What the system can assign: home help, day centre or care home

Terms used

• Teleasistencia — Teleasistencia is a remote-alert service that lets you call for help from home at any time.
• Ayuda a domicilio — Ayuda a domicilio is home help with personal care and household tasks.
• Centro de día y de noche — A centro de día y de noche is a centre that looks after you for the day or the night.
• Atención residencial — Atención residencial is a place in a care home.
• Programa Individual de Atención — The Programa Individual de Atención (PIA) is your personal care plan, setting which services or benefits you receive.
• Centros concertados — Centros concertados are private centres that the public authorities fund to provide places.
• Prestación económica vinculada al servicio — The prestación económica vinculada al servicio is cash to buy a private service when no public place is available.
• Prestación económica para cuidados en el entorno familiar — The prestación económica para cuidados en el entorno familiar is exceptional cash paid to a family member who cares for you at home.

Key rules

• Services first: Services take priority over cash benefits.
• No guaranteed choice: You can state a preference for a care home or day centre, but you cannot insist on a specific one.
• Family carer cash: Payment to a family carer is exceptional and needs your care plan to recognise it.
• Region matters: Amounts and access conditions are set by each region.

Services come first, cash only in defined cases

The system assigns services from a fixed catalogue. Cash benefits exist, but only in defined cases. What you are actually offered, and the amounts, depend on your grade and your region.

The services on offer

• Prevention and personal autonomy services. These aim to delay or reduce dependency.
• Teleasistencia. A device or service that lets you call for help from home.
• Ayuda a domicilio. Home help covering personal care and household needs.
• Centro de día y de noche. A day or night centre.
• Atención residencial. A place in a care home, either for older people or for people with a disability.

How the service is chosen

Your care plan, the Programa Individual de Atención (PIA), sets the type of service. You can state a preference, for example for a particular care home or day centre. You do not have an absolute right to a specific one. Places depend on what is available in public centres and in centros concertados.

Refusing a suitable place without a good reason can lead to the service being removed from your plan or the benefit being lost. The consequences vary by region. Many families accept the place offered and then ask for a transfer, or stay on a waiting list.

The three cash benefits

1. Prestación económica vinculada al servicio. Paid to buy a service from a private provider when no public place is available. This is the usual fallback when there is no place.
2. Prestación económica para cuidados en el entorno familiar. Paid to a family carer. It is exceptional. You must live at home, the home must suit care, and your plan must recognise it. It is the lowest of the three.
3. Prestación económica de asistencia personal. Pays for a personal assistant who helps with work, education and daily life. It is open to people with grade III. Depending on regional rules, it may also be open to grades II and I.

What you would be paid

Maximum monthly amounts are set for each grade (I, II and III) and updated from time to time. What you actually receive also depends on your income and assets and on your region's rules. Ask your regional dependency office for the current figures for your grade.

The choice between a service and cash is set out in the decision below, and common questions on refusals and waiting are in the FAQ.

Choosing between options

Which kind of support will your care plan give you: a service or a cash benefit?

• A service from the catalogue: This is the default. The system offers teleassistance, home help, a day or night centre, or a residential care home, plus prevention and autonomy services, depending on your grade and region.

• Cash to buy a service privately: This fits when no public place is available. Your region pays you to buy the service from a private provider.

• Cash for a family carer: This fits only in exceptional cases: you live at home, the home conditions allow it, and your care plan recognises it.

• Cash for a personal assistant: This fits if you need help with work, education and daily life. It is open to people with Grado III or, depending on the rules, Grado II and Grado I.

Services come first in law. Cash benefits are granted only in these defined cases, and what is actually offered depends on your grade and region.

Frequently asked questions

Can I choose the care home I am assigned?

No, you have no absolute right to choose a specific care home, but you can state your preferences. Your care plan (the PIA) sets the type of service, and the place depends on what is free in public or publicly funded private centres. Many people accept a place first and ask for a transfer later.

What happens if I refuse a place that is offered?

Refusing a suitable place without a good reason can get the service removed from your care plan or lose you the benefit, depending on your region. Ask your regional social services office what counts as a justified refusal before you say no.

What happens if there is no public place available?

Your region can pay you a cash benefit linked to the service instead, so you can buy the service from a private provider. It is meant to cover the gap until a public place is free.

Is the cash benefit for family carers paid to everyone?

No, the cash benefit for care by a family member is exceptional. It is granted only if you live at home, the home conditions allow it, and your care plan recognises it. It is the lowest of the three cash benefits.