Program: Functional adaptation at home for dependent and elderly / or disabled people

摘要

Introduction : In 2006 Spain approves Law 39/2006 of December 14 named "_Promotion of Personal Autonomy and Care for people in dependency situations._" This law represents an advance in individuals’ life and families who have a dependent member. “_In 2014 there were, in Spain, 18’1% of dependent people over 65 years old while in Catalonia there was 18,3%_” (Idescat, 2015). Given the large number of people over 65 years old that are dependent in Barcelona City, Barcelona City Council together with Association for Independent Living create a program named Functional adaptation at home for dependent and elderly / or disabled people. This program is being carried out from 2.011 to the present, and it’s a program for people over 65 years without economic resources and it’s a priority that they live alone or with a dependent person. Objectives : The program objectives are: - Improving the quality of life of this collective: providing autonomy maintaining physical and mental activity while the activity is performed in activities of daily living. It also improves accessibility and security at home, while they are promoting more time in their homes and avoid institutionalization. - Provide the discharge of the caregiver in order to avoid the physical and mental impairment. Project overview : Program: Functional adaptation at home for dependent and elderly / or disabled people is done through requests made by Social Workers from Barcelona’s City Council Social Services Centers and Primary Care Centers in the area of Barcelona as well as coordinators of the service of home care services. Independent Living Center (CVI) professionals: physiotherapist, occupational therapist and speech therapist, value the person’s functional limitations at home. All adaptations are done based on this evaluation, usually with support products and, in exceptional cases, arrangements to improve accessibility at home. In arrangements visits also collaborates an expert accessibility engineer. During the assessment, the person also visits CVI, where professionals evaluate which are the best products for the person while learns how to use the prescribed items. Once the functional adaptation is done, the professionals value the person’s satisfaction and his/her caregiver satisfaction. We specifically re-evalue the autonomy’s capacity in those daily tasks that they could not perform: to take a shower, sitting down and standing up from the sofa... by a new scaling. The number of beneficiaries that has been attended during the period taken from 2011 to 2015 is approximately 3,200 people. Project results : Two months after the interventions are finished, CVI professionals track the actions taken to beneficiaries through a satisfaction survey of the products and their use. 86% of users said they feel more independent and 95% of them said they feel safer than before. This program has allowed to CVI to do a study with the University of Barcelona, Econometrics’ Department. The study says that: "_For every euro invested in support products annual savings ranging between 2.74 and 3.71 euros_, _taking into account the smaller needs of grants to third parties, and prevention of different types of drops. The repayment of the investment would be lower than 5 months in any case_ " "_This study also confirmed the efficiency of preventive policies in order to address future situations of dependency aggravations_" Funding : Funding is made through a collaboration agreement that’s been annually signed between Barcelona City Council and Association for Independent Living (AVI), the entity that manages CVI. Improvement proposal : There must be a drawing hand, in order to amend the current care model (more on an assistance and reagent way) to a different system, where social services politics are conceived on a more preventive and active nature. We believe that should be an enhancement interdisciplinary social network (Social Worker, Home Care Service) and healthcare network (physiotherapist, nurse ...) in which could promote comprehensive care person. Barriers of the implementations process : Starting this project back in 2.011 was hard work as we were in the middle of the economic crisis and it was a revolutionary program that had never been done before in Barcelona. We start all work during 2.010 (meetings with different departments from the City Council, meetings with support products suppliers, etc.) in order to get everything ready to be able to start the program in April 2.011.