How do you ensure good home care for everyone?

for Ettore Jorio and Candida Tucci

It needs to be planned and taken seriously. With an inescapable assumption: the detection of epidemiological needs also related to the risks arising from the difficult accessibility of the destination sites. The one in the South has helped to feed the institutionalization of the elderly, alone and without public services


The need. Everyone bears witness to it, no one has detected it. We are satisfied with the service served by the State, relative to a few years before and based on data assumed very superficially. Suggested by those who have the institutional duty to investigate it on the territory.

We avoid doing as usual
So planning for the future with old things is like assuming you replace the microwave with the old economic kitchens of yesterday. This is for heating the usual soups.

The death toll for Covid-19, especially those reported in facilities for the elderly (especially RSA), has upset the logic of planning interventions. There was a lot of tension in this, the need to get results.

All this is generating health policy mistakes, because it is based on wrong assumptions. Firstly, not to work, previously, to acquire the real epidemiological needs and to decide on the basis of the data that have emerged, discriminated by region and, by region, by territory.

Consequently, having to save face for care for the elderly who are not there, rather than seriously addressing the problem, we run with pre-packaged solutions, by those who have prepared to win series contracts, difficult to ground anywhere. Therefore, home care is increasingly current, neglected by national and regional legislators and regional operators for decades. However, it is being planned without knowing the ideal ways to ensure it: a good income, its regimentation, its consolidation. But above all its enjoyment by the weaker and decentralized community.

The new must coexist with the old even if it is destined to dissolveHome care has the particularity of reaching the citizen in need where they are staying. In short, centrifugal care, exactly the opposite of centripetal care that has always been forced to suffer the periphery. To achieve this, we need to think well and get to know the country well, except that we do not want to destroy what is good. Alas to throw the baby with the bath water.

Changes, especially those in this regard, must be tackled with reasonableness and knowledge of things. Demolishing the existing embassy is usually not a good and correct thing. Society is disoriented, experiences are thrown away, investments made often with sacrifice are burned, a labor problem is generated. The turning point, mainly in the social and health sector, must be done consciously and gradually. Assuming to guarantee home care with a normative and administrative act would mean not having understood anything about care and not being aware of the presence of a nation with a prevalence of elderly people.

It is everyone’s desire
To support and expect an efficient and effective home care, generating in addition to a better economy, is the desire of all, without exception. It is the realization of a dream. The problem is doing it right, without leaving you depressed on the floor. It takes years to bring it to fruition.

In matters of health, it is necessary to establish a hierarchy of values ​​and act accordingly. First, it is necessary to save the level of well-being in enjoyment, however questionable, and at the same time introduce and walk the new hypothesis.

For a good practice of home care, complementary and complementary to the ordinary, it is necessary to take into account several elements, but above all to answer some questions.

First, how to ensure it evenly everywhere, aware that it is one thing to do it in the Po Valley, where operators can reach the most needy even by scooter, another is to pay it to the Alps and the hard Apennines. that characterize the orography of the south, with its 30 million inhabitants.

Know how to deliberate (Einaudi dixit)
Therefore, necessary planning based on an inescapable assumption: the detection of epidemiological needs also related to the risks arising from the difficult accessibility of destination sites, often at the bottom of an inaccessible road network. The one in the South has helped to feed the institutionalization of the elderly, alone and without public services. As such, he is forced to resort to social assistance which, however, no one speaks, writes and legislates.

A survey that, in areas with difficult road access, must be carried out by geographical locations, by peripheral agglomerations and by the degree of (in) efficiency of local public services. All this by technical teams that act in close collaboration with Municipalities and Metropolitan Cities, obviously assisted by the provision of specific regional laws that address and solve the problem of social integration, so far only nominally inflated and abused.

Therefore, home care yes but done with the caution of Manzoni (forward Pedro with judgment), taking into account regional diversity, both in terms of accessibility of needs and the assistance offered by the territories. Except that we want to avoid considering it suddenly as a substitute for the current public-private offer and generate another massacre of the elderly and disabled.

Ettore Jorio
University of Calabria

Candida Tucci
National Vice President of Confapi

June 29, 2022
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