Gori, Cristiano

For a long time, the international literature has described the Italian public system of home care for frail elderly people as underfunded and mostly cash-oriented; a system, thus, relying almost entirely on informal care provided by the family and, more recently, by migrant workers. Abroad and in Italy, most experts have long shared the expectation that, if and when, public expenditure devoted to home care was to increase, the outcome would be an expansion in the provision of services in kind. This study analyses how the provision of home care actually has changed in the last decade.

Italy has one of the highest percentages of older people in Europe, a trend likely to increase faster than elsewhere alongside greater disability. Family support is also weaker through demographic developments and greater female participation in the labour market, and public policies for frail older people are underdeveloped with wide regional variations. The national scheme, the indemnita di accompagnamento (companion payment), is paid to approximately 7.3% of severely disabled people over 65 based on assessment of need.