Toward Better Caring
Envisioning New Strategies for Long-Term Care: Some Thoughts from American and Italian Geriatricians
Paper Presentation in a Themed Session Francesca Degiuli
How to provide long-term care for growing numbers of aging adults has been an issue concerning wealthy, post-industrial societies for quite some time now, but the recent COVID-19 pandemic has made this issue jump to the top of the priority list. Traditionally, studies concerned with the organization of long-term care and its provision have focused on the triad state/market/family to understand its different configurations, practices, and best practices. To this point, however, little attention has been paid to geriatricians and their insights. This paper fills this gap by focusing on how geriatric doctors think, talk, and envision improvements to the current system of long-term care provision at the micro-, meso-, and macro-level. Based on qualitative interviews with 30 interviews with geriatricians conducted in Italy and the United States, the paper sketches some potential strategies aimed at reframing how society at large think about aging and long-term care and its provision.
Advanced Strategies to Contrast the Household Socio-economic Risk Due to Long-term Care Needs in Europe: Results from a Qualitative Study in Italy, Spain, Germany, Austria, Finland and Poland
Paper Presentation in a Themed Session Georgia Casanova
The ageing population and socio-economic deprivation risk are critical social issues in this era. Global health and welfare systems are strongly affected by these growing needs that threaten sustainability. The contrast to health and social provision inequalities has become relevant in designing sustainable development strategies. Households can be directly and indirectly involved in LTC, providing informal care or buying private care. Households investing in LTC are exposed to socioeconomic risk. This study explores in depth households' socio-economic risk due to the long-term care needs of dependent older people in six European countries ( Italy, Spain, Germany, Austria, Finland and Poland), identifying the phenomenon's main characteristics and detecting suggestions for innovative policies. The selected countries are characterised by different national poverty rates and represent European care regimes based on national LTC schemes, offering an international perspective. A set of interviews and Focus groups involved 62 Experts and stakeholders from the six countries. The analysis of linguistic corpus and contents analysis, supported by T-Labs software, confirm how material deprivation and social exclusion are risks related to providing informal care or economic support for care provided at home. Innovative strategies must recognise households' contribution to LTC provisions to implement specific supportive policies.
Implementing Coordinated Multi-level Strategies to Support Informal Carers in Italy: The Gap between Italian Regional Policies and the International Recommendations on Informal Care
Paper Presentation in a Themed Session Cristina Calvi, Federico Sofritti, Giovanni Lamura, Georgia Casanova
After the implementation of a participatory multi-level programme on active ageing, that has led to the first Plan of Action in this field by the Italian government, a similar initiative has been recently undertaken to promote more comprehensive policies to support informal carers of older people with LTC needs. While active ageing is a relatively new policy field, LTC represents a more well-established sector of political action, but in Italy the regionalisation of care competencies has led to strong regional inequalities and a resistance by regional authorities to State interference. The dramatic impact of the pandemic has radically questioned the validity of this approach and an advanced proposal to reform the system is currently being discussed. This paper will reconstruct the state of art of Italy’s regional policies for informal carers of dependent older people with LTC needs, via a secondary data analysis, expert interviews and a bottom-up consultation of main stakeholders involved in the current design of the nation-wide LTC reform. These policies will be analysed in the light of the main European recommendations on this topic. Starting from an analysis of regional differences in informal care policies, key elements are highlighted to be compared with the main international recommendations. The strengths and weaknesses of Italian policies are highlighted in order to provide indications on which regional authorities could work to improve the condition of informal caregivers and to increase the quality of informal care, also combating inequalities between caregivers living in different areas of the country.
