It is usually said that of such a stick, such a splinter.It is not always so, although in the case of Rocío Pérez Cortés the saying is valid.Her mother, nurse, took the first steps of the Mirasierra residence in Cercedilla 30 years ago and for some time she is she who has taken the controls and acts as director and manager of the center.It is a family business, and therefore does not have to account for anyone, according to the phone from the other side of the phone."If at the end of the year we have taken five hard, five hard that we reinvest at the residence," he says.He has always maintained the 46 places that his mother started because he believes that with that it is enough to achieve his two objectives: that the center is profitable and that the attention is personalized enough for each resident to be known for who he is, who hasbeen and who is your family.And that each worker can get to know them in this way.A way of working that, in Rocío's opinion, in addition to offering a better service, has allowed the center to become a kind of Fortin safe from Coronavirus."We have not had any cases," he says, proud.It is not for less.Just 35 minutes from his residence, in the city of Madrid, the COVID-19 has hit the elderly centers, converted into the worst spotlights of the disease.

Mirasierra de Cercedilla residence.

The opacity of the community is maximum, but the numbers end up coming to light.And they are bleak.Madrid is the region that, with enormous difference, accumulates more deaths in its geriatrics by pandemic.In the 475 residences in the region they have died from March 8 to Apriltwo2 at least 7.007 people and, from them, 1.017 had COVID-19 and 4.596 suffered symptomatology compatible with coronavirus.In total, 5.613 Major dead with a safe or probable condition of the COVID-19, which is equivalent to 80% of the total death.Catalonia, the other great focus of the coronavirus, either is left behind: April 30 had died in Catalan residences 1.046 people with confirmed positive and 1.950 with compatible symptoms.two.996 deaths in total.

But there are also forts where the coronavirus has not yet entered.A short distance from the Sagrada Familia, in the Eixample district of Barcelona, is the Senior Center residence, directed by Agustí Ramón.It is kilometers away from the center of Rocío, but both have a lot in common.The Catalan residence has only three places more than the Madrid."There are 49 residents, 44 of them in public and five in private squares," explains Agustí.The 'trick' he uses is the same: he shelters few elders, but all are treated in the most personalized and individualized way possible.Something that, says by phone, cannot be done in centers that exceed hundred users."The ideal number of residents is between 50 and 70 people.If there is less, there are too many economic complications, and if there is more, we stop knowing the resident by name and for their customs, "explains Agustí. "Cuando hay muchas personas, el señor Pedro deja de ser el señor Pedro para convertirse en el residente de latwo14.There he begins to depersonalize everything, "he laments.

Fighting Covid-19

Mirasierra de Cercedilla residence.

It has not been easy, neither for one or another.Protecting the almost 100 residents that add between the two has been the task that were marked since in March the Coronavirus began to show their virulence, especially against the elderly. En el centro de Rocío pudieron comenzar a hacerlo gracias a la experiencia que ya tenían sustwo0 trabajadoras en la lucha contra la gripe, "que año a año también se lleva a muchos ancianos", lamenta."Every year, in addition to vaccinating residents and workers, we emphasize hygiene measures," he says.So the first was to copy that modus operandi.They did it in mid -February, when they also began to control all the relatives who entered the residence."Everyone did them through the same door, their hands were hygienized and the spaces they could travel had bounded," he says.If they normally have five rooms open, then they began to allow the step only for two.The workers, in the same way, had to extreme precautions.None began to work without the proper hand washing and without changing the uniform that, since then, had to remain in the residence to be washed and disinfected right there.

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Thus, between washing and handwashing and between family control and control, they reached the month of March."We started seeing that a tsunami came," says Rocío.So the next step was "to begin to raise awareness among family".He spoke with them and told them that we would have to start taking more drastic measures."One of the first was to prohibit them from getting the elderly to eat outside the residence," he recalls.Until March 6.That day they closed.

"From then on the objective was to reduce the possibilities of contagion," explains Rocío.In a place where residents do not go outside, the only way for the virus to enter was to do it with a worker or with someone who arrived from the outside.So he reduced the suppliers to two and kept six workers living in the center.Four already did it before, but the other two lived in shared floors and were a greater risk."In addition, I assured me that although there were attention to residents, it was going to be able to maintain without diminishing the services we give them," he says.Prevention, in a word.

And knowledge of users, in another.They used the five rooms again, since they were able to better maintain security distances between them, but one dedicated it exclusively to six people with respiratory pathologies."So we could have them much more controlled.A cough sounded and was the doctor "who have hired in the center - despite the fact that the law only forces it in the centers of more than 50 residents."As we know the elderly, we can sectorize them well.In large residences they have done it in zones, but you cannot isolate a greater 15 days in a room.If Covid-19 does not take it, it takes place, "Rocío laments.

