If the decision to go into a home is already difficult for you and those closest to you, when the time comes to choose it is even more difficult. The options have many limitations and the costs are increasing.
The average price of a monthly payment for a home is around 1850 euros, in a country where the average value of old-age pensions does not reach 650 euros. This opens the way for illegal homes, often without minimum conditions. And even in these there is a lack of vacancies. However, in the absence of other options, homes remain the most popular alternative.
When it became too risky to live alone, Maria Alexandra Duarte moved in with her daughter. Within months, Parkinson’s disease (and other pathologies) was compounded by the loss of a large part of mobility, following a stay in hospital. It was at that time that staying at home while her daughter went to work also stopped being a possibility.
A high expense
Ana Mestre doesn’t forget the day she left her mother at home. Today she has no doubt that her mother is better there. Every month there is an expense of 1609 euros, apart from money for diapers and medicines. It’s Maria Alexandra’s life savings that will cover the expenses, until we see.
In addition to financial concerns, finding a place in a nursing home was another concern, as is the case for many families. We took the usual route: we called social and private institutions to find out the availability of beds in various parts of the country.
We wanted to know if face-to-face contact could make a difference, but, in homes on the outskirts of Lisbon, we found a similar reality.
In this space, 20 kilometers from the capital, we found a place for R$1,600, plus the cost of diapers and medication. It was a vacancy for a woman. There are more women in homes, so there are more rooms that can be shared.
The supply of residences for the elderly is far from meeting needs. In Portugal, there are more than 2600 homes and the overwhelming majority have no vacancies. Added to this problem is the price, which has risen year after year.
Finding a place in a social home is almost a miracle and opting for a private home costs, on average, 1850 euros. When choosing, price weighs in the decision.
Maria Lopes is the founder of Lares Online, a digital platform that helps families find the space best suited to their elderly person’s needs, providing them with information and support during the process.
On the phone, social workers are answering families about what they should really consider when choosing a home.
Many people postpone the decision
Moving into a home is rarely planned and, for many seniors, remains a difficult idea to accept. There is a stigma associated with institutions that makes many families postpone this step.
With Lurdes Pinto’s father needing care and her mother overwhelmed, the family was forced to find a solution.
They couldn’t wait months for a place, so they opted for a private home. Lurdes confesses that she felt lost in this choice, not knowing what would be most suitable for her father. It was on the Lares Online website that she found someone to guide her.
For a place in a private home, Lourdes’ father pays 1,900 euros, not counting several expenses paid separately.
In the tour we made around the homes, in addition to the lack of vacancies, the spaces we found also confirm values that do not fit into most Portuguese families’ budgets.
Another of the few vacancies we found in contacts for residences, from the north to the south of the country, was also for the most expensive option.
We also learned that there are private homes where an admission fee is being charged.
Our monthly fee is 1850 euros, excluding diapers and medicines. And there is an entrance fee of 4000 euros. This jewel is not refunded in case of death or in case of withdrawal from the contract.
In Portugal there are three types of vacancies: social or reimbursed vacancies, managed by Private Social Solidarity Institutions or by Misericórdias, with agreements with Social Security. The value of this monthly fee is calculated based on each user’s income.
These institutions may also have extra-agreement vacancies. They are fewer in number and without State participation. The cost is entirely borne by the elderly person or their family. Private vacancies, in private homes or companies, are also not entitled to reimbursement.
When the situation does not allow waiting, due to a lack of vacancies in the social sector, which can take years, many families turn to the private sector. But, in these cases, Social Security does not support it.
Criticism extends to the fact that it is social institutions that define admission criteria, which can make the process unclear and leave room for those who are most disadvantaged to fall behind.
What does the State say?
The State recommends that social vacancies be allocated to those in a more vulnerable economic situation, but does not prevent access to those with higher pensions and resources.
Waiting lists in state-supported homes must be reviewed every year. Criteria such as the elderly person’s health status, family support, the conditions of the house they live in or income are some of the parameters for the user to move up or down in position.
He considers that the State contributes little: 667 euros per bed which, in the view of the president of Aurpis, in Seixal, is not enough to cover the costs.
The complaints heard in this nursing home are repeated in other institutions in the district. Fernando Sousa is in charge of the District Union of Private Social Solidarity Institutions of Setúbal, which manage homes in the social sector. It guarantees that what distinguishes a home are the people who work there and that it is difficult to find the best professionals.
Those who need support most lose out: those who do not have the money to pay a monthly fee that is generally equivalent to two minimum wages. Many can only pay with the help of their family.
The phone call shortens the distance that prevents more frequent visits. About a year ago, Deolinda Saraiva’s brother went to a nursing home in Vila de Rei (Castelo Branco), the family’s land. Losing his mobility prevented him from continuing to live alone.
He says that his brother was registered for a subsidized place four years ago. In the absence of alternatives, Deolinda confesses that she ended up in a home considered illegal.
The news of a vacancy in a shared home in Vila de Rei brought some relief to the family, who had been paying for the expenses for months. But Social Security support, along with Deolinda’s brother’s retirement, is not enough to pay for everything every month.
At 72 years old, he continues to work because of an expense he didn’t count on. He refuses to deny his brother help, but he can’t stop thinking about his own future.
A different situation from other times
The elderly who arrive at homes today are very different from those who arrived ten or twenty years ago: older, sicker, more dependent and with more cases of dementia. The structures that exist do not always follow this reality.
After the difficult decision to place Maria Alexandra in a home, both she and her family adapted to the new reality.
We contacted Social Security to find out if a strategy is planned to increase the response in social cases that depend on State co-participation, if an increase in the value of the co-payment is planned or if those who have this right and cannot find a place can be covered by co-participation in a private home. So far, we have not received a response.
From what we have seen, what exists to face family problems falls short of reality. There is a lack of policies that promote autonomy until later and provide alternatives and solutions that do not exclude anyone and guarantee dignity at this stage of life. It is a priority that cannot be postponed.
