Background information

Where people with dementia receive care and support

The following table provides estimates of the number of people with dementia living at home, in various types of residential care and in hospitals or psychiatric institutions:

It is estimated that more than half of all residents in general/non-specialised nursing homes have dementia. Ratios of staff to residents are not available.

In June 2012, the region of Lazio enacted the local law DPC99/2012 "Assistenza territoriale residenziale a persone non autosufficienti, anche anziane." Amongst other things, this law regulates the amount of time spent by nursing home workers with each resident during a working day:

• Nurses: 36 minutes per day per resident,
• Physiotherapists: 25 minutes,
• Healthcare workers: 70 minutes,
• Other staff: 9 minutes.

This corresponds to the entire staff devoting 140 total minutes of care per day per resident.

The organisation of care and support for people with dementia

The overall organisation of care and support

Diagnoses for dementia are made by specialised Alzheimer evaluation units called UVA. A diagnosis is followed by a therapeutic plan that includes drug prescription and administration.

In a small minority of regions, this will also include the provision of specific care, e.g. day care, home care, etc. However, in most regions this remains the responsibility of the patient's family, which will frequently seek support from local Alzheimer associations.

How specific aspects of care and support are addressed

There is no national policy on the provision of care and support. However, some Italian regions have adopted guidelines and the Emilia-Romagna and Lazio regions have enacted local laws. The number of services varies with the quality of the care home; the "top end" care homes provide many more services and facilities than the average home.

Training

Which social and healthcare professionals provide care and support

The following social and healthcare professionals are involved in the provision of care and support to people with dementia in residential care or living at home.

*Only if they are linked to the provision and organisation of care and support (i.e. not with regard to their role to provide medical treatment).

The type of training that social and healthcare professionals receive

The Ministry of Health authorises training courses in all medical subjects including dementia (ECM, Educazione Continua in Medicina) for all of the professions above except the auxiliaries. Training for auxiliary staff is provided by the regions.

The ECM courses are attended by health professionals on a voluntary basis and according to their needs. Attendance is not required by law and there is no central register of course attendance or completion.

How the training of social and healthcare professionals is addressed

There is no national training policy, as Italy does not have a National Dementia Plan.

Support for informal carers

There is no official support for informal carers. However, the "top-quality" centres provide support, usually in cooperation with local Alzheimer associations.

Section 1.5 below describes the services provided by Alzheimer Uniti Onlus.

National Alzheimer Association

The table below lists services provided by Alzheimer Uniti Onlus.

References

Italian National Institute of Statistics (2011). "Resident population - Final data: Resident population by sex, age class and citizenship - Final data". Accessed on 31 July 2013 at http://dati.istat.it

Italian Longitudinal Study on Aging (ILSA) study, conducted by the Consiglio Nazionale delle Ricerche (CNR), www.cnr.it

Study conducted by CENSIS,www.censis.it

Acknowledgements

Luisa Bartorelli, Geriatrician and President of Alzheimer Uniti Onlus.