That is why it was also important that, before a pandemic that broke out overnight, the elders knew what was happening.And that was the work carried out by Agustí with the psychologist of his center, who worked with each and every residents to explain that his relatives would not go see them.In parallel, the social worker, the administrative and himself, with the telephone list in front, called the relatives one by one."We had to tell them what was happening, how their relative was and tell them that we would call them at all times, but that they could also do it when they wanted.And we always attend to them, "he recalls.Thanks to that, he says, the confidence between the center and the families was total.That, precisely, was one of the things that failed in the management that from the Madrid residence Adolfo Suárez made of the pandemic: telephones that communicated non -stop and lack of information.In the case of Agustí, the opposite.

SENIOR CENTER RESIDENCE OF BARCELONA.

That was the problem, Agustí laments.Until mid -April the Generalitat did not send them materials.What did they do, then?"We have a very creative team," he jokes.They built their own masks, protective screens and gowns with garbage bags.And if there was nothing, he left pharmacy by pharmacy until he was."We have spent more than 4.000 euros in material, "he says."4.000 euros very well invested ", adds."There has been intense hygiene and control of the elderly.In addition, the important thing was to put the necessary means, although they had to be handmade, "he says.But that was not all.As in the case of Rocío, a virus barrier had to be made of the residence door.How?Controlling who enters and who goes out.Above all, workers.In the same way that happened in Cercedilla, when they entered they had to change clothes - because the uniforms could not get out of the center - and wash their hands in detail.And put on masks, gloves, guts, etc..

Customization and knowledge of residents and workers: the necessary change

All effort has worked.The coronavirus has not entered either centers.A part, according to Agustí, has to do with "Luck", but another, both say, with the residence model that both understand as the ideal.Niguno arrives at half a hundred residents and both have about twenty people working in the center.The figures are not trivial and are not the same by chance.The conjunction of both achieves the most important thing: residents are known, their families are known and directors know well who work with them.Otherwise, Rocío could not have recommended two of his workers to confine themselves in the Cercedilla residence.They were not two random people, they were those who most exposed were to a contagion."As I know the staff, I know what kind of life they lead and I know who I have to put more emphasis," he says.In a large residence everything is less personalized.Workers are simple employees and residents are simple numbers.

That is the problem, the two coincide.That is why you have to rethink the model to make it more individualized and personalized, although Rocío indicates that "it will be very difficult".We must not lose sight of the fact that a residence is a business, they say, but the objective cannot be exclusively lucrative, but of social service and attention.If that sight of the residences, the residences stop working."The sector was born with a spirit and objectives that have been distorted when the business has begun to be understood as something commercial. Yo trabajo con la vida de 46 residentes ytwo0 empleadas y tomármelo así hace que actúe de otra manera", dice Rocío, que se fija en el modelo de los países nórdicos.There triumphs the GroupPBoende scheme, residences made up of a set of small apartments in which small groups coexist, something that facilitates social relations.

SENIOR CENTER RESIDENCE OF BARCELONA.

Would it be possible in Spain?At least it would be convenient to raise it, also architecturally."The problem is that residential structures have been made.A large residence is sectorized by plants, but the problem is that the staff broken through those plants and those shifts, so direct contact with the old man is difficult.You have to rethink the model we want, as for the environment, to architecture, everything, "he says.And Agustí thinks the same. "Una residencia detwo0 personas no es viable económicamente, pero distribuir un edificio de 60 personas en unidades detwo0 parcialmente independientes mejoraría la atención", dice.

That is why they criticize the current model, in which there is a good part of groups that manage several residences, even tens.Currently, the sector in Spain is very diverse. En abril detwo019 existían en nuestro país 5.417 residential centers - which include all kinds of collective accommodations, not only residences -, according to network aging data, a platform linked to the CSIC. De ellos, eltwo9% eran públicos y el otro 71% estaban en manos privadas.Within this last group, most do not belong to large chains.However, in the last decade there has been an accelerated concentration process.There are at least 13 groups that manage fifteen or more residences in Spanish soil.According to an investigation carried out by Infolibre, the six most powerful - almost four hundred centers clarify - have as main shareholders in the Jersey Islands (Vitalia Home and Colisée), to an English background (Domusvi), to a background ofCanadian pensions (Orpea), a British -profit (Sanitas) and the president of the ACS construction company and Real Madrid, Florentino Pérez.A business to which French or Swiss capital has also joined and even entrepreneurs linked to PP corruption scandals.

"We are not officials, but our thinking, our behavior and our feeling must be from public servants.I think that working with people should be a life option, a vocation.It is not enough to work and collect, "says Agustí.