The three dependency grades (grados) and how the assessment works

Key rules

• Scoring: The assessment gives a score from 0 to 100, and below 25 points there is no recognised dependency.
• Grades: Grado I is 25 to 49 points, Grado II is 50 to 74 points and Grado III is 75 to 100 points.
• Home visit: The assessment is usually at home, but some regions use a centre or hospital.
• Next step: A recognised grade is followed by a PIA, which gives access to services or benefits once your region approves it.

How the assessment works

A technical team from your region's dependency service visits and scores how much help the person needs with daily life. The score runs from 0 to 100 and comes from a national scale called the baremo. The result is a grade, followed by a care plan called the PIA.

The team is usually led by a social worker. Often a health professional joins, such as a nurse, doctor, psychologist or occupational therapist.

Where the visit takes place

The visit is normally at the home of the person being assessed. Some regions use a social services centre, a residential centre or a hospital instead. This is common when the person lives in a care home or is in hospital. Some regions also use remote or centre-based assessments, so ask your regional dependency service which applies to you.

The three grades

Below 25 points there is no recognised dependency. From 25 points up, the grades are:

• Grado I, moderate dependency (25 to 49 points). The person needs help at least once a day with basic daily activities, or has intermittent or limited support needs.
• Grado II, severe dependency (50 to 74 points). The person needs help two or three times a day, but not the permanent presence of a carer.
• Grado III, great dependency (75 to 100 points). The person needs help several times a day. Because of a total loss of physical, mental, intellectual or sensory autonomy, they need the continuous support of another person.

The old sub-levels within each grade were removed in 2013. You will only see the three grades now.

What happens after grading

Once a grade is recognised, a social worker from the regional or local social services drafts the PIA. It sets which services or benefits are assigned to the person. The social worker consults the person and the family first. You, your family or a legal representative take part and can state your preferences. The regional administration then issues a resolution approving the PIA, and that gives access to the services or benefits.

Prepare for the visit

The visit is where the score is decided, so prepare for it. The checklist below lists what to have ready. Three points matter most:

• Describe the difficulties of a bad day, not a good one.
• Do not help the person to look more capable than they are.
• Have a carer describe night-time needs.

The steps before and after the visit are in the step-by-step application process below.

Choosing between options

Where will the assessment visit take place?

• At your home: This is the usual rule. The team visits and applies the standard scale, which scores 0 to 100 and gives Grado I at 25 to 49 points, Grado II at 50 to 74 points or Grado III at 75 to 100 points. A PIA follows.

Live in a care home or in hospital, or told by your region to attend a centre: expect the visit there. Otherwise expect it at home.

Applying for long-term care support (Dependencia) step by step

• Gather your papers: the regional application form, ID (DNI, NIE or passport), padrón certificate (proof of where you live), a medical report from the public health system, proof of legal residence, and any authorisation if someone applies for you: before you apply

• Submit the application with the medical report to the regional social services, usually through your municipal social services centre: on the day you apply; the legal clock starts here

• Answer any request for missing papers. Income details are often looked up for you; if not, give your latest tax return or pension certificates: after the file is checked

• Take part in the assessment by the regional technical team, usually at your home: after your file is complete

• Receive the resolution that recognises your grade or denies it: the legal maximum is six months from the application, though waits are often much longer

• Meet the social worker to prepare your care plan (PIA, Programa Individual de Atención) and state your preferences, with your family: after a grade is recognised

• Receive the regional resolution approving the PIA, which gives access to the assigned services or benefits: after the social worker's proposal

Checklist

• Arrange for the person being assessed to be at home with the main carer or a relative who knows their daily routine.

• Gather the ID, the latest medical reports, the medication lists and any disability certificate.

• Write down every activity where help is needed: washing, dressing, eating, moving, medication and managing money.

• Describe the real difficulties of a bad day, not a good one, and do not help the person look more capable.

• Show the assessor the layout of the home and any adaptations.

• Ask your regional dependency service whether the visit will be at home or at a centre or hospital.

Frequently asked questions

Who carries out the assessment visit?

A technical team from your region's dependency service carries out the visit, usually a social worker. A nurse, doctor, psychologist or occupational therapist often joins. Each region sets which body does the assessing.

Can the assessment take place somewhere other than my home?

Yes, in some regions the assessment takes place at a social services centre, a residential centre or a hospital, for example when the person lives in a care home or is in hospital. Home is the usual place.

What is the PIA and who decides it?

The PIA (Programa Individual de Atención) is your individual care plan, listing which services or benefits you are given once a grade is recognised. A social worker drafts it after talking with you and your family, and you can state your preferences.

What should I show the assessor about the home?

Show the layout of the home and any adaptations, such as a ramp or a adapted bathroom. If someone cares for the person at night, they should describe those night-time needs too.