Socio-Economic Predictors of Hiring Live-In Migrant Care Workers to Support Community Dwelling Older Adults with Long-Term Care Needs: Recent Evidence from a Central Italian Region

To meet the rising demand for home care, many families in Italy hire live-in migrant care workers (MCWs). However, the reliance on MCWs to provide long-term care (LTC) and a lack of alternative formal care services raises concerns around equality in access to care. This study aimed to determine the socio-economic predictors of hiring live-in MCWs among older adults with LTC needs in Italy, the objective care burden placed on MCWs, and the financial barriers that people in need of care and informal caregivers face when hiring MCWs, analysing data from a cross-sectional questionnaire with 366 older adults with LTC needs and their primary family caregivers living in the Marche region. Binary logistic regression was used to calculate the predictors of hiring a live-in MCW. Having a primary caregiver that had a high school education or above significantly increased the odds of hiring a live-in MCW (Odds Ratio (OR) = 3.880), as did receiving a social pension (OR = 2.258). Over half (57.5 percent) of the people in need of care had difficulties in affording the costs of hiring an MCW in the past year. To increase the sustainability of the Italian MCW market and reduce socio-economic barriers to accessing care, the Italian Government should increase funding for LTC benefits and add means testing and restrictions on the use of cash-for-care allowances

Predictors of digital support services use by informal caregivers:a cross-sectional comparative survey

OBJECTIVES: Digital support services may provide informal caregivers with remote access to information and training about care issues. However, there is limited specific data on how factors such as demographics, socioeconomic resources and the caregiving context may influence caregivers' use of digital support services. The aim of this study is to identify associations between informal caregiver's characteristics and the use of the internet to access digital support services in two countries: Italy and Sweden. SETTING AND PARTICIPANTS: A sample of 663 respondents who have access to the internet participated in a cross-sectional survey by completing the online questionnaire. Respondents were recruited by the Italian National Institute of Health and Science on Ageing and the Swedish Family Care Competence Centre. PRIMARY AND SECONDARY OUTCOME MEASURES: Logistic regression analyses were performed to assess predictors of caregivers' frequent use of the internet to access digital support services. RESULTS: Educational attainment (OR 3.649, 95% CI 1.424 to 9.350, p=0.007), hours per week spent caring (OR 2.928, 95% CI 1.481 to 5.791, p=0.002), total household income (OR 0.378, 95% CI 0.149 to 0.957, p=0.040), care recipient relationship to the caregiver (OR 2.895, 95% CI 1.037 to 8.083, p=0.042) and gender of care recipient (OR 0.575, 95% CI 0.356 to 0.928, p=0.023) were significant predictors in the multivariate analysis for the Italian caregivers group. Hours per week spent caring (OR 2.401, 95% CI 1.105 to 5.218, p=0.027) and age of caregiver (OR 2.237, 95% CI 1.150 to 4.352, p=0.018) were significant predictors in the multivariate analysis for the Swedish caregivers group. CONCLUSIONS: Digital support services could be important tools to empower informal caregivers. When it comes to policy and practice in relation to caregivers, similarly to other broad vulnerable groups, there is no 'one-size-fits-all' approach, and it is therefore important to consider the specific characteristics and needs of both caregivers and care recipients

Impact of the lack of integrated care for older people with urinary incontinence and their family caregivers: results from a qualitative pilot study in two large areas of the Marche Region

Objectives: Urinary Incontinence may have a severe impact on older people and on their family caregivers’ quality of life, especially when support services are scanty or inadequate. This study investigated the support needs and expectations of community-dwelling older people with UI and their family caregivers in the Marche Region (Central Italy).Methods: Face-to-face semi-structured interviews were carried out to eight over-60-year-old patients with UI, four family caregivers, two representatives of the Regional Health System and two pharmacists.Results: Findings show that the insufficient supply and low quality of continence products and the lack of integrated care services negatively affects the well-being of both older people and family caregivers.Discussion: Integrated care services and a standardized system for the periodic assessment of sufferers and a more customized service delivery, including the possibility of choosing brand and type of products for users, may improve the current provision in this Italian regio

How Many Older Informal Caregivers Are There in Europe? Comparison of Estimates of Their Prevalence from Three European Surveys

Informal caregivers are people providing some type of unpaid, ongoing assistance to a person with a chronic illness or disability. Long-term care measures and policies cannot take place without taking into account the quantitatively crucial role played by informal caregivers. We use the European Health Interview Survey (EHIS), the European Quality of Life Survey (EQLS), and the Study on Health and Ageing in Europe (SHARE) to measure the prevalence of informal caregivers in the European population, and analyze associated socio-demographic factors. This rate ranges between about 13 percent in Portugal and Spain, and more than 22 percent in Luxembourg, Belgium, and Denmark. It declines in older age groups and, on average, is lower in men than in women in all countries studied, and lower among the poorly educated compared to those with higher levels of education. However, large variance was observed in the average share of informal caregivers for most countries between the three surveys. Our findings, estimated through the three surveys, reveal common trends, but also a series of disparities. Additional research will be needed to enable policy makers to access a richer and more harmonized body of data, allowing them to adopt truly evidence-based and targeted policies and interventions in this field.Peer Reviewe

Understanding Elder Abuse in Italy:Perception and Prevalence, Types and Risk Factors From a Review of the Literature

The paper aims to perform a review of studies on elder abuse in Italy. Hand searching was undertaken of grey literature and reviews of published papers concerning local, national, and cross-national studies, both in Italian and English languages. Inferences mainly about perception and prevalence, types and risk factors, but also concerning victims and perpetrators when data were available, have been derived through the quantitative and qualitative information collected. On the whole, elder abuse in Italy, with a prevalence rate around 10–14%, is characterized by more female victims, especially in the oldest age groups. The risk of psychological abuse is highest, but the level of financial mistreatment is also high. In domestic settings, difficulties of overburdened family caregivers have been associated with the existence of possible episodes of abuse, which often remain hidden. In institutional settings, neglect of dependent persons, expired medications and lack of hygienic conditions represent the most common forms of reported abuse, uncovered with the help of police inspections. In both settings, the use of physical restraints emerges as an area of concern. Although caution is needed in relation to generalization, the available data suggest the existence of a widespread phenomenon of elder abuse in Italy. But more in-depth research is needed to provide further evidence and to raise the currently relatively low general and professional awareness of elder abuse. Moreover, a dedicated legal framework and protocol for tackling and preventing the phenomenon, and ad hoc support services for the victims, need to be urgently addressed

Dyadic associations between perceived social support and psychological well-being in caregivers and older care recipients

Caregiving can be burdensome for both family caregivers and older care recipients (i.e., adults 75 years or older with care needs). This study aimed to determine dyadic associations between caregivers' and care recipients' perceived social support from others (e.g., family and friends) and psychological well-being as a dyad. Caregivers and care recipients (N = 215 dyads) in this cross-sectional study were recruited by pensioner trade unions in Italy. Both members of the dyad completed the World Health Organization-Five Well-Being Index (WHO-5). Social support was measured with the Carers of Older People in Europe Index for caregivers and the Oslo-3 Scale for care recipients. Dyadic data were analyzed with the actor-partner interdependence model. Caregivers' and care recipients' well-being was moderately correlated (r = 0.41, p < .01), with care recipients reporting significant lower well-being (MCR = 30.95 vs. MCG = 46.45). Social support perceived by the caregivers was positively associated with their own well-being (actor effect; β = 3.31, p < .001) and with the care recipients' well-being (partner effect; β = 0.58, p < .001). No significant care recipient actor and partner effects were detected. This study provided evidence on crossover effects between social support and well-being in caregiving dyads. Findings have implications for research and clinical practice in familial aged care. Family interventions targeted at the caregivers' broader social environment might enhance both dyad members' well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The Active Ageing Index and policy making in Italy

Although the active ageing concept generally has positive connotations, with expected benefits at the micro, meso and macro levels, the application of this concept in terms of policy making presents challenges and risks to be avoided (for instance, a predominantly productivist interpretation and a top-down imposition with limited possibilities for bottom-up exchanges; or a disregard for the risk of excluding older people with more disadvantaged backgrounds). Two crucial strategies to minimise risks are the implementation of policies by considering and respecting territorial diversity, and the involvement of all the relevant stakeholders in a participatory consultative and co-decisional approach. This paper entwines both strategies together by focusing on Italian in-country differences in terms of active ageing, and employing the Active Ageing Index for policy-making purposes. This activity is part of a governmental national pilot project aimed at promoting multilevel co-managed co-ordination of active ageing policies across Italy. The analysis identified five groups of regions that differ from the classical, geographic and socio-economic division between the North, Centre and South. Additional in-group analyses were conducted to investigate within-cluster differences. This study will inform a large multilevel stakeholder network for evidence-based policies and their monitoring at both the national and regional levels, in line with the perspective of mainstreaming ageing

Policy to Reduce Late-Life Social Exclusion – From Aspirations to Action

Drawing on interdisciplinary, cross-national perspectives, this open access book contributes to the development of a coherent scientific discourse on social exclusion of older people. The book considers five domains of exclusion (services; economic; social relations; civic and socio-cultural; and community and spatial domains), with three chapters dedicated to analysing different dimensions of each exclusion domain. The book also examines the interrelationships between different forms of exclusion, and how outcomes and processes of different kinds of exclusion can be related to one another. In doing so, major cross-cutting themes, such as rights and identity, inclusive service infrastructures, and displacement of marginalised older adult groups, are considered. Finally, in a series of chapters written by international policy stakeholders and policy researchers, the book analyses key policies relevant to social exclusion and older people, including debates linked to sustainable development, EU policy and social rights, welfare and pensions systems, and planning and development. The book’s approach helps to illuminate the comprehensive multidimensionality of social exclusion, and provides insight into the relative nature of disadvantage in later life. With 77 contributors working across 28 nations, the book presents a forward-looking research agenda for social exclusion amongst older people, and will be an important resource for students, researchers and policy stakeholders working on ageing

“Ri-Generiamoci”: un progetto per promuovere la Solidarietà Intergenerazionale nel settore della cura all’anziano

Ri-Generiamoci is one research-action project promoted and coordinated by INRCA (National Institute for the Retirement and Care of Aged People, based in Ancona as part of a Retirement and Care Institute with Scientific Purposes). Its aim is that of making teenagers and aged people relate to the topic of the care of the elders. Since this objective is vital to intergenerationalknowledge and understanding, some educational activities have been identified, so that their cognitive or emotional character could reveal effective.In fact, the project is based on the assumption that personal relationships and cooperation are the only way to foster solidarity, thus preventing intolerance and abuse. This project includes: 8th grade students, aged people living in a multipurpose facility (residential and quasi-residential), and associations of volunteers. It was born out of the necessity to provide a clear answer to the needs of a category of people that is overexposed to abuse,as stated in “Abuel: abuse of elder in Europe.” Moreover, it complies with the requests of those who made contact with the Abused Elder People Line (TAM TAM). Both Abuel and TAM TAM are initiatives undertaken by INRCA in the Marche region.Il progetto Ri-Generiamoci è una ricerca-azione promossa e coordinata dall’INRCA (Istituto Nazionale di Ricovero e Cura per Anziani, Istituto di Ricovero e Cura a Carattere Scientifico – IRCCS – con sede ad Ancona), con l’obiettivo di mettere in relazione adolescenti ed anziani rispetto ad una tematica, quella della cura degli anziani, con cui le nuove generazioni vengono sempre più raramente a contatto. Al fine di perseguire questo obiettivo, cruciale per stimolare la conoscenza e comprensione intergenerazionale, sono state individuate una serie di attività pedagogiche di tipo sia cognitivo sia emotivo-esperienziale, certi che il rapporto umano e la collaborazione siano le uniche strade percorribili per l’educazione alla solidarietà e la prevenzionedi atti di intolleranza e di maltrattamento. Questo progetto pilota,che coinvolge studenti di terza media, gli anziani ospiti di una struttura re-sidenziale e semi-residenziale nonché due associazioni di volontariato, nasce dalla volontà di proporre una risposta concreta e lungimirante alle esigenze della popolazione anziana fragile, spesso maltrattata e a rischio di abuso, così come emerso dallo studio “Abuel: abuse of elder in Europe” e dalle richieste avanzate da coloro che hanno fatto ricorso al Telefono AnzianiMaltrattati (TAM TAM), due recenti iniziative condotte dall’INRCA nella regione Marche