ROMA — «The premises for this law were great, and we found ourselves with a mountain that gave birth to a mouse». Mario Possentigeneral secretary of Alzheimer’s Federation Italyexpresses more forcefully than other organizations of “Pact for a new welfare on non-self-sufficiency” the disappointment with the decree implementing the reform, just published in the Official Journal. Because for the 1.4 million elderly people suffering from dementia in Italy, of which 50/60% suffer from Alzheimer’s, the shortcomings of the assistance network are a double problem: «The failure to reform the accompanying allowance weighs particularly on family members of people with dementia, who usually never get the benefit the first time they ask for it”, he explains.
In Calabria
“Mum is 97 years old and needs to be looked after 24 hours a day. My husband and I without assistance”
by Rosaria Amato
A refusal that leaves all the problems of care for relatives, condemned to look after their elderly person “in the solitude of their own home”, and who are therefore “at very high risk of burnout”. For people suffering from dementia, their home “is a safe haven”, an irreplaceable connection to reality, sustainable only with home care.
In Lombardy
“With Alzheimer’s and 70% disability we are not entitled to any help”
by Rosaria Amato
However, the failure to reform home care is one of the major shortcomings of the implementing decree 29/2024 of the enabling law 33/2023, in the opinion of the “Pact”. The law provides for the establishment of a National Elderly Assistance System with the integrated planning of social, health and economic interventions, which should coordinate and make effective the never sufficient and adequate interventions of local authorities and the health system, often limited to a few months a year. But the decree, in the opinion of the “Pact”, “does not identify operational tools that make collaboration between the actors effective”, and therefore establishes “the fragmentation” of the system. If the reform of home care is in fact “cancelled”, that of residential facilities, according to experts, is instead “hinted at”, since the decree simply postpones it to a subsequent provision.
Observation that is not denied by the government: the vice Minister of the Work and Social Policies Maria Teresa Bellucci, responsible for the reform, has explained on several occasions how law 33/2023 is still in full implementation, numerous other decrees are expected to be finalized, some of which fall under the responsibility of the Ministry of Health. «I can only express concern about the lack of attention to the issue of residential housing. – he objects though Franco Massi, president of The moment, a network of organizations working in the social and healthcare sector – Yet after the pandemic there has been a significant increase in waiting lists, which falls on the 215 thousand beds for hospitals for the acutely ill. Beds that have a cost for the health service of 750 euros per day, compared to 55 for the RSA”.
However, Uneba sees a positive glimmer of light in the decree, even if it should be adequately developed: «Reference is made to multi-service centres, which have grown a lot around RSAs, and to day centres, which have an even lower cost than RSAs, and in many cases constitute an optimal solution, they are the links between home care and RSAs. The problem is that the decree postpones the development and resources for this type of service to further measures, and does not even provide anything for the inclusion of other qualified and specialized personnel in the RSAs. We expect a precise investment plan for day centers in the next decrees.”
According to the associations of the “Pact”, the implementation of law 33/2023 would require, once fully operational, an allocation 5-7 billion higher than the current one. An impressive figure, of course. On the question of resources, but also on the method of the reform, there was also a dispute Conference of the Regionsand in particular of Emilia Romagna, Puglia, Campania e Tuscany.
The government has committed to gradually finding other resources, but in the meantime the system remains largely deficient. According to the organizations of the “Pact”, a step forward could be the reform of the carer’s allowance, 531 euros per month which is currently paid to around 1.5 million people, regardless of income, and which constitutes 44 % of the funds currently available to the sector (around 9 billion). This reform could make it possible to guarantee additional resources and services to people in situations of greatest need, but in the report to the decree it is reiterated that the accompanying allowance is not modified “due to a specific choice of the government”. The few additional resources allocated by the decree, 500 million for 2025 and 2026, are concentrated on substantial aid reserved for those aged over eighty with serious pathologies, recipients of accompanying allowance and ISEE of less than 6,000 euros, 850 euros per month. An intervention which, in addition to being for very few (no more than 30 thousand people), is not even structural.
But the real issue according to the organizations remains that, even before the funds, “there is a lack of projects to finance”.
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– 2024-03-31 17:53:11
