Assistenza Residenziale: le risposte del SSN ai bisogni degli anziani

The chapter analyses the need for care of the Italian elderly population and the ability of the Italian National Health Service (NHS) of intercepting it and design the appropriate residential and community services. The time lag spans between 2009 and 2019 and the elderly population is disaggregated into two categories: people between 65 and 74 years of age and people over 75. Data on chronic conditions and disabilities suggest both a trend of active aging, which is more apparent among people younger than 75 and a propensity for procrastinating the average age in which the need for care becomes effective. Despite this trend, the exceptional demographic growth experienced especially by people over 75, which increased by 20% over the last decade, incremented the absolute number of elderly requiring an increasing need for care. This pressure on the Italian NHS clashes with a structural under provision of beds in nursing homes and a scarcity of community care services capable of alleviating the burden of care very often shouldered by informal family caregivers. In 2019, about 1,492,000 individuals aged 75 and over with severe disabilities and 2,633,000 with less severe limitations, were living at their homes. More specifically, about 400,000 people are at high risk of admission in nursing homes due to their inability of self-caring and absence of a valid support from family caregivers. On the supply side, policies of beds’ rationing, which began with the economic crisis in 2009 and ended in 2012, led to an excess of demand and an increasing number of individuals over 75 ageing at home with severe disabilities and very low formal and informal support. The latest policy measures approved under the National Recovery and Resilience Plan are focused on community care services, especially home care services in order to favor ageing in place. Although these measures are highly recommended to provide care to those elderly who are supported and monitored by family caregivers, the need to invest in residential care is still necessary in order to recover the structural gap with other European countries and allow people without family support to find a suitable place to live and to be cared for.