Spain

Demographic information

• Inhabitants: 47,021,031
• No. of citizens 65+: 7,931,164
• No. of citizens 75+: 4,061,564

Source: National Statistics Institute. Municipal Register (1 January 2010)

• No. of people with long-term care needs: 1.259.959,00 

Source: IMSERSO Area Statistics and Evaluation, Directorate General for Evaluation, Quality and Evaluation (1 April 2011)

Characteristics of health, social and long-term care delivery

Spain is a state composed of seventeen Autonomous Communities. Spain has a decentralized health and social system where Regional Ministries of Health are fully responsible for providing health and social care to the population. This welfare model, with separate health care and social services and their interventions, has changed under the new national dependency system which came into force in 2006 and established for the first time specific rights of dependent people and their caregivers. The challenges facing the new dependency care system include, in theory, coordinating the decentralised autonomous system and the state system to manage financial benefits, services and programmes, or setting up regional agencies and dependency assessment bodies that will use national criteria. In the social field, the private sector dominates the care provision. In the health sector, the provision of LTC services in mainly public. Municipalities have almost no impact on LTC planning. Regional governments supervise the care delivery in LTC.

A simplified illustration of LTC provision in Spain

Download here an illustration of possible LTC pathways for Mrs. L.T. Care in Spain.

Background information on key-issues

Quality assurance and quality management in LTC

In order to better understand the situation of quality concerning LTC in Spain we need to understand the current situation, featured by the implementation of Law 39/2006, of 14th December, on the Promotion of Personal Autonomy and Care for Dependent Persons, frequently known as Dependency Law, which aims at regulating LTC in Spain. The Dependency Law, coming into effect on 16th January of 2007, offers a new universal and subjective Right of citizenship which guarantees attendance and care for dependent people. Through the creation of the System for the Autonomy and Attendance to Dependence (SAAD), as the fourth pillar of Welfare, of gradual development from 2007 until 2014 is being made in order to reorganise and improve current resources to attend LTC (more ...)

 The role of informal care in LTC

In Spain, informal carers are generally middle aged female relatives such as wives or daughters of the dependent person between the age of 45 and 65 who either work part time or are unemployed (Carretero et al, 2009). It is also usually provided in the residence of the person in need of care, which is often shared by the carer and other family. While informal care is generally characterized by the close or familial relationship between the cared for person and his/her carer and the lack of compensation, formal care is distinguished by either training of professionals, such as doctors, nurses, or specialists and its cost, although that cost is not always paid by the person in need of care as it might be covered by the government or another organisation. However, there are some forms of care that do not fall under either definition such as untrained help hired by the person in need of care or his/her family. However, this is less common in Spain due to its family-centristic culture. At the same time, older people in need of care can receive care from both informal and formal carers at the same time; the two sources of care are not mutually exclusive and their provisions may complement each other to improve care and reduce the burden on informal carers (more ...)