The future of long-term care, those that guarantee support to older people when they lose autonomy, has returned to the forefront of public debate. The recent decision of the Spanish Council of Ministers to create a specific commission to address this challenge has been received as a necessary step forward by the Spanish Confederation of Senior Citizens' Organizations (CEOMA). However, "optimism comes accompanied by a clear warning: the future of care cannot be designed without listening to those who need it most," it states.
Spain faces an accelerated aging process and more and more people require continuous help for daily activities. In this context, the creation of an Interministerial Commission to promote a fairer, more sustainable, and person-centered model is interpreted as an opportunity. But from CEOMA regret that, in its current approach, senior associations are not directly part of either the plenary or the working groups.
The president of the organization, José Luis Fernández Santillana, insists to Demócrata that the experience of those who live this reality is essential. "It's not just about participating occasionally -he points out-, but about being stably present in the spaces where decisions are made." In his opinion, "excluding that voice can distance policies from true needs and weaken the legitimacy of reforms."
In data
The best country, the most backward
Long-term care offered by healthcare systems for older people varies enormously worldwide. While some countries offer comprehensive and universal services, others rely almost exclusively on family and private resources.
In Norway, the care system is a global example. All citizens have access to medical and social assistance, either at home or in residences, funded by the State. Caregivers are highly trained, and the autonomy and emotional well-being of older people are prioritized. The result is high satisfaction and a lower burden for families.
In contrast, India reflects the challenges of countries with fragmented systems. Most care falls on family members without significant institutional support. Professional services are scarce and expensive, and the quality of care varies enormously. This generates family overload and inequality in access to dignified care.
The cost that falls on families
The issue gains even more relevance if one observes how the long-term care system works in Spain. Nowadays, a good part of the care falls on families, who assume a fundamental role in daily care. Although there are services such as home help, day centers or residences, their development is uneven and, in many cases, insufficient to cover the growing demand.
Furthermore -underscores Fernández Santillana-, "the economic effort continues to be limited in comparison with other European countries. Spain allocates around one percent of its wealth to these cares, a figure clearly inferior to the European Union average, where investment practically doubles". In northern countries, with more consolidated systems, spending is even higher and allows for offering a broader and more professionalized network of services.
José Luis Fernández Santillana:"Giving a voice to older people is not just a matter of participation, but a necessary condition to build a care system that truly responds to their expectations"
The total cost of these cares, both those provided by professionals and those assumed by families, reaches very high figures and does not stop growing with the passage of time. "It is a challenge not only social, but also economic, which will force a rethinking of the model in the coming years if dignified and universal care is to be guaranteed," indicates the president of CEOMA.
In this scenario, the request of Spanish Confederation of Senior Citizens' Organizations (CEOMA) acquires a special weight: "Giving a voice to older people is not just a matter of participation, but a necessary condition to build a care system that truly responds to their expectations. Because, in the end -adds CEOMA-, the debate does not revolve solely around resources or structures, but around something much closer: how we want to live and be cared for in a decisive stage of life".