Friday, October 7

The Government proposes that the residences eliminate the immobilization of the elderly with restraints in three years

The negotiation continues to establish the minimum requirements that residences in the dependency care system must meet. The Ministry of Social Rights and the 2030 Agenda has convened this Friday the social dialogue table, to which it has brought a new proposal in which it sets maximum deadlines for some of the changes provided for in the document. The latest draft, to which has had access, establishes that the centers will have three years from the entry into force of the agreement to approve a “care plan free of restraints”. Recently, the death of an elderly woman in a Madrid residence suffocated by the restraining straps that tied her to the bed has emerged. The plan must contemplate the “total and safe suppression” of the immobilization of the elderly by this means, which can only be used “exceptionally” and in a protocolized manner.

An elderly woman dies suffocated by restraining straps in a Madrid residence investigated for another death

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The department led by Ione Belarra intends to reach an agreement with associations and experts in the sector, unions and employers on the standards that must be met by the services included in the System of Personal Autonomy and Dependency Care (SAAD). The underlying objective is to promote a new residential model, but it will have to be agreed with the autonomous communities, which are competent in the matter, something that the Government wants to do during this first half of the year.

If approved, from then on residential centers, day centers and home care and telecare services must adjust to the new model. The text has been under discussion since last December and it is already the third document on the table, so it can continue to be modified.

With regard to restraints, which those who use them defend are necessary to reduce the agitation of the elderly, the text establishes that “they have the right to receive care free of restraints” and the centers must “have a formal commitment” in this sense. Training will be provided to professionals and restraint must be “exceptional and in situations of urgent need” whenever there is a danger to the life or safety of the person or those around them. Previously, the failure of other alternative measures must be “clearly” verified, the consent of the person or family will be required and the process must be documented and previously communicated to the Prosecutor’s Office.

90 places and coexistence units of 15 people

In addition to a term for the general end of the restraints, in this latest proposal, Social Rights establishes one more term: seven years for existing residences to adapt to the required limits of places. They must carry out works to be divided into spaces of no more than 90 people, create coexistence units of 15 with their own rooms and rooms and have 35% individual rooms.

The new centers must have a maximum total of 90 places, they cannot be divided into sectors and they must have at least 65% individual rooms. The first draft, from December, set this maximum at 50 places. The goal is for residents to live in spaces more like homes than institutions. Residents must have spaces that “duly preserve their privacy”, they will be able to personalize their rooms “to the maximum” and enjoy “spaces of coexistence in the center” independent of the general ones. The latest draft has left the limit for residential centers for people with disabilities at 50, after raising it to 90.

Another of the latest modifications points to the minimum number of inspectors that are established to guarantee that the criteria are met: if in the previous document they were one for every 30 centers, in the new one one for every 25 has been set after complaints from the Platform State of Organizations of Relatives and Users of Residences, which claims one for every 15.

Another source of conflict with family members has been the ratios of minimum required professionals, both auxiliary or geriatric workers and health workers. The latest standard proposed by Social Rights is 0.43 in residences for the elderly until reaching a ratio of 0.51 on January 1, 2027. They are increased compared to previous drafts, but families point to the calculation that was introduced already in the previous draft. In the first, it was specified that the ratio would be calculated with respect to the total places in the center, and now “the number of places occupied in the center up to the limit of 80% of the accredited places” is taken as the basis. The Government has raised the ratio from 0.41 in the previous document to 0.43 in this one.