Annex 1: Dependency degree for activities of daily life
Dependency is defined as the permanent state of persons who, for reasons of age, illness or disability, and linked to the lack or loss of physical, mental, intellectual or sensory autonomy, require the care of another person or persons to carry out basic activities of daily life or, in the case of persons with an intellectual disability or mental illness, other support for their personal autonomy.
The Open Up Guide for the Care Sector recommends disaggregating the dependency for daily life required by the different groups of people with the support of datasets containing such a disaggregation. The aim is to recognise the different care needs of different populations. For example, a child under 3 years of age has more demanding but also different care needs than a 15-year-old adolescent. A person with a hearing impairment has different care needs than a person with a total motor disability. A 65 year old has different care needs than a 95 year old. Thus, the Open Up Guide and its subsequent Care System recognises different capacities, different needs, and aims to disaggregate the target populations as far as possible, so that it is possible to have a more accurate understanding of what care services are required compared to what exists.
The Barthel index is recommended as a reference for the development of dependency indicators. Some countries have developed measurement instruments to identify these types of populations through censuses or national surveys. As an example, in Mexico's 2020 Census, people are asked about the difficulty in exercising some types of activities according to their disability and it is disaggregated as follows:
Distribution by type of disability in the population of children and adolescents:
Type: Visual, Hearing, Mobility, Cognitive, Autonomy, Expression, Mental.
Response of the population: does it with little difficulty, with great difficulty, cannot do it.
Population between 0 and 17 years old.
Distribution by type of disability in the population of elderly:
Type: Visual, Hearing, Mobility, Cognitive, Autonomy, Expression, Mental.
Response of the population: does it with little difficulty, with great difficulty, cannot do it.
Population over 60 years of age.
Distribution of disability in the population
Type: Visual, Hearing, Mobility, Cognitive, Autonomy, Expression, Mental.
Response of the population: does it with little difficulty, with great difficulty, cannot.
Population with disabilities.
Based on the responses, a degree of difficulty is calculated using the following table:
| Dependency degree | Score |
|---|---|
Total | 0 - 20 |
Severe | 21 - 60 |
Moderated | 61 - 90 |
Slight | 91 - 99 |
Null | 100 |
As an implementer of this guide, we recommend you search for data that disaggregates the target populations into meaningful categories for their necessities of care. You may use information in this annex and the information in the Methodological considerations page to determine how to do this.
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