Support to Battle Against Loneliness in Elderly People who are Legally Classified as Incapacitated and Have No Financial Resources , Barcelona

Project location: SPAIN, Barcelona
Project start date: March 2018 - Project end date: February 2021
Project number: 2018-013
Beneficiary: Fundacio Jaume Batlle Bigas, Entitat Tutelar

Scientific advances and the widespread development of the welfare state have resulted in a considerable increase in the life expectancy of people and, as a consequence, many may live these years in relatively good health. However, this increase in life expectancy, which is undoubtedly a positive development, also involves negative aspects such as an increased risk of developing illnesses, among them age-related degenerative brain diseases. Thus, diagnoses of senile dementia and Alzheimer's disease are at an all-time high. People affected by these illnesses are not held responsible for their actions in the eyes of the law, which provides for a process to protect them, their health and their property (erroneously dubbed "incapacitation"). This results in the adoption of a range of protection measures issued by a judge, including the appointment of a guardian, who is usually a relative (for obvious reasons, the law gives priority to family members). However, where this is not possible or the circumstances observed by the judge advise against it, the law in Catalonia stipulates that this guardian is the Catalan government, which in turn appoints and supervises a wardship entity.

The region of Catalonia, which is historically characterised by its associative tradition, has decided to deal with such cases by transferring wardship duties to private, non-profit entities, which are partly subsidised by the government. There are 67 such entities in Catalonia, but just 12 are dedicated exclusively to the elderly population segment; among these is the Jaume Batlle Bigas Foundation.
In 2003, the Catalan Ministry of Labour, Social Affairs and Families granted accreditation to the Jaume Batlle Bigas Foundation for the exercise of wardship positions in Catalonia, and since then the Foundation has exercised more than 291 wardship positions. It currently exercises 106 such positions.

The fact that it is subsidised by the government means that the Foundation must exercise its functions in a professional manner, through the implementation of a suitably qualified workforce with proper employment contracts, made up of social workers, assistant guardians, administration staff, a legal department and management personnel.

The government's model therefore imposes minimum staffing levels and quality indicators that, in the opinion of the Foundation and its Board of Trustees, are insufficient to cover some of the basic needs of those placed under wardship (wards). Aspects not covered by the public subsidy include the need to create emotional, social relationships with those who do not have access to such a network.
Most wardship cases that are referred to the Foundation are characterised by this absence and by the striking levels of loneliness in the lives of these people that reach far beyond the constraints they experience in other aspects of their lives, such as food, health and administration of their assets, which, of course, also become the responsibility of the Foundation from the moment it accepts the wardship role.
To manage each wardship, current regulations stipulate a minimum of one monthly visit by the main guardian and three by the assistant guardian. This means that every ward without family or friends (who make up the majority) receives four visits a month from the Foundation's staff. In other words, those who have no family relationships or active friendships can spend 26 days without any kind of personalised contact, i.e. without anyone spending a few hours chatting to them and, if their health allows it, going for a walk or even eating in a nearby restaurant.

In order to reverse these situations of acute loneliness as far as possible and to stay faithful to the people-centred goals that have set the Jaume Batlle Bigas Foundation apart, it has created the role of the "companion" for wards with no financial resources. This role is not included in the government-subsidised model.

This initiative began in 2015 with the invaluable help of the The Nando and Elsa Peretti Foundation, Delegació a Catalunya.

The companion forms part of the Foundation's social department and visits wards who, in the opinion of the department manager, require special attention and meet the criteria for being beneficiaries of such care: wards without a family network and/or active friendships, and without financial resources.

Therefore, the companion is initially guided by the person responsible for each ward, and a monthly schedule is created, with weekly visits lasting approximately two to three hours each. A companion can make around 15 to 20 visits a week, which equates to an average of 30-40 wards visited per month.

The duties of this professional are to keep wards company and care for and anticipate their basic daily needs, especially their emotional and human needs. These actions are aimed at, for example, increasing, as far as possible, the physical well-being and muscular mobility of wards by encouraging movement either within their home or outside. Moreover, longer periods of conversation undoubtedly result in mental benefits that translate to improvements in both their physical health and, above all, their emotional health. Therefore, the added value this professional offers legally incapacitated wards with no financial resources is evident and considerable, and unquestionably improves their quality of life.

After each visit, the companion draws up a report, which is checked by the main guardian for each case. This information, in addition to the information obtained by the main and assistant guardians, can be used to take decisions that are more adequately suited to each ward and better meet their personal, health-related, financial and emotional needs. The companion is a member of the social department and, as such, attends the weekly meetings held by this department.

The personal bond established with the ward is, without doubt, the most important aspect, because it would not exist without the regular presence of the companion. It helps improve and dignify the final stages of these people's lives.

The permanent recruitment of a professional to form part of the social department, known as a companion, with 30 hours' commitment per week, has, in recent years, allowed the Jaume Batlle Bigas Foundation to meet the basic needs (social, medical, emotional, etc.) of 45 wards with this profile type (i.e. people who are alone, without any social or family support network and no financial resources), in order to improve and dignify, as far as possible, the final stages of their lives.

In view of the achievements of the last two years due to the actions of the companion, who was recruited thanks to aid granted by the Catalan branch of the Nando and Elsa Peretti Foundation, the Jaume Batlle Bigas Foundation hopes to continue providing this important service that makes its social responsibility (i.e. social impact) considerably more effective, but that has an invaluable personal impact on the individual lives of these people.

In view of the number of wards who need this personal companionship, the Foundation also plans to address this new stage with the addition of a second companion so that the care provided by this role can be extended to 80-95 wards.

The staffing costs of recruiting a new companion, this time on a full-time basis (40 hours per week), are higher that those for the current companion because of the increase in hours and the fact that it requires a minimum level of training and, therefore, a professional category that increases the base salary. Likewise, the theoretical maximum cost has been reflected without taking into account possible employment benefits due to the recruited individual's age, social and labour situation.