A new protocol of the Conselleria de Salut has Catalan nursing homes on a war footing. The residences accuse the Generalitat of “cut” your resources even more by reducing from five to four daily diapers for each elderly person (three during the day and one at night). The Department, for its part, denies taking any steps to “reduce benefits of absorbent sanitary products” and speaks of “promotion of quality, safety and efficiency of the pharmaceutical provision”. The pharmaceutical benefit includes so much medicines as medical devices.
The CAPs assure that the department has set an objective for them this year to “reduce spending on pharmacy”
Salut published in 2021 a new protocol on urinary incontinence. However, I had not started it until a few weeks ago. “The reality is that, for a few months, different primary care centers (CAP) are trying to customize the use or need for daily absorbents for each elderly person, depending on whether they are moderately or severely incontinent. The protocol demonstrates considerable ignorance of the care reality”, ensures Andres Rueda, president of the Catalan Professional Association of Directors of Dependency Care Centers and director of the Sant Pere de les Fonts nursing home (Terrassa).
Rueda explains that there are users in nursing homes who are double incontinent (ie, they lose urine and feces). “This is a resident profile that needs more than four diapers a day, because they are bedridden or sitting all day,” says Rueda, who describes “outrageous” the new Salut protocol. “More than 40% of our elderly are in wheelchair. That’s where a lot of ulcers which then become infected. This streamlining of diapers goes on loss of quality and encourages the appearance of injuries”, denounces.
Workers denounce that this rationalization “is detrimental to quality and encourages the appearance of injuries”
Salut, however, denies the cuts and argues that residences can exceed four diapers per user if they need it. “The system emits informational notices only if more than four daily units of diapers are prescribed -in the case of daytime diapers- or one -in the case of overnight or ‘supernight’ diapers. The electronic prescription system informs about the financing conditions and the current recommendations, but it does not limit the volume of diapers prescribed”, say Salut sources.
However, the residences assure that this month the CAPs have begun to send them circular to inform that, instead of five, the diapers for each major will be four, something that they consider a “cut” that adds to the Low worker ratios. “We are absolutely against this measure. It is bad for hygiene and bad for health. More abuse for the elderly”, Rueda complains.
“The system issues informational notices only if more than four daily units of diapers are prescribed,” defends Salut
family doctors who work in the CAPs confirm that one of the objectives that Salut has marked for them this year is, precisely, reduce pharmacy spending. “They threaten us in a veiled way, saying that if we don’t reach those objectives, maybe they won’t have money to cover the staff who go on vacation,” say sources consulted by this newspaper. They have the feeling that things, for a few months, they are “worse”. “This not only affects the residences, but also the elderly at home. Diapers are usually expensive products,” they add.
“An atrocity”
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A worker of a nursing home in Tordera (Barcelona), who prefers to remain anonymous for fear of reprisals, denounces that “cutouts” such as diapers “They are happening in all residences.” Like Rueda, he describes them as “barbarity”. “There are grandparents who are bedridden 12 hours a day. A single change of diaper at night is very little because when they go to bed is when they urinate the most because the bladder relaxes more,” explains this employee.
This new measure, he says, makes the elderly “wake up wet up to the neck” and that the bed is “drenched”. “In summer it is inhuman. Some families don’t know and others are silent,” he says. This worker is now on leave, but says that she will do “everything possible not to return.” “This can with my mental health. All residences are looking for staff and they do not find auxiliaries because people no longer want to work there. The diaper thing adds to the overload of work that we carry with us”, concludes.