For an older person beginning to lose some independence, the choice is rarely as simple as remaining completely unsupported at home or moving into residential care. Between those two positions lies a large space in which structured activity, personal support, rehabilitation, social connection and relief for family carers can make continued life at home more sustainable.
Uruguay’s Centros de Día, or Day Centers, occupy that space. They form part of the Sistema Nacional Integrado de Cuidados (SNIC) and provide daytime care for people aged 65 and over with mild or moderate dependency who continue to live in their own homes. Their purpose extends beyond supervision: centers combine cultural and recreational activity with physical and cognitive stimulation, professional support and opportunities to strengthen community relationships.
Within the wider Uruguay Aging, Long-Term Care & Community Support Knowledge Hub, Day Centers are important because they show what community-based long-term care can look like before severe dependency develops. Uruguay had nine centers operating in 2025. That is still a limited national footprint, but the model is now supported by evaluation evidence and sits within a 2026–2030 reform programme that proposes expansion, stronger regulation and closer integration with community support.
The strategic question is therefore larger than whether Uruguay should operate more buildings called Day Centers. It is whether those centers can become anchors for a wider preventive care infrastructure: helping older people preserve autonomy, giving families sustainable support, connecting health and social resources and creating realistic alternatives to unnecessary institutionalization.
Day Centers occupy the middle ground in Uruguay’s care pathway
Uruguay’s long-term care system contains different forms of support for different levels and circumstances of dependency. Telecare provides remote assistance for older people with mild or moderate dependency. Personal Assistants provide intensive individual support to defined groups experiencing severe dependency. Long-stay establishments provide residential care where people require accommodation and ongoing support.
Day Centers are different. The person remains resident in their own home but attends a community service during part of the week. Current arrangements allow attendance two, three or five days per week, depending on the individual arrangement and service capacity.
This makes the model neither residential nor purely home-based. It is a form of home- and community-based support in which the home remains the center of the person’s life while some care, stimulation and participation occur elsewhere.
The distinction matters because dependency is rarely static. An older person may be physically capable of living at home but becoming isolated. Another may need stimulation and structured activity while a spouse requires periods away from caring. Someone else may have enough functional difficulty to need support during the day without requiring continuous assistance.
A diversified system needs options for those circumstances. Otherwise, people can be left with too little support until their needs become severe enough to fit a more intensive service.
The service combines care, autonomy and social participation
Official descriptions of Uruguay’s Day Centers emphasize comprehensive care, physical and cognitive stimulation, cultural and recreational activities and multidisciplinary professional involvement. Their stated objectives include maintaining autonomy, helping older people remain in their usual environment and supporting families who provide care.
That combination is important. A center designed only as somewhere for an older person to spend several hours would miss much of the model’s potential.
Physical activity may help preserve mobility. Cognitive stimulation can support engagement and functioning. Shared meals or activities can create routine. Cultural and recreational participation can restore roles that become harder to sustain when dependency increases. Staff can also notice subtle changes that may not be visible during occasional formal assessments.
Community participation is therefore not an optional recreational addition to care. For many older people it is part of maintaining function, identity and wellbeing.
This aligns with a broader reablement and restorative approach to independence. The objective is not to remove all risk or perform every task for the person. It is to preserve as much capability, confidence and participation as circumstances allow.
Eligibility targets a stage at which prevention may still change the trajectory
Day Centers currently serve people aged 65 or over who live at home and are assessed as having mild or moderate dependency. Entry follows a dependency assessment, after which an eligible person is interviewed by the technical team at the relevant center before admission.
This places the service at a particularly important point in the long-term care trajectory.
Someone with mild dependency may still perform most activities independently but experience difficulty with selected tasks, mobility or cognition. Moderate dependency may create more substantial support needs while remaining compatible with community living.
At both levels there may still be considerable opportunity to maintain function and prevent avoidable deterioration. This does not mean that all severe dependency can be prevented. Aging, disability and illness cannot be reduced to service interventions. But inactivity, isolation, lack of stimulation, caregiver exhaustion and delayed recognition of changing needs can accelerate loss of independence.
Day Centers can intervene against some of those factors.
That is why their value should be considered through preventative value and early intervention rather than simply through attendance numbers. The relevant question is not only how many sessions were delivered, but whether participation helped people sustain capabilities and community living that might otherwise have deteriorated more quickly.
Scenario: living alone does not have to mean becoming isolated
A 76-year-old widower lives in his own home in a departmental capital. He can wash and dress himself and prepare simple meals, but arthritis has reduced his mobility and he has gradually stopped attending activities outside the home. His daughter visits several times a week, yet she notices that he is becoming quieter and less confident.
His needs do not suggest that residential care is appropriate. Nor does he necessarily need continuous assistance at home. The emerging risk is a combination of functional decline, reduced activity and social isolation.
Following assessment as having mild dependency, attendance at a Day Center several times a week could create a different trajectory. Physical activity gives him a reason to move regularly. Shared activities restore social contact. Staff observe how he manages mobility and participation over time. His daughter remains involved without becoming his only route to the outside world.
The outcome is not simply that he has somewhere to go during the day. The center creates structure around continued community living.
If staff later notice that he is increasingly unable to participate, that information should also matter. A change in mobility, cognition or self-care may justify wider assessment rather than an assumption that the existing Day Center arrangement remains sufficient.
Community care is strongest when it both supports the present and notices when the present is changing.
The evidence suggests that people value the model
Uruguay now has more than policy intent on which to judge its Day Centers. An evaluation undertaken by the Ministry of Social Development’s Dirección Nacional de Transferencias y Análisis de Datos and presented in 2025 examined the experience of people using the programme and their families.
The findings were strongly positive. MIDES reported that 99% of users and families participating in the evaluation identified positive effects on quality of life, while all of those interviewed said they would recommend the programme. Satisfaction with personal-care support, accompaniment and assistance with everyday activities was also reported at 99%.
Participants associated the centers with prevention of dependency and indicated that without attendance they expected greater loneliness and personal deterioration.
These findings should be interpreted appropriately. Satisfaction data are not the same as longitudinal evidence proving that a service prevents institutionalization or reduces healthcare expenditure. People who value a service can still experience declining health or increasing dependency.
But the evidence is important because it captures outcomes that administrative activity data can miss: perceived quality of life, social connection, confidence and the value families attach to support.
Organizations examining comparable community services can use the Community Impact Report Builder to structure evidence about outcomes, participation and wider community value. It is not part of Uruguay’s official evaluation framework, but it reflects the same principle: community care needs evidence of what changes for people, not merely evidence that a service operated.
Family respite is part of the intervention, not a secondary benefit
Day Centers also redistribute care across the week.
An older person may attend for several hours while a spouse rests, attends an appointment or completes tasks that have become difficult to manage alongside continuous caring. An adult daughter may be able to maintain employment more reliably. Family members may gain time to relate to the older person as a parent or partner rather than through an uninterrupted caring role.
This is particularly important because community living often depends on unpaid support that remains largely invisible to formal service systems.
Uruguay’s care policy explicitly seeks greater corresponsabilidad: a more balanced distribution of care between the State, families, community and market, and between women and men. Day Centers give that principle a practical form. Publicly supported care replaces some hours that might otherwise be absorbed entirely by a household.
But respite should not be understood as simply making families more productive carers. People providing unpaid care have legitimate needs of their own. Sustainable support for family carers and care burden requires recognising rest, employment, relationships and personal wellbeing as outcomes in themselves.
This changes how Day Center performance should be understood. The person attending is the primary service user, but some of the programme’s wider social value occurs within the household around them.
Gender is visible on both sides of the care relationship
The 2025 evaluation adds an important gender dimension. Of the 275 people reported as attending Uruguay’s nine Day Centers, 85.5% were women. Women were also the clear majority among the workforce.
Part of the user profile is likely to reflect women’s longer life expectancy. But Uruguay’s own analysis has also raised the possibility that older men may be less likely to recognise or express a need for support and social participation.
This matters operationally. A service can be formally open to everyone while patterns of referral, self-identification and cultural expectations produce uneven take-up.
If older men experiencing isolation or emerging dependency are underrepresented, simply increasing the number of places will not necessarily reach them. Outreach, activity design, referral pathways and public communication may need to consider how different groups understand the purpose of a Day Center.
Gender is equally relevant to unpaid care. Women continue to carry a substantial share of family caregiving, meaning that a community service capable of redistributing hours of care may also affect employment and economic participation.
The center is therefore not just an older-person service. It sits within Uruguay’s wider attempt to change the social organization of care.
Nine centers cannot provide equal territorial access
Uruguay’s current network demonstrates the model but does not yet amount to universal territorial availability.
The official service directory identifies centers in Montevideo and locations across departments including Canelones, Rivera, Rocha, Colonia, Cerro Largo, Paysandú and Tacuarembó. The distribution gives the programme a presence beyond the capital, but nine physical sites across the country inevitably leave substantial areas without nearby provision.
This is especially significant because a Day Center cannot be delivered remotely. Unlike telecare, participation requires the person to travel to a physical location and return home.
For an older person with mobility limitations, the difference between a center being 10 minutes away and 60 minutes away can determine whether formal eligibility has any practical meaning.
Territorial equity therefore involves more than opening places on a map. It requires consideration of:
- where older people with mild and moderate dependency actually live;
- how they can travel safely to and from a center;
- whether attendance times align with transport availability;
- whether rural and smaller communities need different service models; and
- how local health, social and community resources connect with each center.
The 2026–2030 Plan recognizes mobility as part of care infrastructure and specifically links suitable transport programmes with Day Centers for people experiencing dependency. That is a significant operational point: access to a building is not meaningful if the journey itself is inaccessible.
Scenario: eligibility without transport is not effective access
An 81-year-old woman living outside a departmental center has moderate dependency and would benefit from structured activity and respite for the daughter with whom she lives. She is assessed as eligible for Day Center support, but the nearest service is difficult to reach by ordinary public transport.
On paper, the family has gained access to a publicly supported service. In practice, the daughter would need to leave work, drive her mother to the center and return later to collect her. The transport burden could consume much of the respite the service is intended to provide.
The problem cannot be solved by the center alone. It requires coordination between care policy, mobility arrangements and territorial planning.
A suitable transport option could transform the feasibility of attendance. Alternatively, if demand is dispersed across a rural area, a fixed center may not always be the most efficient community-care model. Outreach, community carers or connections with other local facilities could eventually form part of a more flexible response.
This illustrates the difference between service capacity and usable capacity. A funded place only becomes meaningful when the person can reach it safely and consistently.
For Uruguay’s expansion programme, rural and underserved community access should therefore be considered alongside the number and location of new centers.
The operating model depends on national and local collaboration
Day Centers have been built around interinstitutional and community partnerships rather than a single centralized provider model. The service has historically involved the national care system working with departmental and municipal government, civil-society organizations and cooperatives.
Current centers are managed by different community and cooperative organizations, while the State provides the policy and funding framework. Earlier development of the programme also relied on local authorities and organizations contributing infrastructure and community connections.
This gives the centers a strong territorial character. A community organization may understand local networks, transport problems, neighborhood assets and informal sources of support in ways that a purely centralized service cannot.
But partnership models also create governance requirements. National policy needs to produce reasonably consistent expectations even where delivery arrangements differ. Local flexibility should allow a center to respond to its community without creating unacceptable variation in safety, quality or access.
This is where system integration and multi-agency working become operational rather than rhetorical. Responsibility has to be clear enough that partnership does not become fragmentation.
The strongest centers are likely to be those that combine a recognizable national care model with genuine local ownership.
The next phase moves from service expansion towards regulated quality
Uruguay’s National Care Plan 2026–2030 gives Day Centers a more developed policy position than simple continuation of the existing programme.
The Plan proposes opening three additional centers through arrangements involving civil-society organizations, cooperatives or the SIEMPRE modality. More significantly for long-term system maturity, it also proposes designing and implementing a regulatory framework specifically for Day Centers, including requirements, standards and indicators, with strengthened supervision teams.
That is an important transition.
A small programme can rely heavily on close relationships between central teams and individual services. As provision expands, quality needs to become more explicit and reproducible. People should be able to expect a credible standard of support regardless of which organization manages their local center.
Regulation should nevertheless reflect what Day Centers actually exist to achieve. An assurance framework focused only on premises, staffing records and procedural compliance would capture important safety controls but miss much of the service’s purpose.
Quality also concerns whether people retain autonomy, participate meaningfully, feel respected, remain connected with their community and receive support appropriate to changing needs.
Organizations examining similar transitions can use a Regulatory Readiness Gap Analyzer to structure the difference between having policies and being operationally ready to demonstrate them. It is not a Uruguayan regulatory instrument, but the underlying principle is relevant as services move from emerging models towards more formalized standards.
Person-centered planning can stop centers becoming standardized programmes
One of the risks in group-based services is that efficiency gradually displaces individuality.
A center can offer an impressive weekly programme while still expecting every attendee to participate in the same activities at the same pace. That may be administratively convenient, but it is not necessarily person-centered care.
Uruguay’s 2026–2030 Plan proposes institutionalizing person-centered planning across SNIC services and validating a personalized care-plan tool interinstitutionally. For Day Centers, this offers an opportunity to connect group activity with individual goals.
One person may want to improve confidence walking outdoors. Another may value music and conversation because cognitive change has made other activities frustrating. Someone who previously cooked for their family may find meaning in preparing food with others. A person who dislikes organized recreation may prefer practical tasks or quieter social contact.
The point is not to construct a complex clinical plan around every activity. It is to ensure that attendance supports the person’s life rather than merely filling their time.
Person-centered practice also requires attention to choice. Attendance should not become an informal form of containment because relatives or services find it convenient. Older people retain preferences about where they spend their day, who supports them and which risks they are willing to take.
That places rights, consent and decision-making at the heart of community care rather than reserving those issues for residential or clinical settings.
Scenario: the strongest care plan begins with what the person wants to preserve
A 72-year-old former shopkeeper with moderate dependency begins attending a Day Center three times a week. His family hopes the center will keep him safe and occupied, but he is initially resistant. He dislikes being described as needing care and finds some organized activities patronizing.
A standardized response might record non-participation and encourage him repeatedly to join the existing programme.
A person-centered approach asks a different question: what matters enough to him that attending becomes worthwhile?
Staff learn that he misses the daily contact he once had with customers and enjoys practical tasks. Rather than expecting him to participate in every scheduled activity, the center involves him in preparing a shared event and welcoming other attendees. He gradually develops relationships and begins joining physical activity because it helps him remain able to walk to nearby shops.
The change is subtle. The center has not persuaded him to accept a passive identity as a service user. It has connected care with roles he still values.
His plan can then capture outcomes that matter: maintaining mobility, rebuilding regular social contact and continuing activities outside the center. If those outcomes deteriorate, the team has a reason to review what has changed.
This is how a group service can remain individualized without becoming administratively cumbersome.
Day Centers can become observation points for changing dependency
Regular attendance gives staff something that periodic assessment cannot always provide: longitudinal observation.
A worker may notice that someone who normally joins physical activities has begun avoiding them. Another person may become confused about familiar routines. Weight loss, increasing fatigue, deteriorating mobility or withdrawal from conversation can emerge gradually.
None of those observations should automatically become a diagnosis. Day Center workers are not substitutes for medical assessment. But they can identify that something has changed.
The governance question is what happens next.
If concerns remain entirely inside the center, valuable information is lost. If every minor change produces an unnecessary medical referral, the pathway becomes inefficient. Staff therefore need clear routes for discussing concerns with the person, family where appropriate, care-system contacts and health services.
This is particularly relevant as Uruguay seeks to move from applications for individual programmes towards a more integrated SNIC access and trajectory model. The 2026–2030 Plan envisages periodic assessment and referral between benefits as autonomy changes.
Day Centers could become important points within that pathway because they see some people regularly before severe dependency develops.
Health integration should support community care without medicalizing it
Older people attending Day Centers may also live with chronic disease, sensory impairment, frailty, cognitive change or medication-related risks. Coordination with healthcare can therefore strengthen the service.
But integration does not mean turning a community center into a clinic.
The center’s distinctive value lies partly in offering a social environment where the person is not defined entirely by illness or dependency. Health services can support that environment through referral, advice, prevention and timely response without dominating its purpose.
A useful interface might involve primary healthcare responding when staff or the person identify a meaningful change, rehabilitation services contributing where functional decline is emerging, or health promotion activity being brought into the center in an accessible way.
The relevant principle is care coordination across health and social care: information and responsibility should cross organizational boundaries when necessary, while each service retains its proper role.
This becomes particularly important after hospitalization. An older person returning home may temporarily have less confidence or mobility than before admission. Where eligibility and local capacity allow, structured community support could help rebuild routine and social participation while health services address clinical recovery.
Workforce quality determines whether activity becomes meaningful care
Buildings and activity schedules do not create a Day Center model on their own. Its effectiveness depends on the people who work there.
The workforce may include carers, coordinators and professionals contributing different forms of support. Staff need to understand dependency without encouraging unnecessary dependence. They need to support participation while recognizing fatigue, pain or cognitive change. They must work with families without allowing family preferences automatically to displace the older person’s voice.
Group-based care also requires particular skill. A worker may be supporting several people with different abilities simultaneously. Activities need to be inclusive without becoming infantilizing. Risk has to be managed without eliminating ordinary choice.
As Uruguay expands and regulates the model, workforce assurance should therefore extend beyond minimum numbers. Relevant capability includes:
- understanding aging, dependency and functional change;
- supporting autonomy and person-centered planning;
- recognizing safeguarding and health concerns;
- facilitating meaningful group and individual activity;
- communicating with families and other services; and
- reflecting on practice rather than treating routines as fixed.
This links Day Center development with wider questions of workforce capability and skill mix. Community care may appear less intensive than residential provision, but preventive work requires skilled judgement precisely because staff are trying to preserve capability rather than simply compensate for its loss.
Community connection should extend beyond the center walls
A Day Center can inadvertently become an island: people are transported in, participate in activities and are transported home, with little connection to the community around it.
Uruguay’s policy direction points towards something broader.
The National Care Plan proposes strengthening Comunidades que cuidan, or caring communities, including a community carer role in at least ten departments. It also proposes community care centers for older people in housing complexes, intended to connect housing, shared spaces, services, active aging and local support networks.
These proposals should be distinguished from the existing Day Center programme; they are part of the 2026–2030 development agenda rather than evidence that a new national community-care model is already fully implemented.
But the direction is significant.
Existing Day Centers could become platforms from which community support extends outward. Local organizations, health services, cultural groups, educational institutions and neighborhood networks can contribute to participation. Community carers could eventually help people connect with activities or services outside formal center hours.
The stronger opportunity is to use a physical center as infrastructure for community inclusion rather than as the boundary of the care service.
Scenario: a center becomes a local care connector rather than a destination
A Day Center notices that several attendees are physically able to participate in community activities but rarely do so outside center hours. Staff also know of older residents nearby who are becoming isolated but either do not meet the programme’s dependency criteria or are reluctant to attend a formal care service.
A traditional model would keep the center focused on its registered attendees.
A stronger community model could build relationships with local organizations, public services and neighborhood networks. Some activities might deliberately take place in community settings rather than exclusively inside the center. A future community-carer role, if implemented locally under Uruguay’s 2026–2030 programme, could help individuals reconnect with services and activities beyond the building.
The center would still have clear responsibilities to its eligible users. It would not become an unrestricted community center or attempt to replace every local service.
Its role would instead expand from delivering sessions to strengthening connections.
That distinction matters because long-term independence is rarely sustained by one service. An older person may need care support for several hours a week but also benefit from neighbors, cultural activity, primary healthcare, accessible transport and ordinary places where they remain known as a member of the community rather than solely as someone receiving care.
Funding reform will change the balance between universality and contribution
Current official service information describes Day Center attendance as fully subsidized, with no cost to people using the service. The 2026–2030 Plan, however, proposes designing and implementing co-payments across 100% of public and private Day Centers.
This is an important policy development and should not be presented as though it is already the current charging arrangement.
The move raises several questions that will matter as detailed implementation develops. How will ability to pay be assessed? How will contributions avoid deterring people whose needs are preventive rather than immediately urgent? How will private and publicly supported provision interact? What protections will exist for people with low incomes?
Co-payment can broaden the funding base of a service, but it can also change behavior. A family facing a charge may decide that unpaid care at home is cheaper even where Day Center attendance would reduce isolation or support the carer’s employment.
The financing model therefore needs to consider both revenue and the consequences of reduced take-up.
This is particularly important for preventive services because their value may emerge over time. If access helps delay functional decline or makes family care more sustainable, short-term expenditure can contribute to longer-term system value.
Expansion should follow evidence of need, not simply available buildings
The commitment to open three additional Day Centers during 2026–2030 will increase capacity, but location and design will determine how much difference that expansion makes.
National planners need to understand where unmet need is concentrated, how existing services are being used, which populations are underrepresented and what transport or community infrastructure surrounds potential locations.
Existing attendance data alone are insufficient. Low use in an area with no nearby center does not demonstrate low need. It may demonstrate absence of access.
Equally, a high level of expressed demand may reflect the visibility of an established service rather than the full geographical distribution of dependency.
This is where stronger population and service intelligence becomes important. Expansion should combine demographic information, dependency patterns, waiting or referral information, territorial accessibility and evidence from existing centers.
A Digital Twin Scenario Modeler can help organizations exploring comparable capacity decisions test how different service configurations affect demand, workforce and stability. It is not part of Uruguay’s planning machinery, but scenario-based planning illustrates the value of testing service expansion before committing scarce resources.
Outcomes need to connect individual experience with national governance
Uruguay’s evaluation provides a valuable starting point because it asks whether people and families experience the service positively. As the programme grows, the evidence model can become richer.
National governance needs to know whether the centers are reaching the intended population, whether access is territorially equitable and whether service quality is reasonably consistent. Local teams need information that helps them improve everyday practice. People and families need meaningful ways to influence how services develop.
A balanced evidence set could therefore include attendance and retention alongside functional, social and experiential outcomes. It could examine changes in isolation, carer pressure and participation without pretending that every outcome is attributable to the center alone.
Importantly, evidence should lead somewhere.
If one center has unusually high non-attendance, governance should ask why. Transport may be unreliable. Activities may not match users’ interests. Health deterioration may be affecting the population. If men remain substantially underrepresented, outreach and programme design may deserve review. If family satisfaction is high but staff turnover is destabilizing continuity, workforce information needs equal visibility.
Organizations structuring comparable oversight can use the Quality Dashboard Builder to bring service activity, quality and outcome measures into one view. The broader lesson is that evidence becomes governance only when variation prompts interpretation, action and follow-up.
Day Centers should remain an alternative to institutionalization, not a waiting room for it
Uruguay describes Day Centers as an intermediate community option between support at home and institutional care. That is a useful description, but it carries a potential conceptual risk.
Intermediate should not imply that every attendee is progressing inevitably towards residential care.
Some people will experience increasing dependency and eventually require more intensive support. Others may remain at a similar level for years. Some may improve aspects of function or confidence. The objective should be to support the most appropriate living arrangement for each person rather than treating the care pathway as a one-way progression through increasingly institutional settings.
This is why Day Centers connect with the wider international shift from institutional towards community living. The transferable principle is not that residential care should disappear. Some people need and choose forms of accommodation with continuous support.
The principle is that residential placement should not become the default response simply because community infrastructure is too weak to sustain alternatives.
Day Centers strengthen that infrastructure by adding structured support between occasional home assistance and continuous care.
The international lesson is about building the missing middle
Uruguay’s Day Center programme is modest in scale and embedded within institutional arrangements that cannot simply be reproduced elsewhere. Its eligibility assessment, national care system, partnerships with local government and civil society, and future financing arrangements are specific to Uruguay.
The wider lesson lies in the service space the model occupies.
Many long-term care systems have comparatively visible provision at the intensive end: home-care hours, residential facilities, hospital services and emergency support. What is often less developed is the infrastructure that helps people remain active and connected while dependency is still mild or moderate.
Day Centers can occupy that missing middle when they are more than buildings offering activities. Their value comes from combining prevention, respite, observation, social participation and connection with other services.
They also illustrate why community care requires infrastructure. Telling people that aging at home is desirable does not make it possible. Families need support. People need accessible places and transport. Workers need skills. Services need funding. Changes in need have to be noticed. Communities need mechanisms through which formal and informal support can connect.
Other systems could adapt those principles without replicating Uruguay’s precise institutional model.
Conclusion
Uruguay’s Day Centers demonstrate the strategic importance of care that sits between unsupported living at home and institutional provision. For older people with mild or moderate dependency, a few days of structured support can provide far more than supervision: physical and cognitive stimulation, social connection, meaningful activity and an additional set of people capable of noticing when circumstances begin to change.
The model also redistributes care. Families gain periods in which responsibility is shared, while the State and community take a more visible role in sustaining independence. Uruguay’s evaluation evidence suggests that users and families value that contribution strongly, but the present network remains small and territorial access is uneven.
The 2026–2030 period therefore represents an important next stage. Three additional centers, stronger regulation, person-centered planning, improved supervision and emerging community-care roles can deepen the model, while proposed co-payments will require careful attention to affordability and access. Expansion will matter most if it strengthens pathways around each center rather than simply increasing the number of buildings.
Uruguay’s larger opportunity is to make Day Centers part of a connected community-care infrastructure in which prevention, transport, family support, health coordination and local participation work together. Alternatives to institutional care become credible only when communities have enough practical capacity to support them. The future strength of the model will therefore be measured not simply by how many older people attend a center, but by how effectively those people are supported to continue living, participating and exercising choice in the communities they call home.