Spain needs 70,000 more places in nursing homes to meet WHO standards

An old woman in a residence in a town in Madrid, in a file image.CARLOS ROSILLO

In Spain there are 389,031 places in nursing homes for the elderly distributed in 5,542 centers, according to data from the Institute for the Elderly and Social Services (Imserso), published after collecting information from the autonomous communities.

These are figures for 2019. The Association of Directors and Managers of Social Services, which has analyzed the report, recalls that more than 70,000 places would be necessary to comply with the recommendation of the World Health Organization (WHO) to have five for each 100 over 65s.

According to published information, three out of four centers are private and 62% of the places are publicly funded (242,206), which also includes those that are arranged.

Although since 2010 the number of people over 65 has increased by 1.1 million to over nine million last year, residential places have only increased by 20,226, highlights the association, an expert in the sector, in a statement.

In Spain, there are 4.2 places for every 100 people over 65, of which 2.6 are publicly funded, which also includes concerted ones, and 1.6 are privately funded.

Only five autonomies reach the ratio recommended by the WHO: Castilla y León, Castilla-La Mancha, Aragon, Extremadura and Asturias, and Cantabria is close to doing so (to five hundredths).

And only Castilla y León and Castilla-La Mancha also reach this ratio with public funding places (which include their own and those that have been arranged).

The directors and managers of social services point out that the main deficits of places to reach the WHO recommendations are in Andalusia (28,457), Valencian Community (21,900), Galicia (14,902), Catalonia (9,045), Community of Madrid (8,283 ), The Canary Islands (7,472), Murcia (6,502) and the Basque Country (6,074).

And that the community with the highest percentage of places financed by the Administration is the Basque Country, with 74%, and the one with the least, Galicia, with 41%.

Aragon and the Valencian Community are the two autonomous regions that have increased the public funding places the most, the first by more than 100% and the second by 30%.

In Galicia, the Canary Islands and Madrid there is a greater number of residential places of private financing than public, recalls the association.

However, there is no homogeneous census throughout the country to fully know the residential social centers (which not only include those for the elderly, but also, for example, those for the disabled or minors).

With the data published by the Imserso, it is unknown how many of the places are occupied, how many are of public financing and management;

how many, even though they are public, are managed by a company or a non-profit organization, and how many of the private ones are in concert.

Against this background, the autonomous communities agreed last December with the Ministry of Social Rights to prepare a census on residences that includes not only the number of centers, places and residents, but also how many workers they have (number of doctors, nurses, geroculturists, etc).

In addition, according to the documents sent to the communities, the Secretary of State for Social Rights will collect information on age, sex and degree of dependency, as well as the characteristics of the infrastructure (number of floors, individual and shared rooms, etc.).

With the information currently available regarding nursing homes (there are communities that have not provided data), the average number of places per center is 70, with the highest average in the Community of Madrid (110) and the lowest in Extremadura (46).

Eight out of 10 residents are over 80 years old and 71% are women.

The average price of a public square per user per year is 20,686 euros and that of agreement, 19,324.

The average contribution of residents is 36% and 40%, respectively.

After the damage caused by covid-19 in residences, the organization calls for addressing "pending debates", such as the workforce ratios and "the need to increase" the number of farmers and their remuneration, or the model itself, "to overcome the assistance and move towards models that offer intimate environments, avoiding overcrowding and facilitating coexistence and the development of the residents' vital project ”.

Or like the location of the centers, "since their deficiency is centered in large cities", while in rural areas there are sometimes surpluses and "they are not adapted to the characteristics and needs of these territories", a factor that exacerbates depopulation.

And in large cities such as Madrid, "publicly financed places are moving away from large population centers, where private places are much more profitable."