One of the demographic peaks of the old continent rises in Galicia. Official records encumbran to the province of Ourense among the ten oldest areas of Europe: 31% of its inhabitants exceed 64 years and of these 230 can boast of having arrived in the world a century or more ago, twice as much as a decade ago according to the National Institute of Statistics. But in the land of Methuselah, the three public hospitals lack geriatric units and doctors with this specialty. "Longevity is a phenomenon unprecedented in the history of humanity and the UN places it as the greatest social change of this century over new technologies or climate change. But there is a lack of important planning and in Galicia it is looking the other way, "warns Miguel Ángel Vázquez, president of the Sociedade Galega de Xeriatría e Xerontoloxía (SGXX) and member of a working group of the World Health Organization. the impact of aging on health systems.
The promoters of the various protests that have erupted in recent months in Galicia due to the deterioration of the health system, they coincide in pointing out the aging of patients during the last decade as the factor that, together with budget cuts, has put hospitals and health centers to the limit. Only two of the 14 Galician public hospital centers, Vigo and Lugo, have geriatric units, services that according to experts in this specialty "improve survival, prevent functional and mental deterioration and rationalize the use of drugs." There are only 18 geriatricians working in the entire community, points out the SGXX.
Statistical studies have been drawing for years the deep wrinkles that are coming to Galicia, a portrait of a transformation that is approaching in the rest of Spain. Currently, according to the Galician Institute of Statistics (IGE), almost 25% of its inhabitants blow more than 64 candles, three points more than a decade ago and six above the Spanish average. The projections foresee that this percentage will exceed 30% in 2033. For that year, if there is no surprise birth or a rejuvenating arrival of immigrants, it is expected that for every hundred young people under 20 years of age live in Galician territory 226 older (today are 156). This population, the Xunta assures, already absorbs more than half of the annual sanitary cost.
In these years of cuts, doctors have seen how in the consultations and emergencies multiply the octogenarian patients and those who already have the last slope towards the Olympus of the centenarians. Andrea Gallego has been a family doctor for 30 years at the Sagrado Corazón de Lugo health center, another of the oldest areas in Europe. He has witnessed how recession and austerity have impoverished his patients and "weakened" health and social services, the latter vital for the elderly.
Gallego criticizes the lack of time to assist some people who have difficulties even to undress when they are explored, who often can not go to the ambulatory and with whom one has to make very thoughtful decisions because they carry various pathologies and medications: a more organized care around the elderly, the family doctor has to act as an axis to agree on all the specialties that this person circulates and it is complicated, each specialist looks at his part and we have to reconcile them ".
On a regular day, this doctor attends to about 40 people and about 25 are elderly. Marriages abound over 80 years, both sick, who assist each other for lack of caregiver and who, living in the second community with the lowest pensions in Spain, fight to survive evils such as energy poverty. "The most important factors that intervene in the health of the population are not doctors, they are economic issues, the standard of living of patients, and in this crisis we have regressed years in the living conditions especially of our elders. very serious problem ", warns Gallego.
The Xunta asks for more money from the State
The Government of Alberto Núñez Feijóo (PP) claims that the distribution of funds between communities by the Central Administration consider aging and extra needs that face public services to meet these citizens in conditions. According to data from the Xunta, 8.1% of Galicians exceed 85 years and prescriptions are a quarter of all pharmaceutical spending.
The economist Berta Rivera Castiñeira, director of the Macroeconomics and Health research group at the University of A Coruña, maintains, however, that aging "is not the most important factor in the increase in health spending." Others, such as the acquisition of technology or the increase in benefits, make the Galician health service bill even more fatuous, he explains. In his opinion, the "tensions" that the greater age of patients is causing in health have more to do with an "imbalance between the needs of before and now" and with the lack of adaptation of the organization of the system to the new demographic structure. "The lifestyle has changed and Today a person of 65 years has more autonomy than the people of that age ten years ago; you get to a more advanced age but also with better health, "says Rivera.
The geriatrician Miguel Ángel Vázquez, who has been advising various Latin American governments on aging since 1994, agrees that health care for the elderly is not only a matter of resources, but "of planning, organization and coordination with social services." "Galicia has an impressive dispersion and, however, is in line in Spain in telecare. It is worth six euros a month, so it is not a problem of resources ", argues the president of the Galician society of geriatrics. Neither does he believe that "all responsibility lies with politicians, who have it". "There is also a social responsibility. If you go to the doctor with a child and a pediatrician does not see you, protests. And if you're pregnant and a midwife does not take care of you, too. Why not do the same when older people are not treated by specialists? Hospitals are aggressive sites for them and should be in the hands of people who understand their needs. "
To face the coming years, those in which the generation of baby boom will reach the age of retirement, Vázquez claims to the Xunta geriatric units in all hospitals, provide primary care services geriatric care in each region and programs for the prevention of aging in which companies are also involved. "We must change the social image of aging," he argues. "Ageism is the third discrimination after racism and machismo and kills more than high blood pressure. It is dramatic that just because he is 92 years old, no one is treated; First you have to evaluate it. "
The Ministry of Finance conducted a study in 2013 that compared the health expenditure that Galicia faced that year and what it would have if its demographic structure were equal to the Spanish average. According to that analysis, assisting an aging population required 317 million euros in that year. Of the 841 million that the Galician health service invested in that year, 525 were to pay for the prescriptions of those over 65. The calculations concluded that Galicians of retirement age go more than twice as often to primary care visits as other adults and adolescents, a frequency that rises threefold in the case of those over 80, and is the half of those admitted to hospitals.
From the Galician Health Service (Sergas) elude explain the lack in Galicia of geriatric units in hospitals and primary care despite being treated for years of one of the most aging territories in the world. Official sources of this department are limited to pointing out the existence of a project presented in November to "elaborate and implement" an "integral health care plan for chronic patients:" Given the degree of population aging, an organizational adaptation is necessary. the start-up of new work dynamics that favor a comprehensive socio-health care, with a global vision of people and a broad temporal perspective ".