulties). The nutrition 'grid' is built on a 14-day cycle, with seasonal variants, and must ensure a sufficient qualitative and quantitative selection of dishes and their alternation towards the greatest possible variety for the rest cycle. The average cost of food per bed-month in the USSR is 31 rubles 50 kopecks to 36 rubles. Medical supervision consists of a medical examination of vacationers upon arrival and discharge (with measurement of weight and height), assignment to procedures by groups, treatment of those who fall ill in the outpatient clinic and isolation ward (in the latter, the length of stay is no more than 3-4 days), medical control of all procedures without exception, and the conduct of so-called individual consultations (psychotherapeutic treatment of individual addicts and psychoneurotics). Composition of vacationers by health status: healthy 25%, overfatigued 20%, convalescents 2%, sick 53% (the latter in the Rest Home are understood as practically healthy people with certain organic defects). Results of the rest: improvement in appetite and sleep, an average weight gain of 2 kg in 95% of persons who spent at least 12 days in the Rest Home; toning of the cardiovascular apparatus (with the shifting of pulse function and blood pressure towards physiological values); leveling of the color index of the blood due to greater filling of erythrocytes with hemoglobin, an increase in the regenerative capacity of the blood, a decrease in working lymphocytosis; a significant decrease in phenomena of general functional depression (Gelman). The average number of those who rested is 90-95%. In recent years, new construction of Rest Homes has been underway, as most old buildings are difficult to adapt to the needs of such mass institutions as Rest Homes. The basis of new construction is pavilions (wooden, with a capacity of 80-100 people), located in a forest or park and grouped around premises for daytime stay and the dining room. The pavilions consist of separate rooms (4 beds each, 4 m² per person), equipped with washbasins, toilets, and a room for technical personnel (cost 28,000 rubles). With dining rooms and kitchens of sufficient capacity, the number of these pavilions can be continuously increased (given the presence of a sufficient 'green zone'). In large Rest Homes, mechanized kitchens (up to dishwashing) with high throughput have been built (the Kalinin Rest Home near Moscow for 1,700 people). The positive reaction of the working environment to the listed methods of rest, the assimilation of hygienic skills, the increase in attendance at physical culture procedures (up to 90%), the attraction to reasonable entertainment and systematic reading, the conscious perception by vacationers of a firm medical regime (as a prerequisite for proper rest), the awareness of the need to organize one's Sunday, holiday, and annual rest—all this gives the right to consider Rest Homes as schools of a new way of life and a new culture. Examination of those who rested in their family life confirmed the correctness of these considerations. Abroad, the organization of rest is considered mainly in the context of the problem of leisure (from the time when the practice of the 8-hour working day began to enter life). In Sweden, America, England, Finland, and Scandinavia, the fight for healthy leisure is conducted mainly with the help of sports; in Germany, Austria, Switzerland, Czechoslovakia, Poland, and America, tourist societies ('friends of nature') are developed, which have opened Rest Homes in some countries.

The oldest form of longer-term stationary rest in the West are children's homes for weakened, mainly scrofulous children, which originated in Margate (in England) in 1796. In 1885, in Bremen, a Union of Societies for Summer (again, children's) Rest was organized. Regarding adolescents, there is a tendency to expand the excursion method of work practiced in the West. Regarding adults, work is conducted mainly in the field of combating tuberculosis. In particular, in Germany, philanthropic organizations (Catholic, Evangelical, Jewish) and self-governing public and labor organizations (the German Red Cross, Christian and Social Democratic labor unions, International Workers' Relief) have recently begun to create rest homes for adult workers (however, this work has not yet taken on definite, solid forms). A somewhat greater initiative was shown by German white-collar trade unions (the National Union of Clerks, the Union of Technical Employees, the Merchants' Union of 1858). The rest homes of these organizations are ordinary boarding houses in which union members can spend their vacation at their own expense at prices cheaper than in private boarding houses. The main expense of the vacationer consists of the costs for paying for meals, a room, and travel to the rest home and back. But this expense is unaffordable for a huge portion of white-collar workers; they have to start setting aside a certain part of their monthly salary from the autumn of the previous year in order to be able to go on vacation. Before the World War, employees of certain industries organized "vacation funds," into which they made certain contributions at the beginning of each month. Some firms, out of production interests, made subsidies to these funds. In the indicated rest homes, medical supervision, an organized regimen, physical culture, and cultural work are absent. Vacationers are occupied mainly with excursions; in the evenings, they chat by the fireplace, read newspapers, and entertain themselves as best they can. There is no comparing the above with the character and scale of the construction of rest homes in the USSR. One more social movement should be mentioned, which arose at the beginning of the 19th century in England, Denmark, and Germany and has encompassed almost all industrial countries of Europe and America over the last half-century. This is workers' garden-allotments. The essence of this movement consists in providing workers with suburban land plots for the cultivation of garden-allotments by their own efforts and for raising domestic animals (and where possible, for the construction of light dwellings). The goal is the refreshing of health through the stay of a working family in the fresh air during days of Sunday, holiday, and annual rest. The movement is supported by the propertied classes; it distracts the worker from participating in the class struggle, developing in him the instincts of a small property owner. In Italy, it is supported by large capitalists; in France and Belgium, it turns the worker into a petty bourgeois. Attempts at occupying and cultivating land plots by groups of workers with collective cultivation of the land were made in 1922 in Belfort; they still represent a singular experiment; in the RSFSR—see the corresponding decree of the Council of People's Commissars (April 1929).