Follow up model of the Financial Assistance for Care in the environment and support for Care Givers of People in a situation of Dependence
The Monitoring model for cases in which the financial aid for care in the environment, which is not an analysis on aid and services, nor does it aim to reflect on said aids or their development throughout these latest years. The trend, well known for its extension relative to other features and services despite being regarded as an exceptional provision in the legislative text, shows us a reality in which the PECEF has been placed first in the ranking of the assignments catalogue of services and aid. Reality in which this provision has acquired an unforeseen dimension.
Unlike other services or aids referred to in Articles 14 and 15 of Law 39/2006 on the Promotion of Personal Autonomy and Care for Dependent Persons, such as Residential Centres, Day Centres, Home Help Service, Telephone assistance or other financial aids such as those linked to a service (PEVS) or the Personal Assistant (PEAP) in which is given a share of formal services, financial aid for care in the environment (PECEF) incidence and adequacy cab only be found in the hand of the dependent or of his/her caregiver.
The Monitoring Model establishes a procedure for action that allows for intervention, from the beginning or access to benefits or services and after the allocation of the ideal performance as the first phase of the process, it considers a subsequent monitoring of appropriate cases and to ensure quality of care and support. Where appropriate, when malfunctions or failures are identified, a complementary reassessment and analysis of alternatives for providing additional support or to ensure adequate alternative care are identified.
Therefore the approach is proposing a scope beyond the strict follow-up action on an already established situation and incorporating the process as a whole. In the application of the Model, it must always be kept in mind that the objective of supervision is to ensure that care is actually provided with sufficient intensity and that the quality of care is adequate. Also, that caregivers exercise their role under appropriate conditions. In addition to in the environment and context in which care and life are carried out, there is sufficient security.
For this, the process as a whole is analysed, from entering the system and its subsequent evolution, to consider at every stage of the process what type of intervention should be developed. Sufficient knowledge of the case will be necessary in the first phase, in addition to providing information and timely guidance from the start, visiting or making or follow-up contacts with frequencies in a later stage, analysing its evolution and, based on this, the degree of adequacy of the provision.
The Model presented is based on the pilot promoted and funded by the Provincial Council of Gipuzkoa with the collaboration of the municipalities of Irun and Arrasate, which was carried out between July 2014 and February 2015.
Project in which a sample of 320 cases have been used, 215 in Irun and 105 in Arrasate, recipients of the PECEF and also without additional formal services, with aid being given prior to the year 2012 and with Dependency Report Grade II and III.
65% of cases that meet these criteria have been included in the sample, differentiated by age and completeness, 100% of cases in which the age of the caregiver was 75 or older.
The experience has allowed us to design and test the Questionnaire for the case analysis that has been used in the interviews in the homes of people receiving aid. It also has revealed that the visit to habitual living environment of the person is decisive for successful intervention, in which the caregiver is incorporated as a key player in care in the home environment.
The approach of Monitoring Model does not aim to introduce a control/inspection system of the financial aids, but rather necessary supervision in situations of recipient dependence on a financial assistance for care in the environment. Supervision should be based on in-depth knowledge from the beginning, access and allocation of the aid, and a permanent two-way collaborative communication between the Public Service and the family. Permanent and personalised relationship that will allow for identifying changes, assessing new scenarios, agreeing and articulating changes etc. to find the best match between needs and responses.
The main objective is:
Ensuring that care is actually provided with sufficient intensity and that the quality of care is adequate. Also, that caregivers exercise their role under appropriate conditions. In addition to in the environment and context in which care and life are carried out, there is sufficient security.
Therefore the scope goes beyond ensuring the quality of life of the person in a situation of dependency as it incorporates the care giver's role, in addition to the possible consequences of the care.
"Keys for the suitability of the PECEF" (based on financial assistance and other forms of individual financial allocation systems in dependency care systems. SIIS)
Other objectives of monitoring and supervision model are:
- Identifying variations and changes over time that occur in situations of dependency and acting accordingly.
- Customise interventions by Social Services based on the differentiation of circumstances and contexts that characterise situations of dependency.
- Optimising resources, both professional and social services, as the resources contained in the Social Policy are its catalog of benefits and services.
The referral professional should establish a diagnosis of the situation after analysing the information collected by various means, BVD, questionnaire, visit etc.
It will not always be easy to establish a diagnosis with full certainty by applying a method of analysis that, in addition to objective information, will contain information derived from the professional reference's observation and perception which may be subjective. Professional competence in the management and treatment of cases is crucial in this diagnostic function. As such, the professional must keep in mind the context of aid and services in the dependency care system and the purpose of each. Also, the regulations.
Demand, in addition to processing information and relating it in a permanent contrast between the issues addressed, consider actions that can and should be applied in a differentiated and customised way to each situation (information, guidance, advice, psychological or complementary support) and/or referral to another alternative services or aid.
Following the approach of the Model, the professional should establish a degree of adequacy for each case. There may be situations that require further analysis, for certain causes, before determining the diagnosis. A second visit or a short term deadline may be necessary until reaching a conclusion.