Dependency Aid: Supporting Recovery and Rehabilitation

We define dependence on an individual as that permanent state in which for reasons of age, illness or disability, and linked to the lack or loss of physical, mental, intellectual or sensory autonomy, it requires the attention of another or other people or aid important for basic activities of daily living. In the case of people with mental disabilities or mental illness, they may require other supports for their personal autonomy. In older people, due to the combination of age and illness, cases of dependency are more numerous than in other age groups; This circumstance is aggravated by the frequent withdrawal of the social network, which makes it difficult to provide the necessary aid.

All individuals who present these types of needs, regardless of their age, are deserving of special protection from the State. This is already recognized in the Spanish Constitution and since the promulgation of Law 39/2006 on the Promotion of Personal Autonomy and Attention to Dependency (or Dependency Law), the State has articulated this protection with evaluation, control and administration mechanisms. , and endows it with the human, organizational and financial means to carry it out.

In general, the objective of the Dependency Law is to meet the needs of those people who, because they are in a situation of special vulnerability, require support to develop essential activities of daily life, achieve greater personal autonomy and be able to exercise fully their rights as citizens.

This law, which came into force in January 2007, is carried out by different complementary orders and royal decrees, and from the administrations of the Autonomous Communities, in a shared way with local entities, both are in charge of the correct development and application of the Mechanisms of this Law of Assistance to the Dependency in inter-administrative cooperation. To do this, a public use network is configured that integrates different services: public, concerted, collaborative and private, both health and social.

The attention to the dependency that this law regulates is of a public and universal nature, it guarantees equity to ensure equality (that is, in the face of the same need, those who enjoy higher incomes will make a higher copayment than those who do not have them).

The application of the law has been progressive, that is, the people evaluated as most dependent have received the aid first, and little by little the others have been entering. To date, people classified as highly dependent and severely dependent have received these aids. As of 2011, it is expected that individuals with moderate dependency will enjoy them (coverage of mild dependency is not contemplated by the legislation).

The different degrees of dependency are defined as follows:

• High dependency: you need help with several of the basic activities of daily living (ABVD), several times a day, and you need the indispensable and continuous support of another person, or you have continuous support needs for your personal autonomy.
• Severe dependency: requires help to perform several ABVD, 2 or 3 times a day, without requiring permanent support from a caregiver.
• Moderate dependence: you need help to perform several ABVD at least once a day, requiring intermittent support from third parties.

In order to receive these grants, there are some essential requirements, mainly entering one of the dependency categories that have been described and having resided in Spanish territory for at least 5 years, of which 2 must be immediately prior to the application.

Once the request has been made to the social services offices of the Autonomous Communities, a multidisciplinary team evaluates it, with home visits to take into account, in addition to the health of the individual, their functional level with the necessary technical aids, it is that is, the environment where the person lives.

With these data, a resolution of the degree and level of dependency is made and from there the so-called Individual Care Plan is built. For this, the social and environmental aspects of the individual, their economic capacity, the degree and level of dependency, their preferences and needs, and the available resources are taken into account.

In the Individual Care Plans, the provision of services is prioritized, and if they cannot be offered due to lack of resources, an economic benefit will be offered exceptionally. The beneficiaries will contribute in the payment of the services according to their economic capacity.

The services that are usually offered from the Dependency Aid Law are telecare, home help, day and night or residential centers. Regarding financial benefits, these are linked to a support service in the family environment for non-professional caregivers for personal assistance (something like a “salary” for being a caregiver).

All this mechanism, which is correct a priori, and which created great expectations, has been overwhelmed by the avalanche of requests and the consequent scarcity of resources. During 2009 and so far in 2010, due to the economic crisis, which has limited and reduced public budgets, economic resources have even been compromised. In the coming months there will be changes and adaptations in the application of the Dependency Aid Law to avoid the stoppage of aid.