Four in Ten Dependents Lack Necessary Home Care

Directors and managers of care centres for the elderly and people with disabilities, along with numerous social organisations, have long been highlighting the many deficiencies in Spain's dependency care system. Now, the National Institute of Statistics (INE) has provided specific and updated data on the significant scale of a crisis affecting hundreds of thousands of Spaniards.

Nearly four in ten dependents in Spain do not receive the home care they need to live with minimum quality and dignity. This is either because the assistance they receive is insufficient for their needs or because they receive no help at all. This is clarified by the Living Conditions Survey of Spaniards, conducted by the INE with 2024 data, which estimates this unmet need in 37.1% of households with dependents.

The groups most affected by this lack of care are precisely those who need it most: Spaniards over 65 who live alone, with a particular deficit among women. Nearly half of these women, retired and living alone, lack any support (47.1%). The third most affected group, with 42.6% of households without care, consists of couples aged 65 or older with at least one dependent member.

The problem is not only significant but also growing. Eight years ago, in 2016, 30.8% of Spanish dependents in need of home care did not receive it. Today, that figure has risen to 37.1%, an increase of nearly six and a half points, representing a 20% rise in the rate of neglect in less than a decade. There is no single reason why they stop receiving the help they need. Some cases involve rejection or absence due to dissatisfaction with the service, but the main reason is clear: 40.6% of those without a caregiver say they cannot afford it.

The economic issue is also evident when considering family incomes. 41.3% of the poorest dependents must go without the help they need, nearly double the proportion among the wealthier, where only 24% lack a caregiver, and most do so not due to lack of money but for other reasons. The second main reason for this lack, affecting 12% of the total, is that the service, even if requested, is unavailable.

The survey shows that public administrations have made efforts in recent years to increase the benefits received by dependents, especially for the most disadvantaged. However, it also confirms that these investments remain far from what is necessary in a country with a permanently and rapidly ageing population.

The data illustrating the public effort, although insufficient, is that 30% of dependents receiving home care do so for free, representing a 50% increase in gratuity over eight years, as in 2016, only 21% did not pay for this service. However, the same data also shows that 70% are forced to pay for the help they need. In these years, the rate of gratuity has increased, especially among the dependents with the least. Among the lowest incomes, those with free home assistance are nearly half of those with help. Among those without public support, 40% report paying for care with difficulty.

The result of the public funding deficit that prevents meeting the needs of many dependents is visible in another statistic provided by INE technicians. Of the approximately two and a half million Spanish households with a dependent person, nearly one in eight of the total, only a quarter (26%) have the help of a paid caregiver. The socioeconomic gap not covered by social services support is again evident. 22.8% of households with higher-income dependents do not have a paid caregiver, and the proportion rises to 31.5% among the poorest, which is 50% more.