| 1. |
- Garms-Homolová, Vjenka, et al.
(author)
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Clients in focus
- 2012. - 1
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In: Home care across Europe. - : European Observatory on Health Systems and Policies. - 9789289002882 ; , s. 55-70, s. 55-70
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Book chapter (peer-reviewed)abstract
- For every person over the age of 65 in today’s European Union, there are four people of working age but, by 2050, there will only be two. Demand for long-term care, of which home care forms a significant part, will inevitably increase in the decades to come. Despite the importance of the issue, however, up-to-date and comparative information on home care in Europe is lacking. This book attempts to fill some of that gap by examining current European policy on home care services and strategies. Home care across Europe probes a wide range of topics including the links between social services and health-care systems, the prevailing funding mechanisms, how service providers are paid, the impact of governmental regulation, and the complex roles played by informal caregivers. Drawing on a set of Europe-wide case studies (available in a second, online volume), the study provides comparable descriptive information on many aspects of the organization, financing and provision of home care across the continent. It is a text that will help frame the coming debate about how best to serve elderly citizens as European populations age.
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| 2. |
- Barbabella, Francesco, 1984-, et al.
(author)
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Caring For People With Multiple Chronic Conditions In Italy : Policy And Practices
- 2015
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In: Irish Ageing Studies Review. - 1649-9972. ; 6:1, s. 71-71
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Journal article (peer-reviewed)abstract
- Background: An estimated 50 million people in the European Union live with multiple chronic diseases. In Italy, around 26.6% of the population aged 16 to 64 years, reported to have at least one long-standing illness or health problem in 2011. Moreover, around 46% of the population over 50 is suffering from multimorbidity. Some programmes addressing adult or older people with multimorbidity have been introduced.Methods: Data for the ICARE4EU study were collected in the first half of 2014. Eligible programmes focussed on providing care for adult people with two or more medically diagnosed chronic or long lasting diseases (at least onesomatic), involved formalised cooperation between two or more services (at least one medical) and evaluation was available. For each programme an on-line questionnaire was completed and included four main subjects: Patientcentredness, Management, Use of E-health technologies, and Financing systems.Results: In Italy, four programmes met the inclusion criteria. They address both daily patient care and policy/managerial levels. Integration of care services, improved collaboration between care providers, changes in resource utilisation and involvement of informal carers have been observed. In two programmes, older patients are addressed as specific subgroup and in two cases animprovement in the use of E-health tools has emerged.Conclusions: In Italy, new policies and integrated care programmes addressing multimorbidity have been recently introduced in some areas, with good preliminary results.
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| 3. |
- Barbabella, Francesco, 1984-, et al.
(author)
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Opportunities and challenges of migrant work in the Italian long-term care system
- 2013
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In: The Journal of Nutrition, Health & Aging. - 1279-7707 .- 1760-4788. ; 17:Supplement, Juny/july, s. S133-S133
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Journal article (peer-reviewed)abstract
- Introduction: Italy is one of the most aged countries in the world, with a longstanding tradition of family care of the dependent elderly. Inrecent times, however, Italy has been witnessing in-depth social and cultural changes, which have been negatively impacting on informal care provision. In addition, the public long-term care (LTC) system highly relies on cash-for-care schemes for supporting older people, whereas “formal” care services are characterised by weak coverage and intensity. This situation has led to a remarkable increase in theprivate employment of migrant care workers (MCWs), whose number increased by four times in the last two decades.Method: An overview of MCWs phenomenon in Italy is provided through the analysis of empirical data retrieved by available official sources at national level, as well as by results from own surveys conducted in recent years on large samples of MCWs.Results: The following opportunities and challenges concerning MCWs’ employment in the LTC sector were identified: improve MCW’s capacity to deliver quality care; reduce therisk of elder abuse and neglect and of meeting MCWs’ own care needs; increase their social integration in destination countries and reduce “care drain” in sending countries; and how to improve stakeholders’ involvement for a better exchange of good practices and more effective policy measures.Conclusion: In these years, privately employed MCWs have contributed to change the traditional Italian “family care model” into a new “migrant-in-the-family care model”. However, the issue concerning the sustainability of this model within the Italian LTC system in the future is still open.
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| 4. |
- Barbabella, Francesco, et al.
(author)
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Socioeconomic Predictors of the Employment of Migrant Care Workers by Italian Families Assisting Older Alzheimer's Disease Patients : Evidence From the Up-Tech Study
- 2016
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In: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 71:3, s. 514-525
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Journal article (peer-reviewed)abstract
- BACKGROUND: The availability of family caregivers of older people is decreasing in Italy as the number of migrant care workers (MCWs) hired by families increases. There is little evidence on the influence of socioeconomic factors in the employment of MCWs.METHOD: We analyzed baseline data from 438 older people with moderate Alzheimer's disease (AD), and their family caregivers enrolled in the Up-Tech trial. We used bivariate analysis and multilevel regressions to investigate the association between independent variables-education, social class, and the availability of a care allowance-and three outcomes-employment of a MCW, hours of care provided by the primary family caregiver, and by the family network (primary and other family caregivers).RESULTS: The availability of a care allowance and the educational level were independently associated with employing MCWs. A significant interaction between education and care allowance was found, suggesting that more educated families are more likely to spend the care allowance to hire a MCW.DISCUSSION: Socioeconomic inequalities negatively influenced access both to private care and to care allowance, leading disadvantaged families to directly provide more assistance to AD patients. Care allowance entitlement needs to be reformed in Italy and in countries with similar long-term care and migration systems.
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| 5. |
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| 6. |
- Barbabella, Francesco, 1984-, et al.
(author)
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Using eHealth to improve integrated care for older people with multimorbidity : Francesco Barbabella
- 2015
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 25:Supplement 3, s. 48-48
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Journal article (peer-reviewed)abstract
- IssueThe exploitation of eHealth tools in integrated care practices addressing multimorbidity might be a strong driver for facilitating access to the services provided to people with multiple chronic diseases. This is particularly true in the case of older people living in the community, since eHealth could enhance and reinforce care services at home, improving independent living and security of patients.Description of the problemOne of the ICARE4EU project aims, was to explore whether and which kind of eHealth tools are implemented in integrated care practices for older people with multimorbidity across Europe. In fact, eHealth tools could differ widely across practices, requiring specific know-how by users and health professionals for using and maintaining technology-based solutions, adequate financial resources, compatible organisational and cultural environment with innovations.ResultsThe ICARE4EU project selected 101 integrated care practices in 24 European countries, of which 85 included the provision of at least one eHealth tool. Out of 50 practices addressing needs of older people, 42 included some eHealth solution aimed at: enhancing digital communication (64%); monitoring care processes (58%); providing decision support systems (60%); supporting patients' self-management (32%). Two promising approaches exploiting eHealth are presented in detail: the ‘TeleRehabilitation project: Post ICU patient telerehabilitation services' at the Nicosia General Hospital and the ‘Strategy for chronic care' by the Regional Department of Health in Valencia.LessonsThe use of eHealth seems to have many benefits in terms of improvement of integration and management of care, as well as quality of care. However, to realize this benefits, it is important to arrange adequate technical support, legislative frameworks and training of users and health professionals.
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| 7. |
- Chiatti, Carlos, et al.
(author)
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Migrant care work for elderly households in Italy
- 2013
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In: Ageing in the Mediterranean. - Bristol : Policy Press. - 9781447301066 ; , s. 235-256
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Book chapter (other academic/artistic)abstract
- This paper aims at pointing out the need for a more equitable, internationally driven approach to solve elder care staff shortages, on the background of the implications deriving from the widespread phenomenon of employing migrant care workers in the Italian elder care sector. The paper describes at first how this form of care provision has become so popular in this country to face the long term care needs characterising its ageing population. Main reasons are identified, on the one hand, in the decreasing availability of informal care, due to the increasing female participation in the labor market, a longer working life and a reduction in the support provided by social networks. On the “formal” side, a major role has been played also by the lack of appropriate long term care services, such as residential and public home care, as well as by a chronic shortage of nursing staff and a shorter length of hospital stays. The traditionally “cash-oriented” profile of the Italian welfare system – more based on cash-for-care measures rather than in-kind services – has ended up with perpetuating familistic tendencies stimulating the employment of foreign migrant care workers, often on a live-in, undeclared basis. The paper’s conclusions focus on the analysis of the main opportunities and challenges raised by this phenomenon, trying to catch all involved parties’ perspectives: the older care recipients’ families; the migrant care workers; the receiving and the sending societies. This approach allows to identify core advantages of this solution in the possibility to increase ageing in place opportunities (thus reducing institutionalisation rates) and to provide a more personalised home care at reasonable costs. On the other hand, drawbacks can occur in terms of low quality of care, risk of widespread undeclared labour conditions, possible exploitation of foreign migrants and abuse of older people, as well as “brain and care drain” effects in sending countries. A more neutral, internationally driven governance is therefore suggested in order to minimize these risks and promote equitable solutions to solve care provision shortages in some countries without “plundering the future” of other nations.
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| 8. |
- Di Rosa, Mirko, et al.
(author)
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Private employment of home care workers and use of health services by disabled older people in Italy
- 2013
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In: Euroregional Journal of Socio-Economic Analysis. - 2344-6404. ; 1:1, s. 33-42
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Journal article (peer-reviewed)abstract
- Home care workers privately employed by households have become today the “third rail” of longtermcare policies in several industrialised countries. In Italy, estimates suggested that they might be asmany as over 840,000, most of them being foreign-born migrants living with the cared for person. So far, littleattention has been paid to the integration and coordination of these workers within the formal care sector.We analysed a cross-sectional sample of 4,814 disabled older Italians living in the community to assess theassociation between the private employment of home care workers and the likelihood of using other formalservices. After controlling for possible confounding effects of predisposing characteristics and need factors,we found that using private assistance at home is strongly associated with the use of all services. Thesecorrelations suggests that a “crowding-in” effect exists between the use of private care and public formalservices, and a clear pattern of care tasks allocation can be identified in Italy, where family and privatecarers are responsible for assisting the older person with basic tasks of daily living, while the residualcompetences of public formal sector relate to specialised health care services.
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| 9. |
- Eslami, Bahareh, et al.
(author)
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Life-time abuse and mental health among older persons : a European study
- 2017
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In: Journal of Aggression, Maltreatment & Trauma. - : Informa UK Limited. - 1092-6771 .- 1545-083X. ; 26:6, s. 590-607
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Journal article (peer-reviewed)abstract
- This study aimed to investigate the association of lifetime abuse and mental health among older persons, considering associated factors (e.g., demographics) through a cross-sectional design. We recruited 4,467 women and men ages 60–84 years from 7 European cities. Mental health was measured with the Hospital Anxiety and Depression Scale, and abuse (psychological, physical, sexual, financial, and physical injuries) based on the Revised Conflict Tactics Scale and the UK survey of abuse/neglect of older people. Multiple logistic regression analyses showed that country of residence, low educational level, and experienced financial strain increased the odds of probable cases of anxiety and depression. Female sex, white-collar profession, and financial support by social/other benefits/or partner income were associated with higher odds of anxiety, while older age and experience of lifetime injury were associated with increased odds of depressive symptoms. The findings of this study indicate that socioeconomic factors, as well as experienced lifetime severe physical abuse leading to injuries, are significant in perceived mental health of adults in later life.
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| 10. |
- Eslami, Bahareh, 1978-, et al.
(author)
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Lifetime abuse and perceived social support among the elderly : a study from seven European countries
- 2017
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In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 27:4, s. 686-692
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Journal article (peer-reviewed)abstract
- Background: Being a victim of abuse during one's life course may affect social relations in later life. The aims of this study were to: (i) examine the association between lifetime abuse and perceived social support and (ii) identify correlates of perceived social support among older persons living in seven European countries. Methods: A sample of 4467 women and men aged 60-84 years living in Germany, Greece, Italy, Lithuania, Portugal, Spain and Sweden was collected through a cross-sectional population-based study. Abuse (psychological, physical, sexual, financial and injury) was assessed through interviews or interviews/self-response questionnaire based on the Conflict Tactics Scale-2 and the UK study on elder abuse. Perceived social support was assessed by the Multidimensional Scale of Perceived Social Support. Results: Victims of lifetime abuse perceived poorer social support in later life. Multivariate analyses showed that high levels of perceived social support were associated with being from Greece and Lithuania (compared to Germany), being female, not living alone, consuming alcohol and physical activity. Poorer perceived social support was associated with being from Portugal, being old, having social benefits as the main source of income, experiencing financial strain and being exposed to lifetime psychological abuse and injuries. Conclusions: Our findings showed that exposure to psychological abuse and injuries across the lifespan were associated with low levels of perceived social support, emphasizing the importance of detection and appropriate treatment of victims of abuse during their life course. Future research should focus on coping strategies buffering the negative effects of abuse on social relationships.
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