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2014 Conference Presentation

Care models Italy

3 September 2014

Alternatives to home informal care and nursing homes in old age: an Italian exploration

Giuliana Costa, Politecnico di Milano, Italy


The proposed paper is organized in three main parts. The first one provides an overview on issues that Italian elderly people have to deal with in case of being in need of continuous care. In a context where homeownership rates are very high, where caring needs are mainly coped through informal private solutions or with family work, where services in kind for long term care are very modest and in any case cover quite partially caring needs, ageing in place, at home can turn to be quite difficult and not taken for granted anymore. Socio-demographic as well as economic and cultural factors put more constraints in traditional solutions as well as on using nursing homes, considered as a last option by Italians.

All these aspects are slowly pushing social actors and policy makers to rethink the positioning of existing services and the role of elderly housing preferences in the care system. The second part of the article steams from a wide research carried out in 2012–2013 by an interdisciplinary group of researchers and practitioners engaged in broadening the range of existing residential facilities for elderly people in Lombardy, the richest and more populated Region of Italy. Policy makers are interested in expanding the residential and housing alternatives to which people in old age can turn to before been in need of complex care and eventually moving to a (expensive) nursing home. The research is based on 100 face-to-face interviews to elderly that moved to different kinds of existing residential solutions which are not nursing homes.

The main research question addressed here is to what extend people feel at home in these new habitats and which are the aspects that enrich lives in old age in these very peculiar settings. Findings show that even if moving in old age is not part of the Italian culture, that elderly people are quite satisfied by their new housing and caring arrangements, that “place making” and “being in place” are possible to users and that families continue to care and support their elderly members after relocation. The third part discusses policy implications of these findings arguing that it is time to integrate housing, social, health and family policies to cope with the complex needs of an ageing population which as a whole implies policy reforms. It is based on interviews to policy makers and in brief comparative international analysis.


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