Disability, support and long-term social care of an elderly Spanish population, 2008-2009: an epidemiologic analysis

Abstract

BackgroundThough poorly known, relationships between disability, need of help (dependency) and use of social services are crucial aspects of public health. The objective of this study was to describe the links between disability, officially assessed dependency, and social service use by an industrial population, and identify areas of inequity.MethodsWe took advantage of a door-to-door survey conducted in the Cinco Villas district, Spain, in 2008–2009, which provided data on disability, morbidity, and service use among 1216 residents aged ≥50 years, and officially assessed dependency under the 2006 Dependency Act (OAD). Using logistic regression, we combined data collected at homes/residences on 625 disability screened-positive participants, and administrative information on degree of OAD and benefits at date of visit.ResultsBased on 163 disabled persons, the prevalence of residential/community-care users was 13.4% overall, with 6.0% being market-provided, 2.5% supported by the 2006 Act, and 4.9% supported by other public funds. Of 111 OAD applicants, 30 had been assigned an OAD degree; in 29 cases this was the highest OAD degree, with 12 receiving direct support for residential care and 17 receiving home care. Compared to unassessed dependency, the highest OAD degree was linked to residential care (OR and 95% CI) 12.13 (3.86–38.16), declared non-professional care 10.99 (1.28–94.53), and publicly-funded, non-professional care 26.30 (3.36–205.88). In contrast, 43 persons, 58% of the severely/extremely disabled, community-dwelling sample population, 81% of whom were homebound, including 10 persons with OAD but no implemented service plan, made no use of any service, and of these, 40% lacked a non-professional carer.ConclusionsFormal service use in the Cinco Villas district attained ratios observed for established welfare systems but the publicly-funded proportion was lower. The 2006 Act had a modest, albeit significant, impact on support for non-professional carers and residential care, coexisting with a high prevalence of non-use of social services by severely disabled persons.

Individual and institutional factors associated with functional disability in nursing home residents: An observational study with multilevel analysis

“…Among other objectives, nursing homes in Spain aim to provide a pleasant environment and a safe place to live, to enhance the capabilities of the residents, to prevent disability and loneliness, and to promote an environment where the resident is able to live a life with respect, dignity and autonomy [ 29 , 30 ]. However, Spanish long-term care services have been influenced by familiarism and have traditionally been provided to the majority of the elderly on an informal basis and, on a private, for-profit basis [ 31 , 32 ]. Currently, older people with disability live in a care context where long-term care services based on profit and non-profit (public and private) coexist [ 31 ].…”

“…However, Spanish long-term care services have been influenced by familiarism and have traditionally been provided to the majority of the elderly on an informal basis and, on a private, for-profit basis [ 31 , 32 ]. Currently, older people with disability live in a care context where long-term care services based on profit and non-profit (public and private) coexist [ 31 ]. Further, the organizational models of care of nursing homes can influence the autonomy, the dependency and coverage of needs of the residents [ 33 , 34 ].…”

Depresión como predictor de discapacidad en adultos mayores

“…En el 2013 se calculó que a nivel mundial las personas pierden aproximadamente nueve años de vida saludable como consecuencia de la discapacidad 1 , y que el número de personas AM dependientes, aquellas que requieren ayuda para realizar estas actividades, también aumentará, con variaciones importantes de acuerdo a la economía de los países, pues mientras en Suiza la prevalencia calculada fue del 17%, para personas con mas de 75 años, en países en desarrollo como México es casi del 60% 4 . Por lo que, identificar los principales factores de riesgo para el desarrollo de discapacidad en AM, es de suma importancia tanto en términos médicos como sociales, pues la condición de discapacidad hace al individuo más vulnerable, con mayor necesidad de cuidado en casa, número de hospitalizaciones y riesgo de mortalidad 3,[5][6][7] .…”

Incapacidade funcional em idosos cadastrados na Estratégia Saúde da Família nos municípios de São Paulo e Manaus: prevalência e fatores associados

“…Em geral, as mulheres e os idosos mais velhos são os grupos populacionais com maior prevalência de incapacidade funcional, segundo estudos realizados em vários países da Europa, Ásia, África, Américas e Oriente Médio (Almazán-Isla et al, 2014, Biritwun et al, 2016, Katta et al, 2017, Naidoo et al, 2017, Jasser et al, 2017, Adib-Hajbaghery, 2011, Ćwirlej-Sozańska et al, 2018, Almazán-Isla et al, 2017Rodrigues et al, 2009;Hosseinpoor et al, 2012). Estudos nacionais e internacionais associaram a incapacidade funcional ao aumento da idade, baixa renda e menor escolaridade (Alves, 2010;Silva, 2013;Van den Brink et al, 2003;Berkman et al, 1989;Graciani et al, 2004;Alves et al, 2008;Huisman et al, 2003;Alves & Rodrigues, 2005;Jasser et al, 2017;Courtney-Long, 2015).…”

“…Alguns estudos compararam a prevalência de incapacidade funcional entre países e atribuíram suas diferenças às características populacionais (Sousa et al, 2009;Gomez-Olive et al, 2017). Dentro os idosos, a prevalência de incapacidade funcional foi geralmente maior entre as mulheres, as faixas etárias mais velhas, indivíduos com menor nível de escolaridade, com mais comorbidades e residentes em países de renda média e baixa, como demonstrado por estudos realizados em países da Europa, Ásia, África, Américas e Oriente Médio (Rodrigues et al, 2009;Sousa et al, 2009;Adib-Hajbaghery, 2011;Pedro-Cuesta et al, 2011;Hosseinpoor et al, 2012;Silva et al 2013, Almazán-Isla et al, 2014Courtney-Long, 2015;Biritwun et al, 2016;Almazán-Isla et al, 2017;Argyriou et al, 2017;Gomez-Olive et al, 2017;Jasser et al, 2017;Katta et al, 2017;Naidoo et al, 2017;Waterhouse et al, 2017;Ćwirlej-Sozańska et al, 2018;Giacomin et al, 2018 (Barros et al, 2006).…”