The Domiciliary Support Service in Portugal and the change of paradigm in care provision

Abstract

Context of caseIn Portugal, the integration of care services is still in its infancy. Nevertheless, a home support service called SAD (Serviço de Apoio Domiciliário—Domiciliary Support Service), provided by non-profit institutions to the elderly population is believed to be a first approach to integrated care.PurposeThe aim of this work is to describe and discuss the services provided by the institutions that participate in SAD and understand if this service is the first step in a change towards integrated care.Data sourcesThe main data sources were documents provided by institutions like INE (Instituto Nacional de Estatística—National Institute of Statistics) and a questionnaire that was submitted to 75 institutions in order to capture: (a) demographic and structural data; (b) the type of information that the professionals need to fulfil their jobs and (c) the kind of relationship and constraints, if they exist, to better integration, between the institutions that provide SAD and the patients, the social and health systems, and other entities.Conclusion and discussionSAD seems to have been promoting a formal collaboration between several entities in the social and health systems. The information shared between these institutions has increased, but where cooperation in care service provision is concerned this seldom surpasses the social bounds because health care is still difficult to integrate.

Home care in Europe: a systematic literature review

“…In Spain, the main responsibility for policy on home nursing rested with the regional governments, while on home help it was shared between municipalities and regions [51]. This sort of division of responsibilities also existed in Finland [37] and Portugal [50]. …”

Informal support in Portugal by individuals aged 50+

“…Formal care provided at home merely responds to basic necessities, such as food and hygiene, but does not help in solving problems of a more multidimensional nature (Carvalho 2012). Furthermore, the link between formal and informal care is weak (Santana et al 2007), in spite of the existing legislation pointing to their integration. Portuguese informal carers are overburdened with instrumental tasks, which limit their social inclusion and participation, confining them to the household (Carvalho 2012).…”

Perfil de funcionamento do SAD, Serviço de Apoio Domiciliário - caso de Braga, Portugal.

“…Assim, potenciaremos um SAD mais eficiente e próximo das diferentes necessidades da população idosa (Krizaj, Warren, & Slade, 2018) que desenvolve protocolos de boas práticas que forneçam aconselhamento pragmático adaptado à vida real de cada um, aberto à implementação de um plano de cuidados, em função do grau de funcionalidade da pessoa idosa (Sánchez-Cárdenas, & Bermúdez, 2016). Cabendo às IPSS assumir parcerias que operem em regime de interdependência, de modo a se alcançarem objetivos comuns e ao mesmo tempo criar um plano de cuidados individualizados (Santana, Dias, Souza, & Rocha, 2007), dando lugar à figura do personal support worker (Kontos, Miller, MSW, & Mitchell, 2009), que tem como principal função reunir a história de vida da pessoa idosa, adaptar o plano de cuidados e perceber o ajustamento das necessidades da pessoa ao serviço que está a ser desempenhado. Barbosa Estando a apresentar a nova proposta de implementar um modelo de SAD eficiente, eficaz e personalizado que permite a redução do número de hospitalizações e aumenta a satisfação dos utentes, reduzindo os custos associados ao mesmo, em longo prazo (Vilà, A., et al, 2015).…”