Home care: here is who has the right (and how to get it)

The son of an 89-year-old lady living in the Marche region tells us: “My mother is 100 percent disabled, because she is heart disease, suffers from Alzheimer’s and diabetes and has severe kidney failure. We have activated integrated home care (ADI), which, in addition to home visits by a family doctor and nurse, involves specialists such as the cardiologist, the geriatrician and the neurologist. But at the ASL they told me that they don’t have specialists who do home visits, so, for the checks, my mother has to go to the hospital and every time you have to pay an ambulance to carry it. Not even the geriatrician takes care of the patient: he visits home only when it is necessary to establish whether it is necessary or not to take her to a nursing home (Rsa) “.

“No one showed up”

From Sardinia, a lady reports: «My mother, who has an endless series of pathologies, is followed in Adi. Before he had 4 hours of assistance for 4 days a week; now only 2 hours for 2 days a week. The reason? Lack of funds “. “Since last July – says a resident in Lazio – my wife is bedridden because of numerous debilitating diseases. He had to have home assistance from the ASL, with doctors, physiatrist and rehabilitation workers, but no one ever showed up. In order to guarantee the necessary care, I turned to private individuals. Now, however, I have no more money to continue the treatments ». And again, a lady from Campania: “My mother, a cancer patient with heart failure, was hospitalized for bronchopneumonia. Once released from the hospital.

The main problems

Testimonies of people who have turned to the Pit Salute (Integrated Protection Project) of Cittadinanzattiva because they have been denied or reduced home care which they are entitled to by non-self-sufficient persons and in fragile conditions. And these are not isolated voices: the complaints cannot be counted, as also emerges from the last report of the National Coordination of Chronic Patients’ Associations (Cnamc), to which 38 national organizations of individuals with chronic and rare pathologies have collaborated, representative of over 100 thousand citizens. Two associations out of three consider home assistance to be inadequate, especially due to the small number of hours granted, gaps in rehabilitation and problems with medications and home visits. Significant shortcomings are also reported in the social-assistance services. 

40% of Italians are chronically ill

“Although the number of people followed with ADI has increased since 1998, a sign of greater attention to home care, it is also true that the need for this type of care has grown,” stresses Gianfranco Damiani, from the Institute of public health of the Catholic University of Rome, among the curators of the Osservasalute Report, the Observatory that for more than a decade has been monitoring the health of Italians. Today, about 13 million of our compatriots are over 65 and, according to Istat forecasts, in 2043 the elderly will be 32% of the population, of which half are over eighty. Already now about 39% of the population suffers from a chronic pathology and, among the over 75, about 67% have at least two pathologies. According to the Healthcare Observatory of Unisalute, a company of the Unipol group, one Italian out of three last year needed.

Assisted 50 elderly in a thousand

“In our country, on average only 50 out of a thousand over 65 are assisted in Adi – reports Damiani – while the average in OECD countries (the Organization for Economic Cooperation and Development, ed ) is 70 elderly people per thousand. The optimal value is calculated in about 100 people every thousand, as happens, for example, in Holland, Denmark, Switzerland ». This is confirmed by the data from the Home Care Monitoring System (SIAD) of the Ministry of Health: in 2014 the national average of assisted living was 2.31% of the population aged 65 and over (excluding cases with a coefficient of basic care intensity, ie with less than 4 visits per month to the home of the non self-sufficient person, ed ) ».