Innovating LTC: Policy Evidences from Italy in a European Perspective

Italy is one of the countries with the oldest population in the world. In spite of that and of the alarming estimates about population ageing, Long- Term Care (LTC) policy in Italy is still struggling to be recognized as a relevant issue in the public, political, and institutional agendas. So far, policy inertia has instead been prevailing at the national level, leaving the question of how to take care of the growing number of the elderly people largely dependent on the abilities of shrinking families. While institutionalization rates are comparatively low and the provision of public home care services is often weak, the major national measure to support elderly people in need of care consists in a flat-rate, unconditional cash transfer. In this context, most families end up taking care of the elderly at home, either directly (through informal care) or indirectly (by hiring a caregiver or a helper) or both. Against this backdrop, due to the interplay between high functional pressures and low public effort compared to other social policy sectors, LTC policy constitutes a privileged context for investigating current and potential Social Innovation policy developments, especially at the local level. In sharp contrast with the frozen national scenario sketched above, in the last years new solutions in the field of LTC have indeed been experimenting in many territories – particularly in the Northern regions. This has been possible as a result of the entrance into the policy arena of new actors (nonprofit organizations, bank foundations, social partners, private companies, and so on) and of the building up of multi-stakeholder networks between them and local public institutions, also thanks to European funding. Building on this, this chapter aims at dealing with the most recent grey and academic literature on Social Innovation in order to illustrate and compare a set of selected innovative solutions implemented in Italy, paying particular attention to those which – falling in between full institutionalization and full family-based home care – appear as largely promising in terms of divergence from the national status quo.