Understanding Dependency in Spain: A Guide to the Dependency Act

Levels of Dependency

Grade 2 – Severe Dependence: When a person needs help to perform various basic activities of daily living two or three times a day but does not require ongoing support from a caregiver or have extensive support needs for personal autonomy.

Grade 3 – High Dependency: When a person needs help to perform various activities several times a day and experiences a total loss of physical, intellectual, or sensory abilities, necessitating continuous support from another person or extensive support for personal autonomy.

Assessment and Valuation

Instrument and Valuation Bodies: These determine the level of dependency (moderate, severe, or long-term) of a person. The Law 39/2006 establishes a single scale for all Spanish territories (Article 27), regulated by Royal Decree 504/2007 of April 20.

The scale assesses a person’s ability to carry out basic activities of daily living and their need for support and supervision. This applies to individuals with intellectual disabilities, mental illnesses, etc. Each region has a designated national assessment body responsible for determining the degree and level of dependency and specifying the care required.

Assessment Process: Valuation reports on health and living environment are taken into account, including technical aids, orthotics, and prosthetics. Environmental barriers are also considered.

Aid and Community Resources in Valencia

Care Benefits: The Dependency Act covers economic benefits and services. Services are prioritized and provided through the public network of social services in each autonomous community, including accredited public and private centers.

Network of Social Services (SAAD): Article 16 outlines the network, which comprises public institutions of the autonomous communities and local entities.

Specialized Centers:

  • State reference centers for promoting personal autonomy and addressing dependency situations.
  • Accredited private centers.

Service Catalog: Article 15 defines the service catalog, which includes:

  1. Services for preventing dependency situations and promoting personal autonomy.
  2. Telecare services.
  3. Home help services: Addressing personal home care needs.
  4. Downtown day and night services: Day centers for the elderly, day care centers for children under 65, specialized day care centers, and night centers.
  5. Residential care services: Residences for people in a state of dependency due to different types of disabilities.

Different Sites for Different Groups:

  • People with disabilities: Day care centers, early stimulation centers, homes for physically and mentally disabled individuals, sheltered housing for mentally ill individuals.
  • Elderly: Day centers, rehabilitation and social integration centers, residences for mentally ill individuals, sheltered housing for elderly patients with mental illnesses, CEAM, day centers, residences, homes and clubs, residential homes, and sheltered housing.
  • Mixed: Residential facilities for elderly, disabled, and mentally ill individuals, as well as those with physical and mental disabilities.

Economic Benefits

The Dependency Act provides the following economic benefits:

  1. Financial benefits linked to service: This benefit covers service charges outlined in the individual care program (PIA) when care is provided by a public or accredited private entity.
  2. Care and economic benefit for family caregivers and support carers: This benefit depends on the degree and level of dependency and the beneficiary’s economic capacity. It aims to allow the beneficiary to remain at home while receiving care from professional caregivers.
  3. Economic provision of personal assistance: This benefit facilitates the empowerment of people with high dependency, regardless of their age.

Attention to Dependency Situations of Elderly and Disabled Individuals: Dependency Act, Grants, and Resources in the Valencian Community

Council of Europe Recommendations

The Council of Europe has promoted initiatives and recommendations to improve the situation of dependent persons and their caregivers. In the mid-1990s, a group of experts developed a consensus text adopted by most member countries.

In September 1998, the Committee of Ministers of the Council of Europe adopted a recommendation on dependency (Council of Europe, 1998). This recommendation defines dependency as”the need for significant aid or assistance for everyday life activitie” or, more precisely, as”a state in which people find themselves, for reasons related to lack or loss of physical, mental, or intellectual capacity, needing assistance or aid to carry out major acts of daily life, particularly those relating to personal care”

World Health Organization (WHO) Classification

This perspective aligns with the WHO’s International Classification of Functioning, Disability, and Health (ICF), which proposes the following framework:

  • Functioning deficit: Replaces the term”deficienc” and refers to the loss or abnormality of a body part or a physiological function or mental activity limitation.
  • Limitation: Replaces the term”disabilit” and refers to the difficulties an individual may have in carrying out activities.
  • Participation restriction: Replaces the term”handica” and refers to problems an individual may experience in involvement in life situations.
  • Barrier: Refers to all environmental factors that affect functioning and create disability.

Dependency can be understood as the result of a process that begins with a deficit in bodily functioning due to illness or accident. This deficit leads to activity limitations. When these limitations cannot be compensated for by adapting the environment, they cause participation restrictions, resulting in dependence on others for daily living activities.

Law 39/2006: The Dependency Act

This law, in effect since January 1, 2007, aims to recognize the right of citizens to promote personal autonomy and care for people in situations of dependency. It creates a system of autonomy and dependency care (Article 1).

Individuals in Situations of Dependency

  • Elderly individuals.
  • Individuals with moderate, severe, or high dependency.
  • Children under three years old with dependency.
  • Individuals with learning disabilities, intellectual disabilities, and mental illnesses.

Requirements for Dependency Benefits

  • Be Spanish or have legal residence in Spain.
  • Have a specific treatment for disabled children under three years old.
  • Be in a state of dependency at one of the grades established by law.
  • Reside in Spanish territory for five years, with two years immediately preceding the application date.
  • For children under three years old, the residency requirements apply to the person entrusted with their care and custody.

Dependency Rating

Article 26 establishes three levels of dependency, each with two levels of autonomy and required care:

Level 1 – Moderate Dependency: When a person needs help to perform various basic activities of daily living once a day or requires intermittent or limited support for personal autonomy.

or personal autonomy.