How to Request Home Assistance

In an aging country like Italy, home care—that is, medical, nursing, assistance, and rehabilitation treatments for elderly, disabled, or non-self-sufficient people—is essential. And it shouldn't be wasted. In Italy, it varies from region to region, starting with its name: in some regions it's called ADI (Integrated Home Care), in others CADI, and in still others "Home Care."

Index of topics

Who is entitled to it?

The Italian population requiring home care is growing every year: according to ISTAT (the latest data is from 2023), there are 3 million people in our country with severe functional limitations, over 1,8 million of whom are elderly. To these must be added nearly 10 million men and women with "non-severe" limitations, at least for now, of whom nearly 5 million are over 65. In total, approximately 13 million Italians represent the potential user base for home care. And unfortunately, despite a myriad of services offered on paper, the hours of home care received by non-self-sufficient elderly people are decreasing to increasingly insignificant figures: from 18 hours a year in 2018, they have dropped to 15,8 hours in 2023, with huge differences between regions. But to avoid wasting such a crucial opportunity, it is important to have a complete and accurate picture of the home care services offered and the correct path to obtaining them.

How to ask

A home care service is a form of assistance offered by national or regional organizations that allows the person receiving care to maintain their routines and therefore continue to enjoy the space and affection of their family.

Home care can be provided for short periods of time, such as in the case of illnesses or temporary events. Alternatively, in the case of disabilities or borderline disabling conditions , it is possible to request permanent support so that the individual can receive even specialized treatments without having to give up their daily routine.

In the first case, the service is Scheduled Home Care (ADP), a service limited in time and specifically aimed at a transitory clinical-medical condition. Therefore, once the patient has recovered, the service will be permanently suspended. However, this does not mean that home care cannot be used again later for similar problems.

In more severe cases, however, it is possible to access an Integrated Home Care service (ADI), which allows for continuous and consistent professional treatment over time. But we'll delve deeper into this later.

In short, the patient can receive a specific and targeted service to treat or obtain assistance for a problem, whether temporary or permanent. But what types of home care are available to citizens, and what do they consist of? Let's explore them together.

Performances

In Italy, the National Health Service ( SSN ) provides specialized home care services. Specifically, these care measures fall within the Essential Levels of Care (LEA), with the aim of helping citizens in vulnerable situations. The services are primarily designed for non-self-sufficient people , the disabled , and the elderly.

Home care services are also provided by regional or local authorities , such as social services or local associations. Indeed, the options are broader, even if they are not provided equally in all regions. Among the main services offered are:

Home care for minors (ADM)
Home care for disabled people (RDA)
Home care service (USA)
Scheduled Home Care (ADP)
Integrated Home Care (ADI)
Home hospitalization

Home care for minors (ADM)

Home care for minors is provided at the local level through local authorities and social services, and helps vulnerable children and adolescents . Services, primarily educational in nature, can be requested by the family or upon referral. A specialized educational worker will oversee all aspects of the child's school-family and social life, supporting and assisting the child in their daily lives.

Home care for disabled people (ADH)

As in the previous case, it is the local social service that offers this type of service, mostly of a educational. In this case, unlike the services provided at regional level with the National Health Service, it is the educational and personal development The individual is the center of attention. Therefore, a professional trainer will be assigned to support both socially and academically, as well as psychoeducational and cognitive growth and progress.

Home Care Service (SAD)

The SAD service is promoted by local authorities to assist families with severe and disabling disabilities. Compared to home care for disabled people, this service is aimed at families requiring healthcare assistance . The family can therefore be supported, depending on their needs, by a healthcare assistant, an ASA (healthcare assistant), or a nursing staff member.

National Health Service

The National Health Service (SSN) is a package of services provided by regional local health authorities (ASL ) that allows access to basic and more important medical treatments and care directly from home. Services must therefore be activated at the local level by the general practitioner, hospital doctor, the patient directly, or the social services that may be responsible for the patient.

Citizens, when faced with temporary disabling or definitive clinical conditions, can resort to home healthcare services which are grouped into 3 main categories:

Scheduled home care: a transitory disabling condition, therefore lasting for a period of time limited to the episode of illness.
Integrated home careIt can be provided at different levels depending on the severity of the patient's condition. What distinguishes it from the previous service is its continuity, which can even become permanent in the case of terminally ill patients or severe disabilities. Medical services are divided into three levels: ADI 1, ADI 2, and ADI 3. The first and second levels include patients requiring daily care for 5 days (ADI 1) or 6 days (ADI 2) per week, even if they do not present severe complications or critical conditions. ADI 3, on the other hand, is a scheduled service aimed at patients requiring home care 7 days a week.
Home hospitalizationThis is a service defined by a specialist commitment of a type diagnostic-therapeutic-rehabilitative, with high complexity and a scheduled duration. The service is supported by competent specialists and doctors. It is generally accessible to: people with chronic diseases progressive or in the process of worsening which, for obvious reasons, require 24-hour medical and nursing careOnce the patient stabilizes, the service could be replaced with Integrated Home Care.

Home care for the elderly

The regions, through the National Health Service , provide home care services for the elderly . As already mentioned, the service is divided into three main categories, which can be accessed based on the elderly person's condition.

The regional services offered by the Local Health Authorities ( ASL ) can be activated when home-based social and health care assistance is needed . However, it should be remembered that assistance for the elderly can also be activated through local authorities or associations, but for different purposes.

Furthermore, older adults also have other needs, such as a companion for visits, temporary psychological support, and companionship to ward off loneliness. For this reason, regional initiatives such as TeleAssistenza Anziani (Elderly Telecare) exist , allowing home visits in the event of a health emergency or for less pressing, but still significant, needs.

Home care for the elderly under agreement

Elderly people suffering from chronic diseases, disabling clinical conditions, or significant problems can access a fully covered national service.

Specifically, eligible individuals must have illnesses or transitory conditions that prevent them from moving around or significantly limit their daily activities. Through the Local Health Authority (ASL), it is therefore possible to receive nursing care and treatment at home, but not only that.

In fact, in the most serious cases, the patient may receive integrated home care (ADI) or even home hospitalization for a comprehensive service, with the intervention of clinical-medical specialists.

Home nursing care

It is one of the forms of basic assistance provided by the National Health Service and is aimed at patients of any age who have a transitory or serious clinical condition, and who, for this reason, require home healthcare. This may happen, for example, for withdrawals of blood, drip, rehabilitation therapies e administration of drugs with syringes.

Is home care free?

The answer is yes! Home care, both national healthcare and local government care, and social services are free, but the conditions for accessing them are well-defined and cannot be provided unless there are clear social-health problems.

Home care prices

However, national and regional home care cannot fully cover the need, and it may be necessary to turn to a private service such as social workers or similar. In these cases, the costs can be quite high, especially if the service is provided by the hour. hourly cost for home care for disabled or elderly people start from 15-20 euros per hour. Therefore, The best solution in these cases is to request a quote from several professionals or agencies, and only then find the most convenient compromise.

How to get integrated home care

Integrated home care (ADI) can be obtained by making a request to the Local Health Authority, ASL, and by subscribing to the CAD, Home Care CenterThe request can be made by the citizen in person or by family members, the family doctor, the hospital doctor, or social services.

Home care regions

Differences between regions in Italy also lead to divergences in services such as home care. For example, not all regions are able to support the service for its entire duration. The cost of medications or therapies is still largely borne entirely by families, and only in regions such as Veneto and Lombardy have they managed to cover a significant percentage of the costs.

Home care services still suffer from critical issues for which no concrete and effective solutions have been found. Unfortunately, the issue is complex, especially for Italy, which is known to be one of the main European countries with the most marked population aging.

In the latest ISTAT census , in fact, it emerged that in Italy, for every child born, there are now five grandparents . The problem is clear, and especially for long-term care, funds will be increasingly limited, partly due to the country's continuing decline in the young workforce. Healthcare costs will therefore reach significant figures, upsetting an already precarious balance.

According to Eurostat data , Italy allocates only 10 percent of its healthcare spending to long-term care , much less than countries such as the Netherlands (24,8 percent), Sweden (26,3 percent) or Germany (16,3 percent), making it the European nation with the lowest investment.

Respite care

Home care for an elderly and non-self-sufficient person can be combined with a , that is, hospitalization in a nursing home for the elderly or a social health facility (RSA) from one week up to a maximum of 30-60 days. It is essential when the person who takes care of the elderly person has health problems himself, or needs to relieve the burden stress. physical and mental well-being and taking a few days off. This is therefore a temporary solution, but still very useful, which should not be wasted, and instead, as usual, it is applied in a patchy manner in various regions. In some, generally in Central and Northern Italy, it works well, in others, such as Puglia and Sicily, the it is not even foreseen. The cost for the Generally speaking, the cost is divided into half by the region and the other half by the user, but even in this case the rules vary from region to region and in some cases, based on the ISEE, total exemptions are also provided.

Parental leave and extraordinary leave

Law 104 of 1992, a landmark for people with disabilities and their families, also provides another option for those who must continuously care for a severely disabled person: special leave. This leave can last up to two years, which can be split into two parts. During this period, the person retains their job, receives financial compensation, and notional pension credits. Parents of severely disabled people can also request an extension of parental leave, i.e., the period of absence from work, until their child reaches 12 years of age, with compensation calculated at 30 percent of their salary.

How to get home care