Portal de Cartagena
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The health crisis resulting from the pandemic caused by COVID-19 has brought to the table the reality of considering and caring for people in situations of fragility, disability and dependency, many of them elderly people and others younger people with great support needs.
These are situations that are not new, that have been the subject of debate and denunciation for a long time, but have become much more visible now in the face of the harshness of the situations that we are experiencing, emerging major deficiencies in our care system.
Future risks are also being evidenced regarding how to combine values ??that must be balanced in care, such as the health and freedom of people.It is absolutely essential to generate a debate in order to review care in Spain in order to improve care, coordination and alternation of services, and the problems of competencies to achieve the desired efficacy and that dependent people need.HOME CAREWe start from the basis that more than 3/4 of the total of those over 65 years of age and younger people in situations of fragility, dependency or disability, prefer to live at home and continue participating in their community.
It seems evident that we must move forward with a proposal for comprehensive care at home capable of coordinating all those involved in this care: families first, social services (SAD fundamentally, which should be reinforced, although not exclusively), primary and specialized care health, home and care employment sector, assistants, volunteers, local services and community participation initiatives.
It is urgent to expand public coverage and the level of protection for all levels of dependency, and to do so guaranteeing a better functioning of services and infrastructures,incorporating more professionals.
Therefore, it is necessary to provide an integrated social and health care focused on the people who live in their homes, coordinating the necessary services to improve their quality of life and that of their family environment, as recommended by the WHO.In addition, and as long as the danger of COVID-19 lasts, it is necessary to guarantee the implementation of specific and mandatory action protocols, specific training for personnel, supply of specific cleaning products and inspection controls to ensure their compliance, and also ensure that people in the family environment who have taken care of dependent people, users of closed resources (day centers and the like) or SAD, receive the Benefit for care in the family environment, leaving without effect the possible incompatibilities established between services (technical recommendation for action made by IMSERSO).All this will lead to the inevitable increase in the budget and specialized jobs in the short term, in exchange for a significant improvement in the care provided and in the quality of life of the people who receive them, and of tens of thousands of women, above all, who They work in this sector and they do not enjoy the minimum conditions of security and legality, with the personal consequences that this situation generates, but there is plenty of room for it.
Keep in mind that, in 2017, social spending on family / children per capita in purchasing power parity was 760 in the EU-15, 701 in the EU-28 and only 330 in Spain.
As a percentage of GDP, this difference in spending meant that the EU-15 dedicated an average of 2.4% of its GDP to this area, the EU-28, 2.3% and Spain dedicated half (1.2% ).
In millions of euros,This difference translated into an investment of 333 million on average in the EU-15, 359 in the EU-28 and only 14.5 in our country.
On the other hand, based on the data provided by the OECD, in 2017 social spending on long-term care (care for people in situations of dependency) constituted 3.7% of GDP in the Netherlands, 3.2% in Sweden , 1.9% in France, 1.5% in Germany, 1.4% in the United Kingdom and only 0.7% in Spain.CARE IN RESIDENCESWe need to think about and define an in-depth change in the model of accommodation for the elderly or people with disabilities who need support to continue with their life projects.
Housing alternatives that provide professional care and interventions geared towards people-centered care are required.
The experience of other countries, backed by decades of development and scientific evidence, suggests the goodness of disaggregating the concepts of "housing" and "care", making each one depend on its natural competence.
This differentiation, in addition to rationalizing public spending on resources destined for care, would definitively distance us from institutional models.
The house guarantees its own space, privacy;and in domestic settings, care and supports are offered according to the different needs of each dependency situation.Urbanizations with single-family or shared chalets are not necessary due to the high cost that it represents, of construction and management, for Social Services and the majority of dependent people, and because what we are talking about is changing the hospital's shared room copy system, for apartments with new architectural designs and new organizational, service and management formulas that are most similar to a home, where privacy is guaranteed, care is personalized and the continuous rotation of professionals is avoided, and where time and Activities are organized with people in mind and nurturing a meaningful life.Therefore, it is necessary to definitively eradicate the private or concerted macro centers that store people where most of the rooms are shared, and stop perceiving individual rooms as a luxury.
These centers, where people spend most of the day in rooms full of aligned "interns", avoiding contagion when there are easily communicable diseases can end up being an impossible mission as it has happened with the COVID-19 pandemic.
We consider it urgent that, from the residential park that now exists, its transit towards the change of model be brought about, contextualizing it in the concrete reality of each center.At the same time, it is essential to support and care for professionals, dignifying their work, supervising the development of their comprehensive and relational care skills, investing in caring for teams and improving organizations.
This cannot be considered as superfluous and therefore expendable.
Only then can we advance in good care.
The shortage of well-trained professionals and the precariousness of working conditions in private and concerted residences must be corrected since, although it is not a unique or sufficient condition to guarantee the quality of care and support, it is an issue that must be rectified .
Source: Yayoflautas Cartagena
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