Dependency and Care: Perspectives from the Point of View of Professionals Assessing Situations of Dependency in Spain.

Pablo A Cantero-Garlito,Pedro Moruno-Miralles,Juan Antonio Flores-Martos

doi:10.3390/ijerph17041178

Pablo A Cantero-Garlito, Pedro Moruno-Miralles + Show 1 more

Open Access

https://doi.org/10.3390/ijerph17041178

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Abstract

Objective: To describe how the assessors of dependency have perceived the process of implementation of the Dependency Act in Spain. Methods: A qualitative method was used to analyse interview data (discourse analysis). Purposive sampling was applied. Sixteen occupational therapists were included, who served as dependency assessors in Extremadura, a region of southern Spain. Data were collected through semi-structured interviews between February and March 2019, focused on the characteristic of the Dependency Act. A discourse analysis of the narrative information was performed using processes of open, axial, and selective coding, as well as the constant comparative method. Results: Three topics were identified: (1) Benefits of implementation, connected with the consideration as subjects of rights and the increase in resources. (2) Difficulties linked to the bureaucratization of the process, the lack of sensitivity of the scale of assessment, and the unequal access to benefits and services. (3) The impact of the 2012 budget cuts on financing and on dependent people and their families. Conclusions: The Dependency Act has established itself as a political tool that has generated important social and economic benefits. However, significant difficulties have emerged, which should be addressed to ensure better care for dependent persons.

Highlights

The progressive increase in dependent populations in Spain and the resulting need for care have led institutions to develop social, health, and economic policies to prevent, limit, and address the effects of this growth [1]
As a result of this analysis, we identified three main topics related to the implementation of the Dependency Act in Extremadura and the impact of the RDL 20/2012: (1) the benefit it has brought to citizens, (2) the difficulties in its implementation, and (3) the negative effect that the policies adopted during the economic crisis has had on the dependency care system and on dependent persons themselves
The assessors state that the Dependency Act has brought considerable and relevant benefits, on the one hand, in the consideration of dependent persons as beneficiaries of a subjective, universal, and equitable right, establishing and granting legal status to those who need a third person to perform basic ADL

Summary

Introduction

The progressive increase in dependent populations in Spain and the resulting need for care have led institutions to develop social, health, and economic policies to prevent, limit, and address the effects of this growth [1]. The care provided to these people represents a major challenge due to both the number of people in need of care and to the economic effort that it implies [2,3]. In December 2008, there were 442,509 people in Spain recognized as dependent. This number increased to 1,385,037 in December 2019, and 72.58% are 65 years of age or older. It is significant that those over 80 years of age represent 63.92%. 66,618 people under the age of 18 are currently considered as dependent persons (representing 5.92% of the total)

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