Dependency and Care: Perspectives from the Point of View of Professionals Assessing Situations of Dependency in Spain

Objective: To describe how the assessors of dependency have perceived the process of implementation of the Dependency Act in Spain. Methods: A qualitative method was used to analyse interview data (discourse analysis). Purposive sampling was applied. Sixteen occupational therapists were included, who served as dependency assessors in Extremadura, a region of southern Spain. Data were collected through semi-structured interviews between February and March 2019, focused on the characteristic of the Dependency Act. A discourse analysis of the narrative information was performed using processes of open, axial, and selective coding, as well as the constant comparative method. Results: Three topics were identified: (1) Benefits of implementation, connected with the consideration as subjects of rights and the increase in resources. (2) Difficulties linked to the bureaucratization of the process, the lack of sensitivity of the scale of assessment, and the unequal access to benefits and services. (3) The impact of the 2012 budget cuts on financing and on dependent people and their families. Conclusions: The Dependency Act has established itself as a political tool that has generated important social and economic benefits. However, significant difficulties have emerged, which should be addressed to ensure better care for dependent persons.