The characteristics of social health care for dependent people in social institutions.
Throughout our development and growth, the vast majority of the population acquires a set of knowledge and skills thanks to which we are going to forge our identity, our way of seeing the world and the way in which we interact with it. We are learning how to perform tasks that allow us an autonomous and independent subsistence.
However, there are people who for some reason have lost or have not sufficiently developed the necessary skills to carry out day-to-day activities in a totally autonomous way. These people may need some kind of supervision, help or support in the different daily tasks, help that can be provided in many cases by different types of social and health institution.
For this, professionals capable of responding to the needs of this sector of the population are needed, thus requiring training in social and health care for dependent people in social institutions. It is about this topic that we are going to talk throughout this article.
What is social health care for dependent people?
To understand the type of care that should be offered by social institutions to dependent people, it is first necessary to take into account what the concept of dependent person refers to.
We consider a person as a dependent when he / she is in a situation or state of generally permanent characteristics in which for some reason said person has lost or seen his / her faculties or capacities to lead a totally autonomous life reduced, or when he / she has not been able to develop said capabilities completely up to levels that allow independent performance and adaptability to environmental and social demands.
Dependence implies the need for care, support or supervision by other people (or resources) outside the subject himself in order to be able to carry out day-to-day activities or to maintain a performance as autonomous as possible.
Although, in general, when talking about dependency, people with intellectual disabilities or some type of neurodegenerative disease are usually thought of, the truth is that within the concept of dependent person those subjects who have some degree of physical or sensory disability or whose vital activity is highly interfered with by the presence of some type of psychiatric problem.
In addition, people of advanced age or those with delicate health that require continuous assistance are also included.
In some cases the person is in a situation of legal incapacity and may be tutored by a relative or foundation, although it is not necessary to be legally incapacitated to have some degree of dependency.
Thus, support or social health care is not something that only implies an action at a cognitive level but rather comprehensive care, which may include different types of actions depending on the needs, difficulties and / or potential of the subject. It is important to appreciate that the intention of this type of service is not only to alleviate possible deficits, but also to maximize and optimize the individual’s strengths, as well as their quality of life.
It should also be taken into account that when speaking of social health care in social institutions we refer to care that is offered in an organization or structure dedicated to the service and search for the well-being of users, and whose action can be carried out in multiple settings.
Types of social institution for people with some type of dependency
Regarding the type of resource or social or socio-healthcare institution offered to dependent people, we can find different categories with different objectives and types of treatments or supports offered. In this sense, some of the most common are the following.
1. Service for the prevention of dependency situations
These are devices whose main purpose is to try to prevent or limit the possibility or worsening of dependency situations in the population at risk, the most obvious example being that of people with a congenital disability or people of advanced age. Thus, in this type of device we work with a population that either does not yet have a dependency situation or it is sought that this does not limit more than what the autonomy of the person is already doing.
2. Hospitals and Day Centers
Probably the most well-known types of service or socio-sanitary institution, day centers and day hospitals have the main objective of providing complete and comprehensive care to users in order to increase or maintain their level of autonomy, socio-community participation, capacity to self-management and in general their quality of life.
Their biopsychosocial work usually includes the application of rehabilitation measures, restoration or compensation of functions, orientation and advice for the user, facilitation and training of social and family bonding without requiring an income, promoting healthy habits, performing a control of the situation and provide support to both the end user and their environment.
3. Residential Care Centers
This last type of center, also highly known, is dedicated to offering comprehensive social health care but for people who are admitted or located in the same service, in which they live (either permanently or temporarily).
In these centers, users carry out different types of activities, workshops or therapies (depending on the case) that allow them to improve and / or preserve their autonomy and / or capacities, favor their connection and socialization. An example of this type of service can be found in the Llar Residencia, in Catalonia (Hogar Residencia, in Spanish).
4. Other types of service
Although the previous three are some of the most common, it is also worth mentioning the existence of many other types of assistance services for dependent people. Among them we can find the telecare service or home help.
Likewise, and on a more comprehensive health level, we can find various services within the public health portfolio, such as, for example, highly dependent psychiatric units or admission to acute or subacute units, neuropsychiatry or psychogeriatrics.
Degree of dependency and activities from which they are analyzed
It must be borne in mind that in order to offer quality social health care to dependent people, it is necessary first of all to know what their needs are and to what degree they present some type of dependency.
In this sense, it will be necessary for a professional with the appropriate training to be able to assess the subject, for which he will use one or more questionnaires and the observation of the subject as well as the characteristics and reports of his vital situation and the environment. With this, a score will be obtained in the Dependency Assessment Scale that will serve to determine the type or degree of dependency of the person in question.
The type of activities that are analyzed are generally the basic activities of daily life: nutrition, hygiene, sleep, toilet training, mobility and movement, housework, ability to maintain health, ability to make decisions . It is also taken into account if, for example, external help or guidance is required to carry out these actions.
Based on the scale that we have seen, we can obtain three types of dependency: Grade I or moderate in which the subject needs some specific help to be autonomous, Grade II or severe in which although a caregiver is not needed permanent help is needed several times a day to carry out certain basic activities and Grade III or high dependency in which the subject needs a caregiver, supervision or continuous help in their day to day.
Another factor to take into account is that caring for a dependent person requires the collaboration of different professionals from various branches, both health and social.
The specific type of professionals that each person will need can vary depending on the case, but broadly speaking we can find doctors (from any branch be neurology, speech therapy, cardiology, endocrinology, immunology …), nurses, psychologists, assistants, physiotherapists, speech therapists , occupational therapists, social workers, educators, teachers and pedagogues (and not only in the case of children) and in some cases even lawyers.
All of them must coordinate their actions to offer comprehensive care that takes into account the needs, potentialities and difficulties of the dependent person in order to improve their quality of life as much as possible.
Although the different professionals involved will work focusing on their specialty in order to help the subject, we can roughly determine the general nature of the main work that social health care has for dependent people in social institutions.
The performance of the professionals is aimed at the development and implementation of programs aimed at providing assistance that allows the subject to carry out the basic activities with which they have difficulties, the rehabilitation or compensation of systems, capacities and functions, the incorporation from the subject to social participation and bonding with other people and education and psychoeducation directed both to the subject and their environment in order to face possible difficulties and improve the standard of living and the autonomy of the subject.
This action includes the approach to therapies and activities aimed at cognitive stimulation, the cognitive restructuring of distorted beliefs, the use of occupational therapy to improve functionality in basic activities, the promotion of health and the prevention of damage. , adherence to treatments, if any, stress or emotion management or improvement of social participation through various activities and training, among many others.
All this, always maintaining an ethical line in which dignity, confidentiality and respect for the capabilities and independence of the subject prevail, while generating a warm and comfortable environment and seeking the maximum benefit for the subject and avoiding in as possible any damage produced by the care action itself.
- Institute for Training and Social Studies (IFES). Territorial Directorate of Andalusia. (2010). Health care to dependents in social institutions. Training Module 1. Support in the Organization of Interventions at the Institutional Level. Training Unit 1. Support in Reception and Reception in Institutions for Dependent People. Andalusia, Spain